How the Upper Cervical Spine Can Influence Vertigo and Balance

 Why Vertigo Isn’t Always an Inner Ear Problem

Many people believe that vertigo only comes from an inner ear problem, but that’s not always the case. Vertigo can also come from the upper part of the neck in your spine. When people have had vestibular treatment and maneuvers like the Epley and still have not found relief, this can be a sign that the vertigo or dizziness could be coming from the neck. Because multiple systems contribute to balance, identifying the source of vertigo is an important first step in choosing the right treatment approach.

The Role of the Upper Cervical Spine in Balance

Proprioception

Proprioceptors are receptors in the muscles and joints that send information to the brain for spatial orientation and position. The upper part of your neck, your C1 and suboccipital muscles contain up to 50% of all proprioceptors responsible for monitoring head position. If biomechanics in the upper neck are altered, this may contribute to changes in sensory input to the brain and can, in some patients, lead to vertigo symptoms.

Brainstem Proximity

The craniocervical junction has very close proximity to the brainstem. Your brainstem is responsible for interpreting sensory signals between the brain and the body.

Sensory Mismatch

Sensory mismatch can happen when signals sent to the brain from your eyes, ears, and upper neck do not match. Many times, when proper movement is lacking in the neck, the brain does not receive accurate sensory information, which may not align with signals from the eyes and inner ear. This sensory mismatch can feel like unsteadiness, imbalance, or even mimic classic vertigo symptoms.

What Is Cervicogenic Vertigo?

Cervicogenic vertigo simply means vertigo that is caused by altered biomechanics in the neck.

Symptoms patients may notice include:

• Dizziness with neck movement
• Symptoms after an injury
• Posture-related dizziness
• No improvement after vestibular treatment or positional maneuvers like the Epley or Foster maneuver

How Upper Cervical Care Differs From Traditional Chiropractic

Upper cervical chiropractic care is very different from traditional chiropractic. An upper cervical doctor focuses on nervous system function, uses objective measurements, and only adjusts the patient when needed.

Biggest differences:

• Nervous system–focused
• Precise
• Individualized
• Not twisting/cracking-focused
• Not adjusted every time (only when needed)

Who May Benefit From This Approach

Many people may benefit from upper cervical chiropractic care, especially if they are suffering from vertigo. Many patients report a past injury such as a car accident, ski accident, or slip and fall. However, you do not need a major trauma to benefit from upper cervical care. Even prolonged computer use or poor posture can create issues in the neck.

Many of our patients experience:

• Persistent dizziness after BPPV treatment
• Migraines + vertigo
• Chronic neck tension
• History of trauma (big or small)
• Feelings of imbalance or dizziness

In our Boulder office, many patients seeking care for persistent dizziness report that their symptoms worsen with prolonged computer work, neck tension, or after previous neck injuries, suggesting that cervical spine function may play a contributing role. Many patients we evaluate are surprised to learn that dizziness can persist even after successful inner ear treatment when the neck is also contributing to symptoms.

What Patients Typically Experience During Care

The first step in care is typically a 15-minute consultation to determine whether you are a candidate and likely to get good results. Once we establish that you most likely have cervicogenic vertigo, we begin with a detailed intake form and health history.

We then perform specific orthopedic tests of the neck and assess range of motion. Computerized infrared thermography is performed to evaluate brainstem function. The final step is taking biomechanical X-rays to visualize altered biomechanics in the neck and determine how adjustments should be performed specifically for you.

A tailored care plan is then created based on test findings, health history, age, and how long you have been experiencing cervicogenic vertigo. Once care begins, patients typically start seeing results within the first 2–6 weeks.

Frequently Asked Questions About Upper Cervical Care

Does it hurt?

The adjustment should not hurt. Sometimes it may feel slightly uncomfortable when first starting care as movement is restored to the joint.

Is cracking involved?

Our main focus is not to see how much your neck can crack. We use very precise adjustments. Sometimes there may be a small release or noise produced by movement, but your head will not be whipped around and every joint will not crack.

How long until improvement?

Most patients notice improvements within the first 2–6 weeks. It can take a few months for everything to stabilize and for proper motion to return to the neck.

Is this safe?

Upper cervical chiropractic is considered one of the safest chiropractic techniques because we do not rotate or extend the head during adjustments. We use objective measurements and X-rays to help ensure adjustments are performed safely.

 

Vertigo can have more than one cause, and while many cases originate in the inner ear, some patients experience dizziness related to how the upper cervical spine functions within the balance system. Because the neck, eyes, and inner ear work together to maintain stability, identifying the source of symptoms is an important step toward finding the right care. Upper cervical evaluation focuses on restoring proper movement and communication within this system using precise, individualized approaches. For Boulder patients experiencing persistent dizziness, imbalance, or vertigo that has not fully resolved, a thorough assessment may help determine whether the upper neck is playing a contributing role.

If you are unsure whether your symptoms may be cervicogenic in nature, a consultation can help determine whether upper cervical care is appropriate for you. Simply call our office to speak directly to one of our doctors 303-442-5911 or fill out the webform below.