Cervicogenic Dizziness

Neck pain often accompanies dizziness, but it may be difficult to tell whether the dizziness and the neck pain are related or just coincidental. In the 1950s, a clinical syndrome of disequilibrium and disorientation in patients with many different diagnoses of neck pathology—including cervical spondylosis, cervical trauma, and cervical arthritis—was introduced as cervical vertigo. Because true spinning vertigo is rarely associated with this syndrome, cervicogenic dizziness is a more accurate name for this syndrome.

Cervicogenic dizziness tends to be a controversial diagnosis, because there are no tests to confirm that it is the cause of the dizziness. The diagnosis is provided to people who have neck injury or pain as well as dizziness and in whom other causes of dizziness have been ruled out.  Although no formal studies have been completed, true cervicogenic dizziness is thought to be rare.

People with cervicogenic dizziness tend to complain of dizziness (a sensation of movement of the self or the environment) that is worse during head movements or after maintaining one head position for a long time. The dizziness usually occurs after the neck pain and may be accompanied by a headache. The symptoms of dizziness usually last minutes to hours. People with cervicogenic dizziness may also complain of general imbalance that may increase with head movements and with movement in the environment.

An evaluation for cervicogenic dizziness involves a thorough medical evaluation. Testing of inner ear function is usually requested to ensure that the peripheral or central vestibular system is intact. A health care practitioner may perform a maneuver in which the body is turned while the head is held fixed to see if it causes nystagmus (eye movements) or dizziness to confirm the suspected diagnosis. This test can also be positive in healthy individuals.

Cervicogenic dizziness often occurs as a result of whiplash or head injury and is often seen in conjunction with brain injury or injury to the inner ear. The majority of patients improve with only treatment of the neck problem. Several studies have reported that approximately 75 percent of patients improve with conservative treatment of the neck such as medication, gentle mobilization, exercise, and instruction in proper posture and use of the neck.Others improve with treatment of the neck problem in addition to vestibular therapy.

From VEDA publication F-17, Cervicogenic Dizziness