If you suffer from neck pain and vertigo, chances are high that the two are definitely related

Many of us know what neck pain is, what dizziness is, but what exactly is vertigo, or what is the precise meaning of vertigo?

Vertigo is defined as: ” a condition in which somebody feels a sensation of whirling or tilting that causes a loss of balance”

 

I don’t know about you, but I myself experience vertigo. I actually get dizzy going on roller coasters, trying to read in a moving car, going out on a boat in choppy waters, heck I even get dizzy looking at the image above if I look at it long enough. I happen to suffer with neck pain as well. So how is neck pain and vertigo related?

Words I often hear my patients say to described vertigo are: unsteadinesss, dizziness, giddiness, or lightheadedness. So what’s the deal with vertigo? is there any relationship to neck pain or neck problems?. What is the relationship of neck pain and vertigo?

The Relationship Between Neck Pain and Vertigo Explained:

Well its a great question to consider the relationship between neck pain and vertigo because if the two are related, it may explain WHY you get dizzy in the first place

Secondly,  the great news is that if neck pain and vertigo are related to each other, then if we focus on fixing your neck pain, then you can fix the vertigo problem as well.

The part of our brain that is responsible for vertigo is called the vestibular nucleus, which is located in the brainstem.

Whatever information that enters into the vestibular nucleus that causes the nucleus to be excited, creates the sensation of vertigo. The information that enters the nucleus can be normal or abrnormal.

Think about as an example, a spinning body on a roller coaster, a normal sensation of vertigo may develop. The vertigo is a normal response of the spinning. If you stop spinning, you stop sending the information to the nucleus, and the vertigo sensation stops.

The information that enters the nucleus and initiates the vertigo sensations can arise from a number of sources, but classically, four are identified.

1) Inner Ear (Labyrinthine): Problems with the components in the inner ear can be sent to the vestibular nucleus, and cause vertigo. This is actually what I have, as I have had several inner ear procedures as a child with multiple ear infections that required tubes being placed in my ears repeatidly. 

Vertigo results from something called Canalithiasis, a pathological diagnosis for the sensation of vertigo as a result of dislodged particles in the canals of the inner ear. In this instance, neck pain and vertigo are not related. 

This type of Vertigo is also known as BPPV:

Benign:  because it is not a serious cause of vertigo like infection or malignancy

Paroxysmal: the bout last for short duration, typically 20-60 secs, and a sensation of lightheadedness may persist for several hours

Positional: The bout of vertigo is triggered by putting the head into a specific position, (but neck pain and vertigo per se), more specific movements of the neck.

Vertigo: for the sensation of spinning

A technique that we do in the office that has amazing results was pioneered by physician John Epley, MD. This treatment for BPPV involves precise positioning and timing of the head through a series of maeuvers in an effort to move the offending particle along the inner ear to a location that doesn’t cause vertigo. A pubmed search of the National Library of Medicine database finds more than 100 studies on the technique.

 

The second source of information being sent to the vestibular nucleus

2) Cerebellum: The cerebellum is neurologically connected to the vestibular nucleus. It is also know as the “litte brain”, and in their 2001 book Clinical Neurophysiology of the Vestibular System, Dr’s Baloh and Honrubia note that the cerebellum “provides a major souce of input to the vestibular nucleus”.

3) Temporomandibular Joint (TMJ): First reported in the Journal of Laryngology and Otology in 1965 in an article titled (1) Nystagmus and Vertigo Produced by Mechanical Irritation of the Temporomandibular Joint-space. It was shown that the TMJ sends information to the vestibular nucleus thus creating the sensation of vertigo.

What does that mean? Well, if you have had any TMJ problems in the past or currently, and you have vertigo, finding a good rehab specialist to work on the TMJ, evaluating the movement, assessing the muscle function, and rehabing faulty motion and muscle tension can really help the vertigo problem as well. In this case it is the jaw that has relationship to vertigo, and not neck pain and vertigo.

And Lastly (the true relationship of neck pain and vertigo)

4) C1-C3:

Did you know that a study done over 33 years ago in 1977(2) concluded that injecting a saline irritant into the deep tissues of the upper cervical spine will create the sensation of vertigo?

This cause of vertigo is classically termed:

CERVICAL VERTIGO (another way of saying neck pain and vertigo).

this is really good news?

Why?

Because in part 2 of Neck Pain and Vertigo (or dizziness)  are they Related? I will discuss how Cervical Vertigo (neck pain and vertigo) creates dizziness, and better yet, what you can do on your own to address your own cervical vertigo, and how to do it without drugs and medication, and definitaly not surgery.

Till next time, watching your back (and neck). To read part 2 of Neck Pain and Vertigo are they related? click here

References

1) Jordan P, Ramon Y. Nystagmus and Vertigo Produced by Mechanical Irritation of the Temporomandibular Joint-space. J Laryngol Otol. 1965 Aug: 79:744-8.

2) de Jong PT, de Jong JM, Cohen B, Jongkees LB. Ataxia and nystagmus induced by injection of local anesthetics in the Neck. Annals of Neurology. 1977 MAr;1(3):240-6

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