Vestibular symptoms after head and neck trauma involve a dual injury reality affecting both the central nervous system and the cervical structures. Understanding why these symptoms persist — and what comprehensive evaluation involves — clarifies the path to recovery for patients whose dizziness and balance problems have not resolved.
One of the most common and most frustrating experiences for patients who have sustained concussions, whiplash injuries, or other head and neck trauma is the persistence of vestibular symptoms long after they expected to have recovered. The acute event may have happened months or even years earlier — a motor vehicle accident, a sports collision, a fall, a workplace injury — and yet the dizziness, unsteadiness, motion sensitivity, and broader vestibular dysfunction continue to disrupt daily life. Many patients have been told their concussion ‘should have healed by now.’ Many have been evaluated by multiple specialists without clear answers. Many have been left wondering whether their persistent symptoms are real, whether something more serious is happening, or whether they will ever recover.
Post-concussion vestibular dysfunction is a real, recognized clinical entity with established mainstream evidence supporting both the persistence patterns patients experience and the comprehensive treatment approaches that can help. The 2017 Berlin Consensus Statement on Concussion in Sport (McCrory et al., 2017) and the 2017 systematic review by Iverson and colleagues in the British Journal of Sports Medicine (Iverson et al., 2017) established the clinical framework for understanding persistent post-concussion features. Vestibular symptoms are among the most common persistent features, often outlasting other concussion symptoms by months or years when comprehensive treatment is not provided.
Understanding why these symptoms persist requires understanding the dual injury reality of head and neck trauma — the trauma that produced the concussion almost always also affected the cervical structures, and the cervical involvement contributes to persistent symptoms that pure brain-focused treatment cannot fully address. This article walks through what post-concussion vestibular dysfunction actually involves, the multiple mechanisms producing the symptoms, the dual injury reality and why it matters, why symptoms persist when they should have resolved, the standard evidence-based treatments that address the condition, and where upper cervical evaluation has its strongest clinical case among vestibular conditions for appropriate patients.
What Post-Concussion Vestibular Dysfunction Actually Involves
Post-concussion vestibular dysfunction is not a single specific condition but a category of vestibular symptoms and impairments that develop after head and neck trauma. Understanding the spectrum clarifies what patients may experience and what comprehensive evaluation involves.
The clinical spectrum
Post-concussion vestibular dysfunction can manifest in multiple ways. Some patients have persistent dizziness or unsteadiness with no specific provoking factors. Others have positional vertigo from post-traumatic BPPV. Some develop vestibular migraine activated by the trauma. Others develop PPPD as the brain’s adaptive responses to the trauma fail to resolve normally. Some have cervicogenic dizziness as the dominant feature. Many have multiple coexisting conditions producing layered symptom patterns. The 2014 paper by Mucha and colleagues describing the Vestibular/Ocular Motor Screening (VOMS) provided a framework for identifying the multiple vestibular components that can be involved (Mucha et al., 2014).
Common specific symptoms
Patients with post-concussion vestibular dysfunction commonly experience: persistent dizziness or unsteadiness during normal activities, motion sensitivity in busy environments (grocery stores, crowded spaces, scrolling on screens), difficulty with rapid head movements, gaze instability when reading or working at computers, light sensitivity (often related to vestibular-visual integration issues), brain fog affecting concentration and processing, fatigue with activities that challenge the vestibular system, anxiety about activities that provoke symptoms, and reduced confidence with driving, exercise, and other functional activities.
The typical timeline
Vestibular symptoms typically begin within hours to days of the trauma event. The acute phase often involves dramatic spinning vertigo, severe nausea, vomiting, and inability to maintain upright posture, particularly in more significant concussions. The acute phase usually improves over days to a few weeks. For patients who recover fully, symptoms continue to improve and resolve over weeks to a few months. For patients with persistent post-concussion vestibular dysfunction, the symptoms either fail to fully resolve, plateau at incomplete recovery, or initially seem to resolve before returning weeks or months later. Understanding the typical timeline helps patients recognize when their experience differs from normal recovery.
