By: Dr. John Conde DC, DACNB Special to the Boca and Delray newspaper
A common occurrence seen in many physical medicine clinics end emergency rooms is that of neck pain with associated dizziness. Due to the overwhelming focus on the pain and being that most practitioners especially emergency room physicians are not well versed in the diagnosis and treatment of dizziness, it is most often treated with a generic antihistamine such as meclizine. This medication only temporarily reduces the intensity of the symptoms but does nothing to address the cause.
Dizziness can be classified into several categories according to the perception the individual experiences. These categories are the following; vertigo, disequilibrium or imbalance, presyncope, and lightheadedness. Vertigo can be defined as a false perception of moving of self or the environment. Disequilibrium and imbalance are literally described as an inability to maintain balance. Presyncope is delineated as a sense of losing consciousness. Lastly, lightheadedness has been characterized as a vague symptom of feeling disconnected from the environment.
Furthermore, according to Barany society’s committee for the classification of vestibular disorders, the terms vertigo and dizziness are mutually exclusive and share distinctly separate sets of symptoms. Vertigo is defined as a false sense of self-motion without any motion or the feeling of distorted self-motion with normal movement. Dizziness therefore has been described as a sense of disturbed or impaired spatial orientation without a false or distorted sense of motion. Thus, dizziness encompasses the other categories described previously which include disequilibrium, presyncope, and lightheadedness.
Patients experiencing true cervicogenic (neck) dizziness rarely experience vertigo or spinning sensation.These patients usually present with dizziness with associated neck pain, neck pathology, or neck injury as when following an accident. The most common mechanical causes of dizziness in the neck are termed degenerative cervical spine disorder and whiplash associated disorder. Just as the names state, the dizziness can be attributed to neck trauma and neck arthritis. This is an alarming finding as arthritis in the neck is very common in our aging communities. The diagnosis can only be made after a thorough neurological and orthopedic examination including x-rays which will allow the practitioner to rule out other causes of dizziness such as vestibular lesions.
Treatment of cervicogenic dizziness is aimed at restoring health in the tissues of the neck region such as the ligaments, tendons, and the joints. Improving motion and reducing inflammation is paramount and is done through specific manual therapies and with the use photobiomodulation (class IV laser therapy). The lack of neck motion also has central effects in the brain thus necessitating specific balance and vestibular treatments. Once these therapies are administered, most patients should respond well with favorable outcomes.
Dr. John Conde is a Board Certified Chiropractic Neurologist, one of only one thousand in the country. He holds diplomate status through the American Chiropractic Neurology Board. He provides specialized care for difficult cases of back neck pain, numbness-tingling, vertigo-dizziness balance disorders, fibromyalgia, migraines, AD/HD, autism, and dyslexia. His office is located at the Atlantic Grove in Delray Beach and can be reached at 561-330-6096, firstname.lastname@example.org, www.thecondecenter.com