If you have dizziness that seems like fairly constant lightheadedness and gets worse in the evening, you may be suffering from upper cervical dizziness.

Upper cervical alignment problems in the C1 atlas bone or C2 axis bone can cause dizziness, lightheadedness, vertigo, and imbalance, and sometimes tinnitus and headaches.

To screen my patients, I check the active range of motion of their neck during the initial exam. I also perform special physical therapy tests to identify a cervical component of dizziness during a patient exam.

If a patient cannot turn their head ninety degrees to the right and left and extend their neck 75-90 degrees, then dizziness may be coming from their neck.

If one of the special tests indicates that their neck is the root cause of dizziness, I teach my patients self-care techniques and refer them to another healthcare provider who specializes in upper cervical care.

Upper Cervical Dizziness Indicators

Does your neck make noise, like a crunch, click, pop, or grind, when you turn your head side to side?

Neck noises during an active head turn may be a sign that vertigo or dizziness might be from your upper cervical area. Although some patients with upper cervical dizziness do not hear any noises in their neck when turning side to side, they may still feel neck tension.

Common signs and symptoms:

  1. Dizziness never really goes away, and fairly constant lightheadedness, wooziness, or floaty feeling (which may get worse sometimes)
  2. Tenderness or pain in the space behind the ear lobe, back of ear bone, and jaw bone on either side (see the photo at the top of this blog because she is pointing to the spot)
  3. Crunching, cracking, clicking, or grinding noises in your neck when you turn your head from side to side
  4. Can’t turn your head all the way from side to side (Limited neck mobility)
  5. Dizziness symptoms are relieved with ibuprofen or other non-steroidal anti-inflammatory drugs.
  6. Intermittent pressure or fullness in the ears
  7. Intermittent ringing in the ears (tinnitus)
  8. Pulsating dizziness in bed at night, which may change with different neck positions
  9. Anxiety started or got worse with the onset of dizziness
  10. General neck tension
  11. Headaches
  12. Recurrent vertigo

Upper cervical dizziness may or may not be associated with a headache. Migraines, vestibular migraines, tension headaches, and base of skull headaches may co-occur with upper cervical dizziness.

Anxiety may result from upper cervical issues as well due to the neurological strain on the body.

Information on who can help with upper cervical dizziness.

More information about possible root causes of upper cervical dizziness.


This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.

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