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Acupuncture/Vertigo after acupuncture

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Question
hello -

I suffered a neck injury about 6 weeks ago.  MRI showed bulging discs, cervical spondylosis and I have a "pinched nerve" with a numb index finger and a weak triceps muscle.  while I was waiting to see a specialist I thought about trying acupuncture.  I was assured it could not make things worse.

The night after my first treatment in 20 years I awoke, got up and my legs felt rubbery, and not quite right, I felt like I was walking on air and was unsteady.  It was still there in the morning, I felt unsteady walking.  A very strange sensation.  I called the clinic, the owner said she had never heard of this side effect.  An MD friend said I should see a doctor so off I went.

My diagnosis: vertigo.  The MD said it can take hours, days or weeks to go away.  She did not seem to think it was related to the cervical problem but I did some research and it can be.   I have occasional feelings of faint nausea. I think the acupuncture somehow did something to bring it on, I have NEVER had vertigo before.

It's been 6 days and I still have it.  I walk very slowly and feel unbalanced in general.  I have only driven once and probably should not.  Am very worried about this.  Do you have any advice or thoughts?  I read that an acupuncturist who is too aggressive with treatment could cause this.

Thank you

Answer
Dear Rose -

Vertigo can be a very disturbing condition.  It can be the symptom of several different conditions, and it can also be a side-effect.  Given that it occurred immediately after an acupuncture treatment leads one, of course, to suspect a cause-effect relationship.  Also, since imaging revealed cervical disc problems, there may be a relationship there.  

The first question to address is whether an acupuncture treatment can have vertigo as a side-effect.  The answer is a most definite "yes" in certain circumstances.  A bit of neurology information first:  several areas of our body have nerves that function as proprioceptors.  These are what helps us with balance.  Pretty much everyone knows that the inner ear is involved with balance, but there are also "balance nerves" in the ankles and neck.  Someone who has spasm in cervical muscles, particularly the small ones that connect cervical vertebrae together, can experience vertigo if these muscles are suddenly relaxed.  In my practice, I treat many patients with neck injuries and it is not unusual for vertigo to be a minor incident lasting a few minutes after a treatment.  It is possible that the acupuncture treatment relaxed muscles around vertebrae and these moved sufficiently to cause a problem, although it would be unusual for it to last several days.  

My suspicion is that you had a pre-existing condition of "otoconial debris"  ("free floating otoliths")in your inner ear and that positioning for the acupuncture treatment caused them to move, resulting in the vertigo.

You should talk to your primary care physician about the use of the Epley maneuver.  This is a treatment that involves movement of your head in a way that often will reposition otoliths and reduce vertigo.  This is something that I do with moderate success; since you have a pre-existing cervical condition this should not be done by someone whose only training was watching a video on the internet!  Many physical therapists and most osteopathic physicians know how to do this treatment.

I wish you well - - -

Mike Zanoni
Kaneohe, Hawaii

Acupuncture

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Michael M. Zanoni, MS, LAc

Expertise

I am knowledgeable about severe and chronic pain from musculoskeletal or neurological conditions, especially trauma, headache, and fibromyalgia. I can provide guidance that will assist healing and recovery after illness or surgery. I have a particular interest in long-term chronic conditions that are becoming progressively worse or intermittently severe (such as viral hepatitis, Crohn's, or Takayasu syndrome.) I have extensive experience treating endocrine disorders, such as diabetes or thyroid problems, where the primary condition is being monitored by a Western-trained physician, and cancer where there are specific treatment goals other than cure (e.g., decrease of pain; reduction of side effects of radiation and chemotherapy; lessening of edema; palliative treatment of associated conditions.) I do not treat or answer questions about infertility, ALS, or senile dementia.

Experience

I have practiced Oriental medicine for over sixteen years in a variety of settings. Much of my practice has centered around a busy clinic specializing in severe long-term chronic pain conditions and palliative care. For several years I worked in a hospice program. I also established a non-profit community clinic providing care to under-served and homeless patients. My work has found me in an HIV clinic in San Francisco, a busy private practice in Oregon, to traveling on muddy 4-wheel drive roads to see dying patients. I now teach acupuncture and Oriental medicine at a school in Hawaii.

Education/Credentials
My training was at the American College of Traditional Chinese Medicine in San Francisco where I received a masterís degree in Chinese Medicine. I have current board certifications in Oriental Medicine, Acupuncture, and Chinese Herbology from the National Certification Commission for Acupuncture and Oriental Medicine. I also have certifications in Chinese tui na bodywork, Physical Rehabilitation Training, and biofeedback. I am licensed to practice acupuncture and Oriental medicine in Hawaii, Oregon, and Washington. I also have BA, MS, and PhD degrees in subjects not directly related to Oriental medicine.

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