Dominic Stone
Vertigo is a sensation of dizziness or spinning. Cervical vertigo, also known as cervicogenic dizziness, is a neck-related sensation in which a person feels like they or their surroundings are spinning. It is often caused by trauma to the cervical spine, poor neck posture, neck disorders, or head injuries that disrupt head and neck alignment. Structural and functional changes in the suboccipital muscles, such as abnormal head posture, can also induce dizziness and vertigo. Tendinitis of the longus colli muscle, for example, can lead to acute posterior neck pain, neck stiffness, and vertigo. While the exact cause of cervical vertigo is still being researched, muscle tension in the neck and related structures can contribute to this condition and trigger vertigo symptoms.
| Characteristics | Values |
|---|---|
| Condition | Cervical Vertigo (Cervicogenic Dizziness) |
| Symptoms | Dizziness, neck pain, nausea, headaches, neck tightness, neck stiffness, neck trauma, anxiety, stress, fatigue, loss of balance, spinning sensation, lightheadedness, heaviness in the head, faintness, giddiness, unsteadiness, etc. |
| Causes | Poor neck posture, neck disorders, trauma to the cervical spine, head injury, whiplash, sudden neck movement, muscle strain, inflammation, joint issues, injured disks, degenerative disk disease, advanced osteoarthritis, slipped disk, muscle tension, etc. |
| Treatment | Massage, balance exercises, neck movements, muscle relaxants, pain relievers, anti-dizziness drugs, physical therapy, vestibular therapy, posture training, chiropractic manipulation, heat compresses, etc. |
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What You'll Learn
Cervical vertigo (neck-related vertigo)
Cervical vertigo, also known as cervicogenic dizziness, is a condition that causes both neck pain and dizziness. It is often related to certain neck conditions, injuries, or disorders. The dizziness associated with cervical vertigo can last from minutes to hours and may worsen after rapid movements, exercise, or even sneezing.
Cervical vertigo is typically associated with dizziness resulting from a specific neck posture or movement, especially when turning the head. It is caused by a disruption of blood flow to the inner ear or lower brain regions, such as the brain stem. This disruption can be due to various factors, including blockages in the arteries of the neck, which may be caused by atherosclerosis (hardening of the arteries) or dissection (tearing of the arteries).
Traumatic injuries to the head or neck, such as whiplash from a vehicle accident, can also lead to cervical vertigo. Additionally, surgeries in the neck region, especially those close to the brainstem or affecting the arteries, can cause cervical vertigo as a complication. Advanced osteoarthritis in the neck, or cervical spondylosis, can put pressure on the spinal cord, nerves, or spinal cord itself, leading to cervical vertigo.
The diagnosis of cervical vertigo can be challenging, and there is currently no definitive test available. Doctors usually rule out other potential causes with similar symptoms before making a diagnosis. Once cervical vertigo is diagnosed, treatment options include medication to reduce neck tightness, dizziness, and pain, as well as physical therapy, balance exercises, neck movements, and massage.
While cervical vertigo is a treatable condition, it is important to seek prompt medical attention as cervicogenic dizziness can mimic more serious health issues.
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Muscle tension and anxiety
Muscle tension is one of the most common physical symptoms of anxiety. Anxiety is a "somatic" condition, meaning it is caused by internal psychological and physiological functioning rather than an external source. When a person perceives a threat to their survival, their sympathetic nervous system responds with the
Anxiety-caused muscle tension can affect any muscle or group of muscles in the body and can shift from one area to another. It can be experienced as muscle spasms, twitching, "clamping up", and intermittent pain. The degree and intensity of anxiety muscle tension symptoms vary from person to person. For some, the pain may be so restricting that it prevents physical activity, while for others, it may only be slightly uncomfortable. Muscle tension can also cause insomnia, which in turn can add to anxiety.
People with anxiety may find it harder to manage or decrease muscle tension. However, there are activities and exercises that can help reduce muscle tension, such as taking a hot shower or bath, getting a massage, or practicing clinical somatics. Reducing anxiety and stress through conscious intervention, nervous system retraining, and healthy lifestyle habits are also important for preventing future tension.
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Poor posture and neck pain
However, many people adopt a forward head posture, where the neck slants forward, placing the head further in front of the shoulders. This posture increases the load on the cervical spine, as the spine must support increasing amounts of weight. For every inch the head moves forward, the weight the neck supports doubles, increasing stress on the cervical discs, joints, and vertebrae. Over time, this can lead to degenerative spinal issues, as well as muscle imbalances, where some muscles become shortened and tight, and others become elongated and weak. This can cause tightness and discomfort, leading to chronic neck pain.
Forward head posture is often accompanied by forward shoulders and a rounded upper back, which can lead to pain in the neck, upper back, and/or shoulders. Poor posture can also lead to nerve compression, causing pain, numbness, or tingling in the neck, shoulders, and arms. Additionally, increased stiffness in the muscles and/or joints can decrease the neck's range of motion, leading to reduced mobility.
