Management of Cervicogenic Dizziness
Cervicogenic Dizziness has a lifetime prevalence of 15-35% in the general population and has many causes, including vestibular, cardiorespiratory, neurological, mental/psychiatric, and cervical/musculoskeletal. Cervical-related dizziness can be caused by altered blood flow in the cervical arterial blood vessels due to compression or disruption or altered functioning of the cervical proprioceptors and joints. The latter is referred to as cervicogenic dizziness (CGD) and it is generally considered to be a diagnosis of exclusion once other causes have been ruled out in the presence of neck pain and dizziness.
Dizziness, cervical spine, and balance complaints can have a significant impact on daily functioning, thus are all important to address. Manual therapy, including spinal mobilization and manipulation, is frequently suggested as a therapeutic method and has been shown to reduce muscle spasms, restore facet joint mobility and joint play, and promote the flow of afferent information, including proprioceptive information, toward the central nervous system. Vestibular exercises have also been suggested as a possible treatment modality, as they have the potential to stimulate the vestibulo-cerebellar system and compensate for altered cervical afferent input.
Patients with neck trauma, including whiplash, commonly present with central sensitization and/or nociplastic pain (i.e. increased responsiveness of the central neuron to noxious input). This has been linked to prolongation of postural balance complaints, which can complicate therapy. To address possible differences in optimal therapeutic approaches for those with and without traumatic CGD, this study separated the results for these two groups while evaluating the existing evidence on clinical management.
RESEARCH REVIEW: “Management of Cervicogenic Dizziness”
This paper was published in the Journal of Manual & Manipulative Therapy (2022).
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