The recognition as a distinct entity
Post-concussion vestibular dysfunction was historically underrecognized — patients were often told their persistent symptoms were psychological, exaggerated, or ‘just post-concussion syndrome’ without specific characterization or treatment. Recent decades have established the condition as a recognized clinical entity with specific assessment tools, distinct symptom patterns, and evidence-based treatments. The 2014 paper by Schneider and colleagues in the British Journal of Sports Medicine demonstrated that cervicovestibular rehabilitation produced better outcomes than standard treatment in sport-related concussion patients (Schneider et al., 2014), establishing both the legitimacy of the condition and the effectiveness of comprehensive treatment.
The Multiple Mechanisms Producing Vestibular Symptoms After Trauma
Post-concussion vestibular dysfunction involves multiple distinct mechanisms operating together. Understanding these mechanisms clarifies why the condition is more complex than simple brain injury and why comprehensive treatment requires addressing multiple components.
Direct effects on the central vestibular system
Concussion produces multiple effects on the central nervous system that affect vestibular processing. Diffuse axonal injury — microscopic damage to nerve fibers from acceleration-deceleration forces — affects brainstem regions including the vestibular nuclei and the connections involved in balance processing. Neuroinflammation following trauma affects vestibular processing function. The well-documented neurometabolic cascade after concussion — the cellular energy disruption that follows the initial injury — affects the energy-intensive processing that vestibular function requires. The combined effects can disrupt central vestibular processing in ways that persist long after the immediate trauma effects have stabilized.
Peripheral vestibular effects
Trauma can also affect the peripheral vestibular apparatus directly. Forces transmitted through the skull can affect the inner ear structures, sometimes producing labyrinthine concussion with damage to the membranous labyrinth itself. Post-traumatic BPPV is common — the trauma forces can dislodge otoconia from their normal position, producing the positional vertigo characteristic of BPPV. Some patients develop endolymphatic hydrops after trauma, with features overlapping post-traumatic Meniere’s disease. These peripheral effects compound any central involvement, creating the complex post-traumatic picture.
Vestibular-ocular integration disruption
The integration between vestibular and visual systems is particularly vulnerable to concussion effects. The vestibulo-ocular reflex (VOR) — which stabilizes vision during head movement — frequently shows dysfunction after concussion, producing the gaze instability and reading difficulties that many patients describe. The smooth pursuit eye movements that follow moving targets are commonly affected. The saccadic system that produces rapid eye movements between targets may be impaired. The Mucha 2014 VOMS assessment specifically targets these vestibular-ocular components that are commonly affected after concussion.
The autonomic component
Concussion frequently affects autonomic regulation, with post-traumatic POTS being one specific manifestation. The autonomic effects produce dizziness with standing (cardiovascular component) that can be difficult to distinguish from the vestibular dizziness, since both produce similar subjective experiences. Patients often have both autonomic and vestibular components contributing to their dizziness, with each requiring appropriate identification and management.
PPPD development as a complication
Some patients with post-concussion vestibular dysfunction develop PPPD — the chronic functional vestibular disorder in which the brain’s adaptive responses to the acute event become persistent maladaptive patterns. PPPD development is one of the common pathways by which post-concussion vestibular symptoms become chronic and treatment-resistant. The PPPD framework recognizes head trauma as one of the precipitating events that commonly triggers the condition.
Cervical structural injury
Critically, head trauma almost always produces concurrent injury to the upper cervical structures. The 2005 study by Kaale and colleagues in the Journal of Neurotrauma documented upper cervical ligamentous injuries from whiplash mechanisms at forces below those required for diagnosable concussion (Kaale et al., 2005). When trauma is sufficient to produce concussion, the upper cervical structures essentially always experience forces well above the threshold for their own injury. This cervical structural injury is not a separate condition that coincidentally accompanies the concussion — it is part of the same trauma event affecting interconnected systems.
The Dual Injury Reality and Why It Matters
The concept of dual injury — that head and neck trauma essentially always affects both the brain and the cervical structures — is one of the most important framework concepts for understanding post-concussion vestibular dysfunction. The 2014 paper by Marshall and colleagues described the role of cervical involvement in concussion symptoms and recovery (Marshall et al., 2014), and subsequent research has consistently supported the dual injury framework.
