A neck that is out of alignment, also known as a cervical spine misalignment or subluxation, has the potential to cause a variety of symptoms, including dizziness. The neck contains vertebrae, joints, muscles, nerves, and blood vessels that all work together to support the head and allow for motion. When one or more of the vertebrae are out of position, it can disrupt proper functioning of the structures in the neck, leading to problems.
Dizziness refers to feelings of lightheadedness, imbalance, vertigo, and unsteadiness. It’s often described as a “swimming” sensation in the head. Dizziness can be caused by issues in the inner ear, brain, eyes, and body position, including the neck. Research shows that neck problems like osteoarthritis, injuries, and vertebral artery dissections can provoke dizziness through various mechanisms.
So can a misaligned neck lead to dizziness? Here’s a look at the evidence surrounding this question:
How Neck Misalignments May Cause Dizziness
There are a few ways a neck out of alignment is theorized to potentially contribute to dizziness:
– Irritation of cervical spine mechanoreceptors: The upper cervical spine contains mechanoreceptors that detect head position and movement. It’s thought that vertebral misalignments could irritate these receptors, sending abnormal signals about head position to the brain and triggering a sensation of spinning or tilting.1
-Compression of vertebral arteries: The vertebral arteries travel through the transverse foramen (opening) of each cervical vertebra. If a vertebra is shifted out of position, it could narrow this opening and compress the vertebral artery. This may decrease blood flow to the brain, resulting in dizziness.2
– Cervicogenic somatosensory vertigo: Some researchers have proposed that neck problems lead to a condition called cervicogenic somatosensory vertigo. Here, distorted sensory information coming from the upper cervical spine triggers a mismatch between visual signals and neck proprioception, causing vertigo.3
– Referred pain: Cervical structures like muscles and joints have been found to refer pain to the head and face. It’s possible this phenomenon could also manifest with referred dizziness coming from the upper neck.4
– Inflammation: Misalignments may cause localized inflammation in cervical tissues. This can put pressure on nearby nerves, possibly provoking dizziness.5
So in theory, yes, a neck alignment issue could potentially lead to dizziness through these mechanisms. However, more research is still needed to fully confirm cause-and-effect.
Studies Investigating the Link
A number of studies have been conducted over the years investigating the relationship between neck alignment issues and dizziness. Here is a summary of some of the key research:
– A 1992 case study described a 54-year-old woman with chronic neck pain and dizziness. Chiropractic manipulation targeting misalignments in her upper cervical spine provided lasting relief from both symptoms.6
– A 1998 study examined 346 patients with dizziness. They found that disorders of the upper cervical spine, including misalignments, were present in 23% of those with vertigo of unknown cause.7
– A 2001 study compared people with whiplash injuries to healthy controls. Those with whiplash were significantly more likely to experience dizziness, suggesting trauma-induced neck misalignment may provoke it.8
– A 2005 study evaluated over 200 patients with neck pain and imbalance of unknown origin. They found that upper cervical misalignments were common and correction of these misalignments often improved symptoms.9
– A 2010 study found that vertebral artery blood flow increased after chiropractic adjustment in those with neck pain and dizziness, indicating correction of misalignments improved vertebral artery function.10
– A 2016 review found evidence that neck osteoarthritis and joint dysfunction can be associated with dizziness. However, a clear causal relationship could not be established.11
So while individual studies show promise, higher quality randomized controlled trials are still needed to definitively demonstrate neck misalignments provoke dizziness and that correcting them relieves symptoms. There are also many variables that make studying the neck-dizziness connection complex.
Other Causes of Dizziness to Consider
While neck misalignments may contribute, it’s important to note that dizziness can stem from a wide range of underlying causes. Some other common sources include:
Inner Ear Problems
Issues with the vestibular system in the inner ear, like benign paroxysmal positional vertigo (BPPV) or labyrinthitis, frequently cause dizziness and vertigo. BPPV occurs when calcium deposits in the ear canals shift and trigger false sensations of spinning.
Migraines
Migraine-related dizziness is relatively common. It may be related to changes in brain chemicals during migraine attacks.
Cardiovascular Disease
Insufficient blood flow to the brain due to conditions like stroke, heart problems, or low blood pressure can result in lightheadedness and unsteadiness.
Medications
Many prescription and over-the-counter medications list dizziness as a potential side effect. These include blood pressure drugs, sedatives, antidepressants, and more.
Brain Tumors
Growths or structural abnormalities in parts of the brain involved in coordination and spatial awareness may cause dizziness.
Vision Problems
Issues with the eyes, optic nerves, or brain pathways for visual processing can create a sense of the room spinning.
Stress and Anxiety
Hyperventilation related to panic attacks or severe stress can potentially trigger short-term dizziness in some people.
In anyone with unexplained chronic dizziness, it’s important for a doctor to evaluate all of these possible underlying causes through a complete history, physical exam, and diagnostic testing like MRIs and CT scans if needed.
