Cervical Vertigo: The Link Between Neck Pain and Dizziness

Neck pain and dizziness can go hand in hand. It’s called cervical vertigo or cervicogenic dizziness. Here’s how it happens, and what you can do about it.

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Maybe it’s because of that fender bender on the way to the post office. Maybe it’s from all the slouching over your smartphone. Or, maybe it’s your arthritis acting up. Whatever the reason for your cervical vertigo, your world is spinning, your neck hurts like crazy—and you want it to stop.

Woman experiencing cervical vertigo, cervicogenic dizziness, and neck pain and dizzinessCervical vertigo is also known as cervicogenic dizziness.

Cervical vertigo, also called cervicogenic dizziness, is a feeling of disorientation or unsteadiness caused by a neck injury or health condition that affects the neck. It’s almost always accompanied by neck pain. Your range of motion can be affected, too, and sometimes it comes along with a headache. Episodes of cervical vertigo go for hours, and the condition itself can last for years.

Diagnosing cervical vertigo can be difficult. For one thing, some of its symptoms overlap with those of other medical problems, from inner ear issues to stroke to traumatic brain injury (concussion). What’s more, it can be tough to tell if someone’s symptoms are occurring along with their neck problems, or if they’re a result of the neck problems themselves.  

Fortunately, once you’re correctly diagnosed, therapies can typically be done right at home. “If it is truly cervical vertigo and dizziness—if there’s a cause coming from the neck—many of these can be treatable and most without surgery,” says Griffin Baum, MD, a neurosurgeon at Lenox Hill Hospital in New York City. 

So, what brings about cervical vertigo? How do healthcare providers figure out your diagnosis? And most importantly, what can you do about it?

How Balance Works

It takes a lot of coordination to keep your body upright and moving. Balance involves your eyes, muscles, joints, and nervous system working together with a group of tiny organs in your inner ear called the vestibular system. When they’re all in sync, maintaining equilibrium is a piece of cake. When even one part is damaged or disrupted, staying vertical can be a challenge.

While the exact reason for cervical vertigo remains unknown, many experts believe it’s a communication problem between your vestibular system and a sense called proprioception. Proprioception is your awareness of your body’s position and motion. It’s how you know where your limbs and joints are, and how they move through space. Proprioception is informed by sensors in your skin, muscles and joints, which send signals to your nervous system.

The theory is that cervical vertigo occurs when an injury or health condition messes with the receptors in your neck, throwing off your proprioception. This affects the signals sent to the brain and vestibular system, resulting in vertigo.

How to Diagnose Cervical Vertigo

First thing’s first: There is no test to diagnose cervical vertigo. Instead, you have to rule out other potential causes of your symptoms and confirm your issue stems from your neck. This is called a diagnosis of exclusion.

Among the other conditions that have some symptoms similar to cervical vertigo and must be considered are:

·       Benign paroxysmal positional vertigo (BPPV), a vestibular system problem that causes a spinning feeling when you move your head a certain way

·       A brain tumor

·       Fluid on the brain

·       Stroke 

·       Multiple sclerosis

·       Meniere’s disease

“The other thing that always needs to be a consideration would be a concussion, or a mild traumatic brain injury,” Dr. Baum says.

Fortunately (in a way), neck pain is a good clue that your problem may be cervical vertigo. “When patients have pain, they’re typically easier to diagnose because it sort of is a reference,” says Dr. Baum. “It’s a bit of a red flag that says, ‘Hey, this could be coming from the neck.’” When neck pain isn’t present, he adds, healthcare providers almost always believe the dizziness is coming from the ear or brain.

Spine Conditions That Can Cause Cervical Vertigo

There are several possible causes of cervical vertigo. Sometimes, it stems from physical trauma, while other times, it’s 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. “It’s 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 spine’s disks and joints over time. “Discs, which act like a shock absorber [between vertebrae], 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 neck’s 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 out—or herniates—it may push towards the spinal cord. “This can do the same thing [as spondylosis], 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. 

Other factors that may lead to cervical vertigo include:

·       Atherosclerosis, or a hardening of artery walls, which can restrict blood flow to areas that affect balance

·       Neck surgery, if it damages the area or nearby blood vessels

·       Bow Hunter’s Syndrome (rotational vertebral artery occlusion), an uncommon compression of a blood vessel in your neck called the vertebral artery

Treatments for Cervical Vertigo

Fortunately, cervical vertigo can typically be managed without surgery. Start by visiting a healthcare provider, who may begin by treating underlying health problems and/or by prescribing medications to relieve symptoms. Muscle relaxers and over-the-counter analgesics like ibuprofen (Advil) or acetaminophen (Tylenol) could help with pain, for example, while a drug like meclizine can help address dizziness.

Another treatment often recommended for cervical vertigo? Exercise, starting with cardio.

“Aerobic exercise is critical and very easy to do on your own,” Dr. Baum says. Activities like walking, running, biking or swimming can reduce inflammation and pain, though it’s important to break a sweat. “True aerobic exercise is getting your heart rate up into the aerobic zone for at least 15 to 30 minutes per session, for at least three to five times per week. That’s really where you start to see the greatest benefit,” he explains.

Strength and balance exercises can ease symptoms, too. Dr. Baum recommends yoga, Pilates and tai chi because they have mindfulness and breathing components as well as proven pain relief benefits. You have to stick with it, though. “It’s the type of thing where you don’t just do it once and you see an effect,” he explains. “You have to have sustained effort for several weeks to really see benefits.” 

Physical therapy is also frequently recommended for building strength, bettering posture and improving neck mobility. Manual therapy, during which a therapist manipulates your muscles and joints with their hands, has been found in studies to be particularly helpful.

Massage may also be beneficial for cervical vertigo, and don’t count out acupuncture. “Acupuncture is something that has been shown to be absolutely beneficial for neck pain, as well as for the treatment of vertigo, regardless of whether it’s cervical in nature or more cranial,” says Dr. Baum.

Interested in seeing a chiropractor? Many people sing their praises, though Baum advises against having quick, forceful adjustments. Why? “There is a small but not zero percent chance of some very devastating consequences from those violent manipulations—namely a vertebral artery or carotid artery dissection, which leads to a stroke,” he explains. Your best bet: Speak with your primary healthcare provider first to check whether it’s the right treatment for you.

On a related note, it’s probably in your best interest to avoid high-impact sports like football, hockey or boxing during recovery. A jolt to the neck could have serious consequences.

Where to Go If You Suspect Cervical Vertigo

If you have neck pain and dizziness, dial a healthcare provider. “The first place to start is always with your primary care doctor,” says Baum. “The service they provide is exceptional, and they’re going to have a more general view.” Do your research and ask questions, he advises. And above all, don’t let your symptoms go unaddressed—because with a correct diagnosis and therapy, you can feel significantly better, soon. 

Updated on: 03/22/21
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Griffin R. Baum, MD
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