The biomechanical inevitability
When forces sufficient to produce concussion are transmitted through the head, those same forces inevitably affect the neck. The skull cannot move without the cervical spine experiencing the resulting forces. Acceleration-deceleration mechanisms that produce diffuse axonal injury also produce stretch and shear forces on cervical ligaments, joints, and muscles. Direct head impacts transmit forces down through the cervical structures. The biomechanical analysis is unambiguous — trauma sufficient to produce brain injury produces concurrent neck injury.
The Kaale 2005 documentation
The Kaale study used MRI to document upper cervical ligamentous injuries in whiplash patients, finding consistent involvement of the alar ligaments, transverse ligament, and tectorial membrane — the deep ligamentous structures that stabilize the craniocervical junction. The forces required for these injuries were calculated to be below those required for diagnosable concussion. The implication is that whenever a patient has been diagnosed with concussion, upper cervical ligamentous injury was essentially certain to have occurred concurrently, even if not specifically diagnosed at the time.
Why this matters clinically
The dual injury reality has direct clinical implications. Patients with post-concussion vestibular symptoms have two distinct injuries contributing to their symptoms, not one. The brain injury component affects central vestibular processing through the mechanisms described above. The cervical injury component affects vestibular function through different mechanisms — distorted proprioceptive input to the vestibular nuclei, altered mechanical environment around the brainstem, effects on cervical autonomic anatomy, and other pathways. Standard concussion treatment that addresses only the brain component leaves the cervical component unaddressed, contributing to the persistence of symptoms.
Why this is underrecognized
Despite the established framework, post-concussion management often does not adequately address the cervical component. Several factors contribute to this underrecognition. The dramatic nature of concussion symptoms often overshadows the more subtle cervical injury. Standard concussion assessment tools focus on neurological function rather than cervical examination. Many providers treating concussion are not trained to evaluate the cervical component in detail. Imaging studies often do not include the specific upper cervical ligamentous structures that may be affected. The result is that cervical involvement frequently goes undiagnosed even when it is clinically present and contributing to symptoms.
Why comprehensive treatment matters
When both components are addressed, outcomes are typically better than when only one component is treated. The 2014 Schneider study demonstrated that adding cervicovestibular rehabilitation to standard concussion management produced substantially better outcomes than standard treatment alone (Schneider et al., 2014). The principle generalizes — comprehensive treatment addressing the multiple components of post-concussion vestibular dysfunction tends to produce more complete recovery than narrowly focused approaches.
Why Symptoms Persist When They Should Have Resolved
One of the most frustrating aspects of post-concussion vestibular dysfunction for patients is the persistence of symptoms long after the expected recovery timeline. Several factors contribute to this persistence, and understanding them clarifies what comprehensive treatment must address.
The maladaptive pattern problem
When the central nervous system experiences the acute concussion effects, it rapidly adapts through sensory reweighting, postural adjustments, and protective responses. These adaptations are helpful during the acute phase. For most patients, the adaptations resolve as the acute effects subside, with normal function restored. For patients with persistent symptoms, the adaptations become entrenched — the brain continues operating in the post-injury adaptive mode even after the acute effects have resolved. This maladaptive persistence is one of the primary mechanisms underlying PPPD development and other chronic post-concussion patterns.
Continued contributing factors
The cervical structural injury that occurred at the time of trauma typically does not resolve spontaneously. The damaged ligaments may heal incompletely. The muscular compensation patterns become chronic. The altered joint mechanics persist. The distorted proprioceptive input continues feeding the central processing. As long as these continuing contributing factors are present, the central system cannot fully recalibrate to normal function because the inputs it is integrating remain distorted. The persistence of cervical structural problems essentially keeps the post-concussion vestibular dysfunction active.
Inadequate treatment
Many patients with persistent post-concussion vestibular symptoms have not received adequate evidence-based treatment. They may have been told to ‘rest and let it heal,’ which is now recognized as not optimal — the 2013 paper by Leddy and colleagues established that controlled subsymptom threshold exercise rather than complete rest produces better outcomes (Leddy et al., 2013). They may not have received specialized vestibular rehabilitation, which has substantial evidence support (Alsalaheen et al., 2010). They may not have been evaluated for the multiple specific components their condition involves. Inadequate treatment is one of the most common reasons that post-concussion vestibular symptoms persist.
