Dizziness is a common experience, but finding the specific cause can be challenging. When dizziness is accompanied by neck pain, the cervical spine becomes a primary area of investigation. Conditions affecting the C5 and C6 vertebrae can lead to feelings of unsteadiness, a condition known as cervicogenic dizziness.
The Anatomy and Function of C5 and C6
The cervical spine has seven vertebrae; C5 and C6 are located in the middle and lower neck. These segments provide flexibility and mobility for movements like looking up and down. The spinal nerves exiting at C5 and C6 are crucial for upper limb function.
The C5 nerve root controls the deltoid and biceps muscles, influencing shoulder abduction and elbow flexion. The C6 nerve root supplies the wrist extensor muscles and is also involved in elbow flexion. C6 also provides sensation to the thumb side of the forearm and hand.
The C5 and C6 vertebrae contain transverse foramina, small openings that serve as a protected passageway for the vertebral arteries. These arteries supply blood to the back of the brain. Damage or degeneration in this area can have effects beyond localized neck pain.
The Mechanism Linking Cervical Issues to Dizziness
Pathology in the C5/C6 area, such as degenerative disc disease or facet joint arthritis, can indirectly lead to dizziness. The primary mechanism involves a conflict in proprioception, the body’s ability to sense its position and movement in space. The deep muscles and ligaments of the neck, including those near C5/C6, are richly supplied with sensory receptors that send constant information about head position to the brain.
When a disorder affects the C5/C6 segment, it causes tension or inflammation in the surrounding muscles. This sends abnormal signals to the brainstem. This distorted neck input clashes with accurate information coming from the visual and vestibular systems. The resulting sensory mismatch is interpreted by the brain as disequilibrium or dizziness.
A less common mechanism involves mechanical compression of the vertebral artery, sometimes called vertebrobasilar insufficiency. Severe degenerative changes or instability in the lower cervical spine can compromise blood flow, especially during specific neck movements. This reduction in blood supply to the brain’s balance centers, such as the cerebellum, can manifest as dizziness.
Recognizing Cervicogenic Dizziness
Cervicogenic dizziness has a distinct presentation that differentiates it from inner ear disorders. Symptoms are typically described as unsteadiness, lightheadedness, or being “off-balance,” rather than true spinning vertigo. The symptoms are often vague and can fluctuate in intensity, lasting minutes to hours.
A distinguishing characteristic is that dizziness is frequently triggered or worsened by specific head movements, sustained neck positions, or poor posture. This association with cervical spine movement results directly from the proprioceptive mismatch. Patients almost always experience co-existing symptoms, such as chronic neck pain, stiffness, or headaches originating at the base of the skull.
Cervicogenic dizziness does not typically include ear-related symptoms like ringing (tinnitus) or hearing loss, which are hallmarks of true vestibular disorders. This guides the diagnostic process toward a musculoskeletal origin. Recognizing neck-movement-related dizziness alongside cervical discomfort is key to identification.
Diagnostic Procedures and Treatment Options
Diagnosing cervicogenic dizziness requires ruling out other potential causes, such as inner ear or neurological issues. A medical professional performs a physical examination, including orthopedic tests designed to provoke symptoms through neck movement. This assessment checks range of motion, tenderness, and trigger points in the neck muscles.
Imaging studies confirm structural problems in the C5/C6 segment. An MRI or X-ray can reveal degenerative changes, disc herniations, or arthritis causing the dysfunction. These images confirm a cervical pathology correlating with the patient’s dizziness.
Treatment centers on restoring normal neck function and sensory input. Physical therapy is a primary intervention, focusing on improving neck mobility, strengthening deep cervical flexor muscles, and correcting posture. Manual therapy, such as joint mobilization, may address stiffness. Vestibular rehabilitation exercises are integrated to help the brain process conflicting sensory information.