When people experience dizziness, they often think of inner ear problems or blood pressure. But another common and often missed cause is the neck. Known as cervicogenic dizziness, this condition occurs when dysfunction in the neck affects your sense of balance and spatial awareness.
At North Coast Head Neck & Jaw Centre, from our Ballina and Lismore clinics, we regularly see patients from across the Northern Rivers dealing with dizziness that has not improved with other treatments. In many cases, the neck plays a bigger role than they realise.
What is cervicogenic dizziness
Cervicogenic dizziness is a type of imbalance or unsteadiness that arises from issues in the cervical spine, the upper part of your neck. This area contains joints, muscles and nerves that provide important information to the brain about where your head is in space.
Balance depends on three sources of information agreeing with each other: the inner ear, the eyes, and the position sensors in the joints and muscles of the upper neck. The upper neck is especially rich in these sensors, because the brain needs to know exactly where the head is relative to the body.
When the upper neck is stiff, injured or in spasm, the information it sends becomes inaccurate. The brain receives a signal from the neck that does not match what the ears and eyes are reporting, and the mismatch is experienced as dizziness, disorientation or a sense of floating or swaying.
How it typically feels
- Unsteadiness, lightheadedness or a floating feeling rather than spinning
- Dizziness that comes with neck pain or stiffness, or follows neck movement
- Worse after sitting at a desk, driving, or holding the head in one position
- Episodes lasting minutes to hours rather than seconds
- Often begins after a whiplash injury, a fall, or a period of neck pain
- Sometimes with headache at the base of the skull, or visual disturbance
It is different from BPPV, the common inner ear cause, which produces brief spinning triggered by rolling over in bed or looking up, and from vestibular conditions that come with hearing changes or ringing.
What causes it
Cervicogenic dizziness can be linked to several underlying issues:
- Whiplash or neck trauma
- Poor posture, especially with prolonged screen use
- Muscle tension and joint stiffness
- Degeneration or arthritis in the cervical spine
- Compensations after concussion
Because these problems interfere with the position sense your brain relies on, it receives mixed messages and balance suffers.
How it is assessed
There is no single test for cervicogenic dizziness, which makes it harder to diagnose. Because dizziness has several possible sources, assessment has to rule things in and out. We take a detailed history of how the dizziness feels, what triggers it, how long episodes last and what else is going on.
We then assess the upper neck for stiffness, tenderness and movement, test whether neck movement reproduces the symptoms, and screen the inner ear and balance systems so that an ear problem is not missed. If we think the ear or something else is the cause, we will say so and point you to the right person.
Treatment
Where the neck is the source, treatment is aimed at how the neck moves and how accurately it reports position. It may include:
- Gentle joint mobilisation to improve neck movement
- Soft tissue work to release muscle tension
- Exercises to retrain the neck’s position sense and balance
- Postural correction and ergonomic advice
- Support for related conditions such as headaches or jaw tension
We also look at the habits and postures that keep the neck loaded. Most people notice the link between their neck and their dizziness fairly quickly once it is pointed out, and that awareness is part of the treatment.
Dizziness assessment in Ballina and Lismore
Neck-related dizziness is easy to miss, and easy to live with for years once the ear has been cleared. If your dizziness comes with a stiff neck and no one has looked at the connection, it is worth having assessed. You can see our osteopath in Ballina or our osteopath in Lismore; read more on our dizziness and vertigo page.