There are many different causes of upper cervical dizziness.

While upper cervical dizziness can be treated and relieved by a specialized physical therapist or chiropractor, the results may only be short-lived if the root cause is elusive.

For long-term recovery from upper cervical dizziness, the root cause of upper cervical dizziness issues may need to be addressed.

Body Posture

Poor posture can be a root cause of upper cervical issues.

For example, a forward head and rounded shoulders can cause recurring issues with the upper cervical area.

Those patients may need postural retraining and upper back strengthening to correct the root cause of their upper cervical issues, in addition to specialized upper cervical care.

Head Tilt

Tilting your head to the side can cause recurrent alignment problems in the upper cervical area.

This may occur if you have an occupation that requires you to repeatedly tilt your head or lean to the side at work.

Such occupations may include a receptionist without a headset, dental hygienist, surgeon, hairdresser, or eyebrow threader.

Ergonomics on the Computer

Improper ergonomics using a desktop, laptop, tablet, iPad, kindle, or phone can be another root cause of upper cervical dizziness issues.

People who work hunched over a laptop may need to set up their workstations with proper ergonomics to prevent recurring upper cervical issues.

Pro tip: If you are working on a laptop at a desk or table, then you are probably hunched over. If you don’t think so, you can ask someone to take a photo of you from the side to be sure your neck is straight up and not leaning forward.

You may need to get an iPad stand or a laptop stand, for example, to prevent hunching over your laptop or tablet.

There are a lot of good options now for ergonomic setup for different electronic devices.

Smartphone usage

Holding your phone up at eye level can also take the strain off your neck, as opposed to holding your phone down near your chest or waist.

You can try placing a pillow across your stomach while sitting to rest your elbows on. That can help you hold your phone up at eye level.

If your lower arms start to fall asleep, then it is time to take a break from the phone!

You can also set your phone screen on “portrait lock,” then lie on your side with your head on a pillow to look at the phone.

Sleeping Position and Pillow

Your sleeping position may be causing recurrent upper cervical dizissues.

For example, stomach sleepers notoriously have recurring problems with the upper cervical alignment. Stomach sleeping is typically an absolute no if you want to recover from upper cervical dizziness!

If you feel that you need to have that pressure on your abdomen to fall asleep, then you can put a pillow in front of you while on your side and hug it in. If you sleep on your back and you are missing that pressure on your abdomen to help you fall asleep, you can place a small pillow on your tummy or weighted blanket over you if needed.

Depending on whether you sleep on your side or back, you may need a different thickness of the pillow. You can ask your healthcare provider which pillow is best for you. Sleeping propped up due to BPPV can cause recurring upper cervical issues for people with dizziness.

This presents a common catch-22 for people with dizziness.

The vestibular health care provider may tell you to sleep propped up due to BPPV. However, sleeping propped up can affect the alignment of your C1 and C2 bones.

You can discuss your sleeping position and the correct pillow set up with your health care providers.

Unequal Heavy Loading of One Arm

Upper cervical alignment can be affected by carrying a heavy load in one arm.

For example, if you load up all the grocery bags into your non-dominant hand so that you can unlock the front door after grocery shopping, this can cause your upper cervical bones to shift out of place.

When I shop for groceries, I ask the cashier to split up my purchase into two bags of equal weight. That way I can load both arms equally.

When I get to my front door, I put down the bags to unlock and open the door. Then I pick up the equally weighted bags at the same time to walk into the house.

I typically suggest for women to make sure their purse is less than 10 pounds. Holding a heavy purse close to the body, like tucked under an arm, can reduce the strain on the neck.

Golf bags or gym bags can be carried against your body to reduce the unequal weighting of one limb with a heavy bag, if the weight of the bag cannot be reduced.

Another option is to get that heavy load into a rolling bag or in a rolling cart. I use this strategy when I come home from shopping with multiple bags. I may pop up a rolling cart that I purchased at an office supply store to roll all my purchases from my car into the house.

Walking Sideways on a Slanted Surface

A few years ago, I hiked Mission Trails in San Diego with a friend and my upper cervical bones went out of alignment as a result.

When I thought back to why that may have occurred, I realized that the hiking trail was slanted from side to side.

Therefore, I was walking for awhile on a sideways slanted surface while I was hiking.

In response to that, of course my head sought to level itself. Therefore since my lower body was slanted, my upper cervical area compensated by slanting itself as well.

That is a similar concept to having a head tilt that affects upper cervical alignment. However, in this case it was a lower body tilt that my neck was responding to from the slanted surface.

This type of issue can also occur if you walk on the beach at a higher tide, when the beach is not level but slanted.

I can no longer walk on the beach unless the tide is low enough that I can find level sand to walk on. Otherwise I will need an upper cervical adjustment afterward.

Another place to watch out for this type of issue is when you are walking on a sidewalk that has driveways disrupting the level sidewalk surface as they cross.

Some sidewalks have recurring slants when a driveway crosses it. In that case, I look for a level area to walk as I cross the driveway and try to avoid those streets in general when I’m out walking.

Trauma History

A history of whiplash may be a root cause of upper cervical issues.

In that case, soft tissue work may be beneficial for any muscle spasms or scar tissue in the neck, in addition to specialized upper cervical care.

Other Orthopedic Problems

A leg length discrepancy, scoliosis, or a limp while walking due to pain in one leg could cause upper cervical issues.

Those other orthopedic issues may need to be addressed to maximize the benefit of upper cervical care.


TMJ issues can be a recurrent cause of upper cervical problems. Some patients need to see a specialist in TMJ in order to support the best outcomes with upper cervical care.

Those are some examples of root causes that may cause upper cervical alignment not to stay in place after treatment.

You can discuss you individual situation with your health care team to find out if there is a root cause of your upper cervical issues that needs to be addressed for your long term recovery.

Click here for an article on what type of health care providers can help with upper cervical dizziness.


This blog is provided for informational and educational 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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