Do You Recognize These Symptoms
Those who experience cervicogenic vertigo describe the experience in various ways, and it can be accompanied by other symptoms such as nausea, headache, ringing in the ears , and, more rarely, neck pain.
Patients use phrases such as:
- âWhen I turn my neck, it often feels like I am suddenly spinning.â
- âIt is a sensation of falling in slow motion.â
- âThe world around me starts to spin, and I immediately feel nauseated.â
- âI felt off-balance, as everything seemed to tilt around me.â
- âIt comes on suddenly with certain neck movements, and I feel like everything was spinning around me. The spinning causes nausea that is often accompanied by an intense headache.â
If you can relate to any of the above statements, or have similar symptoms, then you may be experiencing cervicogenic vertigo.
Criteria Used By Dr Hain At Chicago Dizziness And Hearing To Diagnose Cervical Vertigo
- Lack of reasonable alternatives .
- Any or all of the above combined with dizziness and nausea
- Nystagmus on head turning .
- Abnormal cervical MRI with disk abutting cervical cord, or readily apparent high-cervical disease.
- Severe stiffness of the neck
- Temporal proximity — onset of dizziness after injury confined to the neck
| Cervical nystagmus recorded with head turned to left. |
- More detail about this test can be found here.
What Is Cervical Spondylosis
Cervical spondylosis is also called cervical osteoarthritis. It is a condition involving changes to the bones, discs, and joints of the neck. These changes are caused by the normal wear-and-tear of aging. With age, the discs of the cervical spine gradually break down, lose fluid, and become stiffer. Cervical spondylosis usually occurs in middle-aged and elderly people.
As a result of the degeneration of discs and other cartilage, spurs or abnormal growths called osteophytes may form on the bones in the neck. These abnormal growths can cause narrowing of the interior of the spinal column or in the openings where spinal nerves exit, a related condition called cervical spinal stenosis.
Cervical spondylosis most often causes neck pain and stiffness. Although cervical spondylosis is rarely progressive, corrective surgery can be helpful in severe cases.
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Disorders Related To Cervicogenic Vertigo
The disorders discussed in this section all have a close link to the cervicogenic region and can occur in conjunction with cervicogenic vertigo.
You may even have a bit of a chicken vs. egg conundrum, as vertigo may appear as a symptom after you experience one or more of the following problems.
As you read through this section, you may have a bit of an âah-haâ moment when you realize that there is a definitive connection between issues you may have viewed as separate problems until now.
Understanding The Autoimmune Response
McIlwain points out that in autoimmune diseases like psoriatic arthritis, the body makes antibodies that attack its own tissues. When those antibodies affect the middle and inner ear, the result can be hearing loss and balance issues.
Researchers are just beginning to investigate how to thwart this autoimmune response. Assuming that the dizziness and hearing loss is part of the autoimmune problem, controlling the autoimmune process in psoriatic arthritis may help alleviate the problem, says McIlwain.
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Can Tight Neck Muscles Cause Dizziness Or Headache
Patients can suffering from seemingly unexplainable headaches and dizziness. Sometimes the cause is tight or stiff soft tissue of the neck.
Soft tissue is characterized as muscle, fat, blood vessels and also supporting tissue that are not bones, joints and cartilage.
Can tight neck muscles cause dizziness or a chronic, persistent headache? Yes, they can. However, it is an unlikely for the diagnosis for your dizziness or headache to be solely tight cervical muscles, as the overarching conditions that connect neck stiffness to these symptoms tend to be more complex. Often tight neck muscles are a symptom of a wider condition that could cause dizziness or headache.
These conditionscalled cervicogenic dizziness and cervicogenic headache, respectivelyare rare, as only up to 2.5% of the population have them.
However, among those who seek medical relief from dizziness or headaches, these conditions can be a common diagnosis. Cervicogenic disorders can dramatically reduce ones quality of life, and produce a wide array of symptoms as detailed in this scientific journal.