Risk Factors
Certain factors may increase someone’s risk of developing both neck misalignments and dizziness, including:
– Previous neck injury like whiplash
– Jobs involving repetitive neck motions
– Poor neck posture – staring down at phones/laptops for prolonged periods
– Muscle tension from chronic stress or jaw clenching
– Sports with head contact like football or hockey
– Connective tissue disorder like rheumatoid arthritis
– Recent viral infection – can cause temporary neck stiffness and vertigo
– Migraines – associated with increased neck pain and dizziness
Being aware of these risk factors can help identify cases where a neck problem may be more likely to contribute to dizziness. However, those without specific risk factors can also develop both issues.
Assessing the Neck-Dizziness Link in Individuals
So how do health providers determine if neck problems are provoking dizziness in specific patients? Some approaches may include:
– Thorough history – asking about the onset and nature of dizziness, associated symptoms, past neck problems.
– Physical exam assessing range of motion, muscle spasms, misalignment, and reproduction of dizziness with certain neck positions.
– Neurological exam checking balance, coordination, eye movements.
– Orthopedic tests like the cervical rotation lateral flexion test.
– Questionnaires like the Dizziness Handicap Inventory.
– Potential use of imaging like CT, MRI, or x-ray to visualize cervical structures.
– Vestibular function tests to assess the inner ear.
– Assessment of improvement after a trial of conservative neck treatment.
Since dizziness can have vague symptoms and many causes, a full workup is key. But if neck involvement is suspected, addressing any alignment or mobility issues present may provide diagnostic clues in some individuals.
Treating Dizziness From Neck Problems
If evaluation does suggest that neck dysfunction is contributing to dizziness, some conservative treatment approaches that may help include:
Chiropractic Manipulation
Spinal manipulation and mobilization techniques performed by chiropractors aim to improve alignment and mobility of the cervical vertebrae and associated joints. They can also help address muscle spasms. Multiple studies show these interventions may benefit neck pain and cervicogenic dizziness.12
Physical Therapy
Physical therapists utilize exercises, joint mobilization, soft tissue release, traction, and more to improve strength, flexibility, alignment, and range of motion in the neck. Studies indicate these modalities can reduce neck-related dizziness.13
Massage Therapy
Massage techniques help relax tense neck muscles that could be contributing to dizziness via referred pain or irritation of cervical nerves. Some trials demonstrate massage can improve dizziness and reduce neck disability.14
Posture Training
Learning and consistently practicing healthy head and neck posture may help reposition vertebrae and relive structures that could be causing dizziness with bad positioning. Proper ergonomics are also key.
Over-the-Counter Medications
For acute flare-ups, over-the-counter anti-inflammatories like NSAIDs may provide some short-term relief from neck-related dizziness. Muscle relaxants can also be used cautiously for severe spasms.
Lifestyle Modifications
Improvements in diet, exercise, sleep habits, and stress management may help reduce muscle tension, inflammation, and risk factors associated with neck misalignments and dizziness. Yoganeck stretches, enhancing cardiovascular fitness, and relaxation techniques can support the cervical spine.
While research overall supports conservative neck therapies for dizziness, the quality of evidence is still emerging. Experts recommend combining multiple modalities like manipulation and exercise for optimal results. If neck treatments do not improve dizziness, it’s also critical to reassess for other causes with providers. Surgery may very rarely be considered for severe vertebral compression cases not helped by other care.
Prevention
Some ways to potentially help prevent neck misalignments that could lead to dizziness include:
– Maintaining proper posture when sitting, standing, and sleeping
– Stretching and strengthening neck muscles through exercise
– Taking breaks from repetitive tasks and varying positions frequently
– Avoiding excessive screen time by looking away periodically
– Using ergonomic office setups and chairs to support the neck
– Managing stress levels through relaxation practices
– Getting chiropractic or massage therapy during periods of increased neck pain
– Using careful technique and protective gear in contact sports
– Treating underlying medical conditions, like autoimmune disorders, that increase neck pain risk
– Recovering appropriately after any neck injury to stabilize vertebrae
No methods can guarantee perfect spinal alignment at all times. But following a neck-healthy lifestyle can help reduce misalignment frequency, especially when combined with regular chiropractic, massage, or physical therapy.
Conclusion
Research indicates that having a neck out of alignment could potentially contribute to feelings of dizziness in some people. Possible ways this may occur include irritation of neck joint receptors, compression of arteries, cervicogenic vertigo, referred pain, and inflammation.
However, high quality studies confirming a direct causal link are still limited. Dizziness is multifactorial, with many other possible neurological, vascular, and inner ear causes. A full evaluation is needed to pinpoint the source in each individual.
For those with evidence pointing toward neck involvement, conservative treatments like chiropractic adjustment, physical therapy, and improving posture/ergonomics may provide relief by realigning vertebrae and reducing spasms, inflammation, and irritation on cervical structures. Combining multiple modalities tailored to the individual tends to yield the best outcomes. Ongoing management is also necessary in most cases.
While more research is warranted on the neck-dizziness connection, maintaining healthy alignment and mobility in the cervical spine through both preventative strategies and restorative therapies appears beneficial for reducing the likelihood of this potential symptom. As neck problems are only one piece of the puzzle, comprehensive assessment and tailored treatment focused on all possible factors driving dizziness in each patient remains key.
