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CERVICOGENIC DIZINESS

Cervicogenic Dizziness Brisbane - Blair Certified Doctor of Chiropractic
Understanding Cervicogenic Dizziness


Are you or a family member been diagnosed with cervicogenic dizziness? How severely has it affected your daily life? Your ability to stand up? To get work done? What about how you feel? Your mood? Do you still feel like the same person you used to be? Or do you find yourself feeling depressed on anxious as soon as the sensation hits.?

One of the most frustrating things about cervicogenic dizziness is that you appear 100% normal on the outside. But on the inside, that is a whole other story. You try to describe to other people what you are experiencing: “It’s like being on a moving boat,” or something like that. However, what they can’t understand is how that movement affects everything in your life! To a certain degree, things like pain - even severe pain - you can block that out. But cervicogenic dizziness, that is a whole other monster! When the feeling comes over you, it’s almost impossible to feel anything else.

Add to it the sense of depression and anxiety that goes along with it. If there is any one way to make any human being feel depressed or anxious, it is to give them a problem that they can’t solve. And if you have been dealing with the sensation for any length of time, you may even be starting to wonder if you will ever be able to get your life back.  It has been my experience working with people who experience cervicogenic dizziness that the person who does not feel anxious or depressed is the abnormal one!

Still, understanding alone has not helped. You have probably done your homework on Google countless times looking for answers, cervicogenic dizziness or for a “dizziness specialist in Brisbane” or near you. You have probably been to neurologists and physiotherapists, who have prescribed you a series of exercises to assist with your cervicogenic dizziness symptoms.

You may also have been prescribed medications like Stematil or even Serc to assist with“motion-sickness. You may also have been recommended anti-depressant or anti-anxiety medication, but what has always bothered you is that these medications may only be treating the symptoms of your cervicogenic dizziness without addressing the underlying cause. There is honesty, and then there is frank honesty. May I be frankly honest with you?

I do not have the answers to “fix” or “cure” cervicogenic dizziness. To the best of my knowledge, no one has completely solved this mystery … yet. However, there are a great many things that I have learned in what it takes to help improve the quality of life and to offer relief for people who do experience cervicogenic dizziness. If you’re looking for natural, non-invasive solution to help, I would like to share with you some of the things that I have learned, and how the unique brand of healthcare that we use at Atlas Health in North Lakes (north Brisbane) called Blair upper cervical care may be able to help you if you are experiencing cervicogenic dizziness.

How to “Read” Cervicogenic Dizziness Symptoms


Cervicogenic dizziness means that you experience dizziness - not vertigo - when triggered by movements of your head or neck. Unlike vertigo, which is the sensation of “the world spinning around you,” dizziness is the sensation of “you spinning within the world.” 

You may not have known this previously, but your sense of balance is influenced by three primary organs: 1) your inner ear (called the vestibular apparatus), 2) your eyes and 3) the nerves in your neck, specifically the upper cervical spine. When people experience vertigo or dizziness, the usual referral is made to an ENT or neurologist who requests an MRI to rule out brain pathology, which includes the inner ear and eyes. Often, these tests come back as “negative,” which means that there must be something else causing the symptoms.

Alas, unless they explicitly state that the dizziness is brought about by head movement, many people who experience dizziness don’t have their neck formally assessed until they see a chiropractor, physiotherapist, or osteopath. Here is usually where the official diagnosis of “cervicogenic dizziness” appears: dizziness that originates from the cervical spine.

The problem with the diagnosis alone is that it does not tell you what the cause of the neck problem is, or what to do about it.


One hypothesis about cervicogenic dizziness is that is is the result of degenerative arthritis in the lower neck, which changes the structural and neurological makeup of the sensors in that part of your body. As a result, your brain receives abnormal information about your head-and-body position, which can spark the sensation of dizziness. 

