Individuals experienced mild dizziness may not think much of it. Over time, the dizziness intensified, becoming so severe that they were unable to turn over or move their neck. Their mental state deteriorated, and they struggled with poor sleep. In extreme cases, they also suffered from nausea and vomiting. Despite visiting multiple hospitals and consulting with neurology and ENT specialists, as well as undergoing head CT scans, MRIs, and vestibular function tests, no issues were found. Although they took various medications, the dizziness persisted. A period of rest would bring some relief, but the symptoms would significantly worsen upon returning to work, severely impacting their daily life and job performance.
Many people assume that dizziness is solely linked to the eyes, ears, and brain, without realizing that it often stems from misalignment of the first and second cervical vertebrae (the atlantoaxial joint). It can also be related to tension in the suboccipital muscles and dysfunction of the proprioceptors in the muscles at the back of the neck.
In clinical practice, dizziness is regarded as a “challenging condition,” but it is far from “incurable.” The reason many patients fail to find relief is that Western medicine rarely considers cervical spine issues as a cause of dizziness.
Cervicogenic dizziness is directly linked to problems with the cervical spine. Without cervical discomfort, there would be no cervicogenic dizziness. This highlights the importance of considering cervicogenic dizziness in patients who experience dizziness or vertigo alongside neck and shoulder discomfort. Even in the absence of such symptoms, a history of prolonged desk work, chronic neck pain, or cervical spine trauma is often present.
Classification
Dizziness is categorized into true and false types based on its nature. It can also be divided into systemic and non-systemic types based on the site of the lesion. Systemic dizziness includes central and peripheral forms, often related to vestibular system disorders, while non-systemic dizziness may be caused by eye conditions, hypertension, anemia, heart disease, mild neurosis, and other factors.
In modern Western medicine, dizziness is frequently diagnosed as “Meniere’s disease,” “vestibular disorders,” or “cerebrovascular disorders.” It is rarely associated with “cervical spondylosis” or “cervicogenic dizziness.” However, from a physical rehabilitation perspective, dizziness often involves not only the eyes, ears, and brain but also the misalignment of the first and second cervical vertebrae (atlantoaxial joint), tension in the suboccipital muscles, and dysfunction of proprioceptors in the neck muscles.
Symptoms
Dizziness is the primary symptom, commonly appearing in the morning. It may be chronic and persistent or episodic with severe vertigo. It frequently occurs when turning the head, lowering the head, or looking upward. In severe cases, patients may suddenly collapse but remain conscious. Other symptoms include fatigue, lethargy, nausea, vomiting, tinnitus, hearing loss, and visual impairment, often accompanied by neck soreness, stiffness, and headaches.
Examination
Patients typically present with marked tension in the muscles from the neck to the scapular region, with noticeable muscle tightness. Cervical mobility is reduced, and cervical joints may be misaligned. X-rays often reveal changes in the normal cervical curvature, narrowed intervertebral spaces, osteophyte growth, and reduced size of the intervertebral foramina, along with asymmetry in the atlantoaxial joint. Further tests may indicate vertebral artery blood flow obstruction or disc herniation.
Causes
Prolonged desk work, chronic strain, or acute injuries can lead to cervical joint degeneration, misalignment, or disc herniation. These issues may cause sympathetic nerve dysfunction, vertebral artery compression or spasm, and proprioceptive dysfunction in the neck muscles. Dizziness caused by vertebral artery compression is often classified as vertebral artery-type cervical spondylosis, characterized by episodic severe dizziness and sudden falls.
The onset and relief of dizziness are often related to neck positioning. Dizziness tends to worsen with sudden head movements, such as turning, extending, or lowering the head, and improves when returning to a neutral position. Clinically, the specific head and neck positions that trigger or worsen dizziness can help provide a more accurate diagnosis of the underlying cause.
Treatment Approach for Dizziness
In clinical practice, the primary goal of treating dizziness is to relieve vertebral artery compression, sympathetic nerve stimulation, and proprioceptive dysfunction. Manual therapy may consider the following four approaches:
- Primarily using cervical spine micro-adjustment techniques, along with soft tissue release techniques for the cervical spine, to correct upper cervical misalignments that cause twisting or compression of the upper vertebral artery, thus restoring blood flow to the vertebral artery.
- Addressing the pathological signals caused by proprioceptive receptors in the soft tissue at the cervical-occipital junction.
- Correcting lower cervical misalignment that causes high-tension stimulation of the cervical sympathetic chain, and combining it with cervical sympathetic ganglion block therapy to provide immediate relief from dizziness.
- Combining acupuncture, massage, and guiding the patient through appropriate neck exercises to strengthen the neck muscles, enhancing cervical spine stability and addressing the root cause of the problem.
Daily Prevention
Pay Attention to Sleeping Posture
The pillow’s firmness and height should fully consider neck comfort. When lying on your back, the pillow should be placed between the head and shoulders to allow the cervical spine’s natural curve to be properly supported by the mattress.
Pay Attention to Sitting Posture
Ensure the hips are fully in contact with the chair seat, with the back straight and shoulders slightly rotated outward, maintaining the natural physiological curve of the head, neck, shoulders, and chest. Try to sit as close to the workstation as possible and adjust the height of the desk and chair to suit your height, reducing fatigue from long periods of sitting. If the job requires long hours at a desk, it’s best to frequently move the neck. Every hour or so, stand up, walk around, and stretch to reduce tension in the muscles of the head, neck, shoulders, and back.
Keep Warm
In cold weather, take care to keep the neck warm, especially for older adults, as cold exposure can cause the neck’s blood vessels and muscles to contract and stiffen, triggering dizziness. Similarly, in summer, be cautious of air conditioning in indoor environments. The cold air can harm the cervical spine, so it may help to wear a scarf around the neck.
Avoid Trauma
Severe trauma can directly damage the cervical spine, and issues like whiplash from car accidents are often overlooked. Many patients, without noticeable trauma, initially ignore the problem, not realizing that the cervical spine is already injured, laying the foundation for cervicogenic dizziness or even more severe cervical spine diseases. If you experience a fall backward or a sudden neck injury, it is advisable to go to the hospital for an examination promptly.
Pay Attention to Rest
Ensuring sufficient sleep and high-quality sleep is an effective way to combat insomnia, nervous exhaustion, other neurological disorders, and cardiovascular issues. Poor rest can also trigger cervicogenic dizziness.
If you need more information, our great team (chiropractor, physiotherapists, acupuncturists and massage therapists) is here to help you. Please don’t hesitate to reach out to us! Book online or call at (905) 257 – 5888.