Cervicogenic Dizziness and Vertigo: Causes and Solutions

Balance issues, dizziness, and vertigo can be incredibly disruptive, affecting daily life and making even simple tasks feel overwhelming. One often-overlooked cause of these symptoms is cervicogenic dizziness and vertigo—a condition linked to dysfunction in the upper cervical spine. Unlike inner ear-related vertigo, cervicogenic dizziness and vertigo arise from mechanical issues in the neck that disrupt communication between the brain, eyes, and vestibular system.

What is Cervicogenic Dizziness and Vertigo?

Cervicogenic dizziness and vertigo originate from problems in the cervical spine, particularly in the upper neck where nerve signals from the body integrate with the brainstem. These issues can result from poor posture, whiplash injuries, concussions, or chronic neck tension. The brain relies on accurate information from the neck to maintain balance, and when the signals become distorted, dizziness and vertigo can follow.

Symptoms of Cervicogenic Dizziness and Vertigo

• Unsteady or spinning sensations, especially when moving the head
• Neck pain and stiffness
• Headaches, often at the base of the skull
• Visual disturbances or difficulty focusing
• Nausea and disorientation

The Role of the Vestibular System in Balance

The vestibular system is a complex set of structures located in the inner ear that helps the brain understand and maintain balance. It plays a key role in detecting changes in head movement and orientation relative to gravity. The system includes the semicircular canals, otolith organs, and the vestibular nerve. Together, these structures provide essential information about spatial orientation, motion, and equilibrium.

In addition to the vestibular system, the brain relies on visual input from the eyes and proprioceptive input from the neck and body to maintain balance. This means that when your head moves, your inner ear detects that movement and sends a signal to the brain, which then processes the information and adjusts accordingly. The eyes play a complementary role, helping the brain adjust for any movement that occurs.

However, when one of these systems is impaired—due to injury, neurological dysfunction, or musculoskeletal issues—it can cause confusion and disruption in the brain’s balance processing, leading to the feelings of dizziness or imbalance. The goal of rehabilitation is to retrain the brain to process these signals more efficiently and effectively.

If you are looking for best upper cervical chiropractors in Spokane to help with issues related to an atlas misalignment, cervicogenic dizziness and vertigo, contact our office at 509-315-8166 to request an appointment.

Understanding the Causes of Balance Disorders

Balance disorders can stem from a variety of causes, and often multiple factors contribute to the issue. Some common causes include:

1. Vestibular Disorders: Conditions like benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Meniere’s disease can disrupt the inner ear’s ability to detect motion and orientation.

2. Neck Issues: Dysfunction or injury to the upper cervical spine (the neck) can affect the proprioceptive signals that the brain uses to maintain balance. This is often seen in people who have experienced whiplash or other neck injuries.

3. Visual Problems: Conditions such as astigmatism or double vision can make it difficult for the brain to integrate visual information properly, leading to balance issues.

4. Concussions or Head Injuries: Traumatic brain injuries (TBI) can have long-lasting effects on balance and coordination. After a concussion, the brain may struggle to interpret signals from the vestibular system, eyes, and neck.

5. Stress and Anxiety: Emotional stress and anxiety can exacerbate balance issues by triggering or amplifying physical symptoms. Stress can cause muscular tension, which in turn may disrupt the proprioceptive feedback needed for balance.

These are just a few of the potential causes, but the important thing to note is that balance issues are rarely caused by a single factor. For many people, the root cause is multifactorial, with several contributing factors working together.

The Blair Technique for Cervicogenic Dizziness and Vertigo

Cervicogenic dizziness and vertigo are conditions that often stem from dysfunction in the upper cervical spine. The Blair Upper Cervical Technique is a precise, non-manipulative approach used to diagnose and correct misalignments in the upper neck, which can contribute to these balance-related issues.