Another hypothesis is that cervicogenic dizziness specifically involves a misalignment or abnormal motion involving the C1-C2 joints in the upper neck. The muscles that support these two vertebrae - the atlas (C1) and axis (C2) - are especially dense with nerve receptors called proprioceptors, which maintain the balance of your head atop your neck. Moreover, a specific one of these muscles called the obliquus capitis inferior (OCI) facilitates 50% of your head rotation and, if irritated, can immediately produce the sensation of dizziness. So if cervicogenic dizziness involves alteration of the nerve signals transmitted from the neck to the brain, the two remaining questions are, “What has happened to cause the problem in the first place?” and “What can you do about it?”

What Can Cause Cervicogenic Dizziness


There are a few interesting patterns that I have observed that are common to almost every single person I have worked with, who experiences cervicogenic dizziness. They have a kink with signs of degenerative arthritis in the lower part of their neck (C4-C6) This degenerative arthritis is precipitated by forward misalignments of the mid-cervical vertebrae. Such misalignments are exceptionally common, but not routinely addressed by most therapies.

These forward misalignments are in direct rotational opposition to the alignment the C1 or C2 vertebrae in the upper neck. For example, the C1 vertebra is shifted backwards to the left … but then the C4 vertebra is shifted forwards to the right.
They exhibit a “torso-twist,” which means that instead of their shoulders and hips naturally sitting in the same plane, they are counterrotated. For example, their right shoulder rolls forwards but the right hip rolls backwards.

The exhibit a postural neck tilt to one direction, but then the head kinks back in the opposite direction, which can impact on the normal flow of blood to-and-from the head.  They have a paradoxical relationship between the structural support of the lower body (i.e., the pelvis) and the neurological systems of the upper body (i.e., the neck). In other words, something in the lower body wants the system to compensate in one direction, but then something in the upper beck wants the system to compensate in the opposite direction at the exact same time.
 
It’s “that something” that appears to be most different in people who experience cervicogenic dizziness. For some people, it appears to be signs of a lower back injury. For other people, it appears to be signs of an imbalance such as a structurally short leg that their body had been able to compensate for for years or decades … that is, until it just couldn’t compensate any more. One way or another, it appears that one of the major factors affecting cervicogenic dizziness is a previously unresolved physical injury of some kind.

Most Common Reasons Adults get Cervicogenic Dizziness


I realise that I am the contrarian when it comes to information about cervicogenic dizziness. So much of the advice focuses on the mental aspect of stress management, and the chemical aspect of low-salt and low-caffeine diets. What I am proposing is that the major underlying issue, and thus the most important piece to helping cervicogenic dizziness is a physical condition caused by an old physical injury.

The degenerative arthritis so common among people who experience cervicogenic dizziness isn’t the type of thing that appears overnight. Think of degeneration like rust on a bike left out in the rain. You can get a sense of how long the bike has been neglected based on how much rust it has accumulated. The same is true with degenerative arthritis. The majority of people who we see for cervicogenic dizziness in our practice in north Brisbane has the equivalent accumulation of 15-25 years worth of damage. What it means is that we are seldom working with new injuries, but instead very chronic ones.

Now, unless you have discovered a way to escape the forces of gravity, time and the continual stress of daily living, it is seldom possible to undo the physical injury that your body has been compensating for all these years. However, it may still be possible to support and then stabilise the underlying injuries so that your body does not need to continuously suffer.

Most Common Reasons Children get Cervicogenic Dizziness


Cervicogenic dizziness is never normal, but especially so in young adults or even children. Still, the youngest person I have worked with who experienced chronic dizziness was only 15 years old. So how is it possible for a 15-year to have a 15-year old injury? The answer is simple: from birth. More appropriately, at the time of birth. Consider the many complications that can complicate the birthing process: breech presentations, forceps deliveries, cords wrapped around necks, etc. A newborn’s head is essential 1/3 of it’s entire body size (vs 1/10th as an adult). That head is essentially like hot plastic: still forming and highly malleable for at least 2 years.

Moreover, that child will now start a process known as “growing up:” learning to sit up, crawl, walk, run, play etc … and at each step along this journey, there are any number of potential instances where damage can occur. “As the twig is bent, so grows the tree.” It is not to say that all bumps, knocks or bruises cause permanent injury - that simply is not true! However, if there is any significant enough bump where mum or dad has to question if everything is okay - or especially when children experience physical symptoms such as headaches, migraines, or other physical problems - then it is easier to act now instead of waiting 15 years for the problem to finally come to the surface.


