Vertigo like symptoms

by Pratima
(Palo alto, CA, USA)

Hi,
I suffer from ocular migraines and they started in 2010 when I was pregnant with my first son. I only had attacks when I was pregnant - the second time with my twins. However in 2014 after an intense dance session I got an ocular migraine the next day. I have been having them regularly since then.

I decided to go on a no sugar, no gluten, no coffee, no alcohol and no grains diet. So I eat just vegetables, fruit, nuts and meat. I started this a week ago.

Yesterday (July 26th) I woke up to vertigo that lasted many hours. I went to urgent care and they tried the epley manauver and didn't seem like it went well. So they gave me meclizam. I took another dose last night.

This morning I didn't wake up to vertigo but I just feel out of sorts. Mind you I felt out of sorts when I woke up yesterday too before I took the drug. Do you think this is bpvv? Or something else is going on? One more datapoint is that my vertigo started after a massage. I had two attacks right after my massage. This attack was after 2 days of getting a massage. Do I need to see a chiropractor?

Hello Pratima,
The key here is a correct diagnosis. True vertigo produces a strange movement of the eyes called nystagmus. Google it.

If you don't have nystagmus during an attack then you probably don't have BPPV. There are other causes of vertigo, some serious.

The hallmark test is known as the Hallpike Dix test. It takes some experience to know how to do it correctly but you could ask your spouse to check. Lying on your back, extend the head and neck and then turn first to the left, for about a minute, and then to the right.

Does it provoke vertigo and if he looks at your eyes are they darting to the side or spinning?

Personally I try to avoid cervical manipulation of patients suffering from vertigo; it can aggravate the condition quite seriously and if you have narrowing of the vertebral artery, one cause of nystagmus, then it can be quite serious.

So my suggestion is to first consult a neurologist.

First a diagnosis; then if you it's positively identified as vertigo, the Epleys. Only after all that has failed would I consider a cervical manipulation.

We are treading on difficult, controversial and potentially thin ice; be careful, be wise. Medication doesn't help BPPV.

Consider too the Brandt Daroff exercises. http://www.chiropractic-help.com/Home-remedy-for-vertigo.html

dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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