Episode Summary
Dizziness with neck pain demands a whole-person approach, from spotting red flags to understanding how visual, vestibular, and proprioceptive systems shape balance. Discover practical assessment tools and targeted rehabilitation strategies that can reduce both dizziness and persistent neck pain.
Dizziness associated with neck pain is presented as a broad clinical problem that requires careful screening and differential diagnosis. Key causes include cervical dizziness, vertebral artery insufficiency, minor brain injury after whiplash, vestibular disorders such as BPPV, medication effects, and anxiety. A central idea is that balance depends on how the brain integrates visual, vestibular, proprioceptive, and emotional input, so symptoms may arise from mismatch between these systems.
Assessment focuses on screening all balance systems in patients with neck pain, headache, or dizziness. Learners are introduced to cervical joint position error testing, smooth pursuit, gaze stability, postural balance testing, and observation of nystagmus. The transcript also outlines clinical reasoning for distinguishing peripheral from central causes, including use of the HINTS exam, Dix-Hallpike test, and patterns of spontaneous or positional nystagmus.
Treatment emphasizes vestibular rehabilitation and targeted retraining based on failed tests. Exercises include gaze stability, smooth pursuit, joint position error practice, and progressive balance training. Functional head and eye movement is encouraged rather than avoidance, with the aim of improving both dizziness and persistent neck pain.