Failure to recognize complications
Post-concussion vestibular dysfunction often involves complications that develop as the original injury evolves — post-traumatic BPPV requiring canalith repositioning, post-traumatic vestibular migraine requiring migraine-focused treatment, PPPD requiring PPPD-specific approaches, cervicogenic dizziness requiring cervical-focused intervention, post-traumatic POTS requiring autonomic management. When these complications develop and are not recognized, the patient may continue to receive generic post-concussion care without the specific treatments their complications require. The failure to recognize and address complications is a major contributor to persistent symptoms.
Anxiety and avoidance
The persistent symptoms typically produce understandable anxiety, which itself contributes to perpetuating the condition. Anxiety increases hypervigilance to symptoms, increases the perception of dysfunction, increases muscle tension, and decreases engagement with rehabilitation activities. Avoidance behaviors develop — avoiding crowded environments, avoiding rapid movements, avoiding exercise — that prevent the central nervous system from getting the exposure it needs for adaptive recalibration. The anxiety and avoidance cycle becomes part of what maintains the condition.
Why the cervical component matters for persistence
Among the factors maintaining post-concussion vestibular symptoms, the cervical structural component has particular relevance because it provides ongoing distorted input that interferes with normal recalibration. The brain attempting to recover from the original injury is receiving unreliable proprioceptive information from the still-affected cervical structures. This unreliable input prevents the central system from recalibrating to normal function — the system cannot fully compensate when the inputs it is integrating remain abnormal. Addressing the cervical component allows the central recalibration that other treatments are trying to support.
Standard Evidence-Based Treatment Foundation
Post-concussion vestibular dysfunction has substantial evidence-based treatment options that should form the foundation of care. Understanding what comprehensive standard care involves clarifies the framework within which all other approaches operate.
Specialized post-concussion evaluation
Patients with persistent post-concussion vestibular symptoms should be evaluated by clinicians with specific expertise in post-concussion management — concussion specialists, sports medicine physicians familiar with concussion, neurologists with concussion expertise, or specialized concussion clinics. The evaluation should include specific assessment of the multiple components: cervical examination, vestibular function testing, vestibular-ocular motor screening (VOMS or similar), autonomic assessment, and screening for complications like BPPV, PPPD, or vestibular migraine. Generic post-concussion management without specific component identification is often inadequate.
Vestibular rehabilitation
Vestibular rehabilitation by qualified physical therapists is one of the most evidence-supported interventions for post-concussion vestibular dysfunction. The 2010 paper by Alsalaheen and colleagues documented improvement in dizziness, balance, and gait following vestibular rehabilitation in concussion patients (Alsalaheen et al., 2010). The rehabilitation should address the specific components present in the individual patient — vestibulo-ocular function, motion sensitivity, balance, gaze stabilization. Rehabilitation should ideally begin once acute symptoms have subsided enough to allow engagement, rather than waiting for full resolution.
Cervicovestibular rehabilitation
When cervical involvement is present (which is essentially always after head trauma), specific cervicovestibular rehabilitation that addresses both components produces better outcomes than vestibular rehabilitation alone. The 2014 Schneider study established this principle in sport-related concussion (Schneider et al., 2014), and the approach has been increasingly adopted in comprehensive concussion management. The cervical components include deep neck flexor strengthening, cervical proprioceptive retraining, postural correction, and manual therapy approaches addressing cervical mobility and tissue function.
Subsymptom threshold exercise
The 2013 Leddy framework established that controlled aerobic exercise at subsymptom threshold (intensity below the level that worsens symptoms) is beneficial in post-concussion recovery rather than complete rest. The concept replaced the older ‘cocoon therapy’ approach with active rehabilitation. Graded exercise rehabilitation supports central nervous system recovery and counteracts the deconditioning that develops from prolonged symptom-driven inactivity.
