Cervicogenic Dizziness: The Underdiagnosed and Misunderstood Cause of Dizziness

Dizziness is a common complaint among patients, and it can stem from a variety of sources. While vertigo, vestibular issues, or neurological conditions are often the first suspects, there’s another cause that frequently flies under the radar: cervicogenic dizziness. Unlike other types of dizziness, cervicogenic dizziness originates from the cervical spine (neck) and is closely linked to musculoskeletal and proprioceptive dysfunction in the neck. Due to its often-overlooked nature, many individuals with cervicogenic dizziness experience prolonged symptoms and challenges in obtaining an accurate diagnosis. Let’s dive into what cervicogenic dizziness is, why it’s commonly misdiagnosed, and how treatment of the neck can help alleviate symptoms.

What Is Cervicogenic Dizziness?

Cervicogenic dizziness is a form of non-vestibular dizziness that arises from issues within the cervical spine. It is typically triggered by abnormal neck movements, posture, or even injury, often leaving individuals feeling unsteady, lightheaded, or as if they’re about to fall. Cervicogenic dizziness is commonly associated with pain and limited movement in the neck, and patients may experience symptoms that are episodic and worsen with certain head or neck movements.

This condition is most commonly seen in individuals who have sustained neck trauma, such as whiplash from a car accident, or those with chronic neck problems due to posture, musculoskeletal imbalances, or arthritis. However, even without these factors, cervicogenic dizziness can still develop due to subtle joint dysfunctions or imbalances in the cervical spine.

Why Cervicogenic Dizziness Is Often Misdiagnosed

Cervicogenic dizziness is often underdiagnosed for several reasons:

1. Non-Specific Symptoms: Dizziness can be a symptom of many different conditions, including vestibular issues (inner ear), neurological disorders, and cardiovascular problems. Cervicogenic dizziness does not have a single hallmark sign, making it difficult to differentiate from other types of dizziness without targeted assessments.
2. Limited Awareness Among Patients and Providers: Many patients and even healthcare providers aren’t aware that cervical spine dysfunction can lead to dizziness. Often, patients are evaluated extensively for vestibular and neurological issues, only to find no clear cause. As a result, cervicogenic dizziness may be overlooked, leading to prolonged symptoms.
3. Overlap with Other Conditions: Cervicogenic dizziness often coexists with other conditions, such as migraines, temporomandibular joint (TMJ) disorders, or inner ear issues, further complicating diagnosis. Patients with a history of neck trauma or chronic neck issues may develop vestibular and musculoskeletal problems simultaneously, making it difficult to isolate cervicogenic dizziness as the primary cause.

The Cervical Spine’s Role in Balance and Spatial Awareness

The cervical spine plays an integral role in balance and spatial awareness through its relationship with the brain and vestibular system. Sensory input from the neck muscles and joints communicates with the brainstem and cerebellum, helping us stay oriented and maintain balance. When there’s dysfunction in the cervical spine, this communication can become disrupted, leading to a mismatch in the brain’s interpretation of body position and movement, thus causing dizziness.

In cervicogenic dizziness, this miscommunication often stems from:

Joint Dysfunction: When the vertebrae in the cervical spine are not moving optimally, it can interfere with normal proprioceptive signals.
Muscle Tension and Imbalance: Tight or imbalanced neck muscles can also alter proprioceptive signals, which impacts balance.
Ligament Strain or Inflammation: Strain in the neck’s soft tissues can trigger abnormal proprioceptive feedback to the brain, resulting in dizziness.

Diagnosing Cervicogenic Dizziness

Diagnosing cervicogenic dizziness requires a multifaceted approach that often includes ruling out other causes of dizziness. Comprehensive physical exams, cervical range-of-motion testing, and proprioceptive assessments are valuable. Specific tests may include:

Joint Mobility Assessment: A chiropractor or manual therapist can assess the movement of each cervical joint to identify areas of dysfunction.
Proprioceptive Testing: Testing for sensory feedback accuracy from the neck, including head repositioning accuracy tests, can help pinpoint discrepancies.
Cervical Vibration Testing: Application of vibration to the cervical region can sometimes reproduce dizziness in those with cervicogenic causes.

Ruling out vestibular causes, inner ear issues, and neurological disorders is essential before confirming a diagnosis of cervicogenic dizziness.

Effective Treatments for Cervicogenic Dizziness

Once cervicogenic dizziness has been identified as the likely cause of symptoms, various treatment approaches can help manage and alleviate the condition. These include:

1. Chiropractic Adjustments: Gentle, targeted adjustments can help restore proper joint movement in the cervical spine. Addressing joint restrictions can alleviate proprioceptive mismatches, reducing dizziness symptoms.
2. Soft Tissue Therapy: Myofascial release, Graston technique, and trigger point therapy can release muscle tension and address imbalances that may be contributing to altered sensory feedback from the neck.
3. Ocular, Proprioceptive Training and Balance Exercises: Exercises that retrain the proprioceptive feedback loop, including targeted neck movements and balance work, can enhance stability and reduce dizziness. Incorporating exercises that improve neck mobility and coordination with the eyes can also help to reestablish accurate sensory input.
4. Postural Correction and Ergonomic Training: Improving posture and ensuring proper ergonomic setups in daily activities can reduce neck strain, preventing further proprioceptive issues that can lead to dizziness. Specific postural exercises are often incorporated into treatment to build strength and flexibility in the neck, shoulders, and upper back.
5. Laser and Vibration Therapies: Class 3B or 4 laser therapy, as well as vibration-based therapies, have shown promise in reducing inflammation, improving muscle tone, and optimizing neuromuscular function in the neck. These can complement adjustments and exercise in relieving cervicogenic dizziness.

Living with Cervicogenic Dizziness: Self-Care and Prevention

While treatment from professionals is essential, self-care practices can further help manage and prevent cervicogenic dizziness. These include regular neck and shoulder stretching, maintaining good posture, and engaging in low-impact aerobic exercises to enhance circulation and reduce tension. Staying mindful of neck strain, especially during activities like prolonged computer work, can also make a significant difference.

Closing Thoughts

Cervicogenic dizziness is an underdiagnosed and often misunderstood condition that can have a significant impact on quality of life. Patients with unexplained dizziness may benefit from a closer examination of their cervical spine function, especially if they have a history of neck pain or trauma. Fortunately, conservative treatments such as chiropractic care, physical rehabilitation, and proprioceptive training can significantly reduce symptoms. By improving awareness of cervicogenic dizziness and its effective treatments, patients and healthcare providers alike can take steps toward accurate diagnosis and successful management, providing relief to those affected by this often-overlooked condition.

If you or someone you know is experiencing unexplained dizziness, especially with accompanying neck pain, consider consulting with a Calibration Chiropractic + Functional Health. Contact our office in Mansfield, Texas, by calling (817) 779-3435 to schedule a consultation because cervicogenic dizziness may be the missing link to finding the relief you've been seeking.

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