Vertigo and Chiropractic This section was compiled by Frank M. Painter, D.C.
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Chiropractic and Vertigo
Comparison of Outcomes in Neck Pain Patients With and Without Dizziness
Undergoing Chiropractic Treatment: A Prospective Cohort Study With 6 month Follow-up
Chiropractic & Manual Therapies 2013 (Jan 7); 21: 3 ~ FULL TEXT
Neck pain patients with dizziness reported significantly higher pain and disability scores at baseline compared to patients without dizziness. A high proportion of patients in both groups reported clinically relevant improvement on the PGIC scale. At 6 months after start of chiropractic treatment there were no differences in any outcome measures between the two groups.
Cervicogenic Dizziness: A Systematic Review
Chiropractic & Manual Therapies 2011 (Sep 18); 19: 21 ~ FULL TEXT
There is moderate evidence to support the use of manual therapy, in particular spinal mobilisation and manipulation, for cervicogenic dizziness. The evidence for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is lacking. Further research to elucidate potential synergistic effects of manual therapy and vestibular rehabilitation is strongly recommended.
Patient With Mιniθre Disease
J Chiropr Med. 2010 (Mar); 9 (1): 2227 ~ FULL TEXT
Treatment included primarily high-velocity, low-amplitude spinal manipulation to the upper cervical and thoracic spine, along with soft-tissue trigger-point therapy, and stretching exercises. Within 2 weeks of treatment, the patient's tinnitus had resolved; and all other symptoms (including vertigo) were improved. The patient's headaches, neck pain, and vertigo were subsequently resolved within 3 months of treatment. The patient experienced only 2 minor episodes of self-resolving "light-headedness" over that time. After 2½ years of follow-up, any occasional episodes of mild aural fullness and/or light-headedness are either self-resolving or relieved with cervical spinal manipulation and soft-tissue treatment.
in a Child with Vertebral Subluxations Undergoing
Chiropractic Care: A Case Study
J. Pediatric, Maternal & Family Health 2010; 2: 8994
The patient is an 11-year-old female who had a one month history of dizziness, fuzzy vision, and inability to stand or walk unassisted. MRI revealed an anatomical variant in which the patients cerebellar tonsils protruded 2mm into the foramen magnum, and there was compression of the pituitary gland by cerebral spinal fluid (CSF). The patient was no longer able to attend school, or perform normal daily activities of an eleven year-old. Physical exam findings indicated the presence of vertebral subluxation at the atlas and occiput. Specific manual and drop table assisted adjustments were performed, primarily in the upper cervical region, based on evidence of subluxation. The patient responded well to care with complete resolution of cerebellar symptoms.
of Spinal Manipulation Therapy for Cervical Vertigo
Zhongguo Gu Shang. 2010 (Feb); 23 (2): 99101
Fixed-point spin reduction of spinal manipulation therapy for cervical vertigo can accurately correct single or multiple vertebral body displacement, restore normal spinal position, reduce the oppression and stimulus of the vertebral artery, release ischemia of vestibular labyrinth, and eliminate the symptoms of vertigo.
Review With Implications For Whole Systems Research
J Altern Complement Med. 2007 (Jun); 13 (5): 491512 ~ FULL TEXT
(1) Adverse effects should be routinely reported. For the few studies that did report, adverse effects of spinal manipulation for all ages and conditions were rare, transient, and not severe. (2) Evidence from controlled studies and usual practice supports chiropractic care (the entire clinical encounter) as providing benefit to patients with asthma, cervicogenic vertigo, and infantile colic. Evidence was promising for potential benefit of manual procedures for children with otitis media and elderly patients with pneumonia.
Chiropractic Care to Correct Vertebral Subluxation:
A Retrospective Analysis
Journal of Vertebral Subluxation Research 2006 (Nov 8); 19 ~ FULL TEXT
Two diagnostic tests, paraspinal digital infrared imaging and laser-aligned radiography, were performed according to IUCCA protocol. These tests objectively identify trauma-induced upper cervical subluxations (misalignments of the upper cervical spine from the neural canal) and resulting neuropathophysiology. Upper cervical subluxations were found in all 60 cases. All 60 patients responded to IUCCA upper cervical care within one to six months of treatment. Forty-eight patients were symptom-free following treatment and twelve cases were improved in that the severity and/or frequency of vertigo episodes were reduced.
A Systematic Review
Man Ther. 2005 (Feb); 10 (1): 413
Dizziness is a common and often disabling disorder. In some people the cause of their dizziness is pathology or dysfunction of upper cervical vertebral segments that can be treated with manual therapy. The aim of the present study was to systematically review the literature on the manual therapy treatment of patients with cervicogenic dizziness, by identifying and evaluating both randomized controlled trials (RCTs) and non-RCTs (controlled clinical trials and non-controlled studies).
in the Geriatric Patient
J Manipulative Physiol Ther. 2000 (Jun); 23 (5): 352362
The patient received upper cervical-specific chiropractic care. Paraspinal bilateral skin temperature differential analysis was used to determine when an upper cervical adjustment was to be administered. Radiographic analysis was used to determine the specific characteristics of the misalignment in the upper cervical spine. Through the course of care, the patient's symptoms were alleviated, structural and functional improvements were evident through radiographic examination, and audiologic function improved.
