A “pinched nerve,” medically termed radiculopathy, occurs when surrounding tissues like bone, cartilage, or muscle put pressure on a nerve root, interfering with its function. This compression typically causes localized pain, numbness, or tingling. Dizziness or unsteadiness is not common for all pinched nerves, but it can occur when the compression is located in the neck, known as cervical radiculopathy. This specific form of dizziness is called cervicogenic dizziness, and it arises because the neck plays a direct role in maintaining balance.
The Cervical Spine Connection
The upper cervical spine (C1-C3 segments) is densely populated with specialized sensory receptors called proprioceptors. These receptors are located in the neck’s joints, muscles, and ligaments, and they constantly relay information to the brain about the head’s position and movement. This continuous flow of information, known as proprioception, is a crucial component of the body’s spatial orientation system.
When a nerve in the upper neck is compressed or irritated (due to injury, inflammation, or joint dysfunction), it sends faulty signals to the brainstem. The brainstem integrates this cervical input with signals from the visual system and the vestibular system (inner ear). When the brain receives conflicting data—such as the inner ear reporting stillness while the neck nerves report movement—a sensory mismatch occurs.
This sensory conflict results in cervicogenic dizziness, often described as unsteadiness, lightheadedness, or floating, rather than the intense spinning sensation of true vertigo. The dizziness is directly related to the neck pathology and frequently worsens with specific neck movements or fixed head positions. The irritated cervical nerves confuse the brain’s balance centers, leading to disequilibrium.
Differentiating Symptoms from Vestibular Disorders
Understanding the type of dizziness experienced is the first step in determining the cause, as cervicogenic dizziness can be mistaken for a problem originating in the vestibular system (inner ear). In cervicogenic dizziness, unsteadiness usually follows neck pain or stiffness, and symptoms are directly provoked by neck movement. The dizziness is non-rotational and does not involve the violent spinning often associated with inner ear conditions.
In contrast, primary vestibular disorders often produce true vertigo, which is the hallucination of movement, feeling like the world is spinning. Benign Paroxysmal Positional Vertigo (BPPV) is a common example, where vertigo episodes are brief (lasting only seconds) and are triggered by specific changes in head position, such as rolling over in bed. These symptoms are not necessarily accompanied by neck pain.
Other vestibular issues, like Meniere’s disease or Vestibular Neuritis, present differently. Meniere’s disease involves recurrent episodes of severe vertigo, often lasting hours, accompanied by auditory symptoms like tinnitus or fluctuating hearing loss. Vestibular Neuritis, an inner ear infection, causes sudden, severe, and persistent vertigo that lasts for days but is not typically triggered by neck movement.
The key distinction is the link between neck movement and dizziness onset, as well as the quality of the dizziness. If symptoms are aggravated by turning the head or maintaining a sustained neck posture, and the dizziness is unsteadiness rather than a spin, a cervical source is more likely. A healthcare provider performs specific physical tests to rule out inner ear issues before confirming cervicogenic dizziness.
Diagnosis and Management of Nerve-Related Dizziness
Since no single test confirms cervicogenic dizziness, diagnosis is often one of exclusion, requiring other causes of dizziness to be ruled out first. A healthcare provider takes a detailed history, performs a physical examination to assess neck mobility and pain, and conducts neurological and vestibular tests. Imaging studies, such as X-rays or MRI, may be used to identify underlying cervical spine pathology irritating a nerve.
Diagnosis is strongly supported if dizziness symptoms lessen or disappear following treatment aimed specifically at the neck. Conservative management is the most common approach, focusing on relieving the underlying cervical dysfunction. Physical therapy is a primary intervention, utilizing manual therapy techniques like mobilization to restore proper joint mechanics.
Specific exercises are employed to retrain cervical proprioception, helping the neck’s sensors send accurate signals to the brain. This involves balance training and exercises designed to improve head and eye coordination. Non-steroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants may be prescribed to manage pain and reduce inflammation. A multimodal conservative approach targeting the neck provides significant improvement for most patients within a few months.