Expert: Dr. J. Shawn Leatherman - 11/26/2008

Question
Hello Sir,

I am 27 years old, Lecturer from India. From past 6 months I am suffering from Tinnitus. I consulted ENT specialist,and he examined my ear and said the buzzing in ear is due to straightening of cervical spine (X-Ray showed it). He gave me betahistine. Buzzing decreased once I followed that course. I also got MRI done of my C.spine, it was perfect no disc herniation. Recently in last week of October in our city of Hyderabad, India a team of chiropractors came from Palmer University, USA. I consulted them and the Doctor there adjusted my c - spine and hips (I also have lumbar spondylolysis). After the adjustment everything was fine. But after 1 week I started feeling pain in my neck. The pain was felt in neck, jaws, and ears. Heaviness in the neck was also felt. I consulted a physiotherapist, he advised me to apply ice. After application of ice, the pain in the neck was gone and I started feeling pressure on my throat, as if something was pressing it. To make my C spine normal I was sleeping without pillow on flat surface. 3 days back when i woke up from sleep, i felt attack of acute vertigo, my ears and neck was heavy, dragging pain in jaws was felt, my bowel movement got disturbed and urine was very scanty. My erection is also not quick, it is taking more time for erection. I also have tingling sensation and dragging or dull pain in my left hand,

I consulted a retired ortho surgeon, who is experienced and very famous. He said that it is due to Cervical Disc. He gave me pain killer (Proxyvon and Ugesic)and asked me to take rest and not to ride bike for one week.

My questions

1. Are these the symptoms of disc herination?
2. Is this happened because of wrong chiropratic adjustment? I came to know 2 days back that the chiropractor who adjusted me was not a doctor but an internn from Palmer University. Am I the victim of neck manipulation?
3. Will wearing collar help me?
4. Is surgery compulsory
5. Can a expert chiro treat me? and will i be normal? In our country there are no expert chiroporators.

Thanking you,

Regards

Mirza

Answer
Dear Mirza,

First of all I am shocked to find out that the ENT told you that the tinnitis is a result of the loss of your neck curve...pretty forward thinking on his part.  This is a possibility due to the neurological connection of the upper cervical nerve roots, the trigeminal ganglion, and the cranial nerves, so it is a possibility.  That being said, I hope he explored other options as well just to be thorough.

Concerning the neurosurgeon, I would have to disagree with his assessment, but only because you just had an MRI that found no disc bulge.  However, he is correct that all of these symptoms can be the direct result of a cervical disc bulge pressing into the spinal cord...this is called a long track sign. But, you can get ear, jaw, and neck pain, tinnitis and pain into the upper extremity without disc pathology. It can be the result of local inflammation, or spurs of the vertebra which are pressing on the nerve root.

The other symptoms you have described are more likely to occur from lower back issues than neck issues, especially in the light that you have a present lumbar spondylolysis.  However, I have to qualify that statement, because the cervical disk can also cause these issues.

Now, it is highly unlikely that the Palmer student caused these issues.  Chiropractic students are taught to adjust the spine in ways that reduce pressure on the discs and joints.  And I have never seen a published case where a disc bulge or herniation was attributed to a chiropractic adjustment.  On the other hand, anything is possible right!?  Please don't ever let any type of doctor treat you in any manner outside their office, or without an examination, unless it is a life threatening event.  

Wearing a collar will help you only in that it will restrict motion so that you do not aggravate the already sensitive area.  However, clinical research has found that utilizing collars should only be done in the first few days after injury as the restricted motion actually makes the problems worse.  You need to have active motion to help with proper scar formation and healing.  And no surgery is not compulsory...you don't even have a valid and confirmed diagnosis at this point.  Not to mention that disk bulges can be effectively treated with exercises, traction and conservative measures...only a small percentage need surgical correction.  In my own clinical experience, about 10% of my disc problem patients need to be referred for surgery.

Yes an expert chiropractor can treat you for these issues.  I see patients in my clinic with these symptoms every week.  But you need to make sure that the chiropractor you choose to see is qualified.  You should find out where they were trained, what their level of expertise is, what post-doctoral training and certifications they have completed, and what their success rate is in treating patients like you.  However, you should also realize that you may actually need a surgical resolution...bottom line is that you should get a second opinion, and make sure that the doctor who performs it does a through exam with orthopedic testing and neurological testing.  If that doctor thinks that the cervical disc is the problem then you need to get another MRI to confirm it and quantify how bad the disc bulge is...only then will conservative care or surgery options be fully appreciated.

Good luck Mirza.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net