Addressing specific complications
When complications are identified, they require specific treatment beyond general post-concussion management. Post-traumatic BPPV requires canalith repositioning maneuvers. Post-traumatic vestibular migraine requires migraine-focused management. PPPD requires PPPD-specific approaches including possible SSRI/SNRI medication and cognitive behavioral therapy. Post-traumatic POTS requires autonomic management. Identifying and addressing these complications is essential — general post-concussion care will not adequately treat them.
Multidisciplinary coordination
Comprehensive post-concussion care often involves multiple providers — concussion physician, vestibular physical therapist, sometimes neuro-optometrist for visual components, mental health support for anxiety/PTSD components, and other specialists as indicated. The coordination of care across providers is itself part of what makes comprehensive treatment effective. Patients who navigate multiple separate providers without coordination often have suboptimal outcomes.
Why Post-Concussion Has the Strongest Case for Upper Cervical Evaluation
Among all vestibular conditions, post-concussion vestibular dysfunction has perhaps the strongest case for upper cervical evaluation. The dual injury reality means cervical involvement is essentially universal, and the cervical component contributes meaningfully to the persistent symptoms that drive patients to seek additional evaluation.
The essentially universal cervical involvement
For most other vestibular conditions, cervical involvement is variable — sometimes present, sometimes not, with the relevance of cervical evaluation depending on patient-specific factors. For post-concussion vestibular dysfunction, the dual injury reality means cervical involvement is essentially always present. The patient may not have specifically diagnosed cervical injury at the time of trauma, but the biomechanics make concurrent cervical structural problems essentially certain. This near-universal cervical involvement makes post-concussion patients particularly appropriate for cervical evaluation.
The mechanism convergence
Multiple mechanisms by which cervical involvement can affect vestibular function converge in post-concussion patients. The distorted proprioceptive input from cervical structural problems affects the central recalibration the brain is attempting after trauma. The compensatory muscle tension produces effects on dural tension through the myodural bridge. The altered cervical mechanics can affect vestibular processing through multiple pathways. The cervical autonomic involvement compounds any autonomic effects from the brain injury. The cumulative effects of these multiple cervical-mediated mechanisms are substantial in post-concussion patients.
The treatment-resistance pattern
Post-concussion patients who do not respond to standard treatments often have unaddressed cervical components contributing to the treatment resistance. Vestibular rehabilitation may produce only partial improvement because the cervical proprioceptive distortion continues feeding unreliable input into the central processing. Medications may help components but not address the structural cervical factors. The pattern of partial response to standard care is often improved when comprehensive evaluation includes the cervical component.
The Schneider evidence base
The 2014 Schneider study demonstrated specifically that adding cervicovestibular rehabilitation to standard concussion management produced better outcomes than standard vestibular rehabilitation alone in sport-related concussion patients. While the study used physical therapy-delivered cervicovestibular rehabilitation rather than chiropractic specifically, the principle established — that addressing the cervical component improves post-concussion outcomes — supports the broader framework that includes upper cervical evaluation as one approach to the cervical component.
The honest evidence framing
Even with the strong case for cervical evaluation in post-concussion patients, the specific evidence for upper cervical chiropractic care in this population remains primarily reasoning-based and case-based rather than supported by extensive randomized controlled trials of the specific intervention. The cervical component clearly matters; the specific evidence for upper cervical chiropractic addressing it remains less robust than the evidence for cervicovestibular physical therapy. Patients should approach upper cervical evaluation as one approach to the cervical component, with continued engagement in standard post-concussion management as the foundation.
How Upper Cervical Evaluation Works for Post-Concussion Patients
For appropriate post-concussion vestibular dysfunction patients, upper cervical chiropractic focuses on the precise structural relationship between the skull, atlas, and axis — the region where trauma forces typically produce the structural problems contributing to persistent symptoms.
Three-dimensional CBCT imaging
Cone beam computed tomography produces a true 3D reconstruction of the upper cervical anatomy and measures alignment to within fractions of a degree. The imaging identifies specific structural problems that may have developed from the trauma event. Standard concussion imaging typically does not include the precise upper cervical evaluation that CBCT provides, so the imaging often identifies structural factors that were not previously documented.
