Expert: Dr. Victor Dolan, DC, DACBSP - 6/1/2009

Question
I just finished reading a letter from another person who had chronic vertigo and was told that the ligaments in her neck were stretched to the point that the neck would not stabilize regardless of chiropractice manipulation. I too have that very same problem and and scheduled to see a prolotherapist in a few weeks. I had this treatment before and it seemed to be the right treatment but I had to move due a job change. Now I am back to the doctor that originally treated me and so I am hoping to improve. The question I have is regarding prolotherapy injections in and around the tiny neck ligaments and the vertebra sound quite scary. What if the needle misses and hits the jugular or the spinal canal itself? The one treatment I had was around the base of the skull so it was not a problem with getting close to the neck or veterbra. Have you heard of someone having this treatment and if so what kind of reaction or success did they have? I am just about at my wits end because I have been dealing with this terrible vertigo for over 20 years and can't seem to figure it out. I have been to numerous neurologists, done MRIs and Xrays (until I think I am glowing) and tried acupuncture, sacro-cranial, etc. with no long lasting success. Sorry to ramble on, but any comments or suggestions would be very much appreciated!

Answer
staten island vertigo, staten island dizziness, proprioception






Hello Cathy,

I am sorry to hear of your complaints, of your vertigo condition.

".....The question I have is regarding prolotherapy injections in and around the tiny neck ligaments and the vertebra sound quite scary......".  Every procedure has risks and benefits.  The more invasive the procedure, usually the bigger the risks, and usually the more invasive procedures are reserved for the bigger, life altering complaints we have.  I am aware of prolotherapy for ligaments/ joints; particularly in the lower extremity- ankles, knees, hips.  I have also heard of it for lower back conditions.  I have not heard of it for the neck,,, but do not let that deter you.
Prolotherapy injection is not that invasive, not that complicated.

The prolotherapy theory is that the injection of a solution (usually simple saline)- causes tightening of loose ligaments where injected. So the utilization in the neck ligaments versus elsewhere, would not seem unusual or 'out of bounds'.  As a Doctor of Chiropractic I have a bias towards less invasive procedures- and I openly admit my bias. As a Doctor of CHIROPRACTIC, I would also recommend talking to the orthopedist or physiatrist MEDICAL doctor who is specializing in this to give you far more information then I could.  This is the practice of MEDICINE, which I as a Chiropractor Cannot really comment upon, or tell you 'Yes, do it', or 'No, do not do it'.

I will comment in general.  

"....What if the needle misses and hits the jugular or the spinal canal itself?....".-  The Doctor doing this is a specialist.  I doubt he/she has EVER pierced the Jugular Vein, Carotid Artery, or Spinal Canal.  I am NOT a specialist in this procedure, but having done human cadaver dissection, and appreciating the training of specialists, it is very unlikely to 'miss the mark'.  This procedure MAY be done under C-arm Xray Video Fluoroscopy- (It may or not be- I would ask the Doctor)- these Xray Guided procedures allow the doctor not only to FEEL the right spot but also see the right spot.  Many times when they do an Epidural Steroid Injection they utilize such Xray to VIEW where they are going, I do not know if they would use it with this particular procedure, but you could ask.  
         Your Doctor will have the PALPATORY (feeling) skills to place the injection correctly, but if you hear that they use this Xray on top of that, this should help calm you also.

".....Have you heard of someone having this treatment and if so what kind of reaction or success did they have?.....", I have not heard of it in the neck in my patient load.  I have heard of it for lower extremity problems primarily.  Just because I am not familiar with it does NOT mean it is not common.

Enough of that discussion.  As a Doctor of Chiropractic, I would recommend this book to you- available at Amazon.com, or www.LifeChangingCare.com
" What do you do when the medications don't work?      
    -- A non-drug treatment of Dizziness, Migraine and other chronic conditions " - Dr. Michael Johnson .
http://www.amazon.com/Medications-Treatment-Dizziness-Fibromyalgia-Conditions/dp...


You have been to the Doctor of Chiropractic and Neurologists, so I assume you have had a simple test such as the Dix-Hall-Pike Test.  This is a simple in-office check.  see: http://www.webmd.com/brain/dix-hallpike-test-for-vertigo-15884

http://www.dizziness-and-balance.com/disorders/bppv/dix%20hallpike.htm

You have been to the Chiropractic and/ or the Medical Neurologists, so I assume you have had ENG and caloric testing -electronystagmography commonly refers to a combination of tests with eye movement recording that includes a search for vestibular nystagmus, ocular motor screening battery, and caloric testing.
see:  http://www.medscape.com/viewarticle/458595_5


A simple maneuver performed in many Chiropractic and Neurology offices is the Epley's Maneuver- this is non-invasive and can be performed several times for greater improvement: see-
http://www.dizziness-and-balance.com/disorders/bppv/epley/first.html

I recommend the website http://lifechangingcare.com/ because these are Doctors of Chiropractic that work with dizziness/ vertigo patients following a specific neurological protocol.  That is also why I recommend Dr. Michael Johnson's book (see above).

I am familiar with these protocols and have helped my Staten Island Vertigo, Dizziness patients with these chiropractic protocols.

I would not deter you from the prolotherapy, but would also recommend you try the conservative protocols outlined by this author.
You could even do the treatments concurrently or sequentially.

THANK YOU for the question! and if further information is needed,,,
please do not hesitate to REcontact me here at AllExperts.com : -
http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm

I hope this helps.


Thanks,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (Email NewsLetter)