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The use of dry needling as a diagnostic tool and clinical treatment for cervicogenic dizziness: a narrative review & case series.
J Bodyw Mov Ther 2018; 22(4):947-955JB

Abstract

STUDY DESIGN

Narrative Review & Case Series.

BACKGROUND

No "gold standard" test presently exists to confirm a diagnosis of cervicogenic dizziness, a condition whereby the neuromusculoskeletal tissues of the cervical spine are thought to contribute to imbalance and dizziness. Clusters of tests are presently recommended to provoke signs and symptoms of the condition. In this regard, dry needling may provide a valuable diagnostic tool. Targeting the musculoskeletal structures of the upper neck with dry needling may also provide a valuable treatment tool for patients that suffer from cervicogenic dizziness. While dry needling has been used to treat various musculoskeletal conditions, it has not been specifically reported in patients with cervicogenic dizziness.

CASE DESCRIPTION

Three patients were screened for signs and symptoms related to cervicogenic dizziness in an outpatient physical therapy clinic. These patients presented with signs and symptoms often associated with (though not always) cervicogenic dizziness, including a positive flexion-rotation test, altered cervical range of motion, and tenderness with manual assessment of the upper cervical extensors. In addition, dry needling targeting the obliquus capitis inferior muscle was used diagnostically to reproduce symptoms as well as to treat the patients.

OUTCOMES

Two of the patients reported full resolution of their dizziness and a significant improvement in their function per standardized outcome measures. While the third patient did not report full resolution of her cervicogenic dizziness, she noted significant improvement, and dry needling was helpful in guiding further treatment. Importantly, the effect of the treatment was maintained in all three patients for at least 6 months.

DISCUSSION

This case series with narrative review covers various testing procedures for cervicogenic dizziness and explores the use of dry needling targeting the suboccipital muscles to evaluate and treat this patient population. The physiologic changes that occur in the periphery, the spine and the brain secondary to dry needling and their potential relevance to the mechanisms driving cervicogenic dizziness are discussed in detail.

Authors+Show Affiliations

Faculty, American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, United States. Electronic address: james.escaloni.pt@gmail.com.Faculty, American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, United States.Faculty, American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, United States.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

30368340

Citation

Escaloni, James, et al. "The Use of Dry Needling as a Diagnostic Tool and Clinical Treatment for Cervicogenic Dizziness: a Narrative Review & Case Series." Journal of Bodywork and Movement Therapies, vol. 22, no. 4, 2018, pp. 947-955.
Escaloni J, Butts R, Dunning J. The use of dry needling as a diagnostic tool and clinical treatment for cervicogenic dizziness: a narrative review & case series. J Bodyw Mov Ther. 2018;22(4):947-955.
Escaloni, J., Butts, R., & Dunning, J. (2018). The use of dry needling as a diagnostic tool and clinical treatment for cervicogenic dizziness: a narrative review & case series. Journal of Bodywork and Movement Therapies, 22(4), pp. 947-955. doi:10.1016/j.jbmt.2018.02.015.
Escaloni J, Butts R, Dunning J. The Use of Dry Needling as a Diagnostic Tool and Clinical Treatment for Cervicogenic Dizziness: a Narrative Review & Case Series. J Bodyw Mov Ther. 2018;22(4):947-955. PubMed PMID: 30368340.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of dry needling as a diagnostic tool and clinical treatment for cervicogenic dizziness: a narrative review & case series. AU - Escaloni,James, AU - Butts,Raymond, AU - Dunning,James, Y1 - 2018/02/17/ PY - 2017/07/15/received PY - 2018/01/21/revised PY - 2018/02/08/accepted PY - 2018/10/29/entrez PY - 2018/10/29/pubmed PY - 2019/5/7/medline SP - 947 EP - 955 JF - Journal of bodywork and movement therapies JO - J Bodyw Mov Ther VL - 22 IS - 4 N2 - STUDY DESIGN: Narrative Review & Case Series. BACKGROUND: No "gold standard" test presently exists to confirm a diagnosis of cervicogenic dizziness, a condition whereby the neuromusculoskeletal tissues of the cervical spine are thought to contribute to imbalance and dizziness. Clusters of tests are presently recommended to provoke signs and symptoms of the condition. In this regard, dry needling may provide a valuable diagnostic tool. Targeting the musculoskeletal structures of the upper neck with dry needling may also provide a valuable treatment tool for patients that suffer from cervicogenic dizziness. While dry needling has been used to treat various musculoskeletal conditions, it has not been specifically reported in patients with cervicogenic dizziness. CASE DESCRIPTION: Three patients were screened for signs and symptoms related to cervicogenic dizziness in an outpatient physical therapy clinic. These patients presented with signs and symptoms often associated with (though not always) cervicogenic dizziness, including a positive flexion-rotation test, altered cervical range of motion, and tenderness with manual assessment of the upper cervical extensors. In addition, dry needling targeting the obliquus capitis inferior muscle was used diagnostically to reproduce symptoms as well as to treat the patients. OUTCOMES: Two of the patients reported full resolution of their dizziness and a significant improvement in their function per standardized outcome measures. While the third patient did not report full resolution of her cervicogenic dizziness, she noted significant improvement, and dry needling was helpful in guiding further treatment. Importantly, the effect of the treatment was maintained in all three patients for at least 6 months. DISCUSSION: This case series with narrative review covers various testing procedures for cervicogenic dizziness and explores the use of dry needling targeting the suboccipital muscles to evaluate and treat this patient population. The physiologic changes that occur in the periphery, the spine and the brain secondary to dry needling and their potential relevance to the mechanisms driving cervicogenic dizziness are discussed in detail. SN - 1532-9283 UR - https://www.unboundmedicine.com/medline/citation/30368340/The_use_of_dry_needling_as_a_diagnostic_tool_and_clinical_treatment_for_cervicogenic_dizziness:_a_narrative_review_&_case_series_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1360-8592(18)30083-4 DB - PRIME DP - Unbound Medicine ER -