It must be noted that both of these conditions are significantly more prevalent in patients over 40 years old.
Read below to provide insight as to whether your source of discomfort comes from cervicogenic conditions, or something else.
What Else Will Help With The Sensation Of Dizziness
It may be worth opening a discussion with your primary care provider about having radiographs taken of the neck to determine the severity of the degeneration. It is also important to rule out other causes of the sensation, such as a condition known as benign paroxysmal positional vertigo which can be assessed using the Dix-Hallpike maneuver and corrected by a professional familiar with the Epley maneuver.
Don’t wait to have your dizziness assessed. Seek out a professional if you begin to experience sensations of vertigo.
References:
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As We Were Ruling Out Possible Causes For My Dizziness More And More Symptoms Developed
If you are like the people with a similar story to that above, your medical journey may have continued like this:
- The dizziness was becoming more frequent and longer in duration. All along I had neck pain, this is why I was going to the chiropractor, but now I was having more symptoms. I started having jaw pain and was told I had TMJ. Along with the more frequent dizziness cam more frequent headaches. They did not develop into migraines although I was warned they could. Mostly I was told I had tension headaches. I also started to have a ringing in my ears.
At some point, my physical therapist confirmed with my doctors, and finally, something began to make sense. Were all these problems in my neck? Did I have cervical neck instability?
Another story: Here is a patient on video. Patricias story is one we commonly see. The results she achieved may not be typical for everyone. Complex cases typically require more than one treatment. Not everyone has successful outcomes. Here is the transcript to read:
My problems began after I fell. I tripped over a curb and fell. After the fall I started having problems with dizziness, being unstable, my ears were ringing. I started getting a lot of head pain, muscle spasms, and pain between my eyes.
Ive now had one dose of Prolotherapy, my symptoms are so much better. Prior to the prolotherapy, I was sort of a prisoner in my own house because of my dizziness and lack of balance, and the pain that I was in.
Here Are Some Of The Tests They Reviewed For Patients Cervical Vertigo And Cervicogenic Dizziness And Brief Reasoning Behind Them:
The Duke researchers were very comprehensive. Here are some of the tests they reviewed for patients in chronic condition and brief reasoning behind them:
Lets point out again that the Duke team suggests that diagnosis is difficult and is sort of like peeling an onion, there are many layers that need to be peeled away, Cervicogenic dizziness is a diagnosis of exclusion.
In research published by Caring Medical: Chronic Neck Pain: Making the Connection Between Capsular Ligament Laxity and Cervical Instability led by Danielle Steilen-Matias. Our team also suggested that the diagnosis of chronic neck pain due to cervical instability is particularly challenging. In most cases, diagnostic tools for detecting cervical instability have been inconsistent and lack specificity, and are therefore inadequate. A better understanding of the pathogenesis of cervical instability may better enable practitioners to recognize and treat the condition more effectively. For instance, when cervical instability is related to injury of soft tissue alone and not fracture, the treatment modality should be one that stimulates the involved soft tissue to regenerate and repair itself.
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Pinched Nerve In The Neck And Dizziness: Is There A Link
Can a pinched nerve in the neck cause dizziness? This is just among the many questions many patients ask during their first consultation. After all, dizziness is quite a common symptom. Sometimes, it denotes a cardiovascular problem like hypertension or stroke. On the one hand, it may be a sign of a vestibular or balance organ malfunction or abnormal blood sugar levels.
Because it can result from various health concerns, some patients wonder if it can get triggered by a pinched nerve in the neck. Lets take a deeper dive into this topic below.
Experts On Cervical Vertigo
We are often asked about who can be seen locally to diagnose and treat cervical vertigo in the United States. The short answer is there does not seem to be any clinician in the United States who has written anything substantial on cervical vertigo. We are trying ourselves .
Furthermore, as noted above, the world literature about cervical vertigo is full of strange and peculiar ideas and suggestions, and we would be hard pressed to recommend someone outside of the US either.