Objective testing before any intervention
Leg length analysis and paraspinal infrared thermography are performed before any adjustment, and corrections are only delivered when objective findings indicate a structural shift. The principle of restraint guided by data is particularly important for post-concussion patients whose nervous systems may be sensitized from prolonged dysfunction — interventions should be objective-finding-based rather than performed routinely.
Precision without manipulation
Corrections are specific to the upper cervical segment and delivered along a calculated vector. There is no twisting, no popping, no full-spine manipulation. The force is low. For post-concussion patients — whose central nervous systems are already disrupted from the trauma — this precision is essential. Aggressive cervical manipulation could potentially aggravate the post-concussion dysfunction and is not appropriate for this population.
Coordination with other care
Upper cervical evaluation should occur as part of comprehensive post-concussion management, not as a replacement for it. Patients should continue their concussion specialist follow-up, vestibular rehabilitation, any appropriate medications, and other components of standard care. The cervical evaluation addresses one component of the multi-component picture, with the other components continuing to receive appropriate attention.
Expected response pattern
When upper cervical correction produces benefit for post-concussion vestibular dysfunction, the response is typically gradual rather than immediate. The chronic patterns that developed after trauma take weeks to months to fully normalize. Vestibular rehabilitation may become more effective once the cervical structural component has been addressed because the central system is now receiving more accurate proprioceptive input to work with. The cumulative effect of comprehensive treatment is what produces recovery, not any single intervention.
When to Consider Comprehensive Evaluation
If you have persistent vestibular symptoms after concussion, whiplash, or neck trauma, comprehensive evaluation matters.
First, ensure you are receiving evidence-based post-concussion care. If you have not been evaluated by a concussion specialist, that should be your first priority. If you have not received vestibular rehabilitation, that should follow. If complications like BPPV, PPPD, vestibular migraine, or POTS have developed, they require their specific evidence-based treatments.
Within comprehensive care, upper cervical evaluation may be worth considering if any of the following are true: Your symptoms have persisted beyond the expected recovery timeline despite appropriate treatment. You have persistent cervical symptoms (chronic neck pain, suboccipital tension, restricted cervical range of motion, cervicogenic headache) alongside your vestibular symptoms. You have features of cervicogenic dizziness mixed with your post-concussion symptoms. Your trauma involved significant cervical mechanism (whiplash, direct neck injury, falls with neck involvement). You have prior concussions or significant prior neck trauma layered on the current presentation. Standard post-concussion treatment has produced only partial improvement.
For patients in the acute phase or early recovery (first weeks to a few months) progressing normally, focusing on standard concussion care is appropriate. Upper cervical evaluation is most relevant for patients with persistent symptoms despite appropriate standard treatment, not as first-line intervention for acute concussion.
To find an upper cervical chiropractor near you, visit www.neckwise.com.
Important Safety Considerations
Several safety considerations apply to post-concussion patients considering any care approach including upper cervical evaluation.
Acute concussion requires medical evaluation, not immediate chiropractic intervention. Patients with recent head injuries should be evaluated by appropriate medical providers to rule out serious complications and establish initial management.
New or worsening neurological symptoms after concussion — increasing headache, vomiting, vision changes, weakness or numbness, confusion, seizures, or other new neurological features — require urgent medical evaluation, not chiropractic care. These features can indicate serious complications requiring immediate medical management.
Aggressive cervical manipulation has been associated with rare but serious adverse events including vertebral artery dissection. Upper cervical chiropractic uses precision-based low-force corrections rather than aggressive manipulation, but patients with significant vascular risk factors or recent significant trauma should discuss these considerations carefully before proceeding.
Patients with hypermobility conditions (Ehlers-Danlos syndrome, hypermobility spectrum disorders) require careful evaluation. The combination of hypermobility, prior trauma, and potential craniocervical instability may require specialized neurosurgical evaluation rather than standard upper cervical chiropractic care.
Where to Go From Here
Post-concussion vestibular dysfunction involves multiple mechanisms operating together — direct central effects, peripheral vestibular effects, vestibular-ocular integration disruption, autonomic involvement, PPPD development, and critically, the concurrent cervical structural injury that is essentially universal in head and neck trauma. The dual injury reality means comprehensive care must address both the brain and cervical components for optimal outcomes. Symptoms persist when these multiple components are not all addressed, when the maladaptive patterns become entrenched, when complications develop unrecognized, and when ongoing contributing factors continue feeding the dysfunction.
