Neck Pain And Dizziness: The Inner Ear May Not Be The Cause

If you have neck pain and are also regularly experiencing dizziness, whether when standing up from a seated position, after turning your head quickly, or simply out of nowhere, the first thought you might have is that they are two separate problems. 

Most people will immediately assume that any dizziness they are experiencing is an inner ear problem. After all, the inner ear is responsible for balance, so it makes sense that any dizziness would be related to it. 

Additionally, many doctors will initially diagnose the symptoms as an inner ear problem. It’s worth mentioning that there are several different types of inner ear conditions, including labyrinthitis, perilymph fistula, Meniere’s, and benign paroxysmal positional vertigo, to name a few.

However, the inner ear is not always the cause of dizziness – especially if it occurs in conjunction with neck pain. Your balance system consists of more than just your inner ear – it also consists of your eyes and upper neck joints. Therefore, if the neck component of your balance system is affected, it can result in both neck pain and dizziness.

How The Cervical Spine Is Linked To Neck Pain And Dizziness

To better understand how problems with your neck can result in dizziness, you’ll need to have a general understanding of the anatomy of your cervical spine. The cervical spine is the uppermost part of your spinal column. It consists of seven vertebrae with cushioning discs between each vertebra. 

There are also two joints located at the back of each vertebra called “facet joints”. All these spinal structures, combined with the muscles, ligaments, tendons, and nerves, control the movement in your neck.

If you’re experiencing neck pain and dizziness, it can stem from issues with the upper part of the neck. The nerves in the muscles and facet joints of the cervical spine help provide the upper neck with position-sense information. This allows the upper neck to coordinate with your eyes and inner ear. As a result, multiple systems keep you upright, walking, and level-headed.

All of the input communications between your balance system must sync together for you to maintain normal balance. If they fall out of sync for whatever reason, such as if your upper neck becomes misaligned due to trauma or poor posture, it can result in neck pain and dizziness. 

It’s also worth noting that the facet joints in your cervical spine are served by small medial branch nerves. These nerves transmit pain signals from the back and neck joints to your head, which is why many people experience headaches in conjunction with neck pain and dizziness.

Neck Pain Causes And Their Common Treatment Options

Now that you understand how the upper neck is linked to dizziness, you’ll probably want to know how to address the source of the problem and eliminate your dizziness without resorting to surgery. Surgeries for neck pain and dizziness, such as a cervical fusion, can lead to permanent disability and countless side effects, such as nerve damage and chronic pain. Not to mention, surgery can be expensive and can take a long time to physically (and emotionally) recover from as well, especially if there were complications (such as infections).

When it comes to treating neck pain and dizziness, there are many conventional, non-surgical treatment options. The right treatment option will depend on the cause and severity of the problem. In some cases, physical therapy might be the best choice to rebuild strength and mobility. 

However, in cases where rebuilding strength and mobility won’t address the root issue, alternative treatment options may be more suitable. The following are some of the potential causes of neck pain and ways in which you can treat them:

Trigger Points

Trigger points, also known as “muscle knots”, are areas of pain and tension found in the muscles. They can develop when the nerves supplying your neck muscles become irritated and may be the cause of your neck pain and/or dizziness.

There is a treatment solution called trigger point dry needling, which involves inserting small acupuncture needles into tight or weak muscle knots to stimulate a twitch response in the muscle fibers, essentially causing them to contract and then relax. This, in turn, helps to alleviate pain.

However, you’ll want to avoid steroid or local anesthetic injections into the trigger points, as these can be myotoxic (toxic to the muscle).

Cervical Muscle Atrophy

If you injure your neck, odds are you’ll stop doing the activities and movements that aggravate the injury and cause pain. However, if you stop moving your neck due to the pain, it can result in cervical muscle atrophy, which is the loss of muscle mass due to a lack of physical activity.

If the multifidus (the deep cervical muscles) weakens, then the muscles that help support your neck (which include the trapezius, levator scapula, and scalene muscles) become overloaded. If one side is more overloaded than the other, it can cause one of your shoulders to end up higher than the other, which throws off your body alignment. 

Besides causing neck pain, any issues with the upper cervical spine’s muscles and ligaments can result in dizziness. Additionally, cervical muscle atrophy can cause the occipital nerve (located in your upper trapezius) to become irritated, leading to headaches.

Facet Joints

If you’re experiencing chronic headaches along with dizziness and neck pain, then it could be the result of a damaged facet joint. Facet joints can be damaged due to injury, repetitive movement, poor posture, and even obesity. Fortunately, treating damaged facet joints is relatively easy. 

This can be done by injecting your upper-neck facet joints with a platelet-rich plasma (PRP), which helps promote healing by increasing the number of growth factors in the joint. As a result, this can help reduce pain and inflammation in your neck.

Upper Neck Ligaments

The most common cause of upper neck ligament injuries are with hyperflexion and whiplash injuries. Whiplash is a neck injury due to forceful, rapid back-and-forth whipping motion of the head and neck.  This can happen with a blow to the head, a car accident, or a fall. 

A hyperflexion trauma can injury the ligaments in the back of the neck and an hyperextension trauma can injure ligaments in the front of the neck like the ALL. 

Additionally, certain injuries or diseases, such as rheumatoid arthritis (RA), can cause the upper neck ligaments to become stretched or damaged. This is because RA inflames the membrane that lines the joints, causing fluids to build up in the joints. 

This, in turn, can cause the supporting ligaments to stretch and lose their elasticity and strength. This is known as craniocervical joint instability (CCJ). 

CCJ can cause too much movement of your head and neck, which puts pressure on the nerves and causes pain, dizziness, and headaches. Prolotherapy or PRP injections can help tighten down the ligaments and provide relief. However, severe cases of CCJ may require a more complex injection procedure.

The Risk Of Steroid Injections And Radiofrequency Ablation Procedures For Neck Pain and Dizziness

When treating patients suffering from neck pain and dizziness, many healthcare providers will simply recommend anti-inflammatory steroid injections or radiofrequency ablation (RFA) procedures. Unfortunately, as common as these procedures are, they are incredibly risky. 

For example, not only do steroid injections become less and less effective each time they’re administered, but they are also toxic to stem cells and can lead to all kinds of side effects, such as infection, skin discoloration, scarring, bone loss, blood sugar level spikes, increased blood pressure, and general pain and discomfort.

RFA procedures can also cause negative side effects. The treatment involves using a heated probe to destroy the nerves surrounding the damaged facet joint. The idea of the treatment is that killing those nerves will prevent pain from being transmitted to the brain. 

While some research supports the effectiveness of this procedure for chronic neck pain caused by damaged facet joints, the procedure can cause many other issues. For instance,those nerves that are burned supply the deep neck muscles as well. 

Thus, that can cause more neck instability leading to addittional damage to the facet joint, causing more severe pain once the feeling returns, requiring more frequent long-term treatments as a result.

Speak With A Neck Specialist About Nonsurgical Options

Dizziness isn’t always an inner ear problem, especially if you’re also experiencing neck pain.

Because upper-neck problems can cause both neck pain and dizziness, you should consult an expert in non-surgical neck treatment to address your symptoms. Doing so will ensure you avoid potentially risky treatments, such as steroid injections, RFA procedures, and surgery.