Cervical Vertigo

Cervical vertigo — also called cervicogenic dizziness — involves problems with your neck that cause you to have neck pain and dizziness. Your cervical spine (neck) plays a key role in balance and coordination. But if it’s inflamed, arthritic or injured, it can make you feel lightheaded and unsteady.

This condition can occur following a cervical spine injury, like whiplash. But in most cases, symptoms don’t appear until years after the initial trauma.

Symptoms of cervical vertigo

Cervical vertigo symptoms vary from person to person. They usually involve episodes of dizziness with related neck pain lasting between several minutes and several hours. Other symptoms may include:

• A sensation of floating
• Balance problems
• Cervicogenic headaches
• Lack of coordination or unsteadiness
• Lightheadedness
• Nausea and vomiting
• Neck tightness
• Posture changes
• Trouble with coordination or unsteadiness
• Visual changes, like rapid eye movements and eye strain

Unlike other types of vertigo, cervical vertigo rarely makes you feel like you’re spinning. Instead, most people describe a lightheaded or “floating” sensation.

Cervical vertigo symptoms overlap with symptoms of many vestibular (inner ear) disorders. Your healthcare provider will rule out these conditions before making a diagnosis.

Cervical vertigo causes

Anytime your cervical spine develops an issue, dizziness and other symptoms can occur. Experts are still researching the exact causes, but possibilities include:

• Neck trauma, including whiplash
• Arthritis in your neck (cervical spondylosis)
• Atherosclerosis in your neck
• Cervical degenerative disk disease
• Head injury
• Herniated disks
• Inflammation
• Joint issues
• Muscle strain

Regardless of the cause, stress and anxiety can trigger symptoms. It may be worse when you move your head or hold the same posture for too long.

How doctors diagnose this condition

There aren’t standard tests for diagnosing cervical vertigo. Instead, your healthcare provider will consider your symptoms. They’ll rule out common inner ear conditions that may cause dizziness.

Tests may include:

• Evoked potential tests
• Magnetic resonance angiography
• Magnetic resonance imaging
• Spine X-rays
• Vertebral Doppler ultrasound
• Vertebral angiography
• Vestibular testing

Testing can also help your provider figure out what’s causing cervicogenic dizziness.

How do you fix cervical vertigo?

Your healthcare provider will treat the condition that’s causing cervical vertigo. They may recommend physical therapy (PT), vestibular rehabilitation and medication. Both PT and vestibular rehabilitation often involve exercises that you can learn during a doctor’s visit. Then, you can do them on your own at home.

Physical therapy

Physical therapy can improve your balance and ease neck pain. A physical therapist can guide you through exercises to strengthen your neck muscles and increase your neck’s range of motion. They can improve your cervical spine’s stability, reducing symptoms.

Manual therapy is one of the most common treatments for cervical vertigo. During manual therapy, your physical therapist will use their hands to massage muscles and work with tissue. This can loosen tight areas and improve blood flow, which helps injured tissue heal.

In some cases, you may need to have an adjustment of your neck and spine.

Vestibular rehabilitation

Vestibular rehabilitation includes exercises that improve your balance and reduce dizziness. They can teach your body’s balance system (vestibular system) to adapt to changes in your neck (like an injury), so you don’t feel dizzy. These exercises can help you:

• Coordinate eye and head movements: Uncontrolled eye movements (nystagmus) are a common sign of balance issues. Exercises can help your eyes sync with your head when you move your neck. This helps you feel steady on your feet.
• Maintain balance: Treatment can improve your posture. It can help you maintain stability when you’re walking.
• Manage symptoms better: Your healthcare provider may work with you to trigger symptoms in a safe environment. They can gradually increase the exposure to desensitize your balance system.

Medications

Medications may also be a part of your cervical vertigo treatment plan. These may include:

• Muscle relaxants to reduce neck tightness
• Pain relievers to ease discomfort
• Medicines that reduce dizziness

Your healthcare provider may also recommend medicinal herbs. A recent study found that certain Chinese herbal medicines may reduce pain in cervical vertigo.

When should I see my healthcare provider?

See a provider if you have symptoms that may be cervical vertigo. Cervicogenic dizziness can mimic lots of other conditions. Many of them are inner ear conditions that can interfere with day-to-day living. The sooner you’re diagnosed, the sooner you can find relief.

Seek emergency care if dizziness and vision changes happen alongside signs of a stroke.

What can I expect if I have cervical vertigo?

Most of the time, cervical vertigo is manageable. But just like there isn’t a single cause, there isn’t a single treatment that works for everyone.

Instead, your healthcare provider will recommend treatments based on what’s causing your symptoms. Most people get better with physical therapy and medications.

Will cervical vertigo show on an MRI?

No. But an MRI can show possible causes of your symptoms. For example, it can show neck problems like a slipped disk or arthritis. It can also show likely causes of pain, like a pinched nerve. These test results, along with others, can help your provider rule out other conditions. It can help them arrive at a diagnosis of cervical vertigo.