10/3/2017 Motion sickness | University of Maryland Medical Center

Motion sickness
Introduction
Motion sickness can happen from any kind of movement, even movement that you are anticipating. People
tend to get motion sickness on a moving:

Boat
Train
Airplane
Car
Amusement park rides

It usually stops as soon as the motion stops.

Although motion sickness is fairly common, and often only a nuisance, it may cause problems for people
who travel a lot. Fortunately, the more you travel, the more you get used to the motion. There are also things
you can do to reduce the chance of getting motion sickness.

Signs and Symptoms

The most common signs and symptoms of motion sickness include:

Nausea
Pale skin
Cold sweats
Vomiting
Dizziness
Headache
Increased salivation
Fatigue

Causes
Motion sickness happens when the body, the inner ear, and the eyes send conflicting signals to the brain. This
most often happens when you are in a car, boat, or airplane, but it may also happen on flight simulators or
amusement park rides. From inside a ship's cabin, your inner ear may sense rolling motions that your eyes
cannot see. On the other hand, your eyes may see movement on a "virtual reality" ride that your body does
not feel. Even viewing a 3D movie may cause symptoms of motion sickness.

Once a person gets used to the movement and the motion stops, symptoms may come back (although usually
only briefly). Sometimes just thinking about movement can cause anxiety and symptoms of motion sickness.
For example, a person who had motion sickness before might get nauseous on an airplane before take off.

Risk Factors
The following are the most common risk factors for motion sickness:
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Riding in a car, boat, airplane, or space shuttle

Young age, children ages 2 to 12 are most likely to get motion sickness.
Being prone to nausea or vomiting
Higher level of fear or anxiety
Poor ventilation in the vehicle
Sitting in the back seat or where you cannot see out the window
Pregnancy

Diagnosis
Your doctor will ask about your symptoms and find out what usually causes the problem, such as riding in a
boat, flying in a plane, or driving in car. Your doctor does not usually need laboratory tests to make a
diagnosis.

Preventive Care
There are several ways you can try to prevent motion sickness:

Sit in the front seat in a car.

Keep your eyes on the horizon.
DO NOT read
Rest your head against the seat back, to keep it still.
Turn the air vents toward your face.
DO NOT smoke

If you have motion sickness on a plane, try these tips:

Avoid big, greasy meals and alcohol the night before air travel.
Eat light meals or snacks that are low in calories in the 24 hours before air travel.
Avoid salty foods and dairy products before you travel.
Sit toward the front of the aircraft or in a seat over the wing.
Turn the air vent flow toward your face.

If you have motion sickness on a boat, try these tips:

Ask for a cabin on the upper deck or toward the front of the ship.
When on deck, keep your eyes fixed on the horizon or land.

Treatment
You can use medication to control your symptoms, but people who travel often may want to learn to control,
and prevent, symptoms. Mind-body practices, such as cognitive-behavioral therapy and biofeedback, may
help. Other alternatives include:

Homeopathy
Acupuncture
Dietary supplements
Changes to your diet
Physical exercise

Medications
Medications for motion sickness may cause drowsiness. Pilots, ship crew members, or anyone operating
heavy equipment or driving a car should not take them. These medications may help:

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Scopolamine (Transderm Scop): most commonly prescribed medication for motion sickness. You
have to take it before symptoms start. It comes in patch form to put behind your ear 6 to 8 hours before
travel. The effects last up to 3 days. Side effects may include dry mouth, drowsiness, blurred vision,
and disorientation.
Promethazine (Phenergan): take 2 hours before travel. The effects last 6 to 8 hours. Side effects
include drowsiness and dry mouth.
Cyclizine (Marezine): works best when taken at least 30 minutes before travel. It is not recommended
for children younger than 6, and side effects are similar to scopolamine.
Dimenhydrinate (Dramamine): take every 4 to 8 hours. Side effects are similar to scopolamine.
Meclizine (Bonine): works best when taken 1 hour before travel. It is not recommended for children
under 12. Side effects include drowsiness and dry mouth.

Nutrition and Dietary Supplements

A comprehensive treatment plan to treat motion sickness may include a range of complementary and
alternative therapies. Ask your team of health care providers about the best ways to incorporate these
therapies into your overall treatment plan. Always tell your provider about the herbs and supplements you
are using or considering using.

Following these nutritional tips may help reduce symptoms:

Avoid spicy, greasy, or fatty meals

DO NOT overeat
Drink plenty of water
Dry crackers and carbonated sodas (such as ginger ale) help some people avoid nausea.
People who tend to have motion sickness may want to eat small, frequent meals.

Herbs
Herbs may strengthen and tone the body's systems. As with any therapy, you should work with your provider
before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites
(glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per
cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to
4 cups per day. You may use tinctures alone or in combination as noted.

Ginger (Zingiber officinale): 250 mg, 3 times daily as needed, for symptoms of nausea. Ginger is a
traditional remedy for nausea, and some studies show it may help with motion sickness. Other studies
have found it does not work, however. Ginger may increase the risk of bleeding, especially if you also
take blood-thinners such warfarin (Coumadin), clopidogrel (Plavix), or aspirin. If you have a heart
condition, talk to your doctor before taking ginger.
Peppermint (Mentha piperita): 1 enteric-coated tablet, 2 to 3 times daily as needed. You may also
make a tea from the leaf. Peppermint can interact with some medications. Ask your doctor before
taking it.
Black horehound (Ballotta nigra): 1 to 2 ml as a tincture or 1 to 2 tsp. of leaves steeped as a tea,
taken 3 times per day. This is a traditional remedy for motion sickness, but no scientific studies have
been done to see if it works. Black horehound can interact with Parkinson medications, and may be
harmful to some people with Parkinson or Schizophrenia.

