How is posture related to dizziness and imbalance?

When you think of dizziness and balance problems, posture may not be something that immediately comes to mind. However, having postural issues can exacerbate dizziness and balance difficulties in some cases. Below are a few examples of postural impairments related to dizziness and imbalance, followed by tips to help improve your posture.

After a neck injury, such as whiplash, or other cervical spine dysfunction

These folks can have problems due to damage to the joint receptors, or motion sensors, of the upper cervical spine. This causes abnormal sensory information to be sent to the brain regarding how the neck is moving. It can result in increased dizziness and imbalance. This can result in postural changes and can further aggravate the problem. Postural re-education exercises can help decrease the symptoms by aligning the spine properly.


A certain type called a vestibular migraine can cause dizziness and imbalance. Postural problems can worsen this, by triggering migraines that provoke the symptoms. Often by working on improving posture through exercises, people can lessen the likelihood of triggering a migraine. Typically posture is one factor, but other lifestyle factors may need to be addressed as well, such as sleep hygiene, dietary triggers and stress management.

Forward head posture and thoracic kyphosis

Years of reaching the head forward in an effort to see a computer screen or work on other tasks can lead to what’s known as “forward head posture.” In some studies, a connection has been found between abnormal neck posture, thoracic kyphosis (an excessive rounding through the upper to mid back), and imbalance and gait problems in older adults.

Neck pain following dizziness or balance problems

Many people with dizziness or balance problems also report neck and/or shoulder pain. Their muscles become very tight and sore from trying to prevent head movement. This in turn can change their posture, which often makes the neck pain worse in the long run and can continue this negative cycle. Gentle stretches can help, and sometimes therapeutic massage is needed to help calm the neck muscles so the head can comfortably turn again. It’s important to interrupt this cycle and help the person to start moving their head again after a vestibular (inner ear) problem, in order for that system to start working properly.

Tips to improve your posture

Do the pencil check:  Curious if you have poor posture? Stand and hold a pen or pencil in each hand. Look down to see which way they point. If they point straight ahead, your posture is probably pretty good. If the pencils point inward, you may be slouching. If the pencils point outward, you may be over correcting your posture.

Be mindful about smartphone use: Repeatedly looking down at your phone increases the strain on your muscles and can change your posture for the worse. This can also cause neck pain down the road. Try sitting and resting your elbows on a table while you hold your phone, so your neck can stay neutral.

Check your desk setup: Do you tend to lean forward to see your computer screen? Are your neck and shoulders tense? You may need to reconfigure your desk and chair for a more ergonomic setup. Mayo Clinic has some great tips and an illustration to help you get started:

Change your position: If you sit or stand in one position for a long time, your postural muscles can fatigue. Try to step away from the computer or shift your standing posture now and then. This link has tips for knitters, who often stay in the same position for long periods of time, but the suggestions could apply to those who work at a computer as well:

Do some stretches: Gentle stretches for your upper traps and pectoralis muscles can help loosen up tight areas.

Core strength: Having strong abdominal muscles can benefit your body all the way up the spine, helping to support you and give you good posture and balance. Pilates and yoga are a few great ways to improve your core strength.

If you are experiencing dizziness or balance difficulties, our specialized physical therapists and physical therapist assistants may be able to help. Contact one of our clinics to find out more, 952-345-3000.



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Nemmers TM, Miller JW, Hartman MD. Variability of the forward head posture in healthy community-dwelling older women. J Geriatr Phys Ther. 2009;32(1):10-4.

O’Brien K, Culham E, Pickles B. Balance and skeletal alignment in a group of elderly female fallers and nonfallers. J Gerontol A Biol Sci Med Sci. 1997 Jul;52(4):B221-6.

Hirose D, et al. Posture of the trunk in the sagittal plane is associated with gait in community-dwelling elderly population. Clin Biomech (Bristol, Avon). 2004 Jan;19(1):57-63.