Question: My wife suffers from occasional bouts of intense dizziness and has motion sensitivity. The vestibular nerve got tweaked, and she became totally incapacitated for a long time. She is mostly better now, but things like receiving a massage where she is face down for an hour cause symptoms. I’m looking to understand the vestibular nerve and whether tight muscles, stress, or vertebrae can impact it.
Your question reflects something many families notice after a vestibular injury: even when someone is “mostly better,” certain positions, movements, or physical experiences—like lying face down during a massage—can still bring symptoms back. This can feel confusing and discouraging, so let’s break down what’s going on in a clear, practical way.
What does the vestibular nerve do?
The vestibular nerve carries balance and motion information from the inner ear to the brain. It tells the brain how the head is moving, where gravity is, and how to coordinate eye and body movements. When this nerve becomes irritated or damaged—often from a viral illness, inflammation, or reduced blood flow—the brain suddenly loses reliable balance information. This can lead to intense dizziness, vertigo, nausea, and motion sensitivity, sometimes for weeks or months.
Even after the nerve injury improves, the brain may remain extra sensitive to certain signals. Recovery often involves the brain relearning how to interpret balance input, a process called central compensation. That process is effective—but not always complete or linear.
Can muscle tightness or stress affect vestibular symptoms?
Yes—but usually indirectly, not by squeezing or damaging the vestibular nerve itself.
Tight neck, jaw, and upper shoulder muscles can alter posture, head position, and sensory input from the neck. The brain uses information from the neck (called proprioception) along with the inner ear and vision to maintain balance. When neck muscles are tight or painful, that information can become distorted, increasing dizziness or disorientation.
Stress plays a major role as well. Stress activates the nervous system’s “threat” response, which can amplify dizziness, motion sensitivity, and nausea. After a vestibular injury, the brain often becomes more alert to anything that feels like motion or imbalance. Stress lowers the threshold for symptoms to reappear.
What about vertebrae or massage positions?
This is a common concern. In most cases, vertebrae do not directly compress or damage the vestibular nerve. However, certain head and neck positions—especially prolonged ones—can temporarily aggravate symptoms by:
- Altering blood flow to the head
- Changing vestibular or neck sensory input
- Triggering positional dizziness
- Overstimulating a nervous system that is still sensitive
Being face down for an hour during a massage can trigger several potential factors: sustained head position, pressure changes, relaxation followed by sudden movement, and reduced visual cues. For someone with a history of vestibular dysfunction, that can be enough to provoke symptoms even long after the original injury.
What can help?
- Position modifications: Shorter massage sessions, neutral head positioning, or side-lying options may be better tolerated.
- Gradual exposure: Avoidance can increase sensitivity over time. Gentle, gradual reintroduction to triggering positions often helps the brain adapt.
- Vestibular rehabilitation therapy (VRT): A trained therapist can help address lingering motion sensitivity and neck-related balance input.
- Stress management: Breathing techniques, pacing, and reassurance all help calm the nervous system.
The big picture
Your wife’s experience doesn’t mean the vestibular nerve is being re-injured. It more often reflects a nervous system that learned to be cautious after a major disruption. With the right strategies, sensitivity usually continues to improve over time.
Your support and curiosity already make a meaningful difference.
Reviewed by Denise Schneider, DPT
This article is based on established clinical understanding of vestibular disorders. References are provided for additional reading.