Acupuncture
Some studies suggest that acupressure may help reduce symptoms of motion sickness in the same way as
acupuncture, although the findings are inconclusive. An acupressure practitioner works with the same points
used in acupuncture, but uses finger pressure rather than needles. Acupressure bands are available
commercially to help prevent motion sickness. Studies suggest these bands may help delay the onset of
symptoms.

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Traditionally, the acupuncture point known as Pericardium 6 is said to help relieve nausea. It is on the inside
of the wrist, about the length of 2 fingernails up the arm from the center of the wrist crease. Many travel
stores sell wrist bands with built-in buttons that apply acupressure to this point.

Homeopathy
Few studies have examined the effectiveness of specific homeopathic remedies. A professional homeopath,
however, may recommend one or more of the following treatments for motion sickness based on their
knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's
constitutional type, includes your physical, emotional, and intellectual makeup. An experienced homeopath
assesses all of these factors when determining the most appropriate remedy for a particular individual.

Borax: for nausea caused by downward motions, such as landing in an airplane

Cocculus: the primary treatment for motion sickness, particularly if nausea and vertigo or other type of
dizziness are present
Nux vomica: for motion sickness accompanied by headache, nausea, and ringing in the ears
Petroleum: for dizziness and nausea that occur when riding in a car or boat
Sepia: for motion sickness brought on by reading while in a moving vehicle
Tabacum: for motion sickness with severe nausea and vomiting

There are "combination" remedies that include these remedies together. Although a classically trained
homeopath may frown upon such combinations, some find them easier and effective for home use.

Mind-Body Medicine
Biofeedback Training and Relaxation

In a study of 55 pilots who had to stop flying due to motion sickness, 76% of them got over their motion
sickness and were able to return to work after a biofeedback training and relaxation program. The pilots sat
in a tilting, rotating chair to bring on motion sickness, while biofeedback instruments recorded skin
temperature and changes in muscle tension. The pilots used relaxation techniques, such as deep muscle
relaxation and mental imagery, while in the chair. Over time, the pilots got used to the rotating chair and no
longer felt sick as they learned to relax.

Cognitive Behavioral Therapy

Cognitive behavioral therapy is used to reduce the anxiety, some people simply develop symptoms just be
thinking about movement or motion sickness. In a study of 50 pilots who occasionally had motion sickness,
86% of them got better after cognitive behavioral therapy. During this therapy, people are slowly exposed to
a situation that causes motion sickness until they have some symptoms, but not until the symptoms become
overwhelming. As they get used to the movement, they build confidence and their anxiety goes down.

Breathing Techniques

In a study of 46 people with motion sickness, those who took slow, deep breaths had fewer symptoms than
those who breathed normally or counted their breaths. Rapid and shallow breathing often makes symptoms
of motion sickness worse. While it makes sense that slow, deeper breathing would help lower anxiety, more
studies are needed to see whether breathing techniques really help reduce other symptoms.

Other Considerations
Prognosis and Complications
Although motion sickness usually goes away after the motion stops and causes no lasting harm, it can be
devastating for people whose jobs involve constant movement, such as a:

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Flight attendant
Pilot
Astronaut
Ship crew member

People who do not travel often may get used to movement during a trip lasting several days. Even those who
travel often may find that symptoms get better as they are more often exposed to motion. However, people
who get anxious before a journey often have worsened symptoms of motion sickness. They may need help
such as biofeedback and relaxation training.

Supporting Research
Beers MH, Porter RS, et al. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, NJ:
Merck Research Laboratories; 2006:1642-1644.

Chepyala P, Olden KW. Nausea and vomiting. Curr Treat Options Gastroenterol. 2008 Mar;11(2):135-44.

Chrubasik S, Pittler MH, Roufogalis BD. Zingiberis rhizoma: a comprehensive review on the ginger effect
and efficacy profiles. Phytomedicine. 2005 Sep;12(9):684-701.

Ernst E, Pittler MH. Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical
trials. B J Anaesth. 2000;84(3):367-371.

Hoffman T. Ginger: an ancient remedy and modern miracle drug. Hawaii Med J. 2007 Dec;66(12):326-7.

Koretz RL, Rotblatt M. Complementary and alternative medicine in gastroenterology: the good, the bad, and
the ugly. Clin Gastroenterol Hepatol. 2004; 2(11):957-67.

Levine ME, Gillis MG, Koch SY, Voss AC, Stern RM, Koch KL. Protein and ginger for the treatment of
chemotherapy-induced delayed nausea. J Altern Complement Med. 2008 Jun;14(5):545-51.

Lien HC, Sun WM, Chen YH, Kim H, Hasler W, Owyang C. Effects of ginger on motion sickness and
gastric slow-wave dysrhythmias induced by circular vection. Am J Physiol Gastrointest Liver Physiol. 2003;
284(3):G481-9.

Rakel: Integrative Medicine, 3rd ed. Philadelphia, PA: Elsevier Saunders. 2012.

Schmal F. Neuronal mechanisms and the treatment of motion sickness. Pharmacology. 2013; 91(3-4):229-41.

Solamini AG. Are there side effects to watching 3D movies? A prospective crossover observational study on
visually induced motion sickness. PLoS One. 2013; 8(2):e56160

Villard SJ, Flanagan MB, Albanese GM, Stoffregen TA. Postural instability and motion sickness in a virtual
moving room. Hum Factors. 2008 Apr;50(2):332-45.

Wang HK. The therapeutic potential of flavonoids. Expert Opin Investig Drugs. 2000;9(9):2103-19.

White B. Ginger: an overview. Am Fam Physician. 2007 Jun 1;75(11):1689-91. Review.

Version Info
Last reviewed on 12/9/2014
Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and
alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed
by the A.D.A.M. Editorial team.

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