Q. Does Diagnostic Testing help to identify Cervical Vertigo?

In many cases, a hands-on exam is sufficient to get started with treatment for cervical vertigo.

My testing methods and root cause analysis are very specific to determine if dizziness and vertigo is related to the neck, either directly or indirectly. I use basic and advanced physical exam techniques for the cervical spine for differential diagnosis of cervical, vestibular, visual, and CNS related dizziness symptoms.

My focus is on identifying and resolving impairments and functional limitations, as well as reducing symptoms and maximizing quality of life so I can tailor the treatment plan to the root cause.

Regarding diagnostic testing, an upright neck X-ray like the type used by NUCCA chiropractors or an upright MRI may be helpful to diagnose an upper cervical alignment problem causing vertigo.

Q. Can the Cervical Spine Cause Dizziness even in the Absence of Neck Pain?

Yes. Traditionally, cervicogenic dizziness is only considered if the patient is complaining of neck pain.

However in my clinical practice focused on resolving vertigo, I have observed that patients with neck stiffness can have dizziness or vertigo from their neck.

Some of them complain of neck pain, but many people with cervical vertigo do not have neck pain. Their only neck symptom may be stiffness.

Q. How can I tell if my Neck Stiffness is Causing my Vertigo?

One common finding in patients with cervical vertigo is an asymmetrical limitation in cervical rotation.

In order to reduce dizziness and vertigo related to the neck, one treatment goal is to restore range of motion to 90° of cervical rotation to the right and left sides (turning your head side to side).

Another treatment goal for cervical vertigo is to increase cervical extension range of motion to 75 to 90° (looking up).

Neck stiffness as an underlying cause of dizziness – and even vertigo attacks – is often overlooked in traditional health care. Yet I have found that when range of motion is fully restored, the dizziness from the neck usually resolves.

Q. Where can I read more about Cervical Vertigo?

I’ve written at least ten blog more articles on the topic of dizziness and vertigo related to the neck that you might find useful. Here are the links:

Upper Cervical Dizziness

Who can Help with Upper Cervical Dizziness

Root Causes of Upper Cervical Dizziness

Can Posture Cause Dizziness?

Dizziness from Whiplash

Dizziness and Neck Stiffness

Dizziness and Neck Pain: the Relationship

Why Do I Have Pulsating Dizziness?

Dizziness with Head Turns

Upper Cervical Dizziness & Vestibular Rehab

Epley Maneuver Modifications for Limited Neck Rotation

Q. Are neck adjustments dangerous?

I believe that the neck must be treated with the utmost care and precautions taken. We must “do no harm” first and foremost as healthcare providers.

The risks of neck care are very real, especially in older adults with osteophytes, which are bone spurs from normal aging. Health care providers must take precautions working with patients with cervical instability such as may occur from rheumatoid arthritis, pregnancy, postpartum, Ehlers-Danlos syndrome, whiplash injury, etc.

For that reason, I only refer to experienced colleagues to treat cervical vertigo for my patients.

Q. How often do you see Cervical Vertigo?

In my approach, I do not consider dizziness and neck symptoms as separate or distinct. Instead, I consider “What is the role of the neck?” in each new case.

The role of the neck in symptoms of vertigo and/or dizziness*:

1) Secondary – due to vestibular issues or anxiety causing neck pain and tension
2) Co-morbid – occurring after head trauma or due to whiplash
3) Mixed or Coexisting – patients with an underlying vestibular disorder and then something happens to their neck
4) Primary Cervical Musculoskeletal – the main cause of dizziness is cervical vertigo (These are often mystery cases that go unsolved!)
5) Compensatory – Not cervical musculoskeletal in origin but the neck is compensating

*I took those notes at a lecture by Dr. Julia Treleaven at ICVR 2022. She’s the first researcher I’ve heard publicly advocate for the way I approach this by asking: “What is the role of the neck for each case?”


This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.

Accessibility Toolbar