Chronic neck pain and vertigo: Is a true balance disorder present?

We sought to establish whether chronic neck pain patients suffering from vertigo and instability have true balance disorders.

Ninety-two patients having suffered from chronic neck pain for at least 3 months were enrolled in the present study. Patients with a history of neck trauma or ear, nose and throat, ophthalmological or neurological abnormalities were excluded. The patients were evaluated in a clinical examination (neck mobility) and a test of dynamic and static balance on the Satel((R)) platform in which mediolateral (Long X) and anterior-posterior deviations (Long Y) were monitored. Our patients were divided into three groups: a group of 32 patients with neck pain and vertigo (G1), a group of 30 patients with chronic neck pain but no vertigo (G2) and a group of 30 healthy controls.

All groups were comparable in terms of age, gender, weight and shoe size. Osteoarthritis was found in 75% and 70% of the subjects in G1 and G2, respectively. Neck-related headache was more frequent in G1 than in G2 (65.5% versus 40%, respectively; p=0.043). Restricted neck movement was more frequent in G1 and concerned flexion (p<0.001), extension (p<0.001), rotation (p<0.001), right inclination (p<0.001) and left inclination (p<0.001). Balance abnormalities were found more frequently in G1 than in G2 or G3. Static and dynamic posturographic assessments (under "eyes open" and "eyes shut" conditions) revealed abnormalities in statokinetic parameters (Long X and Long Y) in G1.

Our study evidenced abnormal static and dynamic balance parameters in chronic neck pain patients with vertigo. These disorders can be explained by impaired cervical proprioception and neck movement limitations. Headache was more frequent in these patients.