Cervicogenic Dizziness

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 Cervicogenic dizziness (CGD) is a syndrome characterised by the presence of dizziness and associated neck pain or dysfunction. These symptoms can significantly impact daily life, causing discomfort and reducing overall quality of if left untreated.

There are many causes of dizziness, and the healthcare professional needs to exclude these as part of the diagnosis of CGD. People with CGD often experience dizziness or a light headedness, presyncope, imbalance or unsteadiness. This is closely associated with neck pain, injury, stiffness, or pathology. It is different to true vertigo, which is a false sense that you are moving, or your surrounds are moving around you. CGD will rarely cause vertigo sensations.

The neck joints and muscles, particularly in the upper cervical vertebrae, house specialized nerves - mechanoreceptors and proprioceptive nerve fibres that constantly relay information about head position and movement to the brain. This information is crucial for coordinating muscle activity and maintaining equilibrium. Proprioception from the neck helps in adjusting posture, coordinating eye movements, and responding to changes in the environment. Disruption in this proprioceptive feedback, such as due to cervical spine dysfunction or injury, can lead to balance issues, dizziness, and a sense of unsteadiness.

Diagnosis of CGD can be challenging and involves ruling out other potential causes of dizziness (vestibular, medication related, vascular disorders, dehydration). Diagnosis is made through a thorough clinical examination, and sometimes imaging studies (such as MRI).

Treatment of CGD focuses on addressing the underlying neck dysfunction. This may include manual therapy to improve neck mobility and strength, strengthening and proprioceptive exercises, posture correction, visual and balance exercises, and sometimes medications to manage symptoms.

While more research is needed to establish definitive guidelines, emerging evidence suggests that manual therapy, including osteopathic techniques, can be effective in managing cervicogenic dizziness. Studies have shown improvements in symptoms such as dizziness, neck pain, and overall quality of life following manual therapy interventions. As with any medical condition, it’s essential for individuals experiencing symptoms of cervicogenic dizziness to consult with a qualified healthcare provider for a thorough assessment and personalized treatment plan.

Prognosis varies depending on the underlying cause and individual response to treatment. Many people with cervicogenic dizziness experience improvement with appropriate therapy, although it may take time and a multidisciplinary approach.

  Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo. Li Y, Peng B.Pain Physician. 2015 Jul-Aug;18(4):E583-95.

Manual therapy for cervicogenic dizziness: Long-term outcomes of a randomised trial. Reid SA, Callister R, Snodgrass SJ, Katekar MG, Rivett DA.Man Ther. 2015 Feb;20(1):148-56. doi: 10.1016/j.math.2014.08.003. Epub 2014 Aug 27.