Cervicogenic Dizziness

What is Cervicogenic Dizziness?

Cervicogenic dizziness is a complex condition characterized by dizziness or vertigo that arises from dysfunction or pathology in the cervical spine (neck). Unlike other forms of dizziness, such as vestibular or central, which originate from inner ear or brain issues, cervicogenic dizziness is believed to stem from neck problems. However, the exact mechanisms underlying this condition are not fully understood. Cervicogenic dizziness is also referred to as cervical vertigo, proprioceptive vertigo, cervicogenic vertigo, and cervical dizziness.

Symptoms of cervicogenic dizziness can differ from person to person. Some of the most common symptoms of cervicogenic dizziness are; 

• Dizziness 
• Lightheadedness 
• Postural Imbalance with neck pain 
• Unsteadiness of gait 
• Cervical pain 
• Reduced cervical range of motion/stiffness 

• Degenerative Conditions: Conditions such as cervical spondylosis or arthritis in the neck can also be contributing factors. 
• Neck Injury: Previous neck trauma, such as a whiplash injury from a car accident, can lead to cervicogenic dizziness. 
• Poor Posture: Prolonged periods of poor posture, such as sitting at a desk with improper ergonomics, can strain the neck and contribute to symptoms. 
• Muscle Tension: Tension in the neck muscles, often due to stress or overuse, can lead to cervicogenic dizziness. 
• Vascular disorders: such as rotational vertebral artery vertigo (also known as bow-hunter’s syndrome), involve a condition where turning the head to one side restricts blood flow in the vertebral artery, leading to a temporary reduction in blood supply to the brain. 

There are no “gold standard” diagnostic tests to identify cervicogenic dizziness as well as no definitive treatment progression. Diagnosis of cervicogenic dizziness is often considered a diagnosis of exclusion.

• Medical History and Physical Examination: A doctor will typically start by taking a detailed medical history and performing a physical examination, focusing on the neck and balance. 
• Diagnostic Tests: This may include imaging tests such as MRI or CT scans to assess the structure of the cervical spine. 
• Cervical Provocation Tests: Specialized tests may be performed to reproduce symptoms by manipulating the neck in certain positions. 
• Hearing and vestibular function tests to rule out other possible causes 

Cervicogenic dizziness often responds well to conservative treatment targeting the neck, but for some individuals, a combination of neck treatment and Vestibular Rehabilitation Therapy is necessary for optimal results. Research indicates that approximately 75% of patients experience improvement with conservative neck treatment, such as gentle mobilizations, exercises, and posture correction. However, for those who continue to experience dizziness despite neck treatment, incorporating vestibular rehabilitation exercises is essential. 

Here are some common treatment strategies: 

• Physical Therapy: Physical therapy is often a cornerstone of treatment. Therapists may employ various techniques such as manual therapy, exercises to improve neck strength and flexibility, postural training, and balance exercises. 

• Postural Correction: Correcting poor posture habits can alleviate strain on the neck and reduce dizziness. Ergonomic adjustments may be recommended for workstations and daily activities. 

• Medications: In some cases, medications such as muscle relaxants or nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to alleviate pain and inflammation associated with cervicogenic dizziness. 

• Modalities: Modalities like heat, ice, ultrasound, or electrical stimulation may be used to reduce pain and promote healing in the cervical spine. 

• Lifestyle Modifications: Avoiding activities or movements that exacerbate symptoms, maintaining proper hydration, and managing stress can all contribute to symptom management. 

• Vestibular Rehabilitation Therapy: If the dizziness persists even after physical therapy.