Cervicogenic dizziness is a feeling of unsteadiness or light-headedness that comes from a problem in the neck, usually alongside neck pain or stiffness. It’s thought to happen when the neck sends inaccurate position signals to the brain, which then conflict with information from the eyes and inner ears. Because there’s no single test for it, cervicogenic dizziness is a diagnosis of exclusion — inner-ear, vascular and neurological causes need to be ruled out first. When it is the cause, randomised trials show that manual therapy to the neck can reduce dizziness, and it is often combined with exercise and vestibular rehabilitation.
At a glance
- What it is
- Dizziness or unsteadiness linked to a neck problem, usually occurring together with neck pain or stiffness
- How it feels
- More often unsteadiness or light-headedness than spinning, and often linked to neck movement or posture
- Common causes
- Whiplash or other neck injury, chronic neck pain, and age-related changes in the neck
- Diagnosis
- A diagnosis of exclusion — inner-ear, vascular and neurological causes must be ruled out first
- Treatment
- Manual therapy to the neck, supported by randomised trials, often combined with exercise and vestibular rehabilitation
- At McKelvie
- 60-minute vestibular assessment with infrared video goggles ($180) in Pickering; no referral needed
What is cervicogenic dizziness?
Cervicogenic dizziness is dizziness that originates in the neck (the cervical spine). It usually feels like unsteadiness, imbalance or light-headedness rather than true spinning, and it typically occurs together with neck pain or stiffness. Many people notice it:
- when turning or tilting the head
- after holding the neck in one position, such as at a desk or while driving
- when neck pain flares up
What causes cervicogenic dizziness?
The muscles and joints of the upper neck are packed with position sensors that tell your brain where your head is in relation to your body. Your brain combines this information with signals from your eyes and inner ears to keep you balanced.
When the neck is injured or isn’t moving well, those position signals can become inaccurate. The mismatch between the neck, eyes and inner ears may then be felt as dizziness or unsteadiness.
Cervicogenic dizziness is most often linked to whiplash or another neck injury, chronic neck pain, or age-related changes in the neck. Because other conditions can cause the same symptoms, it’s a diagnosis of exclusion — other causes need to be ruled out first.
What are the symptoms of cervicogenic dizziness?
- Unsteadiness or light-headedness, usually without true spinning
- Neck pain or stiffness that comes and goes with the dizziness
- Dizziness linked to neck movements or sustained neck postures
- Headache starting at the back of the head or neck
- Reduced range of neck movement
- Feeling off-balance when walking
When to seek urgent medical care
Neck pain with dizziness after a neck injury (for example, a car accident, fall or sudden neck movement), or neck pain with dizziness and neurological symptoms, needs urgent medical assessment — it can occasionally be a sign of a problem with the arteries in the neck.
If dizziness comes on suddenly with a severe headache, trouble speaking, facial drooping, weakness, numbness or loss of vision, call 911 — these can be signs of a stroke.
How is cervicogenic dizziness treated?
The first step is making sure it really is the neck. We assess your vestibular system — including eye-movement testing with infrared video goggles — as well as your neck, so that inner-ear conditions such as BPPV aren’t missed. If anything suggests a vascular or neurological cause, we’ll refer you to your physician for medical investigation before any treatment.
When cervicogenic dizziness is the likely cause, treatment focuses on the neck:
- Manual therapy — in randomised trials by Reid and colleagues, specific neck mobilisation techniques (Mulligan SNAGs and Maitland mobilisations) reduced dizziness compared with a placebo treatment, and some benefits were still seen 12 months later (Reid et al., 2014; 2015).
- Exercise — neck mobility, strength and position-sense exercises. A 2022 review found moderate-quality evidence for manual therapy, and suggested that combining it with exercise may help even more, though the evidence for combined treatment is weaker (De Vestel et al., 2022).
- Vestibular rehabilitation — balance and gaze-stability exercises to retrain how your brain combines signals from your neck, eyes and inner ears.
Screen & rule out
A vestibular assessment with infrared goggles and a careful neck examination, with medical referral if anything suggests another cause.
Treat the neck
Hands-on manual therapy and targeted exercises to restore neck movement and reduce pain.
Retrain balance
Position-sense, gaze-stability and balance exercises to help your neck, eyes and inner ears work together again.
Why choose McKelvie Physiotherapy for cervicogenic dizziness?
- Neck and balance under one roof — our physiotherapy team offers manual therapy alongside vestibular rehabilitation.
- Advanced diagnostic technology — we use infrared video goggles (video-oculography) to record eye movements the naked eye can’t see, so your diagnosis is based on evidence, not guesswork.
- Other causes ruled out first — we check for inner-ear conditions such as BPPV that can cause similar dizziness.
- Vestibular expertise — our team is led by an Advanced Vestibular Physical Therapist (AVPT).
- One-on-one care in private rooms — never rushed, never shared.
- Care that comes to you — in person in Pickering, at home across the GTA, or virtually anywhere in Ontario.
- Direct billing to many major insurers — and no referral needed.
Sources
- Comparison of Mulligan sustained natural apophyseal glides and Maitland mobilizations for treatment of cervicogenic dizziness: a randomized controlled trial. Physical Therapy (Reid SA, et al.), 2014.
- Manual therapy for cervicogenic dizziness: Long-term outcomes of a randomised trial. Manual Therapy (Reid SA, et al.), 2015.
- Systematic review and meta-analysis of the therapeutic management of patients with cervicogenic dizziness. Journal of Manual & Manipulative Therapy (De Vestel C, et al.), 2022.