Your Patients With Neck Pain AND Dizziness Have Higher Disability | Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews

Your Patients With Neck Pain AND Dizziness Have Higher Disability

Your Patients With Neck Pain AND Dizziness Have Higher Disability -

When addressing disability and functional limitations for someone you’re suspecting to have Cervicogenic Dizziness, it is normal practice to use a combination of Neck Disability Index (NDI), Dizziness Handicap Inventory (DHI) to examine functional limitations for general neck pain and dizziness.  You will find this to be a frequent combo in the medical and rehabilitation literature for diagnosis of Cervicogenic Dizziness, but also for benign paroxysmal positional vertigo (BPPV).

Cervicogenic Dizziness in a diagnosis of itself is most often contributed to less disability and functional limitations compared to other vestibular and central dizziness/vertigo diagnoses.  In fact, cervicogenic deficits have been shown to be subtler and less severe than deficits associated with vestibular and central nervous system (CNS) conditions (Field et al 2008, Treleaven et al 2005, Kristjansson et al 2009).

However, two studies I want to bring to your attention that could deflate this traditional thought:

  1. L’Heureux-Lebeau et al 2014 found that the intensity and handicap of the Dizziness Handicap Inventory was similar between Cervicogenic Dizziness and BPPV groups.
  2. Raul Ferrer-Pena et al 2019 Patients with non-specific chronic neck pain in conjunction with dizziness present higher health-related quality of life impairment and higher disability and kinesiophobia compared to patients with isolated non-specific chronic neck pain.

Now granted, the title of this piece only compromises these two studies compared to general thought-process as described above, but I like to ask, what do you see?

Wouldn’t you think a combination of not only having chronic neck pain, but a dizziness symptom, such as lightheadiness or unsteadiness be even more detrimental to your quality of life?

Cervicogenic Dizziness, Cervical Vertigo, Neck Dizziness

A multimodal approach of manual therapy, therapeutic exercise, vestibular and sensorimotor training within a biopsychosocial framework works best for Cervicogenic Dizziness.

Cervicogenic Dizziness, Cervical Vertigo, Neck Dizziness

The combined effect of these two pathologies, both neck pain and dizziness, has the greatest impact it has on health-related quality of life.  In principle, isn’t this what we do for a living?  Improve quality of life?  Allowing our patients to have the best health he/she could imagine?

Why not be efficient in treating both conditions at once?

You can learn more about the screening and treatment process of Cervicogenic Dizzinesss through Integrative Clinical Concepts, where the authors (husband–a manual therapist a wife—a vestibular specialist), teach a very unique course combining both the theory and practice of vestibular and manual principles in their 2-day course.  Pertinent to this blog post, the 2nd day includes the “Physio Blend”, a multi-faceted physiotherapist approach to the management of Cervicogenic Dizziness, which includes treatments of the articular and non-articular system of manual therapy and the most updated sensorimotor exercise regimen.

If you would like to host a course for your staff (either a vestibular, neuro, sports or ortho clinic), please do not hesitate to contact me at for more information.


Harrison N. Vaughan, PT, DPT, OCS, Dip. Osteopracic, FAAOMPT    

Instructor: Cervicogenic Dizziness for Integrative Clinical Concepts

Danielle N. Vaughan, PT, DPT, Vestibular Specialist  

Instructor: Cervicogenic Dizziness for Integrative Clinical Concepts

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