Vertebral Artery Insufficiency (VAI): Causes, Symptoms & Best Physiotherapy Management |Physio360 Chennai.

INTRODUCTION;

Vertebral Artery Insufficiency (VAI) is a serious cervical spine–related vascular condition where the blood flow through the vertebral arteries is reduced. These arteries supply essential oxygen and nutrients to the brainstem, cerebellum, and posterior part of the brain. Any compromise in this circulation can lead to dizziness, imbalance, and neurological symptoms.

At Physio360 Chennai, we frequently evaluate patients with chronic neck pain, dizziness, cervicogenic imbalance, and suspected vertebrobasilar circulation issues. Understanding VAI is crucial for early detection and safe treatment planning.

What is Vertebral Artery Insufficiency?

Vertebral Artery Insufficiency (VAI) occurs when one or both vertebral arteries become compressed, narrowed, or blocked, leading to reduced blood flow to the posterior part of the brain.

It is often associated with:

• Cervical spine degenerative changes

• Prolonged poor posture (e.g., forward head posture)

• Traumatic neck injuries

• Cervical osteophytes

• Arterial dissection

• Severe cervical spondylosis

  
  

Common Causes of Vertebral Artery Insufficiency

1️⃣ Cervical Spine Pathologies

• Cervical osteophytes

• Disc herniation

• Facet joint dysfunction

• Cervical instability

• Rheumatoid arthritis–related joint damage

  
  

2️⃣ Posture-Related Causes

• Forward head posture

• Prolonged computer/desk work

• Muscular tightness (SCM, scalenes, levator scapulae)

  
  

3️⃣ Trauma

• Whiplash injuries

• Sudden neck rotation

• High-velocity impacts

  
  

4️⃣ Vascular Causes

• Atherosclerosis

• Arterial dissection

• Thrombosis

  
  

Symptoms of Vertebral Artery Insufficiency

Patients often present with episodic symptoms triggered by neck position or rotation.

Key Symptoms Include:

• Dizziness or lightheadedness

• Vertigo

• Imbalance/unsteadiness

• Blurred or double vision

• Nausea

• Nystagmus

• Drop attacks (sudden collapse without loss of consciousness)

• Headache (occipital region)

• Tinnitus

• Difficulty speaking or swallowing (severe cases)

If these symptoms occur during cervical extension or rotation, VAI should be suspected.

How Physiotherapists Screen for VAI at Physio360 Chennai

At Physio360, we perform a comprehensive cervical and neurological assessment to identify signs of vertebrobasilar compromise.

Screening Includes:

• History taking (onset, triggers, posture, occupation, red flags)

• Cervical range of motion analysis

• Neurological exam (cranial nerves, coordination, reflexes)

• Vertebral Artery Functional Tests (done with extreme caution)

• Blood pressure and cardiovascular evaluation

• Posture assessment (forward head, thoracic kyphosis)

• Cervical muscle strength and flexibility testing

Note: VAI tests are NOT diagnostic. They are used cautiously to identify risk during cervical mobilisation or manipulation.

Physiotherapy Management for VAI at Physio360

Management focuses on restoring safe cervical biomechanics, improving posture, and reducing arterial compression.

✔ 1. Postural Correction Therapy

• Forward head posture correction

• Cervicothoracic alignment training

• Ergonomic modifications for desk workers

  
  

✔ 2. Cervical Mobilisation (Safe, Non-Thrust Techniques)

• Gentle Maitland mobilisations

• Soft tissue release of SCM, scalenes, paraspinals

• Muscle relaxation techniquesHigh-velocity thrusts (manipulations) are avoided in suspected VAI.

  
  

✔ 3. Strengthening

• Deep neck flexors

• Scapular stabilisers (middle/lower trapezius, rhomboids)

• Upper thoracic extensors

  
  

✔ 4. Flexibility & Mobility Exercises

• Upper trapezius stretch

• Levator scapulae stretch

• Pectoralis minor stretch

• Scalene stretch

  
  

✔ 5. Neurovascular Safety Training

• Teaching safe neck positions

• Avoiding extreme rotation/extension

• Gradual controlled movement training

  
  

✔ 6. Balance & Vestibular Rehabilitation

For patients with dizziness, imbalance, or gait disturbance.

When to Refer to a Specialist

At Physio360 Chennai, we refer immediately if red flags such as:

• Visual disturbances

• Slurred speech

• Difficulty swallowing

• Sudden weakness

• Drop attacks appear during assessment.

Vascular imaging (Doppler, MRI angiography) may be recommended.

Prevention Tips (Expert Advice from Physio360 Chennai)

• Maintain correct desk posture

• Avoid frequent neck cracking

• Strengthen deep neck flexors

• Avoid prolonged cervical rotation (e.g., side sleeping)

• Take micro-breaks every 30 minutes during laptop work

• Avoid sudden neck movements

  
  

Why Choose Physio360 for Vertebral Artery Insufficiency Screening & Cervical Rehab?

At Physio360 Clinic in Chennai, we offer:

• Expert cervical spine assessment

• Evidence-based therapy

• Safe mobilisation techniques

• Posture correction programs

• Personalised dizziness & VAI rehabilitation

We ensure maximum safety, especially for patients with dizziness, hypertension, cervical spondylosis, or postural dysfunctions.

Take the First Step Toward Safe Cervical Health!

If you experience dizziness, neck pain, imbalance, or symptoms during neck movement, don’t ignore them.

Visit Physio360 Chennai for expert evaluation and advanced physiotherapy care. Your neck, brain, and balance deserve the best — Physio360 delivers it.

REFERENCE AND RESEARCH ARTICLE ;

1.Vertebral Artery Interventions: A Comprehensive Updated Reviewhttps://pmc.ncbi.nlm.nih.gov/articles/PMC10201878/.

2.Signs and symptoms of vertebrobasilar insufficiency: A systematic reviewhttps://www.researchgate.net/publication/358675469_Signs_and_symptoms_of_vertebrobasilar_insufficiency_A_systematic_review