Neck Pain and Dizziness

Each year many people suffer from neck pain and dizziness. The number of patients who visit their doctor and the emergency room for dizziness is on the rise.  Dizziness accounts for 7% of doctor visits for people over the age of 45 and is the leading reason to see a doctor in those over the age of 65.  Most people with dizziness are looking for a straightforward diagnosis.  However,  those who present to the emergency department only receive a confirmatory diagnosis in 49.2% of cases.  The purpose of this article is to describe how a physical therapist examines a person suffering from one particular form of dizziness called cervicogenic dizziness.

Cervicogenic dizziness occurs as a result of pain originating from the neck or cervical spine. This occurs because of faulty signaling from the neck to the brain about where your head is in space.  This faulty signaling results in the sensation of dizziness. There is no gold standard test for this type of dizziness.  Instead, the diagnosis is made by excluding other causes of dizziness ranging from cardiovascular causes to metabolic causes, and inner ear causes.

Examination of the Patient with Dizziness

When performing an examination for a person with dizziness there is a 5 step process.  Part 1 includes listening to the patient’s history and determining if their symptoms are consistent with cervicogenic dizziness . Next, part 2 includes testing to see if this patient is appropriate for physical therapy.  Part 3 includes testing the inner ear. The inner ear, or vestibular system, consists of structures connecting with your brain which tell your head where it is in space.  Finally, steps 4 and 5 involve testing the cervical spine.

Testing of the cervical spine may include testing range of motion of the neck, strength of deep neck muscles, and performing a variety of special tests. These tests may include tests for motor control, the neck’s awareness of position sense and the mobility of each vertebra in your neck.  Oftentimes, an examination of one spinal vertebra (shown below) will reproduce the person’s complaints of dizziness.  A treatment plan is developed based on the results of these tests.

neck pain

Treatment of Neck Pain and Dizziness

There are various research papers showing manual physical therapy and exercise reduces neck pain and dizziness. The videos below illustrate two of these exercises.  Thankfully, research shows a year after physical therapy patients who complete these programs are able to maintain their improvements.

Final Thoughts on Neck Pain and Dizziness

Cervicogenic Dizziness is a condition described as neck pain and dizziness originating from the cervical spine. The diagnosis is made by first ruling out other problems.  Successful treatment includes manual physical therapy and exercise.  Thankfully, when a proper diagnosis is made by your physical therapist, this simple approach significantly reduces neck pain and dizziness.  Contact us today if you have neck pain and dizziness or simply have questions about which treatments are right for you.