ChiroACCESS Clinical Review



Dizziness of Cervical Origin: Prevention

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Lead Author(s): 

Dwain M. Daniel, D.C.

  

How this evidence was rated:

Strength of Recommendation Taxonomy (SORT)



Published on

August 2, 2007

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The diagnosis of cervicogenic vertigo has not been accepted universally within the healthcare community (1) and others feel vertigo itself has been poorly defined in the literature (2). Rather than argue semantics, for the purpose of this paper, the term dizziness of cervical origin (DCO) and cervicogenic vertigo will be considered interchangeable and a valid clinical diagnosis. It has been clearly established in the scientific literature that there is significant afferent input from the mechanoreceptors in the cervical spine and surrounding soft tissue and these afferent impulses play an important role in proprioception (3-6). It has been postulated that disturbed afferent input due to injury reduces joint position sense, an essential component of proprioception (7-9). Clinically, dizziness and light-headedness are often seen in the physician’s office as a result of whiplash injury. Additionally these symptoms are a relatively common presenting complaint in the chiropractor’s office (10), regardless of etiology and, based on clinical evidence, respond well to spinal manipulation.

As would be expected due to its inherent controversy, little research has taken place relating to prevention and risk factors.

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References

1. 

Brandt T, Bronstein AM. Cervical vertigo. J Neurol Neurosurg Psychiatry 2001 Jul;71(1):8-12.



2. 

Kerr AG. Assessment of vertigo. Ann Acad Med Singapore 2005 May;34(4):285-8.



3. 

Heikkila H, Astrom PG. Cervicocephalic kinesthetic sensibility in patients with whiplash injury. Scand J Rehabil Med 1996 Sep;28(3):133-8.



4. 

Lee H, Nicholson LL, Adams RD, Bae SS. Proprioception and rotation range sensitization associated with subclinical neck pain. Spine 2005 Feb 1;30(3):E60-E67.



5. 

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6. 

Sjolander P, Johansson H, Djupsjobacka M. Spinal and supraspinal effects of activity in ligament afferents. J Electromyogr Kinesiol 2002 Jun;12(3):167-76.



7. 

Sterling M, Jull G, Vicenzino B, Kenardy J, Darnell R. Development of motor system dysfunction following whiplash injury. Pain 2003 May;103(1-2):65-73.



8. 

Revel M, Andre-Deshays C, Minguet M. Cervicocephalic kinesthetic sensibility in patients with cervical pain. Arch Phys Med Rehabil 1991 Apr;72(5):288-91.



9. 

Revel M, Minguet M, Gregoy P, Vaillant J, Manuel JL. Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. Arch Phys Med Rehabil 1994 Aug;75(8):895-9.



10. 

Job Analysis of Chiropractic. Greeley, Colorado: National Board of Chiropractic Examiners; 2005.



11. 

Young AL, Ragel BT, Su E, Mann CN, Frank EH. Assessing automobile head restraint positioning in Portland, Oregon. Inj Prev 2005 Apr;11(2):97-101.

 [ Full-Text Link ]

12. 

IIHS. Special issue: neck injries in rear-end crashes. Statusn Report: Insurance Institute for Highway Safety; 1999. Report No.: 34.



13. 

Willburger RE, Knorth H, Haaker R. [Side effects and complications of injection therapy for degenerative spinal disorders]. Z Orthop Ihre Grenzgeb 2005 Mar;143(2):170-4.