Expert: Dr. J. Shawn Leatherman - 1/29/2009

Question
I had a dizzy spell a couple of weeks ago and I had burning, numbness and tingling down my right arm. The spell started with me feeling weak in both legs as if I might fall. After this "spell", I never felt "normal again. I felt fatigued, nauseated and started having headaches. My symptoms are worse in the morning when after actually getting up and walking around I feel diizy, faint and started having headaches/ neck aches and shoulder pain. I saw a family doc who ran a CBC BMP and said I had a virus and to give it a week or so. The morning episodes seemed to be getting worse and the pain in my neck/headaches were worse and my neck was feeling very weak in the morning and sometimes spasming. I went to see a chiropractor and he has treated me 3 times this week. I still wake up and get light headed/dizzy/off balance in the morning, with nausea...I was also having neck pain/headaches at night which was preventing my from getting much sleep...which has stopped since treatment. The chiropractor said my neck was out of alignment. I am still very concerned about the dizzy/light headed/sick feeling I have every morning. It gets better if a just take it easy for a couple of hourse, but this is hard to do with a baby and a toddler at home. My headaches seem to start in my neck or back of my head and the pressure/pain increases as it moves up my head to the frontal region, around my ears and behind my eyes...almost like sinus areas. The bad pain lasts about 15 minutes and then I can feel it ease off and my neck gets looser. My vision is clear, but something is bothering it...I am not sire if it is light or movement. The headaches can be anytime, not just in the morning. All the numbness, tingling I was feeling in my arm has gone away. But it seems like I am tender in my neck and spine after treatment.  My symptoms are scaring me and causing anxiety and depression as it has been 2 weeks since I have felt symptom free. Is the chiropractor right for me or should I be seeing a neurologist!?!

Answer
Dear Cassi,

First, relax and take a deep breath.  Now, is there any chance you could be pregnant again...Just checking?  If not, the symptoms you have described are often the result of irritation to the anatomic structures in the neck...such as the suboccipital muscles, the trapezius muscle, the facet joints or the joint capsules.  Try not to let this worry you too much at this point.  Anxiety and depression have been clinically proven to worsen pain symptoms.

The fact that you are seeing improvements in your symptoms after your first few neck adjustments is good.  It is even more important that the radiating numbness and tingling into the arms has been reduced.  This is a sign that the mobility gained from the adjustments is allowing less irritation to the soft tissue of the neck.

Headache pain are is commonly referred from the neck, especially pain that starts in the back of the head and goes over the top or around to the eyes.  These are called cervicogenic or suboccipital headaches, and respond well to chiropractic care.  This is due to restricted movement in the upper joints of the neck which refer pain to the back of the neck, back of the head, and forehead.

Dizziness can also be caused from the associated joint spaces and musculature in the upper part of the neck.  There are receptors in the neck musculature called proprioceptors which send signals to the brain about body position and movement.  Proprioception is the body's awareness of its position and movement in space without the help of visual input from sight, and this is intricately involved in balance. Restricted neck movement will change the normal output from these receptors...and the musculature in the neck has the highest concentration of proprioceptors in the body.  So if the signals are abnormal dizziness can occur.

Concerning your adjustments, being tender afterward is common, and it should lessen as your spinal motion becomes free.  This is usually due to tension of the muscular system when the adjustment is performed.  If you are actually in "pain" after an adjustment, the doctor may need to lessen the amount of force utilized.  I would suggest that you additionally incorporate daily stretching exercises of the neck and upper back musculature, and consider the addition of a few deep tissue massages.  Ask the doctor to instruct you on the proper way to stretch effectively with resistance...often called PNF stretching.  Give the chiropractor a few more visits to get a better result.  Cases like yours frequently take 6-12 visits for the best resolution.  If you are still experiencing dizziness and frequent headaches after this time, re-examination to include inner ear dysfunction, advanced imaging or a referral may be necessary at that time.

Hope this helps Cassi.

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