If you have POTS or dysautonomia and you also have a stiff, tight, or painful neck — that might not be a coincidence.
The cervical spine plays a direct role in how your body regulates blood flow and autonomic function. Here's how.
Eyes, Ears, and Neck: A Connected System
Your vestibular system (inner ears), your visual system, and the proprioceptors in your neck all work together to tell your brain where you are in space. When one of these systems isn't working well, the others compensate.
“Your neck is subservient reflexively to reflexes of the vestibular system... the muscles in your eyes are neurologically tied to the muscles in your neck, particularly your upper cervical spine.”
This means your neck stiffness might not be a neck problem at all. It might be a compensation for something else.
When Your Brain Locks Down Your Neck
If your vestibular system can't properly organize where your eyes should be in space, your brain has a backup plan: stiffen the neck.
“If I'm having problems in my vestibular system being able to organize where my eyes should be in space, what my brain will do is activate cervical collic reflexes that tighten my neck down and make it more stiff.”
The stiff neck is your brain's way of stabilizing a system that's not coordinating properly. It's a compensation — and removing it without fixing the underlying problem could make things worse.
Don't Steal the Compensation
This is why cracking, adjusting, or aggressively loosening a stiff neck can sometimes backfire in dysautonomia patients.
“Maybe that adjustment is there because it needs to be there and we don't want to steal their compensation. We want to be able to fix the problem so they don't have to compensate anymore.”
The goal isn't to force the neck to loosen up. The goal is to figure out WHY the brain is locking it down — and address that.
The Multi-System Decoupling
When these systems become disconnected from each other, the brain can't accurately predict what's coming next. This produces dizziness, disorientation, and autonomic symptoms.
“The interaction between your inner ears and your eyes and your proprioceptive system become decoupled. So the normal waveforms that we experience with movement, they're not as accurate anymore. And that separation or the difference between them gives us the feeling that we're moving.”
Your brain expects certain sensory inputs to match. When they don't, it creates a sense of motion or instability that isn't there — and triggers autonomic responses to deal with a threat that doesn't exist.
The Autonomic Spillover
When this sensory mismatch ramps up brain activity, it doesn't stay contained. It spills over into the autonomic system.
“In some of those cases we'll see especially those ones that affect that brain stem component because we have that sense of motion, you're going to get a ramp up of activity in the autonomic system which may overfire or over mobilize energy in that system.”
So your POTS symptoms might be driven — at least in part — by a sensory coordination problem between your eyes, ears, and neck. Not a heart problem. Not an anxiety problem. A coordination problem.
What Can Be Measured
This isn't guesswork. These systems can be tested:
- VNG (eye movement testing) — Shows if vestibular reflexes are working properly
- Balance testing — Reveals which sensory systems aren't integrating
“The Romberg test allows us to look at dynamically the integration between your vestibular system, your inner ear, your visual system and then your proprioceptive system throughout your body... someone that has all of those things integrating really well, people can typically stand eyes closed, move their heads in different positions and still maintain their balance.”
When specific sensory systems fail these tests, you know where the problem is — and where to direct treatment.
Key Takeaways
- Neck stiffness in dysautonomia is often a compensation — not the root cause
- Eyes, ears, and neck are neurologically connected — dysfunction in one affects the others
- Don't remove the compensation before fixing the underlying problem
- Sensory mismatch can drive autonomic symptoms — it's a coordination error, not "anxiety"
- Testing exists to identify which systems aren't integrating properly
Neck Issues and Dizziness Together?
If your neck problems and dysautonomia symptoms started together and no one has connected the dots, a free consultation call can help determine whether your neck is part of the bigger picture.
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