This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.

What causes dizziness and vertigo?

Dizziness and vertigo are symptoms rather than diagnoses. Inner ear disorders such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and Meniere’s disease commonly produce vertigo with positional triggers, hearing changes, or fluctuating symptoms. Cardiovascular causes, medication side effects, metabolic disturbances, and neurological conditions can produce more general dizziness or imbalance. A careful history that notes the onset, duration, triggers, associated hearing loss or tinnitus, and pattern of episodes helps clinicians narrow possible causes and plan appropriate testing and treatment.

When is the neck or cervical spine involved?

The cervical spine can contribute to vertigo-like sensations when neck dysfunction affects proprioceptive input or when pain and stiffness alter head and eye reflexes. Cervicogenic dizziness is a descriptive term used when symptoms are linked to neck injury, arthritis, or muscle imbalance. Signs that the neck may be involved include symptom provocation by neck movement, concurrent neck pain, reduced range of motion, or a recent whiplash injury. Confirming a neck contribution usually relies on clinical assessment, response to targeted neck treatment, and exclusion of primary vestibular or central nervous system causes.

How is vertigo diagnosed?

Diagnosis begins with a focused clinical exam. Positional tests such as the Dix–Hallpike maneuver help identify BPPV by provoking characteristic eye movements (nystagmus) and symptoms. Vestibular testing (video head impulse test, electronystagmography) and hearing assessments can distinguish inner ear disorders. When neck involvement is suspected, assessment of cervical range of motion, palpation, and provocation tests are used. Imaging such as MRI or CT is reserved for red flags (neurologic deficits, atypical presentations) or when structural cervical spine issues are suspected. A multidisciplinary approach often yields the most accurate diagnosis.

What treatments address vertigo?

Treatment reflects the diagnosis. For BPPV, canalith repositioning maneuvers (for example, the Epley maneuver) are effective in relocating otoliths and relieving positional vertigo. Vestibular rehabilitation therapy—graded gaze stabilization, balance retraining, and habituation exercises—supports compensation for many vestibular disorders. Medications (short-term vestibular suppressants or antiemetics) can ease severe acute symptoms but are not long-term solutions. When cervical dysfunction contributes, targeted physical therapy, manual therapy, posture correction, and specific neck exercises may reduce symptom triggers. In select cases, referral to ENT, neurology, or pain specialists is appropriate.

How does pain influence vertigo and recovery?

Pain, especially in the neck or head, can complicate vertigo recovery. Cervical pain can alter neck motion and sensory feedback, perpetuating imbalance or dizziness. Migraine-associated vertigo often combines headache, light sensitivity, and episodic vestibular symptoms, and its management may include lifestyle changes and migraine-directed therapies. Effective recovery typically involves addressing pain with nonopioid analgesics when appropriate, physical therapy, ergonomic adjustments, and strategies to reduce trigger exposure (sleep, hydration, caffeine, stress). Coordinating pain management with vestibular rehabilitation often improves functional outcomes.

Conclusion

Vertigo and dizziness have diverse causes, and appropriate treatment depends on identifying whether the origin is vestibular, cervical, neurological, or systemic. Clinical assessment, targeted maneuvers, vestibular rehabilitation, and, when indicated, cervical-focused therapy form the core of most care plans. Working with qualified clinicians to establish a diagnosis and a tailored treatment approach helps reduce symptoms and improve balance and daily function.