Dizziness and physical health are associated with pain in dizzy patients—A cross‐sectional study

Abstract

Background and Purpose: Associations between dizziness, health-related quality of life, and musculoskeletal pain have not been systematically explored in patients with vestibular disorders. Such knowledge may be important for choice of treatments.The study objectives were to examine the extent and localization of musculoskeletal pain and explore whether pain was associated with dizziness and health-related quality of life. Methods: The cross-sectional study investigated anonymized data from an earlier survey on patients with long-lasting dizziness (>3 months) examined in an otorhino-laryngological department. The sample includes patient between 18 and 70 years with Ménière's disease, vestibular schwannoma, benign positional paroxysmal vertigo, vestibular neuritis, non-otogenic dizziness, and cervicogenic dizziness. General musculoskeletal, that is, pain in muscles, tendons, and joints was registered by a yes/no question. A pain drawing registered localization of pain. Multiple binary logistic regression models were used to determine the association between pain and vertigo-balance and autonomic-anxiety related dizziness by the short Vertigo Symptom Scale (VSS) and sub-scales (VSS-V, VSS-A), and between pain and health-related quality of life by the SF-36, mental and physical component summary scale (SF-36 MCS, SF-36 PCS). Results: The sample consisted of 503 patients, 60.2% were women, the median age was 50 years. General musculoskeletal pain was reported by 72.8% of patients, neck pain by 59.2% and widespread pain by 21.9%. Multiple binary logistic regression models demonstrated that all the pain measures were significantly associated with VSS-V and VSS-A and SF-36 PCS, but not SF-36 MCS. Discussions: Musculoskeletal pain is prevalent in patients with long-lasting dizziness. The strong associations between pain, VSS, and SF-36 PCS could result in a self-sustaining complex condition. The findings imply that in addition to assessing Ingvild Ølfarnes Gustavsen and Kjersti Wilhelmsen are first authors.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Musculoskeletal pain patterns and association between dizziness symptoms and pain in patients with long term dizziness – a cross- sectional study

“…Association between pain intensity as the dependent variable, and dizziness symptoms, dizziness-related handicap, or dizziness catastrophizing thoughts as independent variables, examined with linear regression analysis.The high prevalence of pain reported in our study is in line with other studies on patients with dizziness(Gustavsen et al, 2021;Malmström et al, 2021;Moen et al, 2022). Despite that estimates of pain prevalence may vary between studies due to differences in methodology, de nitions, and context, the prevalence in the current study was substantially higher than in the general population in Norway (94.5% versus 25%) (Kinge, Knudsen, Skirbekk, & Vollset, 2015;Rustøen et al, 2004).…”

“…However, neck pain is also found to be part of a widespread pain pattern in the general population (Natvig, Ihlebaek, Grotle, Brage, & Bruusgaard, 2010), and this could probably apply to dizziness populations as well. A recent systematic review found that pain in other body parts is also evident in patients with dizziness (Moen et al, 2022), and dizziness is further found to be associated with local as well as widespread pain (Gustavsen et al, 2021). It is possible to speculate that both dizziness and pain could have a mutual preserving effect on each other as both symptoms could result in a more rigid movement pattern, leading to increased muscular tension and reduced recovery from dizziness (Coelho Júnior et al, 2010;Wilhelmsen & Kvåle, 2014).…”

The Significance of Pain Drawing as a Screening Tool for Cervicogenic Headache and Associated Symptoms in Chronic Fatigue

“…Their results have clear points of contact with the present study in that the neck had significance for the health status and that there was a covariation between neck and dizziness. Gustavsen et al 42 studied associations between musculoskeletal pain, dizziness and health-related quality of life, with pain as the dependent variable. They found that musculoskeletal pain was associated with increasing dizziness, and the combination of neck pain and dizziness was proposed as a possible trigger of persistent postural-perceptual dizziness (PPPD).…”

“…Dizziness sometimes accompanies neck pain or related disorders 42 but pain in the upper neck can nonetheless occur without comorbidity of dizziness. Therefore, the assessment of patients with this type of symptoms would most likely benefit from screening with pain drawing along with balance measures.…”

“…36,37 As the vestibular nuclei compose central vestibular outputs on the grounds of information from mechanoreceptors, vestibular organs of the inner ear, and visual system, abnormal C2 input can give rise to distorted experience of movement or balance sense. [38][39][40][41] Dizziness sometimes accompanies neck pain or related disorders 42 but pain in the upper neck can nonetheless occur without comorbidity of dizziness. Therefore, the assessment of patients with this type of symptoms would most likely benefit from screening with pain drawing along with balance measures.…”