Upper Cervical Findings in a Patient with Headaches, Vertigo, Hearing Loss, and Neck Pain
Patient With Vertigo, Headache, And Neck Pain
Jennifer Sanchez presented to Atlas Chiropractic on June 10, 2024, with primary complaints of chronic headaches, vertigo, hearing loss, and neck pain.
History of symptoms
The patient reported a progressive onset of symptoms over a four-year period. Headaches began approximately four years prior to presentation, followed by hearing loss three years prior. Two years prior to evaluation, the patient received a diagnosis of Meniere’s disease.
The patient described symptom relief with rest, medication, and lying down; however, these interventions provided only temporary improvement. Symptoms were characterized as fatigue and dizziness and occurred frequently (50–75% of the time), with episodes described as both constant and sporadic in nature.
Headaches were reported as constant, while the most recent episode of vertigo occurred one month prior to examination. The patient indicated that symptoms were either stable or progressively worsening over time.
Pain Characteristics and Distribution
The patient reported primary pain in the cervical region, described as both achy and stabbing in quality, with an intensity of 7/10. Secondary pain was reported in the occipital region (7/10, achy) and bilateral shoulders (5/10, achy).
Symptoms were noted to radiate into the neck, shoulders, and fingers.
Postural and Range of Motion Findings
Postural analysis revealed the following abnormalities:
- Right head tilt
- Elevated left shoulder
- Elevated left pelvis
- Anterior head carriage
Cervical spine range of motion was decreased in all planes:
- Flexion: decreased (normal ~50°)
- Extension: decreased (normal ~60°)
- Lateral flexion (right and left): decreased (normal ~45°)
- Rotation (right and left): decreased with associated pain (normal ~80°)
Palpation and Segmental Findings
Segmental dysfunction was identified in the upper cervical spine, with fixation noted bilaterally at C1 and C2.
Hypertonicity was present in the cervical musculature at levels C1–C4 bilaterally, as well as in the thoracic region from T4 through T9 bilaterally.
Neurological Assessment
Thermographic evaluation revealed patterns consistent with neuropathophysiological disturbance.
Clinical Impression
The patient presents with chronic, multifactorial symptoms including headaches, vertigo, and hearing changes, in conjunction with objective findings of upper cervical dysfunction, postural imbalance, restricted cervical range of motion, and paraspinal hypertonicity.
These findings suggest involvement of the upper cervical spine as a contributing factor to the patient’s symptom presentation.
Plan and Considerations
Care is directed toward addressing upper cervical dysfunction and restoring structural and neurological balance. Ongoing evaluation will be necessary to monitor changes in symptom frequency, intensity, and functional capacity.
Conclusion
This case highlights the potential relationship between upper cervical spine dysfunction and complex symptom presentations, including vertigo, headaches, and auditory changes. Further observation and clinical correlation are warranted to assess patient response to care.
Case Study: Chronic Vertigo Resolved After Upper Cervical Care in Boulder
Boulder Patient Finds Relief from Chronic Vertigo with Upper Cervical Chiropractic
Patient Overview
A 63-year-old female active professional in Boulder, Colorado presented to our office with a two-year history of recurrent vertigo episodes that significantly impacted daily life and work performance.
Presenting Symptoms
- Spinning sensation when turning the head
- Dizziness with head movement
- Imbalance while walking
- Associated neck tension
- Occasional uncontrolled eye movements
The patient was searching for answers after traditional inner ear treatments failed to resolve symptoms.
Previous Treatments Attempted
The patient underwent vestibular physical therapy and the Epley maneuver. However, symptoms of dizziness and vertigo persisted. In fact, certain physical therapy exercises appeared to aggravate the eye movements and spinning episodes.
Multiple specialists in the Boulder area were consulted to rule out serious pathology, but no clear inner ear cause was identified.
Examination Findings
At our Boulder upper cervical chiropractic office, the following findings were observed:
- Upper cervical misalignment
- Limited neck rotation
- Muscle guarding in the cervical spine
- Postural imbalance
- Neurological findings consistent with altered autonomic function based on thermography
Clinical Impression
Findings suggested cervicogenic vertigo — dizziness related to upper cervical dysfunction rather than inner ear crystal displacement.
This type of vertigo is often overlooked when patients are evaluated strictly for inner ear conditions.
Treatment Plan
Care began at a frequency of two visits per week to stabilize the upper cervical spine and support nervous system function. At each appointment, thermography was used prior to adjustment to assess nervous system patterns. A post-scan was performed after the adjustment to confirm that the correction was achieved and holding appropriately.
Following each adjustment, the patient rested in zero-gravity chairs to allow the body time to integrate the correction and reduce muscular tension. As stability improved and symptoms decreased, visit frequency was gradually reduced based on objective findings and clinical progress.
Patient Progress
Week 2
- Approximately 30% reduction in spinning episodes
Week 4
- Improved balance
- Decreased neck tension
Week 8
- No spinning episodes
- Returned to full activity
Patient Outcome
After 10 weeks of upper cervical chiropractic care in Boulder, the patient reported complete resolution of spinning episodes and significant improvement in neck comfort and flexibility. Most notably, the anxiety surrounding sudden vertigo attacks resolved.
Patient Questioner
What symptoms were you experiencing before care?
“Vertigo sometimes causes severe spinning, especially when I move my head in certain ways. Very often uncontrolled eye movement.”
How did vertigo affect daily life?
“I would occasionally get such bad spinning that I had to sit completely still until it passed. More than anything, I was worried something was seriously wrong with me. I saw multiple specialists trying to rule things out.”
What had you tried before coming here?
“Physical therapy made the eye movements worse. The Epley maneuver aggravated my symptoms because I didn’t have an ear crystal issue.”
When did you first notice improvement?
“About a month after starting treatment. I later stopped care for a few months, and after getting sick, the spinning returned. When I restarted treatment, I noticed improvement quickly.”
What can you do now that you couldn’t before?
“It’s more the relief of not worrying about triggering a spinning episode anymore. I feel steadier, and my neck feels more flexible.”
Not All Vertigo Is an Inner Ear Problem: The Role of the Upper Cervical Spine
Many patients in Boulder are told vertigo is always caused by inner ear crystal displacement. However:
- Not all vertigo is inner ear related.
- Neck dysfunction can disrupt balance signaling between the brain and body.
- Upper cervical alignment may influence dizziness patterns.
- Proper evaluation is essential for accurate diagnosis and targeted care.
If vertigo persists despite vestibular therapy, a cervical spine evaluation may be appropriate.
Who Should Consider an Upper Cervical Evaluation in Boulder?
You may benefit from an upper cervical evaluation if:
- You experience dizziness with neck movement
- Vestibular therapy has not resolved your symptoms
- Your vertigo has remained the same or worsened over time
- You have neck stiffness associated with balance issues
If you are in Boulder or surrounding communities and experiencing persistent vertigo, call 303-442-5911 or complete the contact form on our website to schedule a consultation.