The cervical spine comprises of 7 cervical vertebrae that encompasses the spinal cord as it exits the cranium, 8 cervical spinal nerves that run from the spinal cord, a network of ligaments for bone to bone support along with cervical muscles and tendons to help guide and move the cervical spine.
What is Cervicogenic Dizziness?
Cervicogenic dizziness as defined by Furman and Cass is a ‘non-specific sensation of altered orientation of space and disequilibrium originating from abnormal afferent activity from the neck’ This means that there are abnormal nerve impulses that are being relayed to the brain that gives the sufferer the perception that they are unsteady or slightly off keel.
How do you know if you have cervicogenic dizziness?
There are many causes of dizziness. The 3 most common causes that we see in the clinic are:
1. Benign Paroxysmal Positional Vertigo (BPPV)
2. Vertebrobasilar Insufficiency (VBI)
3. Cervicogenic Dizziness
The first two causes will be the topics of future blogs so we won’t go into a lot of detail with these now. In essence though, the presence of dizziness in these two pathology’s is caused by dizziness on distinct movement patterns or when holding sustained positions through the neck. Clinically we rule out these two causes using specific targeted testing. Once both causes have been excluded, we test further to load the cervical spine, if this reproduces the dizziness then a diagnosis of cervicogenic dizziness can be made.
Dizziness is different from vertigo (the false sensation of spinning) in the perception of movement, though often both are simply referred to as dizziness. Vertigo gives the false sensation of movement of the individual to their environment or the environment to the individual. Where dizziness is the individual’s sensation of unsteadiness with no objective loss of balance. Often these symptoms are akin to light headedness, feely woozy or a fuzzy feeling.
We know that the main cause of vertigo is the vestibular system (inner ear). Dizziness however has many potential causes and cervicogenic dizziness specifically relates to the cervical spine, particularly the upper (top 3 segments) cervical spine.
Cervicogenic dizziness often occurs as a result of whiplash or head injury where there has been damage and inflammation to the structures in the cervical spine. It can also occur slowly due to repetitive overloading of the cervical spine caused from adopting poor postures (forward head positon). It can be seen in conjunction with brain injury or injury to the inner ear however it is difficult to distinguish between causes in these cases and so a diagnosis of cervicogenic dizziness is made in the presence of a neck injury or pain, with the symptom of dizziness, and to whom other causes of dizziness have been ruled out.
The dizzy sensations associated with cervicogenic dizziness are the consequence of a conflict with the information gathered by different postural sensory systems. The alteration of the afferent information of the deep cervical (neck) muscles and the cervical articular proprioceptors (joint sensors) is the pathophysiological basis of cervicogenic dizziness.
Cervicogenic dizziness will usually resolve with treatment of the neck. Clinically we treat with a combination of dry needling, soft tissue release, joint mobilisation and/or manipulation and the use of a deep neck flexor program to improve neck stability and posture. Vestibular rehabilitation may be required for complete resolution if some symptoms remain. In general, the prognosis for patients with cervicogenic dizziness is very good, with 75 percent of patients having improvement in symptoms.
Dizziness of any cause can be debilitating and severely disruptive to our ability to concentrate, so 4 tips to help minimise the risk of developing cervicogenic dizziness:
1. Engage in regular neck mobility exercises – known as chin tucks
2. Engage in regular postural correction exercises using a foam roller
3. Ensure you have your workplace set up to optimise your ergonomics
4. If you experience symptoms make sure you address it early before symptoms intensify.
So that’s a brief overview of how cervicogenic dizziness can occur, If you have questions or comments feel free to e-mail us at firstname.lastname@example.org and we will be happy to answer them for you.
If you think you may already be suffering from neck pain or cervicogenic dizziness, then addressing it sooner rather than later is crucial. So, if you want relief now, call us on (08) 9486 8653 and we will arrange an appointment for you.
Furman JM, Cass SP. Balance Disorders: A Case-Study Approach. 1996:Philadelphia, PA: F.A. Davis Company; 341.