Standard evidence-based treatment — specialized post-concussion evaluation, vestibular rehabilitation, cervicovestibular rehabilitation when cervical involvement is present, subsymptom threshold exercise, addressing specific complications, and multidisciplinary coordination — forms the foundation of care that should be the priority for all post-concussion vestibular dysfunction patients. For patients with persistent symptoms, prominent cervical features, or treatment-resistant patterns, upper cervical evaluation can be one component of comprehensive care addressing the cervical structural factors that other interventions do not specifically target. Post-concussion vestibular dysfunction has perhaps the strongest case among vestibular conditions for the cervical evaluation consideration, given the essentially universal cervical involvement in head trauma.
For patients struggling with persistent symptoms long after their trauma event, recovery is possible with comprehensive care addressing the multiple contributing components. The path forward involves appropriate medical evaluation, engagement with evidence-based treatment, and for appropriate patients, consideration of complementary structural evaluation as part of the broader approach.
To find an upper cervical chiropractor near you, visit www.neckwise.com.
References
- McCrory, P., Meeuwisse, W., Dvořák, J., et al. (2017). Consensus statement on concussion in sport — the 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 51(11), 838–847.
- Iverson, G. L., Gardner, A. J., Terry, D. P., et al. (2017). Predictors of clinical recovery from concussion: A systematic review. British Journal of Sports Medicine, 51(12), 941–948.
- Schneider, K. J., Meeuwisse, W. H., Nettel-Aguirre, A., et al. (2014). Cervicovestibular rehabilitation in sport-related concussion: A randomised controlled trial. British Journal of Sports Medicine, 48(17), 1294–1298.
- Alsalaheen, B. A., Mucha, A., Morris, L. O., et al. (2010). Vestibular rehabilitation for dizziness and balance disorders after concussion. Journal of Neurologic Physical Therapy, 34(2), 87–93.
- Mucha, A., Collins, M. W., Elbin, R. J., et al. (2014). A brief vestibular/ocular motor screening (VOMS) assessment to evaluate concussions: Preliminary findings. American Journal of Sports Medicine, 42(10), 2479–2486.
- Leddy, J. J., Kozlowski, K., Donnelly, J. P., Pendergast, D. R., Epstein, L. H., & Willer, B. (2010). A preliminary study of subsymptom threshold exercise training for refractory post-concussion syndrome. Clinical Journal of Sport Medicine, 20(1), 21–27.
- Marshall, C. M., Vernon, H., Leddy, J. J., & Baldwin, B. A. (2015). The role of the cervical spine in post-concussion syndrome. Physician and Sportsmedicine, 43(3), 274–284.
- Kaale, B. R., Krakenes, J., Albrektsen, G., & Wester, K. (2005). Head position and impact direction in whiplash injuries: Associations with MRI-verified lesions of ligaments and membranes in the upper cervical spine. Journal of Neurotrauma, 22(11), 1294–1302.
- Treleaven, J., Jull, G., & Sterling, M. (2003). Dizziness and unsteadiness following whiplash injury: Characteristic features and relationship with cervical joint position error. Journal of Rehabilitation Medicine, 35(1), 36–43.
- Hides, J. A., Smith, M. M. F., Mendis, M. D., et al. (2017). Multifidus dysfunction and restorative exercises for the lumbopelvic region. Manual Therapy, 28, 31–42.
This article is educational in nature and does not constitute medical advice, diagnosis, or treatment. Individual results vary. Chiropractic care focuses on the structure and function of the spine and nervous system. Patients with concussion or other head and neck trauma should pursue appropriate medical evaluation by qualified concussion specialists and engage with evidence-based standard treatments including vestibular rehabilitation as the foundation of care. Upper cervical evaluation should be considered only for specific patient subsets as a complementary approach rather than a primary treatment. Patients with acute concussion symptoms, new neurological symptoms, or other red flag features should seek urgent medical evaluation. No claim is made or implied that upper cervical chiropractic cures or treats post-concussion vestibular dysfunction or any other specific disease.