Dizziness & Alignment
The neck and head play an important role in keeping us upright and balanced.
How? The neck contains sensors (what us nerds call proprioceptors and mechanoreceptors) and these sensors send information to the brain, specifically the sensory and motor nuclei of the brainstem. Information from these sensors are also sent and integrated with information from our eyes and vestibular system (our inner ear) in the cerebellum.
Lastly, the neck sends information from the sensors to the part of the brain that controls small muscle changes when we move. An example would be when we reach for a coffee cup with our right hand the small muscles of our lower back will contract (with out us knowing) to compensate for the weight of the coffee cup that we are about to pick up. 1
These neck sensors work with our vestibular system and visual system so that when we move, our eyes are able to move smoothly and focus and small muscles throughout the spine can make proper adjustments to anticipate our movement. 1,2,3
These three systems: the neck sensors, the vestibular system and the visual system work together to keep us balanced through specific reflexes.
The reflexes are:
Cervico-collic Reflex- a compensatory response of neck muscles driven by neck sensors during motion of the body that functions to stabilize the head on the body and provide information about the motion of the head compared to the trunk.
Vestibulo-collic Reflex- a compensatory response of neck muscles when motion of the head is sensed by the vestibular system that functions to stabilize the head in space and stabilize the gaze.
Cervico-occular Reflex- A reflexive mechanism that stabilizes the eyes when focusing on an object as we turn our head. This reflex works with the Vestibulo-Occular Reflex and another reflex called the optokinetic reflex(a reflex that stabilizes our eyes when slowly turning the head.)
Vestibulo-occular Reflex- Reflexive response that stabilizes our eyes during movement of our head based on sensors being stimulated in the vestibular system.
Cervico-spinal Reflex- Reflexive response of postural stability based on neck sensors that sense rotation of the neck and head related to the trunk of the body.
Vestibulo-spinal Reflex- Reflexive response of postural stability muscles based on the stimulation of sensors in the inner ear/vestibular system (specifically the labyrinth receptors) when the head moves.
“During the vestibulo-ocular reflex a rotation of the head is detected this then triggers an inhibitory signal to the extraocular muscles on one side and an excitatory signal to the muscles on the other side. The result is a compensatory movement of the eyes.”
Reflexes: Working vs Not Working
When these reflexes are working properly we are able to maintain proper balance, move our head and neck without getting dizzy, and have normal function of the tracking ability of our eyes. 2,4
However, when one of these reflexes isn’t working properly it can lead to balance issues, dizziness and neck pain.
What causes these reflexes to not work properly?
Trauma to the neck (hitting your head, concussion, whiplash), fatigue of the neck muscles, pain and abnormal alignment of the neck and head. 4,5,6,7,8,9
Could your neck and head being out of alignment cause dizziness?
Researchers say, “Yes.”
In fact researchers in Poland found that individuals who have abnormal alignment of the head and neck have an increase in the cervico-occular reflex on one side. Due to this increase in the cervico-occular reflex it increases the chance of developing dizzy spells, blurred vision, painful neck stiffness and headaches. 8
Why does this happen? Remember the sensors we talked about at the beginning of the article?
When our neck is injured, fatigued, in pain or has abnormal alignment the sensors in the neck send signals that don’t match up with the signals sent from the visual system and the vestibular system this then results in the reflexes not working properly which can then lead to pain, instability and dizziness. 5-9
For many individuals with dizziness traditional approaches and treatment aren’t able to provide the relief they are looking for, often times this is due to hyper-focus on the vestibular system rather then looking at all three systems to see how and if they are working together properly.
Luckily for those that suffer from dizziness or vertigo in Columbus and Central Ohio that’s what we do. We look at the entire body and how it’s working together. From the neck and head to the vestibular and visuals system.
If you or someone you know suffers from dizziness or vertigo have them give us a call at 614-769-7831 or forward them this post so they can learn more about how alignment can affect dizziness.
References
1. Macpherson J, Horak F. . Posture. : Kendel E, Schwartz J, Jessell T, Siegelbaum S, Hudspeth A, . Principles of Neural Science. 5th ed. New York, NY: McGraw Hill; 2013:136–142, 158. [Google Scholar]
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5. Montfoort, Inger, et al. “Adaptation of the Cervico- and Vestibulo-Ocular Reflex in Whiplash Injury Patients.” Journal of Neurotrauma, vol. 25, no. 6, 2008, pp. 687–693., doi:10.1089/neu.2007.0314.
6. Ischebeck, Britta K., et al. “Eye Stabilization Reflexes in Traumatic and Non-Traumatic Chronic Neck Pain Patients.” Musculoskeletal Science and Practice, vol. 29, 2017, pp. 72–77., doi:10.1016/j.msksp.2017.03.004.
7. J;, Treleaven. “Dizziness, Unsteadiness, Visual Disturbances, and Sensorimotor Control in Traumatic Neck Pain.” The Journal of Orthopaedic and Sports Physical Therapy, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/28622488/.
8. Zamysłowska-Szmytke, Ewa, et al. “Cervico-Ocular Reflex Upregulation in Dizzy Patients with Asymmetric Neck Pathology.” International Journal of Occupational Medicine and Environmental Health, vol. 32, no. 5, 2019, pp. 723–733., doi:10.13075/ijomeh.1896.01428.
9. Lan, Ping-Heng, et al. “On De Vries J, Ischebeck BK, Voogt LP. ‘Cervico-Ocular Reflex Is Increased in People With Nonspecific Neck Pain.’ Phys Ther. 2016;96:1190–1195.” Physical Therapy, vol. 96, no. 9, 2016, pp. 1477–1477., doi:10.2522/ptj.2016.96.9.1477.1.