Turkish Journal of Physical Medicine and Rehabilitation 2021 , Vol 67 , Num 4

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

Meltem Vural 1 ,Ayşe Karan 2 ,İlknur Albayrak Gezer 3 ,Ahmet Çalışkan 3 ,Sevgi Atar 4 ,Filiz Yıldız Aydın 1 ,İlke Coşkun Benlidayı 5 ,Aylin Gökşen 5 ,Şebnem Koldaş Doğan 6 ,Gülçin Karacan 6 ,Rana Erdem 7 ,Emine Eda Kurt 7 ,Fatma Nur Kesiktaş 8 ,Tuğba Aydın 8 ,Nilay Şahin 9 ,Zafer Aydın 9 ,Banu Ordahan 10 ,Gözde Türkoğlu 10 ,Hatice Reşorlu 11 ,Davut Döner 11 ,Figen Yılmaz 12 ,Hüseyin Bertan 12 ,Deniz Dülgeroğlu 13 ,Özgür Zeliha Karaahmet 13 ,Birkan Sonel Tur 14 ,Esra Moustafa 14 ,Pınar Borman 15 ,Öner İskender 15 ,Saime Ay 16 ,Aydan Kurtaran 17 ,Hülya Şirzai 17 ,Deniz Evcik 18 ,Nalan Çapan 2 ,Belgin Erhan 19 ,Hasan Kerem Alptekin 20 ,Halil İbrahim Ural 20
1 Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
2 Department of Physical Medicine and Rehabilitation, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
3 Department of Physical Medicine and Rehabilitation, Selçuk University Faculty of Medicine, Konya, Turkey
4 University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey
5 Department of Physical Medicine and Rehabilitation, Çukurova University Faculty of Medicine, Adana, Turkey
6 Department of Physical Medicine and Rehabilitation, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
7 Department of Physical Medicine and Rehabilitation, Ahi Evran University Faculty of Medicine, Kırşehir, Turkey
8 University of Health Sciences, Istanbul Physical Therapy and Rehabilitation Training and Research Hospital, Istanbul, Turkey
9 Department of Physical Medicine and Rehabilitation, Balıkesir University Faculty of Medicine, Balıkesir, Turkey
10 Department of Physical Medicine and Rehabilitation, University of Health Sciences, Konya Training and Research Hospital, Konya, Turkey
11 Department of Physical Medicine and Rehabilitation, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
12 epartment of Physical Medicine and Rehabilitation, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
13 Department of Physical Medicine and Rehabilitation, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey
14 Department of Physical Medicine and Rehabilitation, Ankara University Faculty of Medicine, Ankara, Turkey
15 Department of Physical Medicine and Rehabilitation, Hacettepe University Faculty of Medicine, Ankara, Turkey
16 Department of Physical Medicine and Rehabilitation, Ufuk University Faculty of Medicine, Ankara, Turkey
17 Department of Physical Medicine and Rehabilitation, Romatem Kocaeli Hospital, Kocaeli, Turkey
18 Department of Physical Medicine and Rehabilitation, Ankara Güven Hospital, Ankara, Turkey
19 Department of Physical Medicine and Rehabilitation, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
20 Department of Physical Medicine and Rehabilitation, Bahçeşehir University Faculty of Medicine, Istanbul, Turkey
DOI : 10.5606/tftrd.2021.7983 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. Keywords : Balance, cervicogenic dizziness, handicap, myofascial pain syndrome, neck pain