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Cervicogenic dizziness

The ability to sense movement of the neck can be attributed to a dense population of receptors in the muscles, tendons and joints of the upper spine, known as mechanoreceptors. These receptors send information to the brain about neck and head position, enabling our brains to make sense of how the head and neck are positioned relative to the body.  Joint position sense consequently enables the brain to make decisions about necessary muscle activation and movement of the head and eyes.  Altered sensory information from the cervical spine (neck) may be the cause for dizziness in some people.

In the muscles and facet joints (see diagram below) of the neck, or cervical spine, there is a high density of mechanoreceptors, suggesting that the brain requires a lot of information about neck position, particularly in the upper regions of C1-C3.  The brain uses this information to program muscle tone and protective reflexes in the many muscles of the neck enabling joint stability and preventing degeneration.

The brain also integrates neck proprioception (proprioception is the word used to describe the sense of body position and movement) with visual and vestibular information, to enable proper balance, as well as movement of the eyes and head.  Research has shown that impaired neck motion and poor neck proprioception correlates with higher levels of neck pain, as well as contributing to symptoms such as dizziness, migraines, headaches and visual disorders.

To test for neck proprioception impairment the assessor can do the “joint position error test”.  This test assesses the ability of the patient to move the head from position A to position B and then, without vision, return accurately again to position A.  If there is a problem with proprioception, the patient will be unable to accurately move the head back to position A without the assistance of visual feedback.

There are other tests which can help indicate an issue with proprioception of the neck, which once identified, will require rehabilitation. Therapists will use lasers, mirrors, joint mobility and strengthening exercises to assist with improvement of neck proprioception.

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