Poor posture is often caused by looking down at phones, tablets, or other screen devices too frequently and for too long without practicing healthy posture. Other causes include sleeping poorly or in the wrong position, stress, wearing heavy necklaces, having long hair, and longer work hours with fewer breaks from sitting.
To improve poor posture and alleviate neck pain, it is recommended to develop an ergonomic workspace for home and office, practice good posture when sitting, and seek chiropractic care or physical therapy to improve overall health and wellness.
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Treatment options for vertigo
Vertigo is the sudden sensation of losing balance, often described as feeling like you or the world around you is spinning. It is considered a symptom, not a condition, and is associated with ear infections and inner ear disorders. Vertigo is typically treated with exercises or procedures, medication, and in some cases, surgery.
Exercises and Procedures
The Canalith Repositioning Maneuver is a common exercise to address vertigo, specifically Benign Paroxysmal Positional Vertigo (BPPV). This procedure can be done at home and involves the following steps:
- Lie on a flat surface with a pillow behind your head and your legs outstretched.
- Sit up with your back straight and turn your head 45 degrees to the right.
- Recline back down to the pillow with your head still tilted and stay in this position for 30 seconds.
- Turn your head 90 degrees to the left without lifting your neck.
- Turn your entire body so you end up on your left side.
- Return to the starting position and slowly sit back up.
The Semont-Toupet maneuver is another exercise similar to the Epley maneuver but requiring less neck flexibility. It involves the following steps:
- Sit upright on a flat surface with a pillow behind you and your legs outstretched.
- Lie down and turn to your right side, tilting your head 90 degrees to look upward.
Medication
Medications may be prescribed to reduce neck tightness, ease discomfort, and reduce dizziness associated with vertigo. Common medications include:
- Muscle relaxants such as tizanidine and cyclobenzaprine.
- Analgesics such as acetaminophen, ibuprofen, or tramadol.
- Anti-dizziness drugs such as Antivert or scopolamine.
Surgery
In some cases, vertigo may require surgery to fix underlying problems. For example, surgery may be performed to remove an acoustic neuroma affecting the inner ear or to address a tumour or injury to the brain or neck.
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Vertigo caused by longus colli tendonitis
Vertigo refers to a sensation of dizziness or spinning. It can be caused by muscle tension in the neck, known as cervical vertigo or cervicogenic dizziness. This can occur due to poor neck posture, neck disorders, or trauma to the cervical spine.
Now, let's focus on vertigo caused specifically by longus colli tendonitis. Longus colli tendonitis (LCT) is an aseptic inflammatory process affecting the longus colli muscle, resulting in acute posterior neck pain, neck stiffness, and difficulty swallowing (dysphagia). Vertigo is an infrequent symptom of longus colli tendonitis, and the exact mechanism by which it occurs is not yet fully understood. However, a case report described a 38-year-old man who presented with vertigo, dizziness, palpitations, and numbness in the hands. His symptoms were relieved immediately after treatment with corticosteroid injections and acupotomy, and they completely resolved within a week.
The case report highlights the importance of recognizing vertigo as a possible symptom of longus colli tendonitis. This condition is under-reported in the medical literature, and misdiagnosis can lead to unnecessary interventions for vertigo. Diagnosing longus colli tendonitis can be clinically challenging due to the complex anatomy of the prevertebral space and the variable appearance on radiographic imaging. Magnetic resonance imaging (MRI) with fat-suppression sequences can be useful in confirming the diagnosis.
It is worth noting that cervical vertigo, in general, can have various causes, including neck trauma, arthritis, atherosclerosis in the neck, degenerative disk disease, inflammation, poor posture, injured disks, joint issues, and muscle strain. Stress and anxiety can also trigger or worsen symptoms of cervical vertigo. Proper diagnosis is crucial, as cervical vertigo can mimic other conditions such as BPPV, central vertigo, and vestibular neuritis. Treatment options for cervical vertigo may include physical therapy, vestibular therapy, medication, and home exercises recommended by a healthcare provider.
In summary, vertigo can be caused by muscle tension in the neck, and longus colli tendonitis is a rare but under-reported cause of cervical vertigo. Accurate diagnosis and appropriate treatment are essential to manage vertigo symptoms effectively.
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Frequently asked questions
Cervical vertigo, or cervicogenic dizziness, is a neck-related sensation in which a person feels like either they’re spinning or the world around them is spinning. It is caused by issues with the cervical spine, such as neck trauma, arthritis, poor posture, or injured disks.
Cervical vertigo is typically treated by a neurologist, who may prescribe muscle relaxants, pain relievers, or anti-dizziness drugs. Physical therapy, vestibular (inner ear) therapy, and massage are also recommended to improve neck strength and balance.
Symptoms of cervical vertigo include dizziness, neck pain, headaches, nausea, and anxiety or depression. These symptoms can interfere with day-to-day life and may be triggered or worsened by stress and anxiety, which can affect muscle tone and the responses of the sympathetic nervous system.
