Cervical Vertigo: Symptoms, Treatments, and Controversies
- Dr. Cameron Bearder
- Oct 13, 2022
- 6 min read
Updated: 6 days ago
The most important place to start is the definition, which is also one of the controversies. Research papers interchange the names and patients suffering with symptoms of cervical vertigo often have trouble accurately explaining it.
Cervical vertigo has multiple interchangeable names:
Cervicogenic vertigo.
Cervical dizziness.
Cervical vertigo.
Neck vertigo.
Neck dizziness.
The most important question to ask is:
"Do you feel like you are spinning?" If the answer is "No, I do not feel true spinning" then by definition, it cannot be called vertigo. We can then categorize it as dizziness.
The second most important question to ask is:
"Do you have any neck stiffness, soreness, or pain?" If the answer is no, then the likelihood of the issue being neck related goes down but does not disappear. This is where a comprehensive evaluation becomes most important to differentiate type of vertigo.
Understanding cervicogenic dizziness requires a deep dive into the anatomy of the upper portion of the neck, known as the CranioCervical Junction (CCJ). This region plays a crucial role in maintaining balance and orientation.
In this article, we'll explore the symptoms, causes, and treatment options for cervicogenic dizziness, often called cervical vertigo, benign paroxysmal positional vertigo, cervicogenic vertigo, or cervical dizziness.
Cervicogenic Dizziness
Cervicogenic dizziness is a complex condition. It's characterized by a sensation of unsteadiness and imbalance originating from the neck. Cervical symptoms dizziness is often associated with neck stiffness, soreness, and pain. Hence, it's sometimes referred to as neck dizziness. This inclusion is critical for an accurate understanding and diagnosis.
Cervicogenic dizziness is often linked with abnormal neck movement or position. This dizziness occurs because the neck's sensors (proprioceptors) provide incorrect information to the brain. As a result, the brain can struggle with balance and spatial orientation.
This condition is different from other types of dizziness. Unlike vestibular dizziness, which is related to the inner ear, cervicogenic dizziness is associated with issues in the cervical spine. Understanding its unique origin helps in tailored management approaches.
Symptoms of Cervical Vertigo
Cervicogenic dizziness, or neck dizziness, can present with various symptoms, often making diagnosis challenging. Recognizing the specific signs is essential for proper identification. Thorough evaluation of the head and neck, including, but not limited to, analysis of: range of motion, neck muscles, eye movements, and the vestibular system, is recommended. Common symptoms include:
Unsteadiness when standing or walking.
A feeling of swaying or tilting.
Difficulty focusing or concentrating.
Nausea not linked to other illnesses.
Neck stiffness, neck soreness, or neck pain.
Base of skull pain, upper neck pain.
These manifestations may vary in intensity and duration. Symptoms of cervical vertigo might worsen with certain neck movements or prolonged postures, which can increase the tone feedback from the muscles to the brain. Understanding these patterns can help distinguish cervicogenic dizziness from other types of dizziness. Early recognition of these symptoms can lead to more effective management, improved treatment strategies, and a better quality of life.
What Causes Cervical Dizziness?
Neck dizziness arises from various causes, primarily related to neck disorders that disrupt the neck's proprioceptive input and impact balance. Common causes include:
Whiplash, from sports or car collisions.
Neck injuries, from blunt force or falls.
Cervical spondylosis, also known as neck arthritis.
Sensory integration issues, a brain processing issue.
It can be further classified into what's called a Bottom-Up and Top-Down classification:
Bottom-Up refers to an alteration of information FROM neck structures to the brain. Think of this like a computer hardware issue, i.e. the CD drive skipping while reading a disc. This is easier for both clinician and patient to identify and understand.
Top-Down refers to the brain creating an altered pattern of communication TO the structures of the neck. Think of this like a computer software issue, i.e. running an outdated operating system. This is much harder to identify, and requires advanced examination and education to understand.
The biomechanics of cervical vertigo involve intricate movements of the neck that alter normal function. When these disturbances occur, the sensory information reaching the brain becomes inaccurate. Movements that might not usually cause issues can trigger dizziness. Understanding these mechanics helps in recognizing the triggers. It also paves the way for designing effective therapeutic interventions tailored to an individual patient with cervicogenic dizziness.
