Vertigo is a sense of movement or rotation of the patient’s own or an external object. When most people think vertigo, the most common diagnosis is benign paroxysmal positional vertigo (BPPV). This is long for BPPV and the same condition as when people think of crystals being out of place. Most patients with BPPV report vertigo-like episodes when lying down, extending their head or neck, sitting up from a supine position, and bending over.  Another type of vertigo is nautical vertigo. Nautical vertigo is defined as a sensory illusion reminding of movements experienced on board a ship in w ..read more

During the differential diagnosis of a patient with vertigo or dizziness, it is pertinent that the clinician determine if the symptoms are benign / non-benign or central / peripheral. This is our red light or green light system to treat or refer. This is by far the most important decision that comes out of a clinical evaluation and is especially important with neurological symptoms. The most common benign cause of vertigo is benign paroxysmal positional vertigo (BPPV). There are specific subjective and objective findings that are crucial to ruling in BPPV in the dizzy patient. A physical ther ..read more

There are a range of symptoms and variety of potential descriptions of cervicogenic dizziness. Cervicogenic Dizziness symptoms can vary from one person to another and still carries the weight of controversy. The description of dizziness, including a sensation of spinning and/or dysequilibrium is common (Krabak et al 2000, Kalberg 1996).  It has even been described generally as dizziness that may be associated with headache, cervical pain, nausea, cold sweats and/or nonspecific complaints (Morinaka 2006). With that said, the following are the top 5 symptoms of Cervicogenic Dizziness ..read more

Cervicogenic dizziness has been described in the medical literature to be caused by functional problem of the cervical spine associated with postural alignment, proprioception and range of motion. Although cervical dizziness is controversial, we have large randomized controlled trials and systematic reviews saying that manual therapy and exercise can help with dizziness frequency, intensity and duration. However, until two chiropractic pieces have arisen in the last few years, we didn’t know if an improvement in cervical lordosis can be linked to improvement in neck dizziness. I find these art ..read more

Can Craniosacral Osteopathy help Dizziness? As consistent authors, teachers and clinicians that diagnose and manage dizziness disorders, especially from the cervical spine, we always research the newest information out there to help persons with these conditions. I found a recent journal article out of Turkey by Atay et al examining the effect of craniosacral osteopathy on dizziness and balance in individuals who have peripheral vestibular pathology. The participants who were diagnosed with chronic vertigo were divided into two groups:   Cranial osteopathy treatment group Impairment ..read more

Cupping therapy can be described as a technique that uses cups placed over the skin to create negative pressure through suction.  It has been in use all over the world for centuries for many musculoskeletal and some non-musculoskeletal conditions.  The treatment approach has created more buzz in the Physio world for the past few years for musculoskeletal conditions, mostly pain. I believe the pictures of Olympic swimmer, Michael Phelps, in 2016 games was the reason the modality was brought to the attention of the most of the western world.   Therefore, it struck a chord wi ..read more

Is muscle thickness different in persons with cervical vertigo? Out of Iran and part of PhD work, Dr. Ronak Zagar, and colleagues in a 2020 study examined this just question. The study examined muscle thickness of both the anterior and posterior cervical muscles using ultrasound between persons diagnosed with cervical vertigo and compared the results to healthy controls.  Figure 1 from the study is shown below: Ronak Zargar Talebi et al. Evaluation of cervical spine muscles thickness in patients with cervical vertigo and healthy controls through ultrasonographyJ Phys Ther Sci. 2020 Jul ..read more

Save 60% of time with the shortened Dizziness Handicap Inventory In any vestibular, neurological or even orthopaedic practice that treats patients with dizziness and vertigo, the use of the Dizziness Handicap Inventory (DHI) is the most popular self-report questionnaire. We have written about this outcome measure for sensorimotor disorders in a previous post to utilize for clinical practice.  You can also access the DHI, and other sensorimotor measures, on our Cervicogenic Dizziness Kit page. Even though answering 25 questions isn’t the biggest time consuming event for patients and clin ..read more

Of course anyone reading this blog over the last several years realizes the intent is to rule in and rule out the cervical spine as a driver for the symptoms of dizziness, lightheadiness, drunkenness and unsteadiness. Therefore, the question, “Can the teeth cause dizziness” is an interesting inquiry and not a common source of dizziness.  However, for anyone treating upper quarter symptoms, it is pertinent to know a few of these outliers. I would like to initially relay material from a 2019 case report entitled, “Recovering of Dizziness of a Patient with Sinusitis after Root Canal Therapy ..read more

The probability of a patient arriving to your outpatient, physical therapy office with symptoms associated with vertebrobasilar insufficiency (VBI) is very, very, very minimal.  VBI is an important diagnosis to consider, as many symptoms can mimic benign peripheral etiologies in our industry. Most of the data in the physical therapy world on the incidence of VBI is after a manipulation, which is anywhere 1 in 20,000 to 1 in 1 million.  But I’m not talking about iatrogenic causes, but actual spontaneous events, which is what would most likely lead someone to come into your office. T ..read more