What to do about Cervicogenic Dizziness


One of the first important things to do if you are experiencing or have been diagnosed with cervicogenic dizziness is to have proper scans that show not only your brain, but also your neck. These types of scans could include an x-ray or MRI. However, be forewarned that most people who experience cervicogenic dizziness have their reports come back reading “normal” … or at most, only mentioning signs of degenerative arthritis (which is a common finding and no unique to cervicogenic dizziness. What should be clarified is that when these reports come back as “normal,” what they should actually say is “negative.” Negative for pathology such as tumours, bleeding, infections, etc, That would rule out a huge category of problems that could be going on, and then allows your attending healthcare professional to work on finding what is causing the functional disturbance.

Here is where you may have a team of professionals working, or even a single trusted advisor working with you to help with the cervicogenic dizziness symptoms you are experiencing. Such people may include your GP, your neurologist or an ENT, an acupuncturist, a chiropractor or a vestibular physiotherapist.  Especially in Australia, it can be challenging to know who the right person to see is. (Part of the reason has to do with the way the healthcare laws are written that prohibit providers from advertising specialties or that they are a “dizziness specialist.” Now, if that statement is not true, and a person proclaims to have skills or knowledge that they don’t have, that’s a matter for the regulatory bodies. The flip is that it makes it especially hard for you to find someone who actually has specialised knowledge about cervicogenic dizziness, because on the surface, everyone looks the same.) Alas, no easy solutions here.  The best that I know to offer remains the unique approach that we use in our practice here in nprth Brisbane called Blair upper cervical specific chiropractic care.
 

Chiropractic and Cervicogenic Dizziness


Foremost, Blair upper cervical care is not the same thing as general chiropractic or spinal manipulation.  Allow me to explain. Upper cervical care is a post-doctoral study of general chiropractic that requires years of additional study beyond a standard university chiropractic degree. In the United States (where I completed my training), we completed a 4-year university degree, then a 5-year course in chiropractic, and only then were we eligible to being the certification process for upper cervical care. So yeah, there’s a lot to it. 

The Blair technique is a subdivision or particular approach to care that focuses on the normal alignment and movement though the joints of the upper neck including the C1 (atlas) and the C2 (axis). The approach was researched and developed in the USA in order to provide the most precise manner of determine the individual nature of each person’s neck, and then what type of care or adjustments are most appropriate to facilitate the best response possible. You may find it of value to learn that the Blair approach does not involve any no twisting, popping or “cracking” the neck. Let me repeat: no spinal manipulation.

Instead, the procedure is performed on a neutral adjusting table where you lie on your side. Then, a force equivalent only to what you would use to palpate your pulse is directed through the vertebrae in the neck is order to restore normal movement. The procedure is not a direct treatment or cure for the symptoms of cervicogenic dizziness, but remember what we said earlier: cervicogenic dizziness is a functional disorder involving the joints of the neck sending the brain aberrant position-sense information. Therefore, if we can help improve the state and health of your neck, it can help to improve the probability that the nerves in your neck will start to send your brain better quality information. And if that happens, it may be possible for your symptoms of cervicogenic dizziness to improve. 


Chiropractic Treatment for Cervicogenic Dizziness


The focus of Blair upper cervical care is on the alignment of the bones in your neck and the impact that they have on the function and health of your nervous system. The process first involves a baseline assessment of your condition, which includes 1) a specific postural assessment that shows where the stress in your body is (e.g., torso twist, head twist, etc); 2) neurological assessments in the form of infrared paraspinal thermography, which measures the activity of your sympathetic nervous system (which is frequently involved when people experience dizziness) and 3) a unique series of x-ray views that should the alignment of your neck from angles that cannot be seen on standard x-rays or even CTs or MRIs.

As a result, we may be able to identify a situation with your neck that you did not realise you had. Therefore, we may be able to offer a solution that no one else has been able to offer you. May I be frank one last time? I want to repeat something I said earlier about cervicogenic dizziness: it can be a monster. In my career, I have worked to help people dealing with many types of conditions including headaches, migraines, vertigo, fibromyalgia, and so forth. With so many of these types of conditions, usually we see relatively quick signs of progress.

The thing I have learned about cervicogenic dizziness is that there is an unknown “something” that makes it especially difficult to resolve. Since 2018, I have kept track of my personal office statistics. Based on what our clients have reported, the vast majority of people do experience some positive relief of their dizziness 50% of them experiencing significant improvements … but seldom complete resolutions.  If I could snap my fingers to solve the problem of cervicogenic dizziness, I would do so in a heartbeat! However, that’s not how healing works. 

Perhaps it is a limitation of my own knowledge in helping people with cerviogenic dizziness - and maybe there is some other kind of exercise, therapy or treatment that works better. Alas, I have not come across it. If I did, you better believe that I’d be recommending it!  There are no true guarantees in life, but the one promise I can make to you if you are experiencing cervicogenic dizziness is that if you are willing to give Blair upper cervical care a fair go, I will give you my best to be able to help you.

 

References


Armstrong BS, McNair PJ, Williams M. Head and neck position sense in whiplash patients and healthy individuals and the effect of the cranio-cervical flexion action. Clin Biomech (Bristol, Avon). 2005 Aug;20(7):675-84. 
Boyd-Clark LC, Briggs CA, Galea MP. Muscle spindle distribution, morphology, and density in longus colli and multifidus muscles of the cervical spine. Spine (Phila Pa 1976). 2002 Apr 1;27(7):694-701. 
Burcon MT. Health Outcomes Following Cervical Specific Protocol in 300 Patients with Meniere’s Followed Over Six Years. Journal of Upper Cervical Chiropractic Research ~ June 2, 2016 ~ Pages 13-23. 
Grgić V. [Cervicogenic proprioceptive vertigo: etiopathogenesis, clinical manifestations, diagnosis and therapy with special emphasis on manual therapy]. [Article in Croatian] Lijec Vjesn. 2006 Sep-Oct;128(9-10):288-95. 
Kulkarni V, Chandy MJ, Babu KS. Quantitative study of muscle spindles in suboccipital muscles of human foetuses. Neurol Indfa, 2001;49(4):355-9. 
Peng B. Cervical Vertigo: Historical Reviews and Advances. World Neurosurg. 2018 Jan;109:347-350. doi: 10.1016/j.wneu.2017.10.063. Epub 2017 Oct 20. 
Ravn JH, Fuglsang R, Højland C, Hauvik M. The effect of the sympathetic nervous system on proprioception of the neck. Aalborg University. Project supervised by Deborah Falla and Shellie Boudreau. 2009. Date of submission: 1/5/2010. 
Yang L, Chen J, Yang C, et al. Cervical Intervertebral Disc Degeneration Contributes to Dizziness: A Clinical and Immunohistochemical Study. World Neurosurg. 2018 Nov;119:e686-e693. doi: 10.1016/j.wneu.2018.07.243. Epub 2018 Aug 6. 
Yang L, Yang C, Pang X, et al. Mechanoreceptors in diseased cervical intervertebral disc and vertigo. Spine (Phila Pa 1976). 2017 Apr 15;42(8):540-546.
 

Common Conditions

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HEAD PAIN

For all the different types headaches and migraines, it's the upper part of your neck that could be causing it. 

NERVE DISORDER

Because your upper neck affects your brain, it can cause major problems anywhere in your body.  

NECK PAIN

Neck pain and shoulder pain can be signs of a bigger health problem that affects the spinal cord in your neck. 

FACIAL PAIN

Disorders that affect the Trigeminal Nerve are some of the most horrific conditions known to human kind.

VERTIGO & DIZZINESS

Vertigo and dizziness are often major indicators that something is truly wrong with your neck. 

BACK PAIN

Back pain is one of the most common conditions to affect people, but it doesn’t always come from the back.

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