Neck pain and dizziness can be problematic and significantly impact one’s function and quality of life. What is the association between neck pain and dizziness? What is cervical vertigo? What are the treatment options for neck pain and dizziness? Which treatment options for neck pain and dizziness should you avoid? Let’s dig in.
The Balance System
Our body’s balancing system is compromised of three separate systems that work closely together to keep the body in balance: the eyes, inner ear, and upper cervical spine. The upper cervical spine contains and processes information about your position in space and communicates this information to your eyes and inner ears via nerves. There is a constant highway of electrical signals between the cervical spine, inner ear, and eyes that keep us upright, make us aware of our position and enable us to walk, move and run. This balancing system requires the inner ear, eyes and cervical spine to be operational at a high level so that vital information can be exchanged and processed between the three systems (1).
When there is a weak link in the balancing system, the communication between the eyes, inner ears, and cervical spine can be compromised and dizziness may occur. Injuries to the neck can wreak havoc on this complex and delicate system. Facet joints in the cervical spine play a big role in the balancing system in addition to providing support to the spine. They have a rich supply of pain and positional fibers. Cervical facets can be injured as a result of trauma, degeneration or surgery and can be a major source of neck and headache pain (2).
What Is Cervical Vertigo? (Neck Dizziness)
Cervical vertigo is a medical condition in which dizziness originates from the neck and is characterized by the presence of imbalance, unsteadiness, disorientation, neck pain and limited range of motion (3) The dizziness can be closely related to changes in the position of the neck.
To better understand the connection between neck pain and dizziness please click on the video below
Can Cervical Neck Pain Cause Dizziness?
Yes! The balance system is a complex and delicate system that requires the inner ear, eyes and cervical spine to be fully functional and operating at a high level so that vital information can be exchanged and processed. Injury to the cervical facets, discs, and ligaments can cause pain and interrupt or compromise this complex and delicate balance system (4). Neck pain can indeed cause dizziness and regrettably, this is poorly understood and missed by many providers. Patients often continue to suffer from dizziness or are put through the extensive inner ear and eye tests without any investigation of their neck pain and its relationship to their dizziness.
Treatment Options for Neck Pain and Dizziness
Identifying and addressing the source of the upper neck pain is key to reducing the pain and eliminating the dizziness. Neck muscles, ligaments and cervical facets can cause neck pain and dizziness. Treatment options for neck pain and accompanying dizziness include trigger point injections without steroids, physical therapy and massage. When conservative treatment options fail, cervical facet injections have been demonstrated to be effective (5).
The Centeno-Schultz Clinic has extensive experience in the treatment of neck pain and dizziness with PRP and bone marrow-derived stem cells (6). This is a highly-skilled, complex procedure that your local doctor or orthopedic specialist cannot perform. Click on the video below to watch the procedure.
Can a Pinched Nerve in Your Neck Cause Dizziness?
Yes! A pinched or irritated nerve in the neck can compromise the complex and delicate balance system. The inner ear, eyes, and neck must all be functioning at a high level so that vital information can be transmitted and processed. A pinched nerve can wreak havoc on this system with resultant dizziness and neck pain.
Treatments to Avoid for Neck and Dizziness
Steroids have a significant number of side effects which include increased risk of bone death (avascular necrosis), weaken tendons (7) and killing off a percentage of the local healing stem cells (8).
Radiofrequency ablation is a nerve destruction procedure that damages an important nerve to the facet joint and can cause atrophy of the supporting muscles (9).
Cervical fusion is a surgical procedure where two or more cervical vertebra are bolted together with hardware and or bone. There are significant complications associated with cervical fusion which include, infection, failure to fuse and adjacent segment disease (10).
The balance system is compromised for three principles systems: the inner ear, the eyes and the cervical spine. The three systems transmit, share, and process critical information constantly which allows us to be upright and to function. All three systems must be functional at a high level and communicate with each other. Injury to the neck can compromise this delicate and complex system and result in dizziness. Cervical facet joints are a common site of injury and can cause dizziness. Neck pain and dizziness are common and need to be part of any dizziness evaluation. Treatment options to avoid include surgery, radiofrequency ablation and steroids. Platelet-rich plasma is an effective treatment option for neck pain and dizziness.
1.Kristjansson E, Treleaven J. Sensorimotor function and dizziness in neck pain: implications for assessment and management. J Orthop Sports Phys Ther. 2009;39(5):364-77.DOI: 10.2519/jospt.2009.2834
2. Schofferman J, Bogduk N, Slosar P. Chronic whiplash and whiplash-associated disorders: an evidence-based approach. J Am Acad Orthop Surg. 2007;15(10):596-606.
3. Reiley AS, Vickory FM, Funderburg SE, Cesario RA, Clendaniel RA. How to diagnose cervicogenic dizziness. Arch Physiother. 2017;7:12. doi: 10.1186/s40945-017-0040-x
4. Peng B. Cervical Vertigo: Historical Reviews and Advances. World Neurosurg. 2018;109:347-50.DOI: 10.1016/j.wneu.2017.10.063
5. Hahn T, Halatsch ME, Wirtz C, Klessinger S. Response to Cervical Medial Branch Blocks In Patients with Cervicogenic Vertigo. Pain Physician. 2018;21(3):285-94.
6. Cameron JA, Thielen KM (2017) Autologous Platelet Rich Plasma for Neck and Lower Back Pain Secondary to Spinal Disc Herniation: Midterm Results. Spine Res. Vol. 3 No. 2:10 doi: 10.21767/2471-8173.100030
7. .Zhang J, Keenan C, Wang JH. The effects of dexamethasone on human patellar tendon stem cells: implications for dexamethasone treatment of tendon injury. J Orthop Res. 2013;31(1):105-10.DOI: 10.1002/jor.22193
8. Zhang J, Keenan C, Wang JH. The effects of dexamethasone on human patellar tendon stem cells: implications for dexamethasone treatment of tendon injury. J Orthop Res. 2013;31(1):105-10.DOI: 10.1002/jor.22193
9. Dreyfuss P, Stout A, Aprill C, Pollei S, Johnson B, Bogduk N. The significance of multifidus atrophy after successful radiofrequency neurotomy for low back pain. PM R. 2009;1(8):719-22.DOI: 10.1016/j.pmrj.2009.05.014
10.Kong L, Cao J, Wang L, Shen Y. Prevalence of adjacent segment disease following cervical spine surgery: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2016;95(27):e4171. doi: 10.1097/MD.0000000000004171