Neck Stiffness: When to See a Neurologist or ENT

Neck stiffness

Recently, I have been experiencing stiffness in my cervical spine, making it difficult to turn my head.
It feels tight and rigid, and I sometimes feel dizzy, but the dizziness passes quickly.
I'm not sure what the issue could be.
Should I see a neurologist or an ear, nose, and throat specialist?

Miss Chen, 40~49 year old female. Ask Date: 2022/01/25

Dr. Jiang Junyi reply Neurology

Hello Ms.
Chen,
You mentioned experiencing "stiffness in the cervical spine, difficulty turning your head, tightness, and dizziness that comes and goes." I would like to know if your dizziness is accompanied by any other neurological symptoms, such as hearing abnormalities, double vision, or unilateral limb weakness? The symptoms of dizziness, particularly under the following conditions, raise a high suspicion of central vertigo, and further imaging studies should be arranged, such as a CT scan or MRI of the brain, and carotid ultrasound.
1.
Older patients experiencing spontaneous persistent vertigo.
2.
Patients with cardiac and cerebrovascular issues presenting with spontaneous persistent vertigo, with a normal head impulse test.
3.
Spontaneous persistent vertigo accompanied by multidirectional gaze-evoked nystagmus, severe gait instability, or inability to maintain trunk stability when sitting or standing.
4.
Spontaneous persistent vertigo accompanied by headache (especially in the occipital region).
5.
No prior history of Meniere's disease.
6.
Patients with cardiac and cerebrovascular issues presenting with spontaneous persistent vertigo along with hearing loss.
I recommend that you consult with an otolaryngologist and a neurologist to discuss further evaluation and treatment.
Thank you for your inquiry, and feel free to reach out with any related questions!
Wishing you good health and peace,
Dr.
Jiang Junyi
Taoyuan Medical Center

Reply Date: 2022/01/25

More Info

Neck stiffness, particularly when accompanied by symptoms like dizziness, can be concerning and may warrant a thorough evaluation. Understanding when to consult a neurologist or an ENT (ear, nose, and throat) specialist depends on the specific symptoms and their potential underlying causes.

Neck stiffness can arise from various conditions, including muscle strain, cervical spondylosis, herniated discs, or even more serious issues like meningitis or cervical spine disorders. If the stiffness is accompanied by dizziness, it could indicate a few different scenarios. For example, cervical vertigo occurs when neck problems lead to dizziness due to disrupted signals from the neck to the brain. Alternatively, dizziness could stem from vestibular issues, which are typically evaluated by an ENT specialist.

Here are some considerations to help determine the appropriate specialist to consult:
1. Neurological Symptoms: If you experience additional neurological symptoms such as numbness, tingling, weakness in the arms or legs, or changes in coordination, it is advisable to see a neurologist. These symptoms could indicate nerve involvement or central nervous system issues that require further investigation.

2. Dizziness Characteristics: If your dizziness feels like a spinning sensation (vertigo), it may be related to inner ear problems, which would be best evaluated by an ENT. On the other hand, if the dizziness is more related to balance or is triggered by neck movements, it could be more related to cervical spine issues, thus warranting a visit to a neurologist.

3. Duration and Severity of Symptoms: If the neck stiffness and dizziness are persistent, worsening, or associated with severe headaches, fever, or other systemic symptoms, immediate medical attention is necessary. These could be signs of more serious conditions, such as meningitis or a cervical spine injury.

4. Physical Examination: A thorough physical examination by a primary care physician can help determine the next steps. They may assess your neck's range of motion, neurological function, and any signs of infection or other systemic issues.

5. Imaging and Tests: Depending on the findings, your doctor may recommend imaging studies such as X-rays, MRI, or CT scans to evaluate the cervical spine. Blood tests may also be necessary to rule out infections or inflammatory conditions.

In summary, if you are experiencing neck stiffness and dizziness, it is essential to monitor your symptoms closely. If you have additional neurological signs, a visit to a neurologist is warranted. If the dizziness is more pronounced and feels like vertigo, an ENT specialist may be the right choice. Regardless, starting with a primary care physician can help guide you to the appropriate specialist based on a comprehensive evaluation of your symptoms.
In the context of medical knowledge, it is crucial to address neck stiffness and dizziness promptly, as they can significantly impact daily functioning and quality of life. Early intervention can lead to better outcomes, especially if the underlying cause is identified and treated effectively.

Similar Q&A

Understanding Dizziness and Cognitive Issues: When to See a Neurologist

Doctor! I sometimes experience dizziness and a slight headache at the back of my head. I also feel a sensation of something stuck in my throat. Today, while writing, I found it very difficult to write smoothly, and my fingers felt quite uncoordinated and somewhat numb. My work is...

Dr. Jiang Junyi reply Neurology
Hello: Regarding the discomfort in your neck and the numbness in your fingers, it is important to first consider cervical nerve root compression, which can present with pain, soreness, muscle stiffness, or a feeling of heaviness. Symptoms may worsen with changes in weather. I rec...

Understanding Neck Pain: When to See a Neurologist or Orthopedist

Hello Doctor, I have been experiencing a condition over the past few years where I occasionally feel soreness in the back of my neck. When I press on it, there is also a sensation of pain. This discomfort gradually spreads to the back of my head, where the soreness and sharp pain...

Dr. Wang Shouji reply Orthopedics
Ms. Tsai: Your symptoms are mostly not related to the vertebrae. They are likely caused by poor posture, muscle fatigue, and other factors. If you wish to go to the hospital for an examination, you can see either a neurologist, an orthopedic specialist, or a rehabilitation specia...

Understanding Neck Tension and Dizziness: When to Seek Neurology Help

Hello, I would like to ask about my girlfriend's condition. Recently, she often feels tightness in her neck, dizziness, difficulty concentrating, lower back pain, and sometimes nausea. This situation has persisted for almost a month. A few weeks ago, the symptoms would only ...

Dr. Ye Boshou reply Neurology
If it is caused by emotional stress, it is recommended to first consult a neurologist.

Understanding Neck Pain: When to See an ENT Specialist

Hello Doctor: My symptoms include pain near the left side of my collarbone when swallowing saliva (the pain comes and goes), intermittent sharp pain in several areas of my neck, and soreness and tingling in both shoulders that radiates to my arms and sides of my chest. I also exp...

Dr. Zheng Jueyi reply Otolaryngology
Hello, if you continue to feel unwell, it may be related to neuropathic pain or cervical spine issues. It is recommended to schedule an appointment for evaluation with a neurologist and a neurosurgeon.