Principles of Treatment

Question 1

Cervical Vertigo/Dizziness Rehabilitation

Answer 1

• cervical pain & dizziness allows for inhibition normal muscle activity & timing of contractions leading people to re-organize movement which leads to stress of inert tissue & increasing size of neural zone
• clinically seen with loss of eye focus, balance & proprioception of patients with neck pain
• summary: dizziness/pain leads to loss of motor control

Question 2

Treatment principles specific to dizzy patients

Answer 2

• positioning
• central sensitization
• monitor eyes
• nystagmus
• patients are weak, anxious & under-rehabilitated
• balance & visual problems along with dizziness & neck pain
• extremely anxious patients!
• medical specialist: cardiology, ENT, co-treating vestibular therapist

Question 3

General principles for treating dizzy patients

Answer 3

• approach may vary from idiopathic v. traumatic neck pain/dizziness
• rehabilitate early & as much pain/dizzy free as possible
• prevention of severe dizziness between sessions
• restore lordosis
• restore muscle balance

Question 4

Treating dizzy patients - what DOES work (depending on severity)

Answer 4

• team approach
• private treatment room
• dedicated time
• minimize nystagmus
• comprehensive HEP
• gentle manual therapy: grades of mobilization, MET

Question 5

Treating dizzy patients - what DOES NOT work (depending on severity)

Answer 5

• traction
• manipulation (thrust): hand placements, force, risk v. reward
• deep cross frictions
• quick fix approach
• vibration w/ electrical stimulation

Question 6

Proven alterations with OMPT?

Answer 6

• sympathetic hyperactivity inflammatory process
• mechanical hypoalgesia
• synchronization motor response
• greatest input to cervical-ocular reflex