InterestingORLFacts: Can your neck pain make everywhere "spinny"

While the influence of neck position on equilibrium has been known and documented since 1800s, it is often difficult to assume any relationship in situations of neck pain or stiffness associated with dizziness.

That was until 1955 when Ryan & Cope described a syndrome of disequilibrium and disorientation in patients with many different diagnoses of neck pathology including cervical spondylosis, cervical trauma, and cervical arthritis. They labelled this syndrome cervical vertigo.

A flurry of publications on cervical vertigo was to follow. The argument for the existence of this diagnosis was premised on the fact that Proprioceptive input from the neck participates in the coordination of eye, head, and body posture as well as spatial orientation.

However, the interesting fact is that true spinning vertigo is rarely associated with this disease,making some worker to suggest alternative diagnosis of cervicogenic dizziness for this condition.

Also interesting is the fact that while some entities previously defined as cervical vertigo have survived the test of time and may be found in the literature today for example rotational vertebral artery syndrome, post-traumatic cervical vertigo, and cervicogenic proprioceptive vertigo, others such as cervical sympathetic syndrome (Barré-Lieou syndrome), have been discredited.

It was also subsequently elaborated that since neck contains mechanisms directly involved in balance control (neck afferents), cardiovascular control (carotid bodies), and purely vascular structures (carotid and vertebral arteries), and since neck movements are also invariably associated with head movements, then perhaps experiencing unsteadiness or vertigo associated with neck movements could be due to a disorder in vestibular, visual, vascular, neurovascular, or cervicoproprioceptive mechanisms.

The interesting aspect of this exposition is that currently there is no consensus concerning how one diagnoses cervical vertigo, and the literature is replete with poorly carried out studies as well as studies containing strange suggestions regarding mechanism or treatment.

As such the publications on "cervical vertigo" has plummeted in the last half decade.