Can Your Neck Cause Dizziness? Cervicogenic Dizziness Explained (and How We Test It)
Feeling dizzy is one of the most frustrating symptoms out there—especially when it’s not the “room spinning” type, and especially when your tests keep coming back normal.
If your dizziness feels more like:
off-balance / unsteady
lightheaded
“floaty” or disconnected
worse with neck movement, posture, or neck tension
…your neck may be contributing.
This pattern is often discussed as cervicogenic dizziness (sometimes called proprioceptive cervicogenic dizziness). The short version is: your brain builds your sense of orientation using input from your eyes, inner ear, and neck—and when those signals don’t match, you can feel dizzy or unstable.
In this post, I’ll explain:
what cervicogenic dizziness is (and what it isn’t)
why the neck can play a role
what needs to be ruled out first
how we use objective testing (NeckCare + BTrackS) to measure changes over time
Important: Dizziness has many causes. This post is educational and not a diagnosis. If you have sudden severe symptoms (see “red flags” below), seek urgent medical care.
First: “Dizziness” is a big umbrella word
People use “dizziness” to describe different sensations, and the cause can change depending on which one you mean.
Vertigo: spinning or the room moving
Disequilibrium: unsteady / “walking on a boat”
Lightheadedness: faint-ish, sometimes blood pressure/sugar/hydration related
Motion sensitivity: symptoms triggered by busy environments, screens, or head movement
Cervicogenic dizziness usually matches the unsteady / off-balance category more than true spinning vertigo, and it often has a close relationship to neck pain, stiffness, or posture load.
What is cervicogenic dizziness?
Cervicogenic dizziness is a clinical pattern where dizziness or unsteadiness appears linked to neck dysfunction, typically alongside neck pain/stiffness, and after other major causes are ruled out.
It’s also fair to say it’s a debated diagnosis in the research world because there isn’t one perfect “gold standard” test that proves it. Most clinicians approach it as a diagnosis of exclusion + pattern recognition + response to care.
Why your neck can make you feel dizzy
Your upper neck is packed with proprioceptors—tiny sensors that inform the brain about head-on-neck position, movement, and muscle tone.
Your brain constantly merges signals from:
Eyes (visual system)
Inner ear (vestibular system)
Neck proprioception (cervical spine sensors)
If your neck’s input becomes “noisy” (often from injury, muscle guarding, joint irritation, or degenerative changes), you can get a sensory mismatch—and the brain interprets that mismatch as dizziness, unsteadiness, or disorientation.
This is also why some people notice symptoms are worse with:
prolonged forward-head posture (laptop/phone)
long drives
looking up/down repeatedly
sustained neck rotation (painting, cooking, work stations)
neck tightness after stress or poor sleep
Red flags: when dizziness needs urgent evaluation
Get urgent medical care (ER/911) if dizziness is accompanied by any of the following:
sudden severe headache (“worst headache of my life”)
facial droop, slurred speech, weakness/numbness, severe coordination loss
double vision, new difficulty swallowing
chest pain, shortness of breath, fainting
sudden hearing loss
severe new vertigo with neurological symptoms
Even if your symptoms seem neck-related, it’s always smart to rule out dangerous causes first.
Common conditions that can look like “neck dizziness”
Some non-neck causes are very common and can overlap:
BPPV (inner ear crystals): brief spinning with position changes
Vestibular migraine: dizziness + headache history, light/sound sensitivity, visual symptoms
Orthostatic intolerance / dehydration: symptoms on standing, after caffeine, poor sleep
PPPD (persistent postural-perceptual dizziness): chronic “rocking”/visual motion sensitivity
medication side effects, anemia, thyroid issues, etc.
This is why we combine history + screening + objective testing before we ever blame the neck.
How we evaluate suspected cervicogenic dizziness in our office
When someone comes into the office from Encinitas/Carlsbad/Oceanside (or anywhere in North County) with dizziness, the goal is clarity and measurable baselines.
1) History: pattern matters
We look for clues like:
Does it correlate with neck pain/stiffness?
Is it triggered by neck movement or sustained posture?
Was there a prior whiplash, fall, sports injury, or concussion?
Is it spinning or unsteady?
Any migraine history?
Any red flags?
2) Basic screening
Depending on your story, we may recommend co-management or referral for:
vestibular/ENT evaluation
primary care labs
neurology consult
physical therapy vestibular testing
3) Objective testing: measure what the nervous system is doing
This is where we get very specific.
