Neck pain and dizziness are often connected although many people simply consider themselves to be clumsy, to suffer lightheadedness, or have a poor sense of balance. Cervicogenic dizziness may also be associated with headaches and nausea and can be suggestive of pinched nerves in the neck, cervical spinal stenosis, or even infection. Dizziness with neck pain may be fleeting and mild, with patients realizing that sudden neck movements or certain positions bring about the dizzy spells and neck pain. In other cases the pain can be severe and the dizziness extremely debilitating as it may induce considerable fear of falling, disabling nausea, and/or loss of motor skills. Where a patient has neck pain and feels off balance they may be described as having cervical vertigo and have often experienced some kind of trauma to the neck, such as whiplash or a previous fall.
Whiplash, Neck Pain, and Dizziness
Whiplash sufferers frequently experience cervical vertigo with symptoms of neck pain and dizziness; some estimates put the incidence at 80% of those experiencing such neck trauma. Second only to neck pain, vertigo is a common whiplash complaint with dizzy spells of a few seconds or a few minutes. Extension or rotation of the neck are common triggers for neck pain and dizziness and these symptoms usually suggest that recovery from neck trauma is likely to be slow and that problems may be persistent. Symptoms may not occur instantly after neck trauma and some patients only experience their first wave of dizziness and neck pain a week after suffering whiplash.
Other Causes of Neck Pain and Dizziness
Inner ear problems can also be the cause of neck pain and dizziness, particularly where bone deformation or inflammation are causing pressure in the ear and facial structures. The nervous system function that allows us to be aware of our position and posture is called proprioception and relies upon three small tubes in the ear which are fluid-filled and act like an internal spirit-level. Infection, whether bacterial or viral, and trauma, inflammation, or loss of blood supply (through a stroke, for example), can all compromise the health of the proprioceptive mechanism and damage the nerves in the ear.
Diagnosing Neck Pain and Dizziness
Unfortunately, there are no clear-cut tests for cervicogenic dizziness and, as such, the condition remains somewhat controversial. Those suffering from neck pain, neck injury, and dizziness, where other possible causes of dizziness have been ruled out, may be given a diagnosis of cervicogenic dizziness but the condition is still considered rare. The dizzy spells usually occur after initial neck pain and some people also suffer a headache or loss of balance in general.
Inner ear function is normally tested in cases of neck pain and dizziness to check for abnormalities affecting proprioception. Other tests may involve a Dix-Hallpike maneuver where the head is held still as the body is turned to witness any involuntary eye movement or dizziness. In rare cases a patient may undergo MRI or CT scans to investigate possible brain injury or inner ear trauma. X-Rays may reveal spinal stenosis, pinched nerves in the neck, or even spinal cord compression.
Treating Neck Pain and Dizziness
Many of those suffering from neck pain and dizziness turn to chiropractors to address the problem, especially where conventional medicine has failed to adequately resolve their symptoms. Chiropractic manipulation might involve assessment of the muscles, connective tissues, and joints in the neck and correcting postural imbalance causing nerve compression or circulatory problems. Patients with cervical spondylosis, cervical trauma, and/or neck arthritis might suffer from cervical vertigo; such patients should be particularly cautious over having any physical therapy treatment as inappropriate manipulation of the cervical spine could exacerbate symptoms and cause permanent damage.
Conservative treatment for neck pain and dizziness includes medication, mobilization, neck exercises, and postural re-education. In some cases a patient may be advised to use relaxation techniques to relieve muscle tension which could be contributing to neck pain and nerve compression. Vestibular therapy can help those with inner ear problems in some cases.
Barre-Lieou Syndrome – The Cause of Neck Pain and Dizziness
A frequently missed source of neck pain and dizziness, amongst other symptoms, is Barre-Lieou syndrome, a neurological issue affecting the posterior cervical sympathetic nervous system. This portion of the SNS involves a cluster of nerves at the back of the cervical spine and may be responsible for myriad symptoms such as headache, neck pain, earache, facial pain, jaw and dental pain, tinnitus, dizziness (vertigo), nausea, vision problems, and even sinus issues such as congestion. In severe cases a patient may experience localized swelling in the face, cyanosis of the face and numbness, vocal alterations (hoarseness), and paraesthesia and weakness in the arms and hands. The variety of symptoms illustrates the complex nature of the nervous system in the cervical spine where different branches of an individual nerve can be responsible for innervation of the face, neck, and other area of the body.
The over-sensitization of the sympathetic nervous system in Barre-Leiou syndrome may be diagnosed through thermography to measure circulation in the skin of the face, neck, and upper body. Treatment for this source of neck pain and dizziness will involve attempts to improve blood flow in the area, along with lowering any inflammation, eradicating infection, reducing stress, and ameliorating other contributing factors to the syndrome. Sympathetic nerve blocks may be required for a few patients and those suffering neck pain and dizziness following trauma such as whiplash or other neck injury might consider Barre-Leiou as a diagnosis.