Dizziness and Vertigo... Is it coming from your neck?

Cervicogenic Dizziness: A review of Diagnosis and Treatment

Wrisley, D. MS, PT, NCS, et al. Journal of Orthopaedic and Sports Physical Therapy 2000;30(12):755-766

Dizziness is a common symptom that we see as Upper Cervical Doctors.  This article does a great job of covering the basics in diagnosis, pathophysiology (abnormal function) and treatment. 

 Vertigo and Dizziness impact how your ability to take care of yourself and those you love.

Vertigo and Dizziness impact how your ability to take care of yourself and those you love.

·         Cervicogenic (coming from the neck) dizziness is most often associated with flexion-extension injuries.  Most commonly reported in patients who report ataxia, unsteady gait, posture imbalance associated with neck pain, limited cervical range of motion, and headaches. 

·         20% of individuals who experience whiplash complain of neck pain months after the injury occurred.

·         Although dizziness, vertigo and disequilibrium do not frequently occur at initial presentation, 20-58% of individuals who have sustained closed head or whiplash injury experience these symptoms.

·         Strong connections have been demonstrated between the cervical dorsal roots and the vestibular nuclei with the neck receptors (proprioceptors, mechanoreceptors) playing a role in perception of balance and postural adjustments.

·         Current theory that cervicogenic dizziness is due to abnormal afferent input to the vestibular nucleus from damaged joint receptors in the upper cervical region. 

·         A cyclical pattern may exist such that cervical muscle spasms contribute to dizziness and dizziness contributes to muscle spasm.

·         Manual therapy is recommended treatment for cervicogenic dizziness to decrease the irritation of the cervical proprioceptors from muscle spasms and trigger points.