C1-C2 neck problems can contribute to upper neck pain and cervicogenic headache, often felt at the back of the head or behind the eyes. They may also cause a vague sense of imbalance or light-headedness.

But true vertigo (a spinning sensation) is more often from the inner ear, migraine, medication effects, or less commonly a brain or blood-vessel problem. Cervicogenic dizziness is considered a diagnosis of exclusion, meaning other causes should be assessed first. Cummings Otolaryngology Head and Neck Surgery describes it as dizziness associated with neck pain and reduced neck movement, after excluding alternative causes.

Do not assume it is only C1-C2, especially if the vertigo and headache are new, severe, or sudden. Vertebral artery dissection and posterior-circulation stroke can present with headache, neck pain, and vertigo. Tintinalli's Emergency Medicine reports vertigo/dizziness, headache, and neck pain as common symptoms of vertebral artery dissection. The American Heart Association summary also lists headache and dizziness among possible features.

Seek emergency care now if you have any of these:

Until evaluated, avoid forceful neck manipulation or self-adjusting the upper neck. If symptoms are recurrent but not urgent, a clinician can assess the neck, ears/vestibular system, migraine, neurologic signs, and whether imaging is needed.

Vertigo with hearing loss can be an inner-ear problem, such as labyrinthitis, Ménière's disease, or sudden sensorineural hearing loss. It is not typical of a C1-C2 neck problem.

If the hearing loss was sudden, especially in one ear or within the last 72 hours, get same-day urgent assessment by ENT, urgent care, or an emergency department. Sudden sensorineural hearing loss may be treatable, and treatment is time-sensitive. NHS guidance considers it an urgent ENT problem.

Go to emergency care now if there is also:

A clinician needs to look for simple reversible causes such as wax or middle-ear fluid, but should arrange a hearing test and assess for inner-ear versus neurologic causes. Inner-ear inflammation called labyrinthitis can cause severe spinning vertigo, ringing, and sometimes permanent sensorineural hearing loss.

A TMJ click commonly comes from the small joint disc moving slightly out of position. Clicking alone, without pain, locking, or limited mouth opening, often needs no treatment. But TMJ problems can cause jaw/facial pain, earache, and headache. Mayo Clinic guidance notes that painless clicking is usually not a reason for treatment.

However, TMJ does not usually cause true hearing loss or spinning vertigo. It may coexist with them, but the vertigo plus hearing loss needs a separate urgent ear and hearing assessment, particularly if the hearing change was sudden or is mainly in one ear.

Possible inner-ear causes include:

Until you are evaluated:

Please seek same-day urgent care or ENT for the hearing loss and vertigo. Go to an emergency department immediately for weakness, double vision, trouble speaking/walking, new severe headache or neck pain, or persistent vomiting.