A question I often hear from with patients dealing with neck pain, headaches and dizziness is “why didn’t the doctor refer me to physical therapy sooner?”  Also people may have may have been dealing with these symptoms for years and say to me “I had no idea there was therapy like this for my symptoms, I wish I would have found you sooner.”  They have usually seen many specialists, who run medical tests that come back normal, but they are still symptomatic.

The combination of neck pain, headache and dizziness affects an individual from discomfort in their head to imbalance at their feet and ankles. It stems from muscle and connective tissue tension in the neck and affects balance control all the way to the feet.

Neck tension, disc problems, arthritis and postural strain lead to asymmetry in the upper neck that can refer pain to the head, eyes and cause improper head and neck awareness that affects dizziness and balance .  There are many nerve communications and receptors in the upper neck muscles that talk to the inner ear organ (balance) and also influence balance reactions from the feet and ankles (1).

Tight spots known as trigger points in the upper neck muscles can refer pain and tension to the side of the head, behind the eyes and can also trigger migraine headache and dizziness (2).  Migraine may be more common than actually diagnosed.  Currently, 1 in 6 Americans are diagnosed with migraine, and approximately 50% of those with migraine will experience dizziness, vertigo (room spinning) and balance issues (3,4).  Unfortunately, symptoms can get even worse with jaw clenching/ grinding, concussions, whiplash injuries, and poor ergonomics working at desks and computers.

Physical Therapy with a manual therapy experience and a  vestibular ( inner ear) specialty can help you treat the entire system from head to toe to have the best results.  Unfortunately, there is no one medication or medical treatment that will solve all of these overlapping issues.

Here at Core Wellness and Physical Therapy, Renee Ives, PT,  has both manual therapy experience combined with a vestibular rehabilitation certification and she can perform a comprehensive evaluation to rule out vestibular (inner ear ) deficits, neck and posture problems and balance impairments.

A holistic approach of manual therapy and exercise therapy to improve neck range of motion, reduce muscle and facial tension, improve posture, and improve mechanics of the upper neck allows for the best outcomes in pain and dizziness symptoms. In addition, core strengthening, and balance training improve balance reactions and improved awareness of the head and body position in space.  (5,6) Lastly, brain compensation exercises can help any impaired inner ear function.

Do not suffer another day with headache, neck pain and dizziness and let us treat you as a whole person, from head to toe!

1. Grande-Alonso, B. Moral Saiz, A. Mínguez Zuazo, S. Lerma Lara, R. La Touche. Biobehavioural analysis of the vestibular system and posture control in patients with cervicogenic dizziness. A cross-sectional study.Neurología (English Edition). Volume 33, Issue 2, March 2018, Pages 98-106.
2. Thien Phu Do, Gerda Ferja Heldarskard, [...], and Henrik Winther Schytz. Myofascial trigger points in migraine and tension-type headache. J Headache Pain. 2018; 19(1): 84. Published online 2018 Sep 10. doi:10.1186/s10194-018-0913-8
3. Burch, R. , Rizzoli, P. and Loder, E. (2018), The Prevalence and Impact of Migraine and Severe Headache in the United States: Figures and Trends From Government Health Studies. Headache: The Journal of Head and Face Pain, 58: 496-505. doi:10.1111/head.13281
4. Honaker, Julie A. and Samy, Ravi N., "Migraine-associated vestibulopathy" (2008). Special Education and Communication Disorders Faculty Publications. 24. http://digitalcommons.unl.edu/specedfacpub/24
5. Wrisley D, Sparto P, Whitney S, Furman J. Cervicogenic dizziness: A review of di- agnosis and treatment. J Orthop Sports. Phys Ther 2000; 30:755-766.
6. Susan Armijo-Olivo,corresponding author Laurent Pitance, Vandana Singh, Francisco Neto, Norman Thie, Ambra Michelotti. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis Phys Ther. 2016 Jan; 96(1): 9–25.Published online 2015 Aug 20. doi: 10.2522/ptj.20140548.