A Case Report
Spine 2000 (Mar 1); 25 (5): 632634
The authors suggest that the hyperextended neck position during hair shampoo treatment in a beauty parlor may be a risk factor for back lifting or cerebellum vascular insufficiency. Public education should lead to avoidance of this position during hair shampoo treatment at hair dressing salons.
of the Atlantoaxial Joint
J Tradit Chin Med 1999 (Dec); 19 (4): 273278
The derangement of the atlantoaxial joint is one of main cervical sources of dizziness and headache, which were based on the observation on the anatomy of the upper cervical vertebrae, analysis of X-ray film of the atlantoaxial joint, and the manipulative treatment in 35 patients with cervical spondylosis. The clinical diagnosis of derangement consists of: dizziness, headache, prominence and tenderness on one side of the affected vertebra, deviation of the dens for 1 mm-4 mm on the open-mouth X-ray film, abnormal movement of the atlantoaxial joint on head-rotated open-mouth X-ray film. An accurate and delicate adjustment is the most effective treatment.
Eur Spine J 1998; 7 (1): 5558
60% of the patients examined were assessed with upper cervical dysfunction, and 77.4% of them responded favorably to spinal manipulation.
in Vestibular Diseases
Laryngorhinootologie 1992 (May); 71 (5): 246250
Cervicogenic vertigo is caused by functional disorders of the craniovertebral joints. The therapeutic effect of chiropractic treatment in 28 patients with vertigo and purely functional disorders of the upper cervical spine or with a combination of functional disorders of the upper cervical spine and the labyrinth was evaluated. In our opinion chiropractic treatment is mandatory for the therapy of patients with vestibular affections and functional disorders of the craniovertebral joints.
Chiropractic and Balance or Proprioception
on Dizziness and Impaired Head Repositioning of Suspected
Cervical Origin: A Pilot Study
Man Ther 2000 (Aug); 5 (3): 151157
The effects of different forms of therapy-and none-on dizziness and neck pain were compared, using a 100 mm visual analogue scale (VAS). Active head relocation by subjects with dizziness was significantly less precise than in the control group. Manipulation was the only treatment to diminish the duration of dizziness/vertigo complaints during the past 7 days and increased the cervical range of motion. Both acupuncture and manipulation reduced dizziness/vertigo on the VAS scale and had positive effects on active head repositioning.
Cervical Motion, and Oculomotor Function in Patients with
Whiplash Injury
Arch Phys Med Rehabil 1998 (Sep); 79 (9): 10891094
Active head repositioning was significantly less precise in the whiplash subjects than in the control group. Failures in oculomotor functions were observed in 62% of subjects. Significant correlations occurred between smooth pursuit tests and active cervical range of motion. The results suggest that restricted cervical movements and changes in the quality of proprioceptive information from the cervical spine region affect voluntary eye movements. A flexion/extension injury to the neck may result in dysfunction of the proprioceptive system. Oculomotor dysfunction after neck trauma might be related to cervical afferent input disturbances.
in Patients With Chronic Neck Pain: A Pilot Study
J Manipulative Physiol Ther 1997 (Feb); 20 (2): 8085
Subjects receiving manipulation demonstrated a mean reduction in visual analogue scores of 44%, along with a 41% improvement in mean scores for the head repositioning skill. In comparison, a 9% mean reduction in visual analogue scores and a 12% improvement in head repositioning scores was observed for the stretching group. The difference in the outcomes of the head repositioning skill scores was significant (p < or = .05).
in Vestibular Diseases
Laryngorhinootologie 1992 (May); 71 (5): 246250
In our opinion chiropractic treatment is mandatory for the therapy of patients with vestibular affections and functional disorders of the craniovertebral joints.
Chiropractic: The J Chiro Res and Clin Invest 1991; 6 (4): 8487
In this study, chiropractic researchers gave chiropractic adjustments to an experimental group, while the control group was simply monitored. Reaction time was measured before the season began and at six weeks. In the control group, the improvement in reaction time at the six-week check-up was less than 1 percent. On the other hand, the experimental group's reaction time was 18 percent faster.
Charles Masarsky, DC
Even if your practice is not involved in any formal program to rehabilitate balance and proprioception, it is still worthwhile to inform your patients of the interaction between subluxation and balance. The following patient education article is designed to be useful regardless of whether or not you are deeply involved in rehabilitation. Please feel free to use it for bulletin-board display, front-desk handouts, lay lectures or tableside talks.
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