Hello.

I just stumbled on this thread and did not read all of it so forgive me if I'm missing something. But, cervicogenic dizziness (CD) is a very real diagnosis. It is not necessarily caused by anxiety or depression.

It was first described in 1955 by Ryan and Cope under the term ‘cervical vertigo.’ Experimentally induced cervicogenic dizziness was later elicited via anesthetic injection in the necks of normal subjects (de Jong et al. 1977), further proving the neck to be one of the possible sources of dizziness. More specifically, mechanoreceptors of the neck have been implicated as a contributing cause of disequilibrium (Wyke 1979). Some people think this occurs because there is a direct (though minor) link between the neck and vestibular system. So, when neck dysfunction occurs there is (in theory) a mismatch of information going into the vestibular system from the vestibular organs and the neck which results in dizziness.

In the 1990's there was investigation into cervical kinesthetic sensibility (CKS) and the effects of the CKS retraining exercises on improved position sense, neck pain, and cervical ROM (Revel et al. 1991, Revel et al. 1994, Heikkilä et al. 1998). If you look up the Revel articles there are so good exercise ideas for treating cervicogenic dizziness.

It is known that whiplash (Wrisley et al. 2000, Borg-Stein 2001, Endo et al. 2006), cervical Wikipedia reference-linkspondylosis (Ryan and Cope 1955, Reid et al. 2008), hypomobility (Reid et al. 2008), hypermobility (Malmström 2007), and poor dynamic and postural control (Alund et al. 1992, Heikkilä et al. 1998, Malmström 2007) can all contribute to CD. Impairment based musculoskeletal treatment (Malmström 2007), combined manual treatment, exercise, modalities, and medication (Bracher et al. 2000), and SNAGs (Reid et al. 2008) have all been shown to treat CD.

If you believe your patient to truly have cervicogenic dizziness come up with the best impairment based evaluation you can do and treat what you find.

Steve