Vertigo, the feeling of spinning or unsteadiness, is usually associated with issues in the inner ear, which houses the body’s primary balance system. However, the neck also plays a role in maintaining spatial awareness and stability. When an injury or disorder affects the cervical spine, the resulting disruption can lead to a specific type of dizziness similar to vertigo. This connection provides an answer for individuals whose dizziness does not stem from a traditional inner ear problem.
Defining Cervicogenic Vertigo
A neck injury can cause a specific form of dizziness known as Cervicogenic Vertigo. This condition is characterized by feelings of unsteadiness, lightheadedness, or imbalance originating from a disorder within the cervical spine. It is often triggered by acute trauma, such as whiplash, or chronic issues like degenerative changes.
Diagnosis requires physicians to exclude inner ear causes, such as Benign Paroxysmal Positional Vertigo (BPPV) or Meniere’s disease, since symptoms often overlap. While true vertigo is an intense spinning sensation, cervicogenic dizziness is usually described as a floating or off-balance feeling.
The Neurological Link Between Neck and Balance
The link between a neck injury and balance problems involves the neck’s network of sensory receptors, particularly proprioceptors. Located in the joints, muscles, and ligaments of the cervical spine, these receptors continuously send information to the brain about the head’s position relative to the torso. This positional awareness, called proprioception, is a component of the body’s ability to maintain balance.
The brain integrates this neck information with signals from the eyes (visual input) and the inner ear (vestibular input). When injury or inflammation occurs in the neck, it disrupts the flow of accurate proprioceptive signals. The brain receives conflicting or “faulty” information, creating a sensory mismatch with the normal signals from the inner ear and eyes. This confusion leads to the dizziness and unsteadiness characteristic of cervicogenic vertigo.
Identifying Neck-Related Vertigo
Identifying cervicogenic vertigo involves observing a specific pattern of symptoms and ruling out other causes of dizziness. A defining feature is that the dizziness is often provoked or worsened by specific neck movements or by maintaining an awkward head position. Patients typically report generalized unsteadiness or lightheadedness, rather than the severe rotational spinning associated with inner ear conditions.
The dizziness is almost always accompanied by other cervical symptoms, such as neck pain, stiffness, or a headache originating at the base of the skull. Diagnosis involves a physical examination assessing the neck’s range of motion and joint position sense, often using the cervical joint position error test. Healthcare providers also perform tests like the Dix-Hallpike maneuver to ensure inner ear disorders are not the cause.
Treatment Approaches for Recovery
The goal of treating cervicogenic vertigo is to restore normal function to the injured structures in the neck. Physical therapy is an effective intervention, focusing on exercises to improve the neck’s stability, strength, and range of motion. Therapists use manual therapy techniques, such as joint mobilization, to reduce stiffness and pain, which helps correct faulty sensory input.
Specific sensorimotor exercises, including gaze stabilization and head-neck-eye coordination drills, are used to retrain the brain to correctly interpret neck signals. These exercises directly target the proprioceptive deficit causing the dizziness. Short-term use of medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) or muscle relaxers, may also be recommended to manage pain and muscle tension.