Resolution of Vertigo Following Blair Upper Cervical Chiropractic Care: A Retrospective Case Series

Abstract

Background: Vertigo is a debilitating symptom that affects balance and quality of life. While many treatments exist, some cases are refractory, suggesting a potential role for structural interventions targeting the upper cervical spine. This study evaluates the outcomes of patients with vertigo undergoing upper cervical chiropractic care. Methods: A retrospective case series was conducted by reviewing the files of 15 patients who presented with a chief complaint of vertigo at a private chiropractic clinic. All patients were managed with the Blair Upper Cervical Technique, which utilizes specific diagnostic imaging to correct vertebral misalignments. The primary outcome measure was patient-reported percentage reduction in vertigo symptoms following a course of care. Results: The cohort of 15 patients reported a mean symptom reduction of 92% (median 90%). Care plans varied in duration, with significant improvements often noted within 4 to 10 weeks. Outcomes ranged from significant improvement to complete resolution of vertigo and associated symptoms, enabling patients to return to daily activities. Conclusion: The findings suggest that Blair Upper Cervical chiropractic care may be a beneficial approach for managing symptoms in patients with vertigo. The positive outcomes in this case series support the hypothesis that addressing upper cervical biomechanics can influence vestibular complaints. Further prospective research and controlled trials are warranted to validate these results.

Methods

This study was conducted as a retrospective case series. Data was sourced from the clinical records of patients at Upper Cervical of Sioux Falls, a private chiropractic practice in Sioux Falls, South Dakota. Inclusion criteria for the review consisted of patients presenting with a primary complaint of vertigo who had completed an initial course of care and had documented post-treatment outcomes. In total, the files of 15 patients meeting these criteria were reviewed.

All patients included in the series were managed by Dr. Casey Weerheim. The clinical intervention provided was the Blair Upper Cervical Technique. This method involves a detailed patient history and a battery of diagnostic tests, including thermographic imaging and precision digital X-ray analysis, to identify the presence, direction, and magnitude of misalignments in the upper cervical spine. Based on this analysis, a specific, low-force correction is administered to restore normal biomechanics without forceful manipulation.

The primary outcome measure was the patient-reported percentage reduction in vertigo symptoms, captured from clinical progress notes upon completion of the initial phase of care. This metric reflects the patient's subjective assessment of their improvement from baseline. Additional data extracted included patient age range, chief complaint, duration of care, and qualitative descriptions of key health outcomes. As a retrospective review of existing de-identified data, this study has inherent limitations and was not designed to establish causality.

Discussion

The outcomes from this retrospective case series suggest a strong positive association between Blair Upper Cervical chiropractic care and the reduction of vertigo symptoms. The reported mean symptom reduction of 92% across a cohort of 15 patients is a clinically significant finding. These results lend support to the hypothesis that correcting misalignments at the craniocervical junction may play a crucial role in managing vestibular complaints for some patients. The improvements reported here, ranging from substantial relief to complete resolution, highlight a potential non-pharmacological and non-invasive avenue for vertigo management.

The diversity of presenting complaints—including post-concussion syndrome, chronic BPPV-like symptoms, and age-related balance issues—suggests that an underlying upper cervical dysfunction may be a common contributing factor across different vertigo etiologies. The resolution of symptoms following a specific, structural correction implies that the aberrant neurological signaling from cervical proprioceptors was a primary driver of the patients' vertigo.

The clinical implications of these findings are noteworthy. For patients suffering from chronic or treatment-resistant vertigo, an assessment of the upper cervical spine appears to be a worthwhile consideration. The specific diagnostic protocol, including imaging, is fundamental to identifying candidates for this type of care. However, it is essential to contextualize these findings within the study's limitations. As a retrospective case series without a control group, it is impossible to attribute the outcomes solely to the intervention. Natural history of the condition, placebo effects, and patient expectation may have contributed to the reported improvements. To validate these promising results, further research, including prospective cohort studies and randomized controlled trials, is necessary.

Limitations

This study has several important limitations. First, its retrospective design means that data was collected for clinical, not research, purposes, which may lead to reporting inconsistencies. Second, as a case series, there is no control or sham group, making it impossible to establish causality or rule out the influence of the placebo effect, patient expectations, or the natural history of the condition. Third, the primary outcome measure—patient-reported percentage of symptom reduction—is subjective and not a standardized, validated instrument. Fourth, the study was conducted at a single private practice with one practitioner, which may introduce selection bias and limit the generalizability of the findings to other patient populations or clinical settings. The reported outcomes reflect successful cases and may not represent all patients who present to the clinic with vertigo.