From the Research
The initial management for cervicogenic dizziness should involve a multimodal approach focusing on manual therapy and exercise therapy, as this combination has been shown to reduce dizziness, cervical spine, and balance symptoms, according to the most recent and highest quality study available 1.
Key Components of Management
- Manual therapy techniques, including gentle cervical spine mobilization, soft tissue manipulation, and specific stretching exercises, to improve neck mobility and reduce muscle tension
- A structured rehabilitation program that includes:
- Proprioceptive training
- Vestibular habituation exercises
- Targeted strengthening of the deep neck flexors and scapular stabilizers
- Patients should perform exercises daily, gradually increasing intensity as tolerated
Pain Management and Activity Modification
- Pain management may include over-the-counter analgesics, such as acetaminophen (500-1000mg every 6 hours as needed) or NSAIDs like ibuprofen (400-600mg three times daily with food) for short-term use
- Activity modification to avoid positions that provoke symptoms is important during the acute phase
Importance of Accurate Diagnosis
- Cervicogenic dizziness is a diagnosis of exclusion, and healthcare professionals should follow a systematic diagnostic approach to rule out other vestibular, medical, and vascular disorders that cause dizziness, as outlined in previous studies 2
- A thorough assessment by a physical therapist or healthcare provider experienced in treating cervical spine disorders is essential for accurate diagnosis and effective management, as highlighted in earlier research 3, 4
Recent Evidence and Recommendations
- A 2022 systematic review and meta-analysis found moderate quality evidence that manual therapy reduces cervicogenic dizziness, cervical spine, and balance symptoms, and very low quality evidence that the combination of manual therapy and exercise therapy has an even stronger positive effect 1
- A 2024 case report demonstrated the effectiveness of conservative management, including manual therapy and cervical stability exercises, in improving symptoms of cervicogenic dizziness associated with upper cervical instability and postural orthostatic tachycardia syndrome 5