The Relationship Between Dizziness and Neck Pain

• ClinicalTrials.gov Identifier: NCT03531619
• Recruitment Status: Active, not recruiting
• First Posted: May 22, 2018
• Last Update Posted: August 26, 2021
• Sponsor: Haukeland University Hospital
• Information provided by (Responsible Party): Haukeland University Hospital

Study Description

Brief Summary:

Both dizziness and neck pain are common complaints in the Norwegian population. The cervical spine has a highly developed proprioceptive system, which is involved in head and gaze stabilization as well as postural control. Thus, it has been argued that dizziness and/or unsteadiness can occur due to loss of or inadequate stimulation of neck receptors in patients with neck pain. Still, the notion of dizziness due to cervical dysfunction is a controversial topic. However, clinicians report that patients referred for dizziness often complain of neck pain, and vice versa.

This study is a multi-center study including patients referred to 1) a neuro-otologic clinic due to dizziness and 2) a rehabilitation clinic due to neck pain. Both clinics are tertiary care university clinics. The study explores the prevalence, severity and spectrum of symptoms as well as clinical findings in patients with various combinations of dizziness and neck pain. The aim is to see if these patient groups differ from each other in terms of clinical characteristics, symptoms and quality of life. Additionally, the aim is to examine if there is a relationship between neck dysfunction and dizziness, and last, if the symptoms persist longer in patients with both dizziness and neck pain.

Condition or disease
Dizziness; Vertigo; Neck Pain

Detailed Description:

This is a longitudinal study with data collected at baseline, 6 months and 3 years follow-up.

Variables collected at baseline include age, sex, symptom variables including Dizziness Handicap Inventory, Vertigo Symptom Scale Short Form, Haukeland Dizziness Questionnaire, Visual analog scale, Hospital Anxiety and Depression Scale, RAND-12, dynamic posturography, video-based head impulse test, bithermal caloric tests, Neck Disability Index, as well as neck examinations including pressure algometry and measurements of the range of neck movements.

Follow-up data after 6 months include the same patient-reported outcomes as at baseline.

Study Design

• Study Type: Observational
• Estimated Enrollment: 370 participants
• Observational Model: Cohort
• Time Perspective: Prospective
• Official Title: Dizziness and Neck Pain - is There a Relationship and Does it Matter?
• Actual Study Start Date: July 11, 2017
• Estimated Primary Completion Date: February 1, 2022
• Estimated Study Completion Date: March 1, 2022

Groups and Cohorts

Group/Cohort
Dizziness; Patients referred to a neuro-otological clinic due to dizziness who answer that they do not suffer from neck pain
Dizziness and neck pain; Patients referred to a neuro-otological clinic due to dizziness who answer that they suffer from neck pain
Neck pain; Patients referred to a rehabilitation center due to neck pain who answer that they do not suffer from dizziness
Neck pain and dizziness; Patients referred to a rehabilitation center due to neck pain who answer that the suffer from dizziness
Healthy Control; Healthy Controls without neck pain or dizziness

Outcome Measures

Primary Outcome Measures :

1. Difference between Groups in the Dizziness Handicap Inventory (DHI) [ Time Frame: Baseline and 6 months follow-up ]
   25-item symptom score. 0-100 Points on dizziness handicap severity
2. Difference betwee Groups in the Neck Disability Index (NDI) [ Time Frame: Baseline and 6 months follow-up ]
   10-time symptom score. 0-50 Points on neck disabilty severity

Secondary Outcome Measures :

1. Correlation between Posturography and neck pain [ Time Frame: Baseline ]
   Path length is used as measure of steadiness. Neck pain is measured With a pressure algometer, measuring the pressure pain threshold of the neck in kilo pascal.

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 67 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes
• Sampling Method: Non-Probability Sample

Study Population

1. Patients referred to the ENT department of Haukeland University Hospital due to vertigo with suspected vestibular origin will be divided into two groups depending on whether or not they report concurrent neck pain.
2. Patients referred to the Nordås clinic due to chronic neck pain will be divided into two groups depending on whether or not the report concurrent dizziness.

The healthy controls will be recruited among employees at Haukeland University Hospital.

Criteria

Inclusion criteria for patients:

• Residence within the Health Region of Western Norway AND
• Referral to the ENT department of Haukeland University Hospital due to vertigo OR
• Referral to Nordås Outpatient Clinic due to neck pain lasting > 3 months

Exclusion criteria for patients:

• Severe orthopaedic or neurologic disease affecting postural balance
• Inability to undergo test protocol due to physical or language barriers
• Quaternary referrals (vestibular schwannomas or divers with vestibular disorders)

Inclusion criteria for healthy controls:

- Employees at Haukeland University Hospital

Exclusion criteria for healthy controls:

• Known neurologic or vestibular disease or ongoing ear disease.
• Neck pain within last 3 months

Contacts and Locations

Locations

Norway

Haukeland University Hospital

Bergen, Norway

Sponsors and Collaborators

Haukeland University Hospital

Investigators

• Study Director: Stein Helge Glad Nordhal, Professor II; Norwegian National Advisory Unit on Vestibular Disorders

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Knapstad MK, Goplen FK, Ask T, Skouen JS, Nordahl SHG. Associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain - a cross-sectional study. BMC Musculoskelet Disord. 2019 Nov 10;20(1):528. doi: 10.1186/s12891-019-2922-4.

• Responsible Party: Haukeland University Hospital
• ClinicalTrials.gov Identifier: NCT03531619
• Other Study ID Numbers: 2017/783
• First Posted: May 22, 2018
• Last Update Posted: August 26, 2021
• Last Verified: August 2021

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Haukeland University Hospital:

posturography; quality of life; pressure algometry; cervicogenic dizziness

Additional relevant MeSH terms:

Vertigo; Neck Pain; Dizziness; Pain; Neurologic Manifestations; Vestibular Diseases; Labyrinth Diseases; Ear Diseases; Otorhinolaryngologic Diseases; Nervous System Diseases; Sensation Disorders