Dizziness and Neck Stiffness

Typically the neck is not even considered as a possible root cause of dizziness unless the patient complains of neck pain.

I have found neck stiffness can cause motion-activated dizziness and neck pain.

Neck Mobility is Important to Relieve Cervical Dizziness

After working collaboratively on over a thousand complex patient cases with my highly experienced orthopedic manual physical therapy colleague, we have discovered dizziness and neck stiffness go hand-in-hand for some patientseven in the absence of neck pain.

Proper alignment of the bones of the neck, jaw, ribs, shoulders, full spine, and all the bones from head to toe is important for dizzy patients with neck pain or stiffness.

In addition, restoring normal mobility and range of motion of all the joints affected by neck stiffness is key, so the patient is fully functional without triggering motion-activated dizziness from the neck.

The neck should be able to actively rotate about 90 degrees to the right and left, as well as looking up with about 75-90 degrees extension. Neck stiffness that limits normal neck mobility and active range of motion may be a root cause of dizziness with head motion.

Vestibular PT and Neck Care

I have met many vestibular physical therapists who are also trying to treat the patient’s dizziness and neck stiffness themselves, in addition to providing vestibular rehab.

Conversely, I have met highly experienced vestibular physical therapists who either told me straight up that they “just ignore the neck” when treating dizzy patients or appeared to disregard the role of the neck in causing dizziness or vertigo when we discussed patient cases.

Inspired by these current trends within traditional vestibular health care, my orthopedic manual physical therapy colleague and I developed and co-instructed a physical therapy continuing education (PT CEU) course in March of 2023.

Our goal was to share our innovative, collaborative methods for managing patients with some of the most difficult and complex cases of dizziness and vertigo.

Two Specialty Providers is my Method and Recommended Approach

In many seemingly hopeless patient cases, my orthopedic manual PT colleague and I have been privileged to support and witness miraculous recoveries by combining vestibular rehab and orthopedic manual physical therapy.

See my suggestions about how to sequence vestibular rehab and upper cervical care.

A history of neck trauma or neck injury may precede upper cervical dizziness.

Yet alignment problems with the C1 and C2 bones, as well as dizziness and neck stiffness, can arise without any specific injury to the neck.

Exercise affects Dizziness and Neck Stiffness

Patients with cervicogenic dizziness often feel temporary relief during light cardiovascular exercise.

Examples include walking on a level surface or riding on a recumbent stationary bike with a backrest. I have even met some patients with cervical dizziness who reported relief while dancing or using the elliptical machine.

Since their neck is in a neutral, upright position and the blood flow to their brain and ears increases while exercising, that type of light cardio is usually beneficial in treating dizziness and neck stiffness.

However, all treatments and exercise recommendations should be determined on a case-by-case basis considering all factors.

More information about deeper root causes of upper cervical dizziness.


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.

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