Can anyone describe an MWM for cervical origin dizziness?

[linbin]

Dear msk101,

The best explanation that I have come across on the effect of the muscles which attach to the mastoid to dizzines or vertico is that these can induce referred pain into the ear and thus upset the balance mechanism of the ear.

i wonder how the muscles induce pain into ear.i would like to know the reference

[neuromuscular]

[QUOTE=linbin;24393]

Dear msk101,

The best explanation tht I have come across on the effect of the muscles which attach to the mastoid to dizzines or vertico is that these can induce referred pain into the ear and thus upset the balance mechanism of the ear.

i wonder how the muscles induce pain into ear.i would like to know the reference

Dear linbin:

The best resource on this is the manuals by Janett Travell on the pain refferal patterns of the muscular systems. There are two manuals. I believe the title of the manuals is Myofascial Pain & Dysfunction: the trigger point manual.

Referred pain by muscles is by far the most overlooked problem. Visceral pain referral is used extensively by the medical practitioner, but muscular pain referral is not

Hope that this is helpful.

Best regards,

Neuromuscular

[linbin]

hi buddy
thanks a lot for the reply .i will check the book mentioned.
i agree with you that somatic referred pain are not extensively studies compared to visceral refered one

[psychophysio]

Has she been seen by a neurologist? Left arm drift is a bit weird - does she have any other cerebellar signs (abnormal Finger-nose-finger, heel-shin, rapid alt. movements, +ve Romberg)? A Ct does not give particularly good images of the brainstem and cerebellum but I suppose you would see if she had a stroke 14 months ago.

good luck!

[Fyzzio]

Hi,
after reading through all the comments, I am still wondering, what the original problem was, e.g. why did your patient had cervical mob in the first place?
To me her presentation is similar to that of a mild TBI.
She does display clear neurological symptoms, so I really am surprised, that her neurology review was all clear.
Has she had a full oculomotor and vestibular Physio assessment?
Cheers,
Fyzzio

[msk101]

HI All,

Yes, client has been seen by a neuro. I sent her back for a contrast MRI and am now hoping to hear something on that. also has had a full neuro assessment which, other than the light headedness and left drift when walking, is within normal range.

Something's not right for sure (understatement of the century).

Original Cx mob from what i can tell (i was not the treating physio) was post-shoulder surgery and prolonged sling use which resulted in Cx tension and pain. Onset of current symptoms 2 days later. presented to me 13 months later after referral from the neurologist to me.

I have seen the Travell and Simons trigger point info and have done some work on the musculature of the Cx but to no avail. other than better Cx ROM. but no symptom resolution. I am more and more thinking cerebellar infarct (perhaps the original mobs threw off a clot from the carotid artery????) and have referred back to the neuro with a long list of things i've done and want checked out more thoroughly.

oh well... you win some and lose some... fortunately the balance is generally in favour of the winning but not in this case.

Thanks to everyone for their ideas and suggestions.

Msk101

[neuromuscular]

Sorry the referred pain or paraesthesia of the work of Janett Travell et al did not work. There may be more involved. Hope that you find some other helpful info.

However, if nothing else does turn up, see if another muscle that you did not try may be a factor. It may be one that is not directly attached to the mastoid.


Best regards,

Neuromuscular.

[atcjoeyb]

I'm actually very curious about this case b/c I believe I have the same problem. I dislocated my shoulder a little over a year ago and after weeks in a sling I began to have cervical stiffness. I saw a chiro and began having severe bouts of dizziness. I stopped being adjusted and the dizziness appeared to go away, but still returns intermittently. Something just "doesn't feel right" with my neck and I sit, stand, walk, etc. very hesitantly for fear of provoking the dizziness. I was tested for vertigo, mri's (brain/shld), catscans, and everything came back negative but I still experience these bouts of dizziness. My eyes begin to hurt a little and it feels like everything gets cloudy and sometimes my neck will "pop" like a knuckle cracking causing the symptoms to diminish instantly. One time my SCM completely locked up so I try to do soft tissue on that, but I honestly feel like trigger pt. on Levator Scap. on the non-injured side (probably from compensatory tightness for the months post-injury) releases the most tension in my neck. I still think i have an instability issue, but I've seen so many doctor's and find it hard to believe they all would've missed this. I work for a physical therapy company, so it's embarassing that I cannot solve my own problem. Try working on her Levator mm. Anybody have any other ideas???

[neuromuscular]

I'm actually very curious about this case b/c I believe I have the same problem. I dislocated my shoulder a little over a year ago and after weeks in a sling I began to have cervical stiffness. I saw a chiro and began having severe bouts of dizziness. I stopped being adjusted and the dizziness appeared to go away, but still returns intermittently. Something just "doesn't feel right" with my neck and I sit, stand, walk, etc. very hesitantly for fear of provoking the dizziness. I was tested for vertigo, mri's (brain/shld), catscans, and everything came back negative but I still experience these bouts of dizziness. My eyes begin to hurt a little and it feels like everything gets cloudy and sometimes my neck will "pop" like a knuckle cracking causing the symptoms to diminish instantly. One time my SCM completely locked up so I try to do soft tissue on that, but I honestly feel like trigger pt. on Levator Scap. on the non-injured side (probably from compensatory tightness for the months post-injury) releases the most tension in my neck. I still think i have an instability issue, but I've seen so many doctor's and find it hard to believe they all would've missed this. I work for a physical therapy company, so it's embarassing that I cannot solve my own problem. Try working on her Levator mm. Anybody have any other ideas???

Dear atcjoeyb,

If you have ruled out other factors, the refered pain patterns or paraesthesthesia effect of tigger points, as it is not always "pain" that is referred, can have a great effect.

The levator scap. can cause pressure to and distortion to the upper cervical bones. If the trigger pt. of the levator scap. does not correct it, then consult Janett Travell's manuals for other possibilities. The other option is a NUCCA chiropractor, but that is usually not necessary, if you can find the specific muscular distress.

Hope that this is helpful.

Best regards,,

neuromuscular.

[hanover1]

actjoey, since you had a chiropractic manipulation, that takes you into a different aetiology than msk101's patient, who aside from cervical mobilisations, had no 'trauma' to the cervical region, therefore your problems are most likely entirely different.
msk101- is it possible your patient has vestibular migraine?