Otoneurology is the specialty that seems most reasonable for cervical vertigo – -but there are very few otoneurologists in the world. Practically, the safest thing to do to us seems to be to locate a sympathetic and thoughtful physician to be the “captain of the ship”, see appropriate specialists to exclude alternatives involving the ear , and brain , and take reasonable measures to decrease neck pain and stiffness .
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How Can Foraminal Stenosis Lead To Dizziness
Foraminal stenosis is a condition that occurs in the spine when the openings that allow nerve roots to exit the spinal cord, called foramina, experience narrowing. This narrowing can be caused by a number of related spine conditions including bulging discs, herniated discs and bone spurs. Although foraminal stenosis is common and not necessarily painful, it can cause symptoms if there is enough constriction to compress a nerve root and interfere with its functioning.
Some of the most common symptoms of foraminal stenosis include local pain, pain that shoots along the nerve and tingling, numbness or muscle weakness in the extremities. Patients diagnosed with foraminal stenosis may experience other symptoms, like headaches or dizziness, and wonder if they are related to this condition or if it is due to another cause. It is important to speak to your doctor for a proper diagnosis of any symptoms, but it can also be beneficial to educate yourself as a patient. By learning more about how foraminal stenosis could be related to feelings of dizziness and vertigo, you can work more closely with your doctor to get the care and treatment you deserve.
How A Physio Can Help
Physiotherapy management requires assessment and treatment of all the abnormalities found in the joints, muscles and neural structures. As well as education on posture and work practices.
Postural Assessment and Advice Education on optimal trunk posture and postural retraining is vital. Without postural correction cervical headaches can linger for extended periods.
Mobilisation Stiff joints in the neck should be mobilised to restore range of movement. Stiffness in the jaw joints can also be problematic and should be mobilised if needed.
Stretching Stretching of the neck and shoulder muscles can help alleviate headaches.
Strengthening cervical muscle retraining is vital. Your physiotherapist will show you how to retrain your deep neck muscles to restore the normal muscle balance and recruitment
Stress and tension management Identification and reduction of the sources of stress and tension need to be incorporated as this commonly leads to tightness in the upper back and neck muscles.
Soft tissue work and massage Your physiotherapist may use different massage and soft tissue techniques to help the muscles in your neck and upper back.
Acupuncture Acupuncture is the placement of very think needles into specific locations in the body. It is often used to help alleviate headaches.
Neural stretching Abnormal neural tension can also contribute to cervical headaches. Your physiotherapist will assess this and provide appropriate stretches as needed
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Cervicogenic Dizziness: How To Know If Your Dizziness Is Coming From Your Neck
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Does it ever seem that when your neck hurts, you end up feeling dizzy as well? Or does it seem that certain movements or postures of the neck make you feel dizzy?
If so, it is possible that your neck is contributing to your dizziness. Studies have shown that dizziness can affect 20 to 30% of the population, and there are a lot of potential causes including disorders of the cardiovascular, neurological or vestibular systems.
Another potential cause is cervicogenic dizziness – imbalance or dizziness that arises from the neck. As a standalone cause of dizziness, cervicogenic dizziness is controversial. However, more research is being done in this area, furthering our understanding of how the bodys different systems interact.
We know that proprioceptive input from the neck helps coordinate eye movement, body posture and balance. Moreover, studies have shown that an anesthetic injection of the nerves in the upper neck can produce dizziness and nystagmus .
It has also been shown that electrical stimulation of the cervical muscles can induce the sensation of tilting or falling, so we can say we certainty that an anatomical connection exists.
How do I know whether I have cervicogenic dizziness?
A vestibular therapist may also evaluate your awareness and control of neck position and movement by having you wear a laser headlamp.
What should I do?
