Case Report

Cervicogenic Dizziness after Humeral Fracture: A Case Report

Abstract

Background: Cervicogenic dizziness is a nonspecific sensation of disequilibrium in the space. Abnormal proprioceptive inputs from the cervical spine and neck muscles may induce cervicogenic dizziness. Trigger-point activation of the suboccipital muscles may be related to cervicogenic dizziness. This case study aimed to present a case of cervicogenic dizziness after humerus fracture.

Case Report: The present case report describes a 38-year-old man who was referred for physiotherapy to restore the motion of his right shoulder after surgery for a humerus fracture. The patient reported dizziness after the shoulder surgery. The patient had no medical problems that could induce dizziness. Physical examination revealed a trigger point activation of the suboccipital muscles. Myofascial release and chin-tuck exercises were performed, and the patient reported improvement in dizziness. Trigger point activation of the suboccipital muscles in this patient may be related to abnormal head posture during shoulder surgery and/or impaired scapulohumeral rhythm and overactivity of the cervical muscles participating in shoulder elevation.

Conclusion: The possibility of cervicogenic dizziness should be considered after humeral fractures.

1. Grande-Alonso M, Moral Saiz B, Mínguez Zuazo A, Lerma Lara S, La Touche R. Biobehavioural analysis of the vestibular system and posture control in patients with cervicogenic dizziness. A cross-sectional study. Neurologia (Engl Ed). 2018;33(2):98-106. doi: 10.1016/j.nrl.2016.06.002. [PubMed: 27452617].
2. Chu EC, Wong AY. Cervicogenic Dizziness in an 11-Year-Old Girl: A Case Report. Adolesc Health Med Ther. 2021;12:111-6. doi: 10.2147/AHMT.S341069. [PubMed: 34866956]. [PubMed Central: PMC8636150].
3. Jiam NT, Murphy OC, Gold DR, Isanhart E, Sinn DI, Steenerson KK, et al. Nonvestibular Dizziness. Otolaryngol Clin North Am. 2021;54(5):999-1013. doi: 10.1016/j.otc.2021.05.017. [PubMed: 34538360].
4. Yacovino DA, Hain TC. Clinical characteristics of cervicogenic- related dizziness and vertigo. Semin Neurol. 2013;33(3):244-55. doi: 10.1055/s-0033-1354592. [PubMed: 24057828].
5. Kulkarni V, Chandy MJ, Babu KS. Quantitative study of muscle spindles in suboccipital muscles of human foetuses. Neurol India. 2001;49(4):355-9. [PubMed: 11799407].
6. Sung YH. Suboccipital Muscles, Forward Head Posture, and Cervicogenic Dizziness. Medicina (Kaunas). 2022;58(12). doi: 10.3390/medicina58121791. [PubMed: 36556992]. [PubMed Central: PMC9786116].
7. Reiley AS, Vickory FM, Funderburg SE, Cesario RA, Clendaniel RA. How to diagnose cervicogenic dizziness. Arch Physiother. 2017;7:12. doi: 10.1186/s40945-017-0040-x. [PubMed: 29340206]. [PubMed Central: PMC5759906].
8. Devaraja K. Approach to cervicogenic dizziness: a
comprehensive review of its aetiopathology and management. Eur Arch Otorhinolaryngol. 2018;275(10):2421-33. doi: 10.1007/s00405-018-5088-z. [PubMed: 30094486].
9. McLain RF. Mechanoreceptor endings in human cervical facet joints. Iowa Orthop J. 1993;13:149-54. [PubMed: 7820735]. [PubMed Central: PMC2328986].
10. Pettorossi VE, Schieppati M. Neck proprioception shapes body orientation and perception of motion. Front Hum Neurosci. 2014;8:895. doi: 10.3389/fnhum.2014.00895. [PubMed: 25414660]. [PubMed Central: PMC4220123].
11. Farhani-Sameni N, Sheikhhoseini R, Piri H, Soltani F. The Effect of Reactive Neuromuscular Training versus General Warm-up on Proprioception and Balance in Female Handball Players with Rounded Shoulder: A Controlled Laboratory Study. J Orthop Spine Trauma. 2024;10(3):105-10. doi: 10.18502/jost.v10i3.16780.
12. Hallgren RC, Pierce SJ, Sharma DB, Rowan JJ. Forward Head Posture and Activation of Rectus Capitis Posterior Muscles. J Am Osteopath Assoc. 2017;117(1):24-31. doi: 10.7556/jaoa.2017.004. [PubMed: 28055084].
13. Bogduk N. Cervicogenic headache: anatomic basis and pathophysiologic mechanisms. Curr Pain Headache Rep. 2001;5(4):382-6. doi: 10.1007/s11916-001-0029-7. [PubMed: 11403743].
14. Peng B, Yang L, Li Y, Liu T, Liu Y. Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review. Pain Ther. 2021;10(1):143-64. doi: 10.1007/s40122-020-00230-z. [PubMed: 33464539]. [PubMed Central: PMC8119582].
Files
IssueVol 11 No 1 (2025) QRcode
SectionCase Report
DOI https://doi.org/10.18502/jost.v11i1.18013
Keywords
Dizziness Humeral Fractures Myofascial Release Therapy Spine Trigger Points

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Bokaee F. Cervicogenic Dizziness after Humeral Fracture: A Case Report. J Orthop Spine Trauma. 2025;11(1):39-41.