Is My Neck Tension Causing My Head Pain and Dizziness?

In 2005, I was working as a student clinician in a rehabilitation clinic and my supervisor told me the client’s leg pain was coming from their back.  I was baffled, how was that possible?  How could their leg pain be back pain?  It was leg pain!  My supervisor went on to explain “sciatica.”  She said it is called referred pain and it happens throughout our body, such as when people feel left arm pain while having a heart attack. 

I later learned that we don’t only experienced referred pain, we also experience other referred sensations.  In 2008, I was learning a headache treatment and my mentor pressed on my upper neck and I felt head pain, dizziness, nausea, and visual disturbance. It was so weird, I didn’t have any problems before she pressed on my neck and as soon as she stopped pressing the sensations went away. 

I was so fascinated, how and why do we experience referred sensations?

How

Scientists propose that we experience referred sensations (or referred symptoms) due to something called “convergence.” Convergence is when nerves carrying signals from one part of the body meet up with nerves carrying signals from another part of the body and beyond the meeting point the signal flows along a common channel (Figure 1.)

Figure 1. the various theoretical types of nerve convergence (McMahon, 1995, p. 134, taken from Morrison, 1987)

Once the signal reaches the parts of the brain responsible for interpreting where the signal originally came form, the brain decides it came from the most innervated and sensitive area.  

When it comes to neck muscle tension referring pain into the head, the point of convergence is the trigeminal nerve nucleus located in the spinal cord and the brain stem.  This process of neck pain referring to the head is explained well in this (hyperlink https://www.youtube.com/watch?v=ZAmhCiA0Eio) brief YouTube video by Physiotutors. 

When it comes to neck muscle tension causing dizziness, visual disturbance, and nausea, the convergence occurs in areas of the brain called the vestibular nuclei, thalamus, cerebellum, reticular formation, and cerebral cortex (De Hertogh, 2025).

Why?

Our eyes see, our muscles move, and our vestibular system enables us to stay upright.  Our ability to walk over to a piece of fruit, pick it up, and bring the fruit to our mouth depend on our eyes, muscles, and vestibular systems working together. 

To work together, our muscles, eyes, and vestibular system need to talk and to talk their signals need to converge. In other words, our ability to interact with the world depends on “multisensory integration.” The upside to multisensory integration is we can throw, catch, run and jump; the down side is referred symptoms.

What can you do?  

Neck dysfunction causing your symptoms (or “cervicogenic” symptoms) is a diagnosis of exclusion.  In other words, when doctors rule out all other known causes of your symptoms, they decide your neck may be the cause.  I discuss some for the other causes of cooccurring head pain, dizziness, visual disturbance and nausea in this (hyperlink – UCI) blog post and this (hyperlink migraine) blog post. 

So, if your doctor thinks you may have cervicogenic head symptoms, it might be worth trying treatments that help the muscles in the upper neck relax and trying exercises that improve neck movement and control.  In my experience, different people respond to different treatments.  Some people respond well to massage, some to joint mobilisation, some respond to acupuncture, some to exercise, some to injection therapies, and others to some combination of aforementioned.  I have even seen some people respond to the use of a neck brace for periods of the day. 

I suggest you consult your doctor or primary care clinician. If you and your doctor agree that neck muscle treatment is worth trying, start with the option you feel most comfortable or familiar with and go from there.