Blair practitioners use a combination of patient history, physical examination, and advanced imaging to determine if upper cervical misalignment is contributing to dizziness and vertigo symptoms. The diagnostic process includes:

• Patient History & Symptom Evaluation: We assess when dizziness occurs, what triggers it, and whether there are accompanying symptoms such as neck pain, headaches, or visual disturbances.
• Blair Upper Cervical Palpation & Motion Testing: Gentle tests assess joint function, helping to pinpoint restrictions and asymmetries in the upper cervical spine.
• Blair-Specific X-Rays or CBCT Imaging: Unlike standard X-rays, Blair imaging takes customized views of the atlas (C1) and axis (C2) based on the patient’s anatomy. This allows us to see misalignments that could be affecting the brainstem, vestibular pathways, and overall neurological function.
• Infrared Thermography or Neurological Scanning: Some practitioners use thermography or computerized scans to assess nervous system function and determine if a correction is needed.

Blair Upper Cervical Treatment for Cervicogenic Dizziness and Vertigo

Once a misalignment is identified, a precise, customized correction is made. This process includes:

• Gentle, Non-Manipulative Adjustment: Unlike general chiropractic manipulation, Blair corrections are low-force and tailored to the patient’s unique misalignment. There is no twisting or cracking.
• Post-Adjustment Rest Period: Patients rest for a short time to allow the correction to stabilize, ensuring the nervous system adapts properly.
• Follow-Up and Stability Monitoring: Regular check-ups assess whether the correction is holding. If the alignment remains stable, fewer adjustments are needed over time.

By restoring proper cervical alignment, the nervous system can regain optimal function, allowing the brainstem, vestibular system, and cervical proprioceptors to communicate correctly. This often leads to significant reductions in dizziness, vertigo, and balance disturbances.

If you or someone you know is struggling with cervicogenic dizziness and vertigo, consider consulting a Blair Upper Cervical Chiropractor to determine if an upper neck misalignment could be the root cause. A precise, individualized approach may be the key to lasting relief.

 

The Process of Retraining the Brain

The key to overcoming balance disorders is rehabilitation—a process that involves retraining the brain to process sensory input correctly and efficiently. One of the most effective methods for balance rehabilitation is vestibular rehabilitation therapy (VRT). VRT consists of exercises designed to stimulate and challenge the vestibular system, helping to reestablish its connection with the brain.

In addition to VRT, upper cervical chiropractic care can be beneficial, particularly for those who have issues with neck misalignment or injury. Upper cervical chiropractors use specialized techniques to correct misalignments in the upper cervical spine, which can help restore proper proprioceptive feedback and reduce balance issues.

Both approaches work together to improve the brain’s ability to integrate and process signals from the vestibular system, eyes, and neck. Through consistent practice and gradual progression, the brain learns to process these signals correctly, resulting in improved balance and stability.

Vestibulo-Ocular Reflex (VOR) Exercises for Balance

One of the foundational concepts in vestibular rehabilitation is the vestibulo-ocular reflex (VOR). The VOR is a reflex that stabilizes vision during head movements by coordinating eye movement with head movement. When you turn your head, the VOR ensures that your eyes continue to focus on an object, even as your head moves. The goal of VOR exercises is to retrain the brain and vestibular system to properly coordinate these movements.

Below, I’ll walk you through three basic VOR exercises designed to improve balance and retrain the brain. These exercises are intended to be used as part of a comprehensive rehabilitation program and should be performed under the supervision of a qualified professional.

VOR Exercise 1: Head Turns with Visual Fixation

For this exercise, you’ll need to hold your thumb out in front of you, just as shown in the video. Keep your eyes locked on your thumbnail while you slowly turn your head from side to side. The objective is to maintain focus on the thumb without letting your gaze waver.

• Instructions:

  1. Hold your thumb out in front of you at eye level.

  2. Focus on the thumbnail.

  3. Slowly turn your head side to side, keeping your eyes fixed on the thumb.

  4. Perform 10 to 20 repetitions per side.

It’s common to feel a slight dizziness or imbalance while performing this exercise, especially in the early stages. This is a sign that your brain is being challenged and retrained. Just like working out a muscle, it’s normal to experience temporary discomfort. However, any dizziness or imbalance should subside within 20 to 30 minutes. If it persists for longer, consult a specialist.

