Arthritis in the neck, medically known as cervical spondylosis, is a common age-related condition involving the wear and tear of the spinal disks and joints. This degeneration can cause stiffness and pain, and it is increasingly recognized as a potential contributor to feelings of unsteadiness or lightheadedness. While the inner ear is the most common source of dizziness, damage to the complex mechanics of the cervical spine can disrupt the body’s balance system.
The Specific Connection
Neck arthritis can cause dizziness, a specific syndrome formally recognized as Cervicogenic Dizziness (CGD). This diagnosis is given when dizziness and balance problems are directly associated with an issue in the cervical spine, such as degenerative changes or trauma. Cervical spondylosis involves the breakdown of cartilage, the formation of bone spurs (osteophytes), and the stiffening of the spinal joints. These structural changes create a dysfunction that initiates the balance problem, making CGD a neurological consequence of an underlying mechanical problem in the neck.
CGD is characterized by neck pain that occurs alongside a sense of disequilibrium or unsteadiness. It represents a diagnostic challenge because its symptoms overlap with other, more common causes of dizziness originating in the inner ear. Treatment relies on correctly identifying and managing the underlying cervical spine issue.
How Neck Changes Disrupt Balance
The mechanism linking neck arthritis to dizziness primarily involves a sensory conflict in the brain, often called proprioceptive disruption. The joints, muscles, and ligaments of the upper cervical spine (C1-C3 levels) contain numerous proprioceptors, sensory receptors that tell the brain where the head is positioned in space. Degenerative changes or inflammation from arthritis corrupt the signals sent by these receptors, delivering faulty information to the brain’s balance centers. This sensory mismatch conflicts with accurate signals coming from the eyes and the inner ear (vestibular system), resulting in dizziness or unsteadiness.
A second, less common, mechanism involves the vascular system through the vertebral arteries. These arteries run through bony tunnels in the cervical spine to supply blood to the brainstem and inner ear. Severe arthritic changes, such as large bone spurs (osteophytes), can compress one of these arteries during specific head movements, like turning or looking up. This temporary restriction of blood flow, known as rotational vertebral artery occlusion, can lead to transient dizziness, sometimes referred to as Bow Hunter’s Syndrome.
Identifying the Symptoms
Dizziness stemming from the neck typically presents as vague unsteadiness, lightheadedness, or a sensation of being “off balance,” rather than true spinning vertigo. The symptoms are often fluctuating and may last from minutes to hours, unlike the brief, intense spinning associated with inner ear conditions. A defining characteristic is that the dizziness is usually triggered or worsened by specific neck movements, such as turning the head quickly, or by maintaining an awkward posture for a prolonged period.
The dizziness is accompanied by other symptoms that localize the problem to the neck. These commonly include neck pain, stiffness, and a reduced range of motion. Patients may also experience headaches, often originating at the base of the skull and radiating up the back of the head.
Diagnosis and Relief Strategies
Diagnosing Cervicogenic Dizziness is primarily a process of elimination, requiring a differential diagnosis to rule out inner ear, vision, or neurological issues. A healthcare provider will typically perform a thorough physical examination, including tests of the neck’s range of motion to see if movement provokes the dizziness. Specific clinical tests, such as the smooth pursuit neck torsion test, assess the neck’s proprioceptive function by evaluating how the eyes track a target while the neck is rotated.
Imaging studies, such as X-rays or MRI, are used to confirm the presence and severity of the underlying arthritic changes, like cervical spondylosis and osteophytes. However, imaging alone cannot confirm the dizziness is cervicogenic, as many people have neck arthritis without balance issues. The diagnosis relies on correlating the imaging findings with the patient’s symptoms and the physical exam results.
Relief strategies focus on conservative, non-surgical approaches aimed at improving neck function and correcting the sensory mismatch. Physical therapy is a primary treatment, including exercises for postural correction, deep neck muscle strengthening, and specific range-of-motion drills. These exercises help restore the accuracy of proprioceptive signals from the neck to the brain. Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants, can help manage the pain and inflammation that contribute to the faulty signals. In some cases, specialized vestibular rehabilitation exercises are used to help the brain better process and integrate the conflicting sensory information.