Internal Medicine

Dizziness from the cervical spine

introduction

dizziness (med. Vertigo) caused by the cervical spine is also called more cervicogenic dizziness (coming from the cervical spine) or Cervical vertigo designated. Often the vertigo symptoms occur Acceleration trauma or any other type of accident that affects the cervical spine.

There are different types of vertigo. Vertigo caused by the spine is usually not considered Vertigo perceived, but often as vertigo, which is accompanied by an unsteady gait. Dizziness can also trigger a disturbed feeling of position in the room. The dizziness symptoms increase with movements or after prolonged forced posture and often parallel pain in the neck area occurs. The mobility of the neck and head is often restricted and the muscles of the cervical spine and the shoulder and neck area are painfully tense.

The dizziness can last a few minutes, but can also be about drag on for several hours. Atypical for dizziness emanating from the cervical spine, other complaints are like Hearing impairment or Visual disturbances. Dizziness due to a cervical spine disorder is a very common cause of dizziness in Germany, but it will often not recognized.
If the diagnosis is made correctly, cervicogenic dizziness can occur handled well become and can be completely reverse engineerwhen treated consistently.

Symptoms

dizziness can manifest itself in many different variations and is often a Warning sign of the brain. In general, those affected feel uncomfortable, insecure and light-headed.

Vertigo: You have the feeling that something is rotating in you or that the environment circles around you.
Vertigo: One thinks to sway or the environment seems to move, similar to a ship.
Elevator dizziness: You have the feeling of being pulled up or down, similar to an elevator
Tendency to fall: the feeling of tipping forward or backward
Lightheadedness: permanently existing e.g. Vertigo

Causes of dizziness

Certain Sensory and nerve cells derive information from the muscles and tendons of the Cervical spine to the Equilibrium organs further. Damage to these sensory cells can lead to a Spatial perception disorder (Dizziness) and unsteady gait or a Leaning to fall to one side come. These sensory cells transmit every change in the position or posture of the muscles to the brain, which in turn transmits the Balance and spatial orientation are regulated.

These are to be distinguished Damage to the organ of equilibrium in the ear themselves, which can trigger similar complaints. Often, vertigo caused by a cervical spine is caused by a Accident event triggeredIt is more difficult to assess dizziness without a previous accident. This can be Changes in the cervical spine due to an anomaly or age-related changes act that cause the dizziness.

Tension in the shoulder and neck musclesThat can no longer be deliberately released can also trigger dizziness. A Herniated disc in the cervical spine, Blockages of the upper two cervical vertebrae (Atlas and Axis), Looseness or instability of the ligamentous apparatus such as frequently recurring blockages can also trigger cervicogenic dizziness.

Rarely can one Narrowing of an artery in the cervical area be the cause of the dizziness. The so-called Vertebral arteries are small arteries, each right and left through one bony canal in the cervical spine run away. They supply along with the large carotid arteries on the front of the neck (Carotid arteries) the brain with oxygenated blood.

A narrowing of these cervical spinal arteries does not lead to complaints during normal movements in everyday life, but extreme head rotations can be due to a Circulatory disorders of the brain Dizziness occur. This circulatory disorder can rarely lead to a critical undersupply of the brain lead, for example if the artery of the opposite side is not created (i.e. missing) or this also a constriction having. If the artery on the opposite side is intact, however, it can be under normal Conditions the narrowing fully compensate.

Tension

For our orientation in space (where is right / left, up / down) and our associated movements, humans have a complex one Regulation mechanism in the brainthat brings together information from various sensory organs and calculates them. The signal receiver, so-called Receptors, but not only in ours Balance organ in the inner ear, but rather distributed throughout the body. Above all, there are many and important receptors in our muscles and connective tissue, which transmit signals to the brain about our posture and position in space. A particularly large number of these receptors are located in the short neck muscles. If tension develops in these areas, information is passed on to the brain, which is combined with other information, e.g. the receptors of the eyes and feet do not match. This Misinformation is then absorbed by the brain and confusion occurs. The consequence is the disruption of the orientation and the Movement coordination With dizziness.

