Who can Help with Upper Cervical Dizziness

Upper cervical care is a specialty area of clinical focus within both physical therapy and chiropractic care.

Many general physical therapists and general chiropractors cannot adequately adjust the C1 atlas bone or C2 axis bone, which are at the top of the neck.

The adjustment is really tricky due to the delicate structures of the head, neck, blood vessels, and brainstem that are so closely intertwined in the upper cervical area.

For example, I assess for upper cervical dizziness during my history taking phone calls and initial exams.

I provide analysis and educate my patients as to how a problem in their upper cervical area may be contributing to their dizziness, vertigo, or imbalance.

However, I would not attempt to treat this problem since it requires specialized orthopedic manual therapy skills for upper cervical care.

I refer to a highly skilled orthopedic manual physical therapist to help with upper cervical dizziness.

For my patients who prefer chiropractic care, I have a few favorite local chiropractors I trust as well to help with upper cervical dizziness.

Physical Therapy Can Help

Physical therapists with orthopedic manual therapy training in the head, neck, and jaw may be able to help.

You may need manual therapy adjustments to help with upper cervical dizziness.

The physical therapist may also teach you exercises for stretching and strengthening of your muscles to help with upper cervical dizziness.

You may need postural retraining if you have forward rounded posture or another posture problem.

The physical therapist may be able to determine if another orthopedic problem somewhere else in your body is causing the upper cervical issues.

For example, having one leg longer than the other or scoliosis can cause recurring upper cervical alignment problems.

For more on the potential root causes of upper cervical dizziness, click here.

Chiropractic Care Can Help with Upper Cervical Dizziness

Chiropractors who have upper cervical specialty training may be able to help with upper cervical dizziness.

For my patients who prefer chiropractors over physical therapists for spinal care, I refer to a select few local upper cervical chiropractors who are trained in one of the following methods:

  • Blair technique

Remember that the chiropractor must have special training in upper cervical care.

TMJ Specialist May be Needed Too

TMJ issues may also be related to upper cervical issues, so you may need to see a TMJ specialist if you have jaw problems too.

You might need orthodontic care or a night splint to help with jaw problems that are contributing to upper cervical dizziness.

How Do I Know When I Need Upper Cervical Care?

I know when my C1 bone goes out of alignment because I start getting lightheaded, with recurring headaches, neck tension, and jaw pain. I may also experience brief dizzy spells that are more intense and tinnitus.

After my C1 is treated by a manual physical therapist, the baseline lightheadedness is resolved, the headaches are fewer and less severe, and the tension in my neck and jaw pain is gone. The dizzy spells and tinnitus typically improve also.

Keep in mind that upper cervical dizziness may have a deeper root cause that needs to be addressed for the best recovery.

Upper cervical dizziness can also co-occur with BPPV and other root causes of dizziness and may be exacerbated with vestibular rehab.

For more information about neck and dizziness, click here and here.


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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