TREATMENT OF CERVICAL VERTIGO (cervicogenic dizziness):

Timothy C. Hain, MD • Page last modified: September 9, 2022

See also: cervical vertigo (overview)diagnosisTreatmentCasesControversyHistoryReferences

TREATMENT OF CERVICAL VERTIGO (cervicogenic dizziness):

What we do suggest doing for cervical vertigo:

For the usual person in whom cervical vertigo is a diagnosis of exclusion, and pain is prominent, physical therapy treatment is recommended, possibly combined with medication to relieve pain and reduce spasm.

What we suggest not doing:

Chiropractic treatment for cervical vertigo.

We generally think that chiropractic treatment is not a good idea for vertigo of any type, including cervical vertigo. We realize that this may not set well with the chiropractic community, but this is the author's opinion.

There are two reasons:

Bizzare treatments such as lasers.

There are very bizarre treatments that have been reported for cervical vertigo, that we will mention briefly. In recent years, the general population has gotten the idea that lasers are good for nearly any medical problem. We have encountered, for example, situations where lasers to the external ear are suggested as treatment for tinnitus. This seems to us simple fraud. In a similar way, some have suggested that "laser acupuncture" is effective for cervical vertigo. This is implausible as lasers have no mechanism of manipulating the neck. The literature substantiates that laser acupuncture is ineffective for cervical vertigo (Aigner et al, 2004).

Zhu et al (2019) suggested "Cervical lamina block therapy could significantly shorten the clinical hospital stays of patients with cervical vertigo (P = 0.000) and improve vertebral artery flow (P < 0.05)". We think it is a bizzare idea that any type of block could do anything more than make a temporary change. It might be a helpful diagnostic test however.

PROGNOSIS of cervical vertigo.

Cervical vertigo is poorly defined, and due to this, no relevant studies exist of prognosis.  In the author's clinical practice, his impression is that cervical vertigo is a poor prognosis condition. The reason for this is that the musculoskeletal conditions that are associated with cervical vertigo  - neck stiffness, pain, disk disease and facet arthropathy, are also slow to resolve.  A second reason may be that the patients seen in the author's clinic usually have already had symptoms for many months.

With respect to the chronicity of whiplash injuries, Dufton et al (2012), recently found in a very large study that about 25% of persons after whiplash injury develop chronic symptoms. Another recent meta-analysis reported that between 14 and 42% of patients with WAD will develop chronic neck pain (Rodriquez, Barr et al. 2004). In the same study, it pointed out that roughly 75% of all persons with injury, had previous neck pain.

REFERENCES:

See also: cervical vertigo (overview)diagnosisTreatmentCasesControversyHistoryReferences