Spine Conditions That Can Cause Cervical Vertigo
There are several possible causes of cervical vertigo. Sometimes, it stems from physical trauma, while other times, its a result of a health condition affecting the spine. Growing older is a potential risk factor, since wear and tear can affect neck strength and mobility and increase your chances of developing certain health issues. The most common causes include:
Whiplash: Sometimes, when your head and neck snap forward and backward at a high speed, it can result in whiplash. Its a generic catch-all for a neck spasm after a somewhat high-velocity type injury, most commonly after a motor vehicle accident, says Dr. Baum.
Cervical spondylosis: Also called arthritis of the neck, cervical spondylosis refers to the breakdown of your spines disks and joints over time. Discs, which act like a shock absorber , start to lose water content, and it begins a degenerative inflammatory cascade, explains Dr. Baum. During that process what can happen is that you develop bone spurs. These can cause compression of the necks nerves, blood vessels or even the spinal cord, sometimes resulting in vertigo.
A herniated disc: When the jelly-like center of a spinal disc bulges outor herniatesit may push towards the spinal cord. This can do the same thing , compressing the spinal cord or the spinal nerves, says Dr. Baum.
Poor posture: Over time, slouching when you sit or bending your neck forward to read can compress the vertebrae at the top of your spine.
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Symptoms Of Alternative Diagnoses
That being said, there is a number of other spine and neck conditions that may be causing the dizziness.
If youre feeling any of the following symptoms then chances are youre suffering from a diagnosis similar to, but not necessarily, CGD:
- Nausea and vomiting
- Hearing loss
- Exhaustion
If youre experiencing any of these symptoms in addition to dizziness and headaches, seek medical attention immediately.
Functional Examination Of Motion Segments Of The Upper Cervical Spine Is Important In Diagnosing And Treating Vertigo
Why do we find this one sentence so remarkable? Because this one line may be the answer for many of you reading this article. Lets explain.
The researchers suggest that you must examine the motion segments of the upper neck because it is the unresolved vertebral segments that are causing the problems. In our 26+ years of service in treating cervical neck disorders, we have found that many patients who come through our doors do not have an accurate diagnosis or assessment of their situation.
As you can see in the video below, DMX is a motion picture of the bones while a person is moving. It is a dynamic diagnostic tool, versus a static one. The scan is produced in real-time, while the person is moving his/her neck. Pain typically occurs with motion. By being able to see the bones in motion, DMX picks up abnormal or excessive motion whereas MRI, CT scan, and static x-rays do not.
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Cervical Myofascial Pain Syndrome
Myofascial pain syndrome occurs when painful trigger points develop in the muscles and surrounding connective tissues. When this condition is primarily felt in the neck region, it is called cervical myofascial pain syndrome. In addition to having tender trigger points than can flare up when touched or during activity, muscles can become achy and stiff, and pain can spread to the head or shoulders. While cervical myofascial pain syndrome is rare, it is estimated that about one-third of people with this condition also have dizziness. 2
Cervical myofascial pain syndrome has no known cause. Some suspected causes include previous injury, overuse or repetitive neck movements, poor posture, and/or stress. While the connection between this neck pain and dizziness is unclear, some evidence suggests that treating myofascial pain syndrome such as with trigger point injections, physical therapy, or medicationcan reduce both the pain and dizziness.3
See Home Remedies for Neck Pain and Dizziness
What Are The Treatments For Neck Arthritis
Neck arthritis treatment usually involves over-the-counter NSAIDs such as aspirin, ibuprofen, naproxen, and analgesics to relieve pain and inflammation. Nevertheless, always consult with a doctor about your therapy as these drugs can also have side effects and interactions with other medications.
For treating autoimmune arthritis, we use disease-modifying antirheumatic drugs such as methotrexate, leflunomide, and sulfasalazine. Their goal is to modulate the immune system activity to control inflammation and its related symptoms and slow down the disease progression.
In some cases, your doctor can recommend visiting a physiotherapist to perform specific exercises to strengthen the muscles around the neck and increase flexibility and range of motion.
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