The CranioCervical Junction (CCJ), the Neck, and Their Roles in Cervicogenic Dizziness
The CranioCervical Junction (CCJ) is where the skull meets the cervical spine and is unlike any area in the entire human body. This area is a complex network involving:
Unique bones, Atlas and Axis (C1 C2).
Critical ligaments, for stability.
Neurologically-rich muscles, for position awareness.
Important structures, blood flow, to and from the brain.
The CCJ plays a significant role in cervicogenic dizziness, with the muscles surrounding the bones relaying positional information to the brain. Dysfunction in this area, from neck injury, trauma, distorted posture, or whiplash injury, can alter the position of the upper neck and disrupt normal signal transmission, leading to symptoms like dizziness, imbalance, and disorientation. The proper functioning and ideal positioning of the CCJ are essential for maintaining balance and spatial awareness.
The middle and lower portions of the neck can also contribute to feelings of dizziness, most likely from things like spinal disc issues and arthritis in some of the smaller supporting joint structures. These issues can either change the tone of the surrounding muscles or irritate sensitive neurological structures, creating a distortion of information to the processing centers in the brain.
Diagnosing Cervicogenic Dizziness: Tests and Challenges
Diagnosing cervicogenic dizziness is often complex due to its overlap with other dizziness types and misclassification into cervical vertigo. Differentiating it from vestibular disorders requires a thorough evaluation, looking at the inner ear system, the visual system, and the cervical spine.
Inner ear testing can identify vestibular organ dysfunction.
Eye-tracking technology can evaluate neurovisual issues.
Diagnostic imaging, such as MRIs or CT scans aids in identifying structural issues in the CCJ and neck.
Cervical range of motion and cervical joint position error testing can help identify proprioceptive issues in the neck.
Traditional healthcare does NOT typically examine this comprehensively but rather in isolation. This typically delays an accurate diagnosis, prolongs suffering and feelings of dizziness, and wastes both time and money. A multidisciplinary approach is vital in effectively managing cervicogenic dizziness.
Cervical Vertigo Treatment
Effective management of cervicogenic dizziness often involves a combination of approaches, therapies and rehabilitation exercises. Integrating various treatment modalities ensures both a holistic and thorough approach, addressing the diverse factors that contribute to cervicogenic dizziness.
A well-rounded treatment program might include:
Upper Cervical Spine adjusting.
Neck proprioception tasks.
Cervical strengthening exercises.
Physical therapy.
Balance training routines.
Vestibular adaptation exercises.
Regular care under professional guidance is essential for efficacy. Adhering to a personalized exercise plan can significantly improve a patient's quality of life by reducing dizziness and increasing resilience against future episodes.
Keeping abreast of research is crucial for optimizing cervicogenic dizziness management. New studies illuminate the pathophysiology and refine treatment techniques. Advances in diagnostic tools and therapeutic interventions improve accuracy and effectiveness. Engaging with current literature and research findings empowers healthcare professionals to provide state-of-the-art care for patients.
Conclusion: Managing Cervicogenic Dizziness
for Better Quality of Life
Understanding a patient's history is crucial for making an accurate initial diagnosis. Guiding questions allow patients to articulate their experiences and symptoms of cervical, providing the foundation for accurate clinical insights and an optimal treatment plan. From this starting point, thoroughly evaluating all involved systems enhances the clinician's understanding, paving the way to effective treatment.
Effectively managing cervicogenic dizziness requires comprehensive care and informed strategies. Grasping the intricate relationship between the upper neck, spinal cord, inner ear, vestibular system, and current symptoms is essential for effective treatment. It is well established that an integrative approach can alleviate symptoms, enhance daily functioning, and improve overall well-being. If you seek Evaluation and Treatment for Vertigo, Dizziness, or Meniere's Disease, we are ready to support you.
The Keystone Experience takes a different approach compared to traditional methods that often work in isolation. If you are experiencing balance issues, feeling dizzy and lightheaded, or still find yourself asking questions such as, "Why do I feel dizzy?" or "Why do I feel off-balance but not dizzy?" We sincerely encourage you to reach out today.
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