Tip: Start by performing this exercise seated. As your balance improves, you can progress to standing and, eventually, standing on a pillow to increase the challenge.

VOR Exercise 2: Eye-Head Coordination

In this exercise, you’ll be moving your eyes and head independently of each other. The goal is to train the brain to process these movements separately.

• Instructions:

  1. Hold both thumbs out at shoulder width so that you cannot see both at the same time.

  2. Focus on one thumb with just your eyes.

  3. Turn your head to follow the thumb with your eyes.

  4. Repeat in the opposite direction—eyes first, then head.

  5. Perform 10 to 20 repetitions per side.

This exercise is designed to improve the coordination between your eyes, neck, and inner ear. It trains your brain to allow these systems to move independently, which is essential for improving balance and spatial orientation.

VOR Exercise 3: Coordinated Head and Hand Movements

In this advanced exercise, you will be coordinating the movement of your head and thumb. The goal is for both your thumb and head to move in sync.

• Instructions:

  1. Hold your thumb out in front of you.

  2. Move your thumb and head together in the same direction.

  3. Repeat the movement from side to side.

  4. Perform 10 to 20 repetitions per side.

This exercise is designed to challenge the brain’s ability to integrate and coordinate sensory information, which is crucial for balance. It requires more advanced coordination between the inner ear, eyes, and neck.

Progressing the Exercises

The difficulty of these exercises can be adjusted based on your progress. Here are some ways to make them more challenging as your balance improves:

• Seated position: Start by performing the exercises while seated. This minimizes the risk of falling and provides a stable base to work from.

• Standing position: As the exercises become easier, perform them standing to further challenge your balance.

• Standing on a pillow: Standing on an unstable surface, such as a pillow, adds an extra layer of challenge by forcing your brain to adjust to an unstable environment.

• Walking while performing the exercises: For the most advanced version of these exercises, try performing them while walking. This requires the highest level of coordination and balance.

The Importance of Patience and Persistence

Balance rehabilitation is a gradual process, and it’s important to set realistic expectations. It may take time—sometimes months or even years—to see significant improvement. This is especially true for those with complex, multifactorial balance issues.

In my own experience, I’ve dealt with a combination of factors that contribute to my balance challenges. I have an astigmatism in my right eye, upper cervical misalignment, an old back injury, and a past ankle issue. All of these contribute to the imbalance I feel on a daily basis.

As frustrating as it can be, I’ve learned that persistence and patience are key. Progress may be slow, but every step forward counts. The exercises outlined in this article are just one part of the solution. Working with qualified specialists, such as vestibular therapists or upper cervical chiropractors, can help you address the root causes of your balance issues and create a personalized rehabilitation plan.

Conclusion

Balance issues are complex and can arise from a variety of causes. Whether due to vestibular disorders, neck misalignments, vision problems, or past injuries, retraining the brain to process sensory information correctly is essential for restoring balance.

The VOR exercises presented in this article are a great starting point for improving coordination and balance. However, it’s important to work with healthcare professionals who specialize in vestibular rehabilitation and upper cervical chiropractic care to ensure a safe and effective rehabilitation process.

Recovery is not always straightforward. Many factors, including vision issues, jaw alignment problems, and lower spinal injuries, can play a role in balance dysfunction. Stress often exacerbates symptoms, making it essential to approach treatment holistically. Cervicogenic dizziness and vertigo require a comprehensive approach, including upper cervical chiropractic care, vestibular rehabilitation, and lifestyle modifications.

Seeking Professional Guidance

If you experience persistent balance issues, consulting a professional can provide tailored guidance. Upper cervical chiropractors specialize in correcting structural misalignments that contribute to cervicogenic dizziness and vertigo, while vestibular therapists help retrain the brain’s balance processing.