How can an inner ear or balance problem give you neck pain?
The vestibular system – functional significance
The vestibular system or inner ear AKA your balance system is the fastest system in the body and vestibular imbalances cause a whole host of problems other than just bad balance, such as chronic neck pain.
Our brains are wired for SURVIVAL and a functioning vestibular system does the following;
- Allows us to see our prey/ predator and move quickly at the same time – or to play most sports or chase after kids.
- Stabilises visual image on retina – Being able to read while being a passenger in a car.
- Stabilises the head and neck in relation to the body during movement- Prevents ‘bobble head’ when moving about playing sport, dancing or just going about your daily life.
- Tells your brain which way is up- During a bad attack of vertigo people often need to lie down as the brain is disorientated
- Provides information on how fast you are travelling and in which direction so you can easily navigate your way around the world.
The eyes provide visual information to the brain and the joints / skin / muscles provide information on body position in space (proprioception). All of these incoming sensory inputs are processed by different parts of the brain to allow you to move easily and safely through the world as well as make the correct decision quickly. This means the vestibular system is just as important to the average Joe Bloggs as it is to a professional athlete.
The concept of sensory mismatch
The brain views the eyes and the vestibular system are very important and ‘believes’ the information they give. The whole body adjusts for the eyes and the vestibular system, which means if there is something wrong with the information that the vestibular system or eyes provide to the brain it will have an impact on other systems in the body. There is a neurological link between the gut and the vestibular system, which is why you can feel sick when you get dizzy.
Sensory mismatch is when some or all of the information gained from the senses is of bad quality (eg you have poor sight in one eye). The brain now has to try and process the bad input which uses up resources or it can just use it, which could mean being inaccurate when trying to hit a ball. Postural issues like head tilts and some types of scoliosis in the spine are due to a vestibular issue. Your brain thinks your head is straight, but it isn’t really.
From a health and wellness perspective, sensory mismatch can cause the following.
- Neck pain or stiffness
- Back pain
- Blurred/Double Vision
- Balance Problems
- Lack of coordination
- Sympathetic wind-up (over active fight or flight response. Feeling ‘stressed’ all the time.
Case Studies / Examples
The reason spine pain, vertigo, vestibular issues and headaches can be so difficult to treat is because there are many parts of the brain or nervous system that can be affected. The two examples below are ‘visual vertigo’ and ‘Proprioception dependence’ as they are quite common.
Passive locomotion, e.g. riding in a car or traveling by boat or plane
- viewing an optokinetic stimulus (passing train, walking down supermarket aisle, passing telegraph poles)
- watching large moving visual objects (traffic, clouds, trees)
- viewing a large screen motion picture
These people have become over dependant on their visual systems for orienting themselves around the environment, their vestibular system has become ‘lazy’ and their proprioception is inaccurate. To fix visual vertigo, working on the vestibular system and proprioception (touch, spatial awareness, parietal lobe) rather than vision exercises would be the best approach.
These people often have tight necks which flare up after stretching, massage or treatment. This is because there is mis communication between the vestibular system, eyes and brain and the brain isn’t sure where the head is in space or how to stabilise the neck properly. Muscles in the neck tighten to stabilise which then causes pain or stiffness. When the neck muscles are released by a physio or osteopath they have accidentally taken away the compensatory stability, so the brain then ‘panics’ which can set off pain, cervicogenic vertigo or muscles tightening even more than before.
May stiffen spine as compensation strategy => adjust => decompensate => dizzy / nausea / pain / tightness
People are more prone to cervicogenic vertigo if proprioceptive input becomes unreliable, e.g. injury to paraspinal muscles and/or spinal joints, rapid head movements, neck pain, neck muscle fatigue, prolonged periods of inactivity, massage.
A combination of visual and vestibular exercises would work best for this type of vestibular issue, rather than massage or stretching.
There are other types of vertigo and other causes for chronic spine pain, but if it is something that you suffer from then looking into your vestibular system should be one of your top priorities.