Tuesday, 25 May 2010

Neck Pain and Dizziness

imageBy Joel Rosen

Did you know that many neck pain sufferers also suffer from vertigo and dizziness as well? I'd be willing to bet though that many of these people don't realize that the all three are related.

This article will explain how they are related, why neck pain and dizziness often occur together, and better yet, what you can do about it.

Vertigo is defined as: " a condition in which somebody feels a sensation of whirling or tilting that causes a loss of balance"

If you have ever felt dizziness, then you understand that eerie sensation of tilting or spinning! I should know I often experience vertigo myself. I especially get dizzy going on roller coasters, Ferris wheels, and other things too. Like trying to read in a moving car, going out on a boat in choppy waters, or watching a bumpy home video, when the camera is shacking constantly.

As a chiropractic physician and rehab specialist, I often hear my patients say when describing vertigo are: unsteadiness, dizziness, lightheadedness, or even giddiness.

Why do we get vertigo? Does vertigo have any relationship to neck pain or neck problems? If so, what?

Great questions to ask because if they are related the answers may explain why we get dizzy in the first place.

Secondly, if neck pain, dizziness and vertigo are related, then if we focus on fixing your neck pain, then you can fix the vertigo problem as well.

Understanding the anatomy will really help you understand how they are related.

The part of our brain that is responsible for vertigo is called the vestibular nucleus, which is located in the brainstem. Stimuli, or information from the body travels up the spinal cord into the brainstem, and then into the brain.

Whatever information that enters into the vestibular nucleus that causes the nucleus to be excited, creates the sensation of vertigo. The information that enters the nucleus can be normal or abnormal.

As a normal signal for example think about a spinning body on a roller coaster, a normal signal of information being sent the brain is the sensation of spinning. Consequently, a sensation of vertigo may develop. The vertigo is a normal response of the spinning. If you stop spinning, you stop sending the information to the nucleus, and the vertigo sensation stops.

The information that enters the nucleus and initiates the vertigo sensations can arise from a number of sources as well. Let's talk about four of them.

Firstly, labyrinthine (inner ear): inner ear problems may be sent to the vestibular nucleus, and cause vertigo. This is what I have personally. Having several inner ear infections as a child, I had repeated tube procedures into my ears, which unfortunately created a large amount of scar tissue in my inner ear.
Something called Canalithiasis produces vertigo a pathological diagnosis for the sensation of vertigo as a result of dislodged particles in the canals of the inner ear.

This is also known as BPPV:

B stands for benign, because it is not a serious cause of vertigo like infection or malignancy

P stands for paroxysmal, which suggests the bout last for short episodes, typically 20-60 seconds, and a sensation of lightheadedness may persist for several hours.

P stands for positional, because the vertigo is dependent on the positions of your head and neck.

V stands for Vertigo.

Whenever a bout of benign paroxysmal positional vertigo (BPPV) occurs, an incredibly basic, but hugely successful technique for treating and elimination vertigo should be performed.

Pioneered by physician John Epley, MD, the procedure is aptly called, the "Epley" procedure. This procedure to treat BPPV involves precise positioning and turning of the head through a series of positions with intention to move the problematic particle along the inner ear to a location that no longer sends information to the brainstem.

Another source of information that enters the nucleus and initiates the vertigo sensations can arise from the cerebellum.

The cerebellum is linked neurologically to the vestibular nucleus. Also known as the "little brain", one of the cerebellum's functions is to provides a major source of input to the vestibular nucleus, or the vestibular centers.

A third source of stimuli to theses vestibular center is the Temporomandibular Joint (TMJ): It was been shown that the TMJ sends information to the vestibular nucleus as well.

So if you have ever had jaw problems, as well as neck pain (which are also closely related as well) in the past or currently, then you've have probably experienced vertigo as well. Thus, proper evaluation of the TMJ, determining how well the jaw is opening and closing, also called "tracking", understanding if this is a sensitive area, grinding the teeth in the evening are all sure signs that you may have TMJ issues.

More importantly though, rehabbing the TMJ by restoring and rehabbing faulty motion patterns, as well as easing muscle tension, being aware of grinding your teeth, and maybe even wearing a mouth guard, can all really help the vertigo problem as well.

A final source of stimulation to the vestibular nucleus in the brainstem is the cervical neck bones at the level of C1, C2, and C3.

It's true, and in a study performed over 33 years ago in 1977 found that by injecting a saline irritant into the deep tissues of the upper cervical spine will create the sensation of vertigo?

When this occurs, when the tissue of the upper neck, including the neck bones, discs, and joints send faulty signals to the vestibular centers in the brain, vertigo obviously develops.

This cause of vertigo is classically termed CERVICAL VERTIGO.

Cervical vertigo, or vertigo caused from neck problems can easily be addressed by focusing on restoring proper neck function, neck posture, and neck ranges of motion.

In part 2 of Neck Pain and Dizziness I will discuss how Cervical Vertigo creates dizziness, and better yet, what you can do on your own to address your own cervical vertigo. What you can do on your own to restore proper neck function, posture and ranges of motion.

Learn that, and get rid of your dizziness, and neck pain. Perfect.

Till next time, watching your back (and neck).

Dr Joel Rosen, D.C. BPE, BA (Psych), is a Doctor of Chiroprrtic as well as a lifestyle & conditioning coach in Boca Raton, author of Lose the Neck Pain System, a contributing author to a number of article directories and magazines

Dr. Joel's neck pain elimination system websites feature his best-selling Lose the Neck Pain System for neck pain, upper back pain, headache pain, carpal tunnel syndrome, and even lower back pain and his membership site offers access to all of Dr Joel's Lose the Neck Pain System and video clips for men and women and discussion forums.

Dr. Joel Rosen also has an advanced education background, completing a Master's of Science Degree in Exercise Physiology from McMaster University in Hamilton, Ontario, Canada and completing a Psychology from York University in Toronto, Ontario, Canada.

image Dr. Joel Rosen combines both disciplines as well as his doctorate in chiropractic to give his patients the cutting edge rehab strategies and techniques for obtaining optimal health and ending years of pain and suffering. Dr. Joel continues to study the latest training, supplementation, and nutrition research that will help improve client's health and wellness as well as their physical and mental performance.

Check out his website at

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