Myofascial Pain Syndrome in Patients with Cervical Vertigo

Objective To delineate the clinical manifestation of myofascial pain syndrome (MPS) around the face, neck and shoulders in patients with cervical vertigo (CV) and to determine whether treatment of MPS can improve CV. Method We evaluated 72 patients who were diagnosed with CV and 72 patients as controls who had MPS in the neck and shoulder without vertigo symptoms. Clinical evaluations for MPS were performed on all subjects, and vestibular function tests were also performed in patients with vertigo symptoms. Most patients and controls received treatments including trigger point injection, physical therapy or medication, and were then followed up. Results Seventy CV patients (97%) had MPS in the face, neck and shoulders. The distribution of trigger points in CV patients differed from that in controls, especially in the lateral neck muscles (odds ratio=0.361, p=0.019). The gender, age, symptom duration and number of trigger points were not different between CV patients and controls. 57 CV patients and 56 controls that had received treatments were followed up. Vertigo symptoms improved in 40 CV patients (70%) after treatment of MPS and pain symptoms improved in 77% of CV patients and 75% of controls after treatment. Conclusion Most CV patients had myofascial pain syndrome and the distribution of trigger points differed from that in controls. Treatment for myofascial pain syndrome could improve vertigo symptoms in CV patients, but further study is required to delineate the relationship between MPS and CV.