Prevalence, etiology, and biopsychosocial risk factors of cervicogenic dizziness in patients with neck pain: A multi-center, cross-sectional study

Abstract

Objectives: This study aims to investigate the prevalence, etiology, and risk factors of cervicogenic dizziness in patients with neck pain. Patients and methods: Between June 2016 and April 2018, a total of 2,361 patients (526 males, 1,835 females; mean age: 45.0±13.3 years; range, 18 to 75 years) who presented with the complaint of neck pain lasting for at least one month were included in this prospective, cross-sectional study. Data including concomitant dizziness, severity, and quality of life (QoL) impact of vertigo (via Numeric Dizziness Scale [NDS]), QoL (via Dizziness Handicap Inventory [DHI]), mobility (via Timed Up-and-Go [TUG] test), balance performance [via Berg Balance Scale [BBS]), and emotional status (via Hospital Anxiety- Depression Scale [HADS]) were recorded. Results: Dizziness was evident in 40.1% of the patients. Myofascial pain syndrome (MPS) was the most common etiology for neck pain (58.5%) and accompanied with cervicogenic dizziness in 59.7% of the patients. Female versus male sex (odds ratio [OR]: 1.641, 95% CI: 1.241 to 2.171, p=0.001), housewifery versus other occupations (OR: 1.285, 95% CI: 1.006 to 1.642, p=0.045), and lower versus higher education (OR: 1.649-2.564, p<0.001) significantly predicted the increased risk of dizziness in neck pain patients. Patient with dizziness due to MPS had lower dizziness severity scores (p=0.034) and milder impact of dizziness on QoL (p=0.005), lower DHI scores (p=0.004), shorter time to complete the TUG test (p=0.001) and higher BBS scores (p=0.001). Conclusion: Our findings suggest a significant impact of biopsychosocial factors on the likelihood and severity of dizziness and association of dizziness due to MPS with better clinical status.

Proprioceptive Cervicogenic Dizziness: A Narrative Review of Pathogenesis, Diagnosis, and Treatment

“…Dizziness is one of the most common reasons for consultation in adult patients [ 1 , 2 ]. It is an umbrella term used to describe various sensations, including vertigo, disequilibrium, lightheadedness, or presyncope ( Table 1 ) [ 2 ].…”

“…A recent clinical observation of a large number of cases (1000 cases) found that cervicogenic dizziness accounted for 89% of all dizziness, or vertigo [ 5 ]. Cervical spondylosis was one of the common causes of dizziness in the elderly in a community survey [ 1 ]. Among patients with cervical vertebral whiplash injuries, the prevalence of dizziness has been variously reported, ranging from 20% to 90% [ 6 ].…”

“…Among patients with cervical vertebral whiplash injuries, the prevalence of dizziness has been variously reported, ranging from 20% to 90% [ 6 ]. Nearly half of patients with neck pain have cervicogenic dizziness [ 1 ]. However, cervicogenic dizziness is the most controversial among all dizziness because its pathogenesis is unclear, and its diagnosis and treatment are difficult [ 6 , 7 , 8 , 9 ].…”

Clinical and Psychological Variables in Female Patients with Cervical Syndromes: A Cross-Sectional and Correlational Study

“…Depending on the type of symptoms and other signs, such as restrictions on the range of movement (ROM), the most common classifications in clinical care are cervicogenic dizziness (CGD), tension-type headache (TTH) and mechanical chronic neck pain (MCNP) [ 5 , 13 , 14 ]. These clinical symptoms are more frequent in women than in men [ 13 , 15 , 16 ].…”

“…Some of these variables may be predicted in patients with CP based on pain intensity. For this reason, it is suggested that psychological distress and kinesiophobia may be pain mediators in patients with CP [ 16 , 22 , 23 , 24 , 25 ]. Recent evidence suggests a relationship between pain intensity, cervical ROM, psychological distress and kinesiophobia [ 16 , 22 , 23 , 24 , 25 ].…”