Understanding Cervicogenic Dizziness: Diagnosis and Treatment Explained

Vestibular physical therapists Abbie Ross, PT, DPT, NCS, and Danielle Tolman, PT, DPT, sit down with Rob Landel, PT, DPT, FAPTA, to unpack cervicogenic dizziness (CGD) — what it is and isn’t, how to tell neck-driven dizziness apart from inner ear causes, and the clinical tools that actually make a difference.They dive into the head–neck differentiation test, cervical joint position error (JPE) testing with a laser, and why CGD rarely causes vertigo or spinning. You’ll also hear how concussion, whiplash, BPPV, and migraine can overlap with neck-related dizziness — plus practical insights on manual traction, cervical strength and endurance training, “pain-first” strategies, and when a short-term collar might help (despite its bad reputation).Episode Resources:Website: skillworks.bizEmail: [email protected] For more FREE resources, click ⁠⁠⁠here⁠.⁠⁠Hosted by:🎤 Dr. Abbie Ross, PT, NCS🎤 Dr. Danielle Tolman, PT For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠[email protected]⁠⁠⁠⁠⁠⁠⁠⁠Connect with Us:→ ⁠⁠⁠Book a free call with us⁠⁠⁠→ ⁠⁠⁠Get free resources straight to your inbox⁠⁠→ ⁠⁠Join The Dizzy Reset⁠→ ⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠→ ⁠⁠⁠Follow us on Instagram⁠⁠⁠→ ⁠⁠⁠Follow us on TikTok⁠⁠⁠→ ⁠⁠⁠Follow us on Facebook⁠⁠⁠→ ⁠⁠⁠Disclaimer⁠⁠⁠→ ⁠⁠⁠Enjoying the podcast? Leave us a review!Timestamps:00:00 – Welcome & show open00:45 – Dr. Lindell’s background & early vestibular days03:01 – How far vestibular rehab has come03:58 – Defining CGD clinically05:26 – Symptoms CGD 06:26 – CGD with vestibular or central issues; trauma link 07:25 – Secondary CGD from guarding & “moving in blocks”08:31 – Is CGD over- or under-diagnosed?12:11 – BPPV + trauma: when to probe the neck14:10 – Migraine, vestibular migraine, cervicogenic headache—untangling overlap16:26 – How neck input feeds spatial orientation19:43 – Mismatch analogy: why CGD feels like seasickness21:10 – History taking: get precise about “dizzy”22:38 – Traumatic vs. atraumatic onset; red flags & neuro screen26:28 – Exam flow once central/peripheral causes are ruled down27:22 – Head–Neck Differentiation Test (separating head vs. neck motion)30:17 – Cervical Relocation / Joint Position Error (JPE) Test with laser33:27 – Testing extension: stabilizing neck vs. moving head in block35:03 – Treatment blueprint: mobility, pain, motor control, strength/endurance37:26 – Laser tracing progressions 38:20 – Timelines: why strength/endurance take the longest46:18 – Why one therapist managing vestibular + MSK is ideal49:18 – Evidence & experience with traction/manipulation for CGD50:43 – “Heavy-headedness”53:22 – Fatigue → increased sway; training normalizes it54:48 – Wrap-up & future part 2 ideas