Cervicogenic Dizziness and Manual Therapy

Massage therapists are uniquely suited to incorporate a number of rehabilitation strategies for patients with Cervicogenic Dizziness.

Why Does Massage Therapy Work for Cervicogenic Dizziness?

Several hypotheses regarding the etiology of cervical vertigo, such as neurovascular, somatosensory input, vascular and cervical instability, have been put forward (Yacovino et al. 2013).

A biopsychosocial framework helps put into context the interconnected and multidirectional interaction between: physiology, thoughts, emotions, behaviors, culture, and beliefs. In terms of clinical responses to massage therapy there are a couple of proposed mechanisms of action, including but not limited to: neurodynamics, contextually aided recovery, and neuromodulation

Structures to be Aware of When Treating Cervicogenic Symptoms

A treatment plan should be implemented based on patient-specific assessment findings and patient tolerance (Jung et al. 2017). It should include screening to identify cervicogenic symptoms after a pathomechanical event, leading to appropriate management and medical referrals.

Structures to keep in mind while assessing and treating patients suffering from cervicogenic dizziness may include neurovascular structures and investing fascia of:
• scalene muscles
• sternocleidomastoid
• temporomandibular joint
• longus colli muscle (Lui et al. 2017)

More to Explore

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https://www.ncbi.nlm.nih.gov/pubmed/27044009

Cheever, K., Kawata, K., Tierney, R., Galgon, A. (2016). Cervical Injury Assessments for Concussion Evaluation: A Review. J Athl Train.
https://www.ncbi.nlm.nih.gov/pubmed/27835042

Ellis, M.J., Leddy, J., Willer, B. (2016). Multi-Disciplinary Management of Athletes with Post-Concussion Syndrome: An Evolving Pathophysiological Approach. Front Neurol. (OPEN ACCESS)
https://www.ncbi.nlm.nih.gov/pubmed/27605923

Gong, W. (2013). Impact of longus colli muscle massage on the strength and endurance of the deep neck flexor muscle of adults. J Phys Ther Sci.
https://www.ncbi.nlm.nih.gov/pubmed/24259809/

Hain, T.C. (2015). Cervicogenic causes of vertigo. Curr Opin Neurol.
https://www.ncbi.nlm.nih.gov/pubmed/25502050

Jung, F.C., Mathew, S., Littmann, A.E., MacDonald, C.W. (2017). Clinical Decision Making in the Management of Patients With Cervicogenic Dizziness: A Case Series. J Orthop Sports Phys Ther.
https://www.ncbi.nlm.nih.gov/pubmed/28992773/

Kennedy, E., Quinn, D., Tumilty, S., Chapple, C.M. (2017). Clinical characteristics and outcomes of treatment of the cervical spine in patients with persistent post-concussion symptoms: A retrospective analysis. Musculoskelet Sci Pract.
https://www.ncbi.nlm.nih.gov/pubmed/28347935

Leddy, J., Baker, J.G., Haider, M.N., Hinds, A., Willer, B. (2017). A Physiological Approach to Prolonged Recovery From Sport-Related Concussion. J Athl Train. 
https://www.ncbi.nlm.nih.gov/pubmed/28387557

Li, Y., Peng, B. (2015). Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo. Pain Physician.
https://www.ncbi.nlm.nih.gov/pubmed/26218949

Liu, X.M., Pan, F.M., ... Wu, D.S. (2017). Does the longus colli have an effect on cervical vertigo?: A retrospective study of 116 patients. Medicine (Baltimore).
https://www.ncbi.nlm.nih.gov/pubmed/28328822

Makdissi, M., Schneider, K.J., ... Johnston, K.M. (2017). Approach to investigation and treatment of persistent symptoms following sport-related concussion: a systematic review. Br J Sports Med.
https://www.ncbi.nlm.nih.gov/pubmed/28483928

Marshall, C.M., Vernon, H., Leddy, J.J., Baldwin, B.A. (2015). The role of the cervical spine in post-concussion syndrome. Phys Sportsmed.
https://www.ncbi.nlm.nih.gov/pubmed/26138797

Minguez-Zuazo, A., Grande-Alonso, M., Saiz, B.M., La Touche, R., Lara, S.L. (2016). Therapeutic patient education and exercise therapy in patients with cervicogenic dizziness: a prospective case series clinical study. J Exerc Rehabil.
https://www.ncbi.nlm.nih.gov/pubmed/27419118

Reid, S.A., Callister, R., Snodgrass, S.J., Katekar, M.G., Rivett, D.A. (2015). Manual therapy for cervicogenic dizziness: Long-term outcomes of a randomised trial. Man Ther.
https://www.ncbi.nlm.nih.gov/pubmed/25220110

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https://www.ncbi.nlm.nih.gov/pubmed/24855132

van Vugt, V.A., van der Horst, H.E., Payne, R.A., Maarsingh, O.R. (2017). Chronic vertigo: treat with exercise, not drugs. BMJ. 
https://www.ncbi.nlm.nih.gov/pubmed/28835412

Yacovino, D.A., Hain, T.C. (2013). Clinical characteristics of cervicogenic-related dizziness and vertigo. Semin Neurol.
https://www.ncbi.nlm.nih.gov/pubmed/24057828

Yardley, L., Barker, F., ... Little, P. (2012). Clinical and cost effectiveness of booklet based vestibular rehabilitation for chronic dizziness in primary care: single blind, parallel group, pragmatic, randomised controlled trial. BMJ.
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