NeckCare testing: ROM + Joint Position Error (JPE)
A big part of “neck dizziness” comes down to sensorimotor control—your brain’s ability to know where your head is in space and guide movement accurately.
One way to quantify that is the Cervical Joint Position Error (JPE) test, which is commonly used to assess cervical proprioception. Research supports that JPE testing can be reliable when performed correctly, and it’s often used in people with neck pain and dizziness-type presentations.
In plain English:
If you close your eyes and try to return your head to “center,”
how close do you get?
and does accuracy change depending on direction (left/right/up/down)?
With NeckCare, we use this as a baseline and then re-test over time. If someone’s symptoms are improving and their JPE is improving, that’s a meaningful signal that the system is calming down—not just “guesswork.”
We also track range of motion (ROM) because neck stiffness and guarded movement can feed the mismatch loop.
BTrackS balance testing: quantify stability (not just “how you feel”)
Dizziness can be sneaky because it fluctuates day-to-day. That’s why we like objective balance metrics.
BTrackS is a portable force plate system that quantifies postural sway and balance performance with standardized protocols. There’s published work supporting BTrackS validity/reliability and normative/reference data across different populations.
What that means for you:
We can measure your balance today (baseline),
then repeat it after care and/or home exercises,
and see whether stability is objectively improving.
This is especially helpful when your symptoms feel subjective (“I feel 10% better… I think?”). Balance testing gives us something concrete to track.
So… how does treatment usually work?
Cervicogenic dizziness care is typically treated like a neck + sensorimotor rehab problem:
reduce neck irritation/guarding
improve movement quality
improve proprioception and balance
(when appropriate) integrate vestibular/visual components
Research reviews suggest manual therapy can reduce cervicogenic dizziness symptoms, and effects may be stronger when combined with exercise/sensorimotor rehab (though quality varies across studies).
What care may include
targeted, gentle upper cervical care (when appropriate based on exam/imaging)
mobility and posture coaching (simple, realistic changes)
cervical proprioception drills (often built around JPE-style retraining)
balance work (progressed safely based on testing)
coordination with vestibular PT when indicated
Key point: We don’t want you stuck guessing. We want a plan with re-testing.
A quick self-check: does this sound like you?
Cervicogenic dizziness is more likely when:
dizziness is episodic and linked to neck pain or stiffness
symptoms are triggered by neck movement or sustained posture
there’s a history of whiplash, concussion, or chronic neck tightness
you feel more unsteady than truly spinning
It’s less likely when:
dizziness is primarily triggered by rolling in bed + feels like strong spinning
symptoms are clearly tied to blood pressure drops, fainting, or heart symptoms
there are neurological red flags
(And yes—sometimes it’s both: inner ear + neck + migraine patterns can overlap.)
What to expect at an evaluation (Encinitas / North County)
If you come in for dizziness, the goal isn’t to slap a label on it. The goal is to answer:
What needs to be ruled out?
Is there a neck-driven pattern?
What can we measure today?
What would improvement look like objectively?
That’s why we like pairing:
NeckCare ROM + JPE testing
BTrackS balance testing
with a detailed history and exam.
Ready to get answers?
If you’re dealing with dizziness and you suspect your neck might be part of it, we can help you:
screen the pattern,
build measurable baselines,
and create a plan that’s re-tested over time.
FAQs
Is cervicogenic dizziness “real”?
Many clinicians recognize the pattern, but it remains debated because there’s no single perfect diagnostic test. Most approaches treat it as a pattern + exclusion of other causes + response to care, rooted in the sensory mismatch model.
How do you test for it?
There’s no one definitive test, which is why we use:
history + symptom triggers
screening for other causes
objective measures like cervical proprioception (JPE) and balance testing
to track change over time.
What’s the difference between vertigo and cervicogenic dizziness?
Vertigo usually implies spinning, often inner-ear related. Cervicogenic dizziness is more often unsteadiness/disorientation, commonly linked with neck pain/stiffness and neck movement/posture triggers.
Does treatment actually help?
Systematic reviews suggest manual therapy can reduce cervicogenic dizziness symptoms, and outcomes may be better when combined with exercise/sensorimotor rehab (evidence quality varies).
Do I need imaging?
Not always. Imaging decisions depend on your history, exam findings, and red flags. In some cases, advanced imaging can help rule in/out specific structural issues and guide clinical decisions—but it’s not automatically required for every dizziness case.
