If you’ve had dizziness, chances are someone has mentioned what’s called Benign Paroxysmal Positional Vertigo, or BPPV. It is the most common vestibular disorder, with about 1 in 50 people getting it at some point in their lifetime.(1)
However, if you’ve been treated for this type of dizziness and it never fully resolves or continues to return, it’s possible that another condition should be considered: cervicogenic dizziness.
Cervicogenic dizziness is a type of dizziness coming from the neck, or cervical spine. Neck pain itself is a very common condition, and a glaring history of problems in the neck or whiplash injuries may raise suspicion of cervicogenic dizziness. However, patients with vestibular problems may avoid moving their head and begin to develop secondary neck problems.
There are a few explanations for dizziness coming from the cervical spine. For one, it is possible that vascular issues in the blood vessels that supply the brain could be impacted. A thorough examination by a physical therapist or other healthcare provider can help to rule this out. Probably a more common occurrence is that information coming from the upper cervical spine (the top 3 segments of the neck), because it communicates with the brain through connections near the brainstem, can be misunderstood by your brain. Think of your brain as the last person in a game of telephone. It’s trying to figure out what the received signal means, and sometimes it misunderstands the message. This happens all the time elsewhere in our body, usually as referred pain. In fact, “sciatica,” one of the most common musculoskeletal conditions in the world, is an example of this phenomenon. Patients have symptoms in their leg even though the problem is in their back.
Perhaps one reason that cervicogenic dizziness isn’t diagnosed as often is because it has no diagnostic test. Imaging of the neck might be helpful in some individuals, but positive imaging findings are so common in asymptomatic people that imaging is unlikely to give a clear answer. Physical examination testing in those with cervicogenic dizziness does not always provoke symptoms and if it does, these symptoms may be very mild.(2)
If you have had vertigo repeatedly, have had trauma to the neck, or have neck pain or headaches in addition to vertigo, you may have cervicogenic dizziness. Treatment may involve hands-on treatment to the neck, visual tracking exercises, specific neck movements, and exercises to improve the endurance and strength of neck muscles.
Do you think you might have cervicogenic dizziness? Drop us a line below.
- von Brevern M, Radtke A, Lezius F, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry 2007;78:710–5. 1.
- Kristjansson E, Treleaven J. Sensorimotor function and dizziness in neck pain: implications for assessment and management. J Orthop Sports Phys Ther. 2009;39(5):364-377.