Cervicogenic headