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Chiropractic Research Review

Combined Chiropractic and Medical Management of Cervical Vertigo

Cervical vertigo is the second most commonly diagnosed type of vertigo, presenting with symptoms such as vertigo, tinnitus, hearing loss, and cervical pain. Proposed physiopathologic mechanisms for the condition include abnormal stimulation of the articular capsule and muscular proprioceptors at the upper cervical spine.



The objective of this study was "to characterize the patient population with cervical vertigo and observe therapeutic results of a treatment protocol by using distinct conservative modalities." Fifteen subjects with cervical vertigo participated in a treatment program that combined spinal manipulation; manual techniques (postisometric relaxation, ischemic compression and proprioception on affected muscle groups) analgesic electrotherapy; labyrinth sedation; surface electromyography biofeedback; and an exercise program.

Results: At the end of treatment (averaging five treatment sessions over 41 days), 60% of patients reported complete remission of vertigo. Twenty percent reported consistent improvement with rare, mild recurrence of symptoms. Only two patients were still using medication compared with nine patients at baseline. The authors note that a conservative treatment protocol utilizing multiple modalities may be effective in patients with cervical vertigo, and suggest further controlled studies to assess its validity.

Take Note: This was a nicely-conducted case series in which a conservative treatment protocol resulted in improvements in the active patient group. However, the lack of a control group, and the broad range of interventions employed, limit the conclusions that can be drawn.

Bracher ESB, Almeida CIR, Almeida RR, et al. A combined approach for the treatment of cervical vertigo. Journal of Manipulative and Physiological Therapeutics, Feb. 2000:23(2), pp96-100. Reprints: (800) 325-4177 (ext. 4350); Fax: (314) 432-1380

Chiropractic Research Review

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