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

Chang, T.P., Lin, Y.W., Sung, P.Y., Chuang, H.Y., Chung, H.Y., Liao, W.L. (2016). Benign Paroxysmal Positional Vertigo after Dental Procedures: A Population-Based Case-Control Study. PLoS One.

Cheever, K., Kawata, K., Tierney, R., Galgon, A. (2016). Cervical Injury Assessments for Concussion Evaluation: A Review. J Athl Train.

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)

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.

Hain, T.C. (2015). Cervicogenic causes of vertigo. Curr Opin Neurol.

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.

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.

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. 

Li, Y., Peng, B. (2015). Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo. Pain Physician.

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).

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.

Marshall, C.M., Vernon, H., Leddy, J.J., Baldwin, B.A. (2015). The role of the cervical spine in post-concussion syndrome. Phys Sportsmed.

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.

Popkirov, S., Staab, J.P., Stone, J. (2017). Persistent postural-perceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness. Pract Neurol.

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.

Schneider, K.J., Meeuwisse, W.H., ...  Emery,  C.A. (2014). Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial. Br J Sports Med.

van Vugt, V.A., van der Horst, H.E., Payne, R.A., Maarsingh, O.R. (2017). Chronic vertigo: treat with exercise, not drugs. BMJ. 

Yacovino, D.A., Hain, T.C. (2013). Clinical characteristics of cervicogenic-related dizziness and vertigo. Semin Neurol.

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.