Dizziness That Accompanies Cervical Movement Impairments May Originate from Vertebrobasilar

Vertigo

Dizziness that accompanies cervical movement impairments may originate from vertebrobasilar insufficiency (VBI), the vestibular system, the visual system, or from structures that constitute the cervical spine, i.e. cervicogenic dizziness. Cervicogenic dizziness has been described as a false sense of motion or a nonspecific sensation of altered orientation; spinning, whirling, and lightheadedness, or a sense of disequilibrium. It has been proposed that degenerative changes of joint and periarticular soft tissue structures may lead to an altered/false sense of motion. Differentiation tests can be performed by Physiotherapists to differentiate the cause of dizziness: vestibular, visual, cervical articular, or vertebrobasilar systems. Based upon the outcome of these tests the Physiotherapist would treat the client accordingly.

Physiotherapists can effectively treat cervicogenic dizziness. Treatment may include: manual joint mobilizations (including gliding mobilizations, specific joint traction mobilization, translatoric mobilization) for cervical joint hypomobilities; cervical stabilization and joint protection techniques for cervical joint hypermobilities; movement reeducation techniques including the use of thoracic extension to decrease the

necessity of end-range cervical extension, and the use of thoracic rotation in extension for the purpose of minimizing full cervical rotation.

Physiotherapists do not use rotational mobilization/manipulations that potentially can compromise vertebral artery blood flow. Vertebral artery (VA) comprise in response to spondylotic changes has the potential to produce dizziness. In the lower cervical region, the VA may be distorted or displaced secondary to enlargements of facet joints. In the upper cervical spine, blood flow changes secondary to changes in lumen diameter may occur due to excessive rotation occurring between the C1 and C2 vertebrae.

Trained Physiotherapists in the treatment of BPPV perform the Modified Canalynth Repositioning Procedure with success rates 95.6% after the first maneuver. This procedure utilizes headshaking techniques to facilitate detachment of particles adhering to the cupula and utilizes set positions of the body/head so the force of gravity moves the displaced crystals through the semicircular canal and then into the utricle.

Physiotherapists at the Ayr Physiotherapy Clinic differentiate causes of dizziness/vertigo and undergo effective treatment. Please book an appointment if experiencing dizziness, disequilibrium, vertigo or neck pain.

Call 519-632-8822

Reference:

1. Kondratek MK, Creighton D, Krauss J. Use of translatoric Mobilization in a Patient with Cervicogenic Dizziness’s and Motion Restriction: A Case Report. Journal of Manual and Manipulative Therapy 2006; 14(3): 140-151.