Prevalence and consequences of concurrent dizziness on disability and quality of life in patients with long-lasting neck pain.

PURPOSE: The purpose of this study was to examine the prevalence of concurrent dizziness in patients seeking treatment for neck pain at a secondary care clinic and examine how dizziness associates with physical function, disability, quality of life, and duration of neck pain. METHODS: This was a cross-sectional study where patients referred for neck pain (n = 133) were recruited from an outpatient spine clinic and divided into: patients with and without dizziness. All patients were examined with posturography, global body examination-flexibility and cervical range of motion, and completed the Neck Disability Index (NDI) and RAND-12 health survey. Patients with concurrent dizziness completed the Vertigo Symptom Scale short form (VSSsf). RESULTS: Forty-three percent of the patients reported dizziness. Concurrent dizziness was associated with increased postural sway with eyes open (p < .001), eyes closed (p = .024), eyes open on foam (p = .010), eyes closed on foam (p = .003), higher disability on the NDI (ß: 2.9, p = .009), RAND-12 physical (ß: -4.3, p = .014) and mental subscales (ß: -4.0, p = .014). A higher score on NDI was associated with higher score on the VSSsf (total score: r = 0.51, p < .001, anxiety: r = 0.52, p < .001, vertigo: r = 0.43, p = .02.). CONCLUSION: Dizziness is common among patients with long-lasting neck pain. It is associated with higher disability due to neck symptoms and general health-related quality of life. The findings highlight the importance of evaluating and addressing dizziness in patients with neck disorders.

Associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain - a cross-sectional study.

BACKGROUND: It is theorized that neck pain may cause reduced postural control due to the known physiological connection between the receptors in the cervical spine and the vestibular system. The purpose of this study was to examine whether the pressure pain threshold in the neck is associated with postural sway in patients with dizziness or neck pain. METHODS: Consecutive patients with dizziness (n = 243) and neck pain (n = 129) were recruited from an otorhinolaryngological department and an outpatient spine clinic, respectively. All subjects underwent static posturography. Pressure pain thresholds were measured at four standardized points in the neck, and generalized pain was assessed using the American College of Rheumatology tender points. The relationship between postural sway and pressure pain threshold was analyzed by linear regression, and the covariates included age, sex, and generalized pain. RESULTS: In the dizzy group, there was a small, inverse relationship between pressure pain thresholds and sway area with eyes closed, after adjusting for age, sex, and generalized pain (bare platform; lower neck, p = 0.002, R2 = 0.068; upper neck, p = 0.038, R2 = 0.047; foam rubber mat; lower neck, p = 0.014, R2 = 0.085). The same inverse relationship was found between pressure pain thresholds in the neck and the Romberg ratio on a bare platform after adjusting for age, sex and generalized pain (upper neck, p = 0.15, R2 = 0.053; lower neck, p = 0.002, R2 = 0.069). Neither of these relationships were present in the neck pain group. CONCLUSION: Our findings indicate that the pressure pain threshold in the neck is associated with postural sway in patients suffering from dizziness after adjusting for age, sex, and generalized pain, but only with closed eyes. The association was small and should be interpreted with caution. TRIAL REGISTRATION: Trial registration: Clinicaltrial.gov NCT03531619. Retrospectively registered 22 May 2018.