The second article in our series on dizziness and vertigo focuses on dizziness, specifically cervicogenic dizziness. Before we start, I feel it is important to make a distinction between the terms dizziness and vertigo, as many people use them interchangeably even though they are two different symptoms. Vertigo is a feeling that the room is spinning around you whereas dizziness is described as feeling faint, woozy, weak, or unsteady. The key difference between the two is the spinning sensation. Cervicogenic dizziness is a condition commonly seen in our clinic that with treatment can be quickly and effectively resolved.
Cervicogenic dizziness is thought to result from improper information being relayed to the brain from the joints and muscles in the neck.1,2Research has shown for some time that like the vestibular system, the neck plays a important role in hand-eye coordination, balance, and posture.1,3It therefore makes sense that dysfunction or problems with the neck will result in improper input to the brain, which can sometimes be interpreted as dizziness. In addition to dizziness patients with this condition will generally experience unsteadiness with walking, as well as neck pain, or headache. People with a history of head trauma, neck arthritis, and disc herniation are more likely to experience cervicogenic dizziness.1
Unlike benign paroxysmal positional vertigo (BPPV) which generally resolves in 30-60 seconds, symptoms of cervicogenic dizziness last from minutes to hours.1There may not be a specific direction of neck movement that brings on dizziness, but neck movement in general. When a person has BPPV they can usually identify a specific movement that provokes symptoms, for example rolling to the left in bed. Because there is not one specific provoking movement and there are not any reliable clinical tests to diagnose cervicogenic dizziness, it is generally a bit harder to identify. Diagnosis of this condition is made by exclusion1, meaning no other cause of these symptoms have been identified, including stroke, BPPV, or Meniere’s disease.
Once a proper diagnosis has been made appropriate treatment can be provided. In our clinic we have found interventions that focus on the restoration of normal neck movement including stretches, soft tissue work (massage/fascial manipulation), and postural retraining to be very effective in improving and resolving symptoms of dizziness. Many times, throughout the course of therapy, we will also see notable improvement in associated symptoms including neck stiffness, neck pain, and headache. The best part is many times significant changes in symptoms can be achieved in just a few visits. With that being said, it may take longer to achieve changes in symptoms that have a longer history. It is therefore imperative to seek prompt treatment when symptoms first arise.
If you or someone you know is experiencing the symptoms we have described but are unsure if physical therapy is appropriate, we are here to help and offer free phone consultations and fifteen-minute screenings. Please feel free to contact either our Harrisonburg or Broadway office to schedule a screening or consultation.
Thank you for taking the time to read this article. I want to briefly conclude with what is arguably the most important take away from this article series. Although symptoms of dizziness and vertigo may arise from the conditions we discussed, they may also be symptoms of more serious medical conditions that require immediate medical attention. With that being said, the following signs/symptoms are important to keep in mind to avoid improper handling of a serious medical condition. These signs/symptoms include: constant vertigo (spinning), the feeling of being pushed to one side, facial asymmetry, problems swallowing, problems speaking, loss of consciousness, unexplained falls, changes in sensation, and upper eyelid drooping. If any of these signs or symptoms are present the person experiencing them should seek immediate medical care at an emergency department.1
- Wrisley, D. M., Sparto, P. J., Whitney, S. L., & Furman, J. M. (2000). Cervicogenic dizziness: a review of diagnosis and treatment. Journal of Orthopaedic & Sports Physical Therapy, 30(12), 755-766.
- Furman, J. M., & Cass, S. P. (1996). Balance disorders: a case-study approach. Philadelphia, PA: FA Davis.
- Brown, J. J. (1992). Cervical contribution to balance: Cervical vertigo. The Head Neck Sensory Motor System., 644-647.