Cervicogenic dizziness is a clinical syndrome characterized by the presence of dizziness and associated neck pain. It is a diagnosis of exclusion, meaning that other potential causes of dizziness must be ruled out before a diagnosis of cervicogenic dizziness can be made. This can make it challenging for healthcare professionals to differentiate cervicogenic dizziness from other vestibular, medical, and vascular disorders that cause dizziness.
The symptoms of cervicogenic dizziness include imbalance, unsteadiness, disorientation, neck pain, limited cervical range of motion (ROM), and may be accompanied by a headache. The cervical spine may be considered the cause of the dizziness when all other potential causes have been excluded. To be considered cervicogenic dizziness, the dizziness should be closely related to changes in cervical spine position or cervical joint movement.
The exact cause of cervicogenic dizziness is not fully understood. Some researchers have suggested that faulty cervical proprioceptive inputs may play a role in the development of symptoms. It has been proposed that disruption of normal afferent signals from upper cervical proprioceptors to the vestibular nucleus results in an inaccurate depiction of head and neck orientation in space.
When diagnosed correctly, cervicogenic dizziness can be successfully treated using a combination of manual therapy and vestibular rehabilitation. Manual therapy techniques such as sustained natural apophyseal glides (SNAGs) and self-SNAG exercises have been shown to be effective in reducing symptoms. Vestibular rehabilitation is an exercise-based program designed to reduce vertigo and dizziness, gaze instability, and/or imbalance and fall risk.
Exercises for Cervicogenic Dizziness
Cervical vertigo, also known as cervicogenic dizziness, can cause instability and disorientation due to neck injury or health conditions that affect the neck. Tight muscles in the neck can contribute to these symptoms, which can be alleviated with the right stretches and exercises. This article will show you some practical techniques to relieve cervical vertigo.
Rotation Movements for Neck Loosening
To begin, loosen your neck with some rotation movements. Start by keeping your head neutral and rotating from side to side. Do this continuously, taking a small break if needed. If your muscles are tense, you may not be able to rotate too far, but try to push yourself to achieve the stretch. Then, move on to lateral cervical curves, where you move your head from side to side, bringing your ear closer to your shoulder.
Stretching Trapezius Muscles
One of the best stretches for the neck is the upper trapezius stretch. This muscle attaches to the neck and can contribute to cervical vertigo if tense. Sit on your hand on one side, and stretch the opposite side’s trapezius muscle by bringing your other hand over your head and above where you are placing your finger on your ear. Gently pull towards the side until you feel the stretch in the muscle. Hold this for 30 seconds and repeat it three times on each side.
Elevator Scapula Stretching
The levator scapula muscle is another muscle that can cause tension and contribute to cervical vertigo. You can stretch this muscle by touching your shoulder blade and pushing your elbow upwards. Alternatively, keep your hand behind your back or place it underneath your other hand. Rotate your head at a 45-degree angle, where your knee is, place your hand on your head, and pull down almost as if tucking your chin into your armpit. Hold for 30 seconds and repeat three times on each side.
Isometric Exercises for Cervical Vertigo
Isometric exercises can activate the muscles without causing significant movements that may be painful. Begin with isometric lateral bending movements by placing your hand on your temple or fingers on your temple, using your palm to avoid movement. Push towards your hand, starting at 25-30% strength, hold for three to five seconds, relax and repeat on each side.
Next, do isometric rotation movements by placing your hand on your temple or fingers on your temple and pushing towards your hand at 25-30% strength. Hold for three to five seconds, relax, and repeat on each side.
Chin Tuck Exercise
Chin tuck exercises can help to reset your posture and alleviate cervical vertigo. Maintain a neutral chin position and attempt to touch your chin to your chest, holding for three to five seconds, relaxing and repeating several times. As you progress, you can use your finger as a target to touch your chin to and hold for three to five seconds.
Scapular Squeezes
Squeezing your scapulas together can also help to alleviate cervical vertigo. Visualize someone touching your spine and squeezing your shoulder blades together. This exercise should be done while keeping your shoulders relaxed and focusing on muscle movement. Repeat several times, holding for three to five seconds.
Conclusion
In conclusion, cervicogenic dizziness is a complex condition that requires careful evaluation to accurately diagnose. Once diagnosed correctly, it can often be successfully treated with manual therapy techniques such as SNAGs combined with vestibular rehabilitation exercises.
These techniques can help loosen tight neck muscles and activate proper muscles without causing painful movements. Start incorporating these exercises into your daily routine, and you will soon see the benefits.
Remember to seek medical advice before starting any exercise program, especially if you have underlying conditions.
MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.