Myogenic Dizziness

By Carol Cote, PT, CCTT, CODN, CMTPT

Feeling dizzy? It could be related to your neck muscles. Do you suffer from episodic dizziness? Myogenic (from muscles) dizziness is a common reversible condition that can be readily treated and once relieved sustained via key neck/eye and breathing exercises. This is a common but often missed/misdiagnosed condition involving your inner ear balance center (vestibular), vision and neck muscles that orient your head to gravity (head right reflexes).

Our auto pilot brain (autonomic nervous system) is designed to keep us oriented to gravity. Our human instinctive brain is hard wired to have us survive. We have reflexes that are involuntary automatic responses to have us survive. Head righting reflexes keeps your head oriented to gravity (eyes horizontal, nose vertical). Our human brains are hard wired for this because we have to hold our head up and balance our body against gravity to survive independently in this world. This is so automatic that we are not aware that these reflexes are happening. Reflexes are NOT under our control. For example, try sneezing with your eyes open. Our human body is blind to gravity and many of these reflexes that we take for granted.

Myogenic dizziness develops when the signals from our inner ear balance center (vestibular) signals from what we see and the neck muscles of how we hold our head up don’t match up in the brain. Neurologists, ENT’S and ophthalmologists’ are able to diagnose problems of the balance center (vestibular) and vision. The muscular component is not recognized. A trained physical therapist in head, neck and jaw (certified cervical temporomandibular therapist) is able to evaluate and treat this condition. Neck muscles are critical to auto pilot demands of head righting, balance, posture and breathing. Most people who develop this problem are not aware of these faulty habits. Onset can be fast (whiplash, falls and trauma) or gradual from head posture (working at a computer or aging). It can also be episodic related to stress and anxiety (clenching and breath holding).

A physical therapist can quickly relieve the muscle contractures/trigger points within the muscle via dry needling, manual therapy and neuromuscular re-education and key exercises of the jaw, tongue, neck, eyes and breathing exercises. The patient is empowered by being given key exercises and self care strategies (I call it homework). This simple condition can resolve in as few as 4-6 visits. Long standing conditions >6 months may take longer to resolve. The key to sustained relief is the education and self trained awareness of postural breathing and orofacial (tongue, mouth and jaw) habits that are at the root of the problem. Most medical insurances cover these services if provided by a physical therapist.

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