Dizziness? How to Tell If It’s Your Neck or Inner Ear

Added: 2026-06-01

[00:00:00]If you've ever felt dizzy, off-balance, foggy, spinning, vertigo, where you're almost going to feel like you're falling over, you One of the first things you probably think of is where is this coming from?

[00:00:10]And many times, the most common cause of true vertigo would be coming from your inner ear. But what about that other feeling, that residual disequilibrium, fogginess, drunkenness state?

[00:00:20]Oftentimes, this is not coming from your inner ear, but from your neck. So, how do you determine the difference between either your inner ear or your neck causing your dizziness? That's what we're going to discuss today.

[00:00:32]Identifying the cause of your vertigo or dizziness is often the first step in recovery. In my clinical practice on a day-to-day basis, I see many patients suffering from dizziness, vertigo, headaches, vestibular migraines, you name it, I've seen it. And oftentimes, they're coming confused because no one's been able to tell them the cause or what to do to fix it. It's one of the biggest frustrations patients present to my office with. I'm hoping this video is going to give you some clarity about how to determine what is causing your dizziness and vertigo and the steps necessary to get your life back.

[00:01:05]One thing that is important to understand is that dizziness is a very broad term and people use it to describe whether they have vertigo or dizziness.

[00:01:13]Some people will describe their sensations as spinning, light-headedness, I'm going to fall over, imbalance, head fogginess. Really, there's a a range of descriptors that people will use, and listening to those and understanding what they mean goes a long way in trying to understand where that's coming from in the first place.

[00:01:31]Whether someone has floating sensations, disorientation, fogginess, unbalance, or unsteadiness, those are key descriptors to find out the cause of your problem.

[00:01:42]Generally speaking, inner ear problems are the true cause of what we call vertigo, where the world or the room is spinning around you, and if you did not hang on to something, you might literally fall over. Neck-related dizziness, something we see in our office every day, is usually described by patients as floating sensation, unbalanced, disorientation, a drunkenness feeling, just not feeling well as they move about their day. The distinction between those two symptoms is very important. Let's start with the one of the most common causes of vertigo, the true room is spinning, I got to hang on to myself before I fall over. Often times this is caused by benign paroxysmal positional vertigo or BPPV.

[00:02:22]This happens when crystals in your inner ear end up in a place they're not supposed to be and tricks the brain into thinking their head or body is moving when in fact it's not. Your inner ear is responsible for telling your brain where your head is in space relative to gravity and how it moves through space and if those crystals are in the wrong spot, you get vertigo. So, how do you determine if that is in fact causing your vertigo? Patients with BPPV will often describe short but intense episodes of vertigo that calm down when they stop moving. Often times it's when they roll over in bed or they look down or move a certain position and that intense vertigo starts immediately. It's scary, it's anxiety inducing and often times associated with you feeling nauseous. Most often it's certain head movements that you can reproduce that cause that vertigo sensation. The one of the biggest clues that you have BPPV is that those episodes are short but intense. For example, you roll over in bed and boom, it hits. It lasts anywhere between 20 and 30 seconds, maybe up to 60 seconds in some, but most often times by 60 seconds you've got your bearings back and you feel better again. People will often say, "I feel fine if I stay still, but once I move my head, everything spins." That's a very common symptom pattern in someone with BPPV.

[00:03:37]Now, let's compare that to neck related dizziness or cervicogenic dizziness, sometimes referred to as cervical vertigo, but not a true vertigo in the sense of the spins. This type of dizziness comes from neck tissues, things like your upper cervical spine, the muscles around the neck, the joints, and the mechanoreceptors that are really in high concentration in our upper neck.

[00:03:56]The neck and related tissues in the neck provide constant information to the balance centers in the brain that tell our brain where our head is in space.

[00:04:04]When those signals become dysfunctional because of a neck issue, then our brain will release faulty information causing that dizziness feeling. Three things need to line up for us to feel balanced and stable. Our visual system has to give information from our environment to the balance centers in the brain. Our inner ear also does, and finally, the proprioception in our neck. When all three of those systems, our visual system, our inner ear, and our neck or proprioceptive system give the same messages, we're able to maintain balance and equilibrium. When one of those systems are off, that's when we feel dizzy and unbalanced. Common symptoms related to neck dizziness that kind of tell us the path we should be looking at is stiffness in the neck, headaches, lack of range of motion, when we start to feel a floating sensation, a drunkiness, or we just can't concentrate. Almost like a head fogginess. It's constantly there that doesn't really allow us to feel confident when we're moving around. We can also feel a pressure in our head, and sometimes these symptoms will either stay all day or they'll fluctuate during the day depending on what we're doing.

[00:05:02]Often times, if we're staring at a computer screen and our posture's changing and our muscles are fatigued, this can bring on those neck dizziness symptoms. Unlike with an inner ear or BPPV, it's often not a violent spin.

[00:05:14]It's more of that unsteadiness, that fogginess, or that unbalanced state.

[00:05:18]That is a huge clue to determine the cause from a violent spin like true vertigo versus a neck dizziness where you're just unbalanced and just not feeling yourself. A few other clues that your dizziness might be coming from your neck is if you suffer chronic neck tension, you might have tension type headaches, you have tenderness in some of your muscles in the back of your skull, or even at the front in your SCMs. These are all clues that when your dizziness is related to that, you could be suffering from cervicogenic dizziness. Symptoms of cervicogenic dizziness will often worsen to after prolonged sitting, computer work, a long drive, if you have stress it's causing tension in your muscles, or you have very little neck movement, and you feel that you're extra stiff. And finally, with cervicogenic dizziness you'll often find for those patients who've had trauma, for example, whiplash or concussion, often times those dizziness symptoms will show up after that. Now, let's walk through a side-by-side comparison of true vertigo or cervicogenic dizziness.

[00:06:15]Inner ear vertigo will often involve sudden quick attacks that calm down after you stop moving. They will often be caused when you roll over in bed or move your head in a certain position.

[00:06:25]And you may feel nauseous or anxious when one occurs. Neck-related dizziness is a bit different. It is a true sense of dizziness where you're going to feel off balance, drunkenness, disequilibrium. You might have pressure and headaches associated with it as well, and it can often be associated with posture-related strain both in your neck and upper back. Those symptoms alone can be very helpful clinically to determine the cause of your dizziness or vertigo. Dizziness or vertigo should never be treated with guesswork. Always see your health care provider for an appropriate diagnosis to make sure there's nothing more sinister happening.

[00:06:56]Different causes require different approaches to treatment. For example, BPPV often responds really well to repositioning maneuvers. In the description below, I'm going to leave a couple PDFs to help determine the cause and treatment if you do have true vertigo. So, I want you to look below to find these. Cervicogenic dizziness often responds really well to restoring proper neck motion or restoring dysfunction to neck tissues. I'm also going to leave in the description below a link to one of my favorite cervicogenic dizziness exercise, the quadruped chin tuck with rotation. You can follow along to help start to move that process of moving you in the right direction if you are suffering from cervicogenic dizziness.

[00:07:38]I'm also going to leave this exercise in the description below as well. I find that when patients have either vertigo of the sense where it's coming from the inner ear or the upper neck, vestibular ocular rehab can be effective in helping both of those. So, I suggest if you have either of those or both, you add those to your routine to help you start the process of getting well again. Remember, the first important thing is to get the appropriate diagnosis, and then you can work at the cause to get yourself feeling better again. If you're suffering from dizziness or vertigo, I understand it can be very anxiety-inducing.

[00:08:10]I also understand it can really affect your quality of life, and often times patients will go months without understanding the cause of their problem. I encourage you to always follow up with your healthcare provider to make sure you're getting the appropriate diagnosis, but know this, once you get that diagnosis, there is a way out of this, and you will improve, you'll get your quality of life back, and your anxiety will reduce as you gain back control of your life. If you like videos like this, show me some support by giving me a thumbs up. If you are new to my channel, maybe you'll consider subscribing so you can be informed when I upload a new video. I appreciate you tuning in. I can't wait to see you in my next video. Please make sure you check the description below for some of the attachments I've promised in this video, and I can't wait to see you in my next video. Until then, stay well.