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Cervicogenic Dizziness

What is Cervicogenic Dizziness?

Cervicogenic dizziness is dizziness that may come from a problem in the neck. It can make you feel lightheaded, unsteady, off balance, or “not clear.”

This diagnosis is still debated. Not all experts agree that cervicogenic dizziness is a separate diagnosis, and there is no single test that can prove it. Because of this, a provider usually checks for other more common causes of dizziness first, such as inner ear problems, migraine, or neurological conditions.

What is Happening in My Body?

Your brain uses signals from your neck, eyes, and inner ears to help you stay balanced. If your neck is painful, stiff, or injured, the signals from your neck may not match the signals from your eyes and inner ears. This can make some people feel dizzy or unsteady.

This may happen after:

  • Whiplash
  • A car accident
  • A fall
  • Head or neck injury
  • Neck arthritis
  • Neck muscle or joint problems

Because of this, you may feel:

  • Neck pain
  • Neck stiffness
  • Dizziness
  • Lightheadedness
  • Unsteadiness
  • Disorientation
  • Headaches
  • Symptoms that get worse with neck movement

True room-spinning vertigo is less common with cervicogenic dizziness. If you have spinning vertigo, your provider may check for inner ear problems, such as Benign Paroxysmal Positional Vertigo (BPPV).

It is important to know:

Neck pain and dizziness are both common. Sometimes they are related. Sometimes they are separate problems. Cervicogenic dizziness can take time to diagnose because the symptoms can look like other conditions.

Other causes of dizziness should be ruled out first, such as:

How is Cervicogenic Dizziness Diagnosed?

Cervicogenic dizziness is diagnosed by a trained provider.

Your provider may:

  • Listen to your medical history
  • Ask about your neck pain and dizziness
  • Check your neck movement
  • Check your balance
  • Check your eye movements
  • Look for signs of inner ear problems
  • Rule out more serious causes of dizziness

There is no single test that proves cervicogenic dizziness. It is usually diagnosed after other causes of dizziness have been ruled out.

What Your Provider May Ask

At your appointment, your provider will ask you questions to learn more about your symptoms. To prepare for this, it might be useful to think about, and even write down, your answers to the following questions.

Your provider may ask:

  • Do you have neck pain or stiffness?
  • Did you have a recent neck injury?
  • Have you had whiplash?
  • Do you have neck arthritis or another neck condition?
  • When did the dizziness start?
  • What makes your symptoms worse?
  • How long do your symptoms last?
  • Do you feel room-spinning vertigo?
  • Do you have headaches?
  • Do you have hearing loss or ringing in the ear?
  • Do you have heart or blood pressure problems?
  • Did you start any new medicines?

Tests That May Be Used

Testing depends on your symptoms. Not everyone needs every test. You can talk with your provider about what tests they plan on doing with you.

Your provider may use:

  • Neck exam: checks movement, pain, stiffness, strength, and posture
  • Balance testing: checks how steady you are when standing or walking
  • Eye movement testing: looks for signs of inner ear or brain-related dizziness
  • BPPV testing: checks for a common inner ear cause of spinning vertigo
  • Vestibular testing: may include VNG, ENG, vHIT, caloric testing, or VEMP
  • Hearing test: checks if hearing loss is part of the problem
  • X-ray or MRI: may show arthritis, disc problems, or other neck changes
  • Blood vessel testing: may be used if your provider is concerned about blood flow in the neck or brain

These tests do not always prove cervicogenic dizziness. They help your provider rule out other causes and choose the right treatment.

How is Cervicogenic Dizziness Treated?

Treatment usually focuses on the neck and the balance system.

Physical Therapy for the Neck

Physical therapy may include:

  • Posture education
  • Gentle neck range of motion exercises
  • Neck strengthening
  • Stretching
  • Manual therapy
  • Home exercises

Vestibular Rehabilitation Therapy

Vestibular therapy may help if you also have balance problems or motion sensitivity.

This may include:

  • Eye and head movement exercises
  • Balance exercises
  • Walking exercises
  • Practice with movements that trigger symptoms, done in a safe way

Medication

Your provider may suggest medicine for pain, muscle tightness, nausea, or dizziness. These medicines are often used short term. Use them only as directed by your provider.

What Can I Expect Over Time?

Will I get better?

Most people improve with the right care.

How Long Will It Take?

It may take time to get the right diagnosis. Once treatment starts, many people improve as their neck pain and movement improve. Recovery time is different for each person.

Can I Live a Normal Life?

Yes. Most people return to normal activities. Some people need physical therapy, vestibular therapy, or both.

When Should I Call My Provider?

Call your provider if your dizziness is new, getting worse, or not improving.

Seek urgent medical care right away if you have:

  • New weakness or numbness
  • Trouble walking
  • Trouble speaking
  • Double vision
  • Severe or “worst ever” headache
  • Fainting
  • Chest pain
  • Constant, worsening vertigo
  • New hearing loss
  • Repeated vomiting
  • A fall with head injury

Questions to Ask Your Provider

To learn more about your dizziness and prepare for any potential treatment, it may be helpful to ask:

  • What do you think is causing my dizziness?
  • Could my neck be part of the problem?
  • Have other causes of dizziness been ruled out?
  • Should I do physical therapy for my neck?
  • Do I also need vestibular therapy?
  • Where should I go for therapy?
  • Are there movements I should avoid right now?
  • What symptoms should make me seek urgent care?

Key Points to Remember

  • Cervicogenic dizziness may come from a problem in the neck.
  • It often happens with neck pain, stiffness, or limited neck movement.
  • It can be hard to diagnose because it is often more likely for other conditions can to cause dizziness.
  • Other causes of dizziness should be ruled out first.
  • Physical therapy and vestibular therapy may help.
  • Most people improve with the right treatment.

Additional Resources