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Vertigo and dizziness cover a spectrum of very different conditions — and the treatment approach (including whether acupressure is appropriate at all) depends entirely on what's causing them. Benign paroxysmal positional vertigo (BPPV) is the most common cause of true vertigo in Canada and has a specific mechanical fix (the Epley manoeuvre) that works in about 80% of cases. Acupressure is not a substitute for the Epley, but it may help with the nausea, anxiety, and residual unsteadiness that accompany and follow BPPV episodes. For other types of dizziness — orthostatic, stress-related, cervicogenic — the points below have more direct relevance.
Before going further: some forms of sudden dizziness are medical emergencies. This page includes a clear list of warning signs at the end. Read it before applying any of the points below if your dizziness is new or severe.
BPPV vs. Other Causes: Why It Matters
Benign paroxysmal positional vertigo (BPPV) is caused by calcium carbonate crystals (otoconia) that have dislodged from the utricle in the inner ear and migrated into one of the semicircular canals. The result is brief, intense spinning triggered by specific head movements — rolling over in bed, tilting the head back, or bending forward. Episodes typically last less than 60 seconds and stop when movement stops. BPPV is harmless but extremely disorienting.
The Epley manoeuvre — a sequence of guided head movements that repositions the displaced crystals — resolves BPPV in the majority of cases, often in a single session. If you suspect BPPV, the most important first step is getting an assessment from a physiotherapist or physician who can confirm the diagnosis and perform or guide you through the Epley. Physiotherapists in Canada are directly accessible without a GP referral in all provinces, and vestibular physiotherapy is a recognized specialty.
Other common causes of dizziness include:
- Orthostatic hypotension — blood pressure drops when standing, causing brief lightheadedness. Usually benign but warrants investigation if frequent.
- Vestibular neuritis — inflammation of the vestibular nerve following a viral illness. Causes persistent vertigo for days to weeks; typically improves on its own but may benefit from vestibular rehabilitation.
- Cervicogenic dizziness — dizziness originating from the neck, often associated with stiffness or poor cervical proprioception. Responds well to physiotherapy, and this is where neck acupressure points (GB20, TW17) are most relevant.
- Anxiety-related dizziness — very common; the vestibular system is highly sensitive to autonomic activation. PC6 and ST36 are particularly relevant here.
- Ménière's disease — episodic vertigo with hearing loss, tinnitus, and ear fullness. A chronic condition requiring medical management.
PC6 — Neiguan ("Inner Pass")
Location: On the inner forearm (palm side), three finger-widths above the wrist crease, between the two prominent tendons running up the centre of the forearm. To find the tendons: make a loose fist and flex your wrist slightly — the two tendons (palmaris longus and flexor carpi radialis) become visible. PC6 is between them, three finger-widths above the wrist.
Why it matters for dizziness: PC6 has the strongest evidence base in the acupressure literature — it's the point targeted by Sea-Bands and acupressure wristbands for nausea and motion sickness, with multiple Cochrane-reviewed trials confirming efficacy. Vertigo almost invariably causes nausea, and the vestibular-nausea connection means PC6 addresses a major part of the symptomatic burden. The point also has a calming effect on the autonomic nervous system, which is relevant when anxiety is amplifying dizziness symptoms.
Technique: Firm downward pressure with the opposite thumb, pressing toward the wrist bones (radius and ulna) rather than into soft tissue. Hold for 30–60 seconds; breathe slowly. Repeat on the other wrist. This point can be stimulated for several minutes continuously during acute nausea from vertigo — it's where the wristband's sustained pressure mechanism comes from.
TW17 — Yifeng ("Wind Screen")
Location: In the depression directly behind the earlobe, between the mastoid process (the hard bone behind the ear) and the posterior edge of the mandible (jawbone). Open your mouth slightly — the hollow deepens and becomes easier to feel. Press directly inward.
Why it matters: TW17 is positioned immediately adjacent to the middle ear and is traditionally used for all ear-related conditions — tinnitus, hearing problems, and vestibular symptoms including dizziness. It sits over the facial nerve and is close to the stylomastoid foramen. The proximity to the inner ear anatomy gives it logical relevance for ear-related vertigo. It's also used for cervicogenic conditions affecting the jaw and temporal region.
Technique: Use the middle finger or index finger. Apply moderate inward pressure — not deeply, as this area is sensitive. Hold for 30 seconds, release, repeat 3–4 times bilaterally. Often produces a sensation of pressure or mild warmth behind the ear.
GB20 — Fengchi ("Wind Pool")
Location: At the base of the skull, in the two hollows on either side of the midline — where the neck muscles (trapezius and sternocleidomastoid) attach to the occiput. Find the midline at the back of the head, then move outward about 1.5–2 inches on each side into the soft depression between the muscles. GB20 is almost always noticeably tender, especially when the neck is stiff.
Why it matters: GB20 is one of the most widely used acupressure points in clinical practice and has particular relevance for dizziness originating from the neck (cervicogenic dizziness) or associated with tension headaches. The suboccipital muscles at the base of the skull contribute significantly to proprioceptive signalling — when tight, they can interfere with the brain's spatial orientation processing. GB20 sits directly over this muscle group. It's also a standard point for migraine prevention, which sometimes presents with dizziness as a prodrome.
Technique: Use both thumbs simultaneously, pressing upward and inward toward the centre of the skull. Start with moderate pressure and increase gradually. Hold 30–60 seconds. This is one of the few points that's more effective when pressure is applied upward (toward the skull) rather than straight in. Many people report immediate release of tension and improved neck mobility after a few repetitions.
SI19 — Tinggong ("Palace of Hearing")
Location: Directly in front of the ear, in the depression formed when the mouth is slightly open, just anterior to the tragus (the small cartilage flap in front of the ear canal). The point is most accessible with the mouth open 1–2 cm — the depression becomes distinct.
Why it matters: SI19 is the primary point for ear conditions in TCM practice — tinnitus, ear fullness, hearing changes, and vertigo associated with inner ear dysfunction. It's used alongside TW17 for vestibular symptoms and alongside GB20 for a complete ear-region protocol. For Ménière's disease, which involves ear pressure and fullness, SI19 may help reduce the sensation of ear congestion that often precedes vertigo episodes.
Technique: Gentle inward pressure with the index finger, with mouth slightly open. Hold 20–30 seconds. This is an area where gentle is sufficient — the point is sensitive and deep pressure isn't necessary.
ST36 — Zusanli ("Leg Three Miles")
Location: On the outer (lateral) side of the lower leg, four finger-widths below the lower edge of the kneecap, and one finger-width lateral to the tibia (shin bone). To find it: sit with the knee slightly bent, place four fingers just below the kneecap, then press against the tibia and slide outward slightly into the fleshy area of the tibialis anterior muscle.
Why it matters for dizziness: ST36 is a broad-spectrum point for digestive and energetic issues, but its relevance to dizziness is primarily through two pathways: it stabilizes the autonomic nervous system and reduces nausea (relevant for any vertigo-associated nausea that PC6 doesn't fully address), and in TCM it's used when dizziness has a component of fatigue or blood sugar irregularity — "empty" dizziness from low energy rather than inner ear dysfunction.
Technique: Firm thumb pressure downward, 30–60 seconds per side. ST36 is generally less sensitive than the ear or suboccipital points and can tolerate sustained, fairly firm pressure.
The Epley Manoeuvre: What Acupressure Can't Replace
If your vertigo is BPPV — brief episodes triggered by head movements — the Epley manoeuvre is the treatment. It works by guiding the displaced otoconia back to the utricle through a specific sequence of head and body positions. A physiotherapist can confirm which ear is affected (using the Dix-Hallpike test), identify which canal the crystals are in, and guide you through the correct repositioning sequence. This typically takes 10–15 minutes and resolves BPPV 80% of the time within one or two sessions.
Self-administered Epley manoeuvres based on online guides have a lower success rate because accurate canal identification requires assessment. If BPPV is confirmed, physiotherapy referral is the right next step. Physiotherapy is covered under most Canadian extended health plans, and vestibular physiotherapists are available in most cities.
Acupressure — specifically PC6 and ST36 — can help manage the nausea and anxiety that accompany a BPPV episode and the post-episode unsteadiness that sometimes persists after the crystals are repositioned. It's a symptom management tool in this context, not a mechanical fix.
When Dizziness Needs Urgent Medical Attention
The following symptoms mean you should call 911 or go to an emergency department. Do not apply acupressure first:
- Sudden severe headache unlike any you've had before, with dizziness or vertigo
- Dizziness with neurological symptoms: double vision, slurred speech, difficulty swallowing, facial droop, arm or leg weakness
- Dizziness following head trauma
- Loss of consciousness, even briefly
- Chest pain or palpitations with dizziness
- New hearing loss that comes on suddenly alongside vertigo (could be a vascular event affecting the inner ear)
- Inability to walk or severe balance loss that doesn't resolve in minutes
Dizziness can be a presenting symptom of stroke, particularly posterior circulation (cerebellar) stroke. The FAST stroke signs (Face drooping, Arm weakness, Speech difficulty, Time to call 911) are the standard Canadian Red Cross guidance. If any FAST signs are present with dizziness, call 911 immediately.
For related conditions that sometimes overlap with dizziness, see the acupressure for tinnitus guide (ear-based symptoms), acupressure for anxiety (when anxiety is driving vestibular symptoms), and acupressure for neck pain (cervicogenic dizziness context).