Many people experience neck pain and dizziness at the same time. Sometimes this is referred to as cervical vertigo or cervicogenic dizziness. This dizziness may come and go or occur with motion of the cervical spine (neck), and it can involve unsteadiness, light-headedness, blurry vision, ringing in ears, nausea, headaches, and/or other troubling symptoms. Here are a few possible ways that a neck problem may contribute to dizziness.

Whiplash injury

When the neck is abruptly whipped back and forth, it can cause a whiplash injury. A rear-end auto collision is one of the top causes of whiplash. While neck pain is the most common whiplash symptom, many other symptoms may be present, such as dizziness.

When dizziness accompanies whiplash, it could be due to a concussion (brain injury) that occurred at the time of the collision. Another possibility is that specialized receptors (proprioceptors) within the neck’s muscles or joints become injured. The muscles and joints in your neck are believed to have receptors that send messages to the brain. These receptors give feedback on the position of the head and neck. Along with the inner ear and eyes, the proprioceptors in the neck are believed to play a role in maintaining balance. An injury to these proprioceptors may contribute to feeling dizzy or unsteady.

See Whiplash Symptoms and Associated Disorders

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Vertebrobasilar insufficiency

When one of the vertebral arteries gets compressed or inflamed within the cervical spine, it could cause vertebrobasilar insufficiency (VBI). With VBI, a reduced amount of blood reaches the brain, inner ear, or brainstem. When this happens, serious symptoms can occur, including dizziness. One type of VBI is called Bow Hunter’s syndrome, which involves temporary dizziness or other symptoms occurring when the head is turned to the side (like a bow hunter does). While this type of compression is rare, it most commonly occurs between the C1 and C2 vertebrae in the cervical spine. 1 Devaraja K. Approach to cervicogenic dizziness: a comprehensive review of its aetiopathology and management. Eur Arch Otorhinolaryngol. 2018; 275(1):2421-2433. doi: 10.1007/s00405-018-5088-z. It is typically caused by a bone spur on a vertebra in the neck that pinches the artery when the head is turned.

Watch Spinal Motion Segment: C1-C2 (Atlantoaxial Joint) Animation

Cervical myofascial pain syndrome

Myofascial pain syndrome occurs when painful trigger points develop in the muscles and surrounding connective tissues. When this condition is primarily felt in the neck region, it is called cervical myofascial pain syndrome. In addition to having tender trigger points than can flare up when touched or during activity, muscles can become achy and stiff, and pain can spread to the head or shoulders. While cervical myofascial pain syndrome is rare, it is estimated that about one-third of people with this condition also have dizziness. 2 Sahin N, Karatas O, Ozkaya M, Cakmak A, Berker E. Demographics features, clinical findings and functional status in a group of subjects with cervical myofascial pain syndrome. Agri. 2008; 20(3):14-9.

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Cervical myofascial pain syndrome has no known cause. Some suspected causes include previous injury, overuse or repetitive neck movements, poor posture, and/or stress. While the connection between this neck pain and dizziness is unclear, some evidence suggests that treating myofascial pain syndrome— such as with trigger point injections, physical therapy, or medication—can reduce both the pain and dizziness. 3 Cho DK, Rhee CK, Lee SJ, Jang YY, Hyun JK. Myofascial pain syndrome in patients with cervical vertigo. Ann Rehabil Med. 2011;35(2):243-249.

See Home Remedies for Neck Pain and Dizziness

When to see a doctor

Unexplained dizziness needs to be evaluated by a doctor, especially if it lingers or keeps coming back. A qualified medical professional can perform a physical exam and conduct diagnostic tests to help identify the possible cause of neck pain and/or dizziness. While there is currently no diagnostic test to prove a neck problem is causing dizziness, a doctor can narrow the list of possible causes and recommend treatments. Spinal injections and/or additional testing may help clarify the source of the pain and help improve your quality of life. When neck pain and/or dizziness are accompanied by other troubling symptoms, seek medical attention immediately. Some examples include persistent nausea, severe headache, fevers, chills, weakness, numbness, or bowel/bladder dysfunction.

See When Back Pain May Be a Medical Emergency

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What Causes Neck Pain and Dizziness?

Stretches and Exercises for Neck Pain and Dizziness

  • 1 Devaraja K. Approach to cervicogenic dizziness: a comprehensive review of its aetiopathology and management. Eur Arch Otorhinolaryngol. 2018; 275(1):2421-2433. doi: 10.1007/s00405-018-5088-z.
  • 2 Sahin N, Karatas O, Ozkaya M, Cakmak A, Berker E. Demographics features, clinical findings and functional status in a group of subjects with cervical myofascial pain syndrome. Agri. 2008; 20(3):14-9.
  • 3 Cho DK, Rhee CK, Lee SJ, Jang YY, Hyun JK. Myofascial pain syndrome in patients with cervical vertigo. Ann Rehabil Med. 2011;35(2):243-249.

Dr. J. Rafe Sales is an orthopedic surgeon specializing in spine surgery and reconstruction at Providence Brain and Spine Institute. He is the Co-Medical Director of Spine Surgery Services at Providence Health Systems. He is also the Founder and Director of the Summit Spine Institute, where he has more than a decade of experience caring for patients.

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