From the Research
Chronic cervicogenic dizziness and fatigue in a middle-aged man are primarily caused by cervical spine dysfunction, particularly upper cervical joint restrictions or degenerative changes, as supported by the most recent study 1. The etiologies of chronic cervicogenic dizziness and fatigue in a middle-aged man are multifaceted, involving:
- Cervical spine dysfunction, including upper cervical joint restrictions or degenerative changes that disrupt normal proprioceptive input from cervical mechanoreceptors, creating a sensory mismatch between vestibular, visual, and proprioceptive systems, resulting in dizziness 1
- Contributing factors such as poor posture, occupational strain, previous whiplash injuries, and cervical muscle imbalances with weak deep neck flexors and tight suboccipital muscles
- Psychological factors like anxiety and stress that can exacerbate symptoms through increased muscle tension
- Vascular compression syndromes, including vertebral artery compression during head rotation, potentially reducing blood flow to the brainstem
- Metabolic factors like vitamin deficiencies, particularly B12, or thyroid dysfunction that can independently contribute to both dizziness and fatigue The resulting chronic dizziness often leads to fatigue through constant compensatory efforts by the nervous system, disrupted sleep patterns, and the energy-depleting effects of persistent sympathetic nervous system activation. Key considerations in diagnosis and management include:
- A thorough understanding of the proper tests and measures to accurately rule in or rule out competing diagnoses, as outlined in 2
- A stepwise process for evaluating patients who may have cervicogenic dizziness, as described in 2
- The importance of considering cervical spine dysfunction and associated conditions like postural orthostatic tachycardia syndrome (POTS) in the differential diagnosis of chronic dizziness, as highlighted in 1
- The potential effectiveness of conservative management, including manual therapy and cervical stability exercises, in improving symptoms of cervicogenic dizziness, as demonstrated in 1 and 3