(For more information, read our article: Dizziness due to tension.)

disc prolapse

Between each of our Vertebral bodies lies a so-called Intervertebral disc, which is made up of two parts, the outer fiber ring and the inner gelatinous core. The main tasks of the intervertebral discs are to dampen shocks and limit the range of motion. This heavy load to which the intervertebral discs are exposed every day, occurs in the course of life degenerative changes. In the course of these changes it can happen that the outer fiber ring tears and the liquid gelatinous core emerges disc prolapse. Depending on where the tear occurs, the gelatinous core can spread in different directions. If the leaked core causes the Backmarks or compressions one Nerve root It can lead to dizziness, among other things, as the receptors in the nerves are stimulated and pass on incorrect information to the brain, which does not match the information from other sensory organs. Herniated discs of the cervical spine are less common than in the Lumbar spine, but show an upward trend.

blockade

An accident such as having a car accident Whiplash, Sports accidents with a fall on the head or falling like from a tree, can uppermost cervical vertebrathat sits directly on the skull can be shifted slightly to the side, tilt slightly and / or twist. It follows that in this area the Spinal cord gets pinched and it becomes permanent Pressure load comes. As a result, the sympathetic nervous system is stimulated more than necessary. Besides other symptoms like Increase in blood pressure, Ringing in the ears and Poor concentration it can too dizziness come.

A blockage in the area of the cervical spine can occur, especially in the Infancy come because at this point the Holding apparatus the spine is still very weak. You must therefore be particularly careful during the Birth process be proceeded. A slight pull on the head during the expulsion phase for support can be enough to cause a displacement of the vertebral bodies. Children born with blockages in the upper cervical spine may develop into so-called "Screaming kids". This is most likely due to night pain owing to Tension.

fear

Also Anxiety disorders or depression can cause dizziness. Many anxiety and panic patients suffer from dizziness, but often none neurological or vestibular Have the causes determined. A distinction can be made between two syndromes:

Phobic attack vertigo with and without panic symptoms
Psychogenic stance and gait disorder

In many cases, fear and dizziness are mutually dependent, because those who suffer from dizziness frequently get fear of possible attacks of dizziness and their consequences.

diagnosis

The diagnosis of dizziness, which occurs due to changes in the cervical spine area, can be not by a simple test be asked. Observing that one Turning or lifting the head which triggers vertigo symptoms can on the one hand for one cervical vertigo as well as for one Disturbance of the organ of equilibrium speak in the ear. Any movement of the cervical spine inevitably leads to a movement of the head, which makes diagnosis difficult.

The Definition of the cause from vertigo through the cervical spine compared to other, vertigo-inducing diseases is therefore difficult. Basically, it is important to consider other causes that cause symptoms of dizziness, such as:

benign positional vertigo
Meniere's disease
Attack-related vertigo
Sudden hearing loss etc.

reliably exclude. Hardenedness, bad posture and restricted mobility in the neck area can also indicate cervicogenic dizziness.

A muscular cause can be identified by a physical exam (such as the Finding painful pressure points) can be diagnosed relatively quickly.
Also a Herniated disc of the cervical spine can through a radiological imaging (Nuclear spin, MRI of the cervical spine) can be easily identified.
Further information on this topic can also be found at: MRI of the cervical spine

The reliable diagnosis of blockages and other causes of dizziness is a little more difficult. Under certain circumstances, the clarification of the cause of vertigo symptoms is a cooperation of General practitioner, ear, nose and throat specialist, neurologist, orthopedist and ophthalmologist required.

Therapy of vertigo caused by the cervical spine

Since the causes of dizziness are so diverse, the therapy is also very different. Basically it is important that therapy targeted against the cause of the vertigo is. In the case of vertigo through the cervical spine is one to recommend orthopedic and sports medical treatment. However, sometimes a neurological evaluation (e.g. with a Herniated disc of the cervical spine) necessary be.

Dizziness caused by an accident in the cervical spine often develops during the Treatment of pain and muscular tension the cervical spine well back. The symptoms usually improve within a few weeks (in around 75% of cases) anti-inflammatory, pain reliever, and muscle relaxing drugs combined with physiotherapy exercises.

It can additionally

acupuncture
Neural therapy
massage,
manual therapy or
Remedial gymnastics (for example with the help of a dizziness program)

be performed. A Hyperextension of the cervical spine should be avoided will and Exercises to relax the neck should be especially at Neck stressful activities (e.g. office or computer activities) are carried out regularly.

Sometimes, however, an additional, so-called vestibular rehabilitation perform. This is a special balance training performed, whereby the Brain learning should the Dizziness as a faulty signal to interpret. Different exercises for Stabilization of the equilibrium system should lead to an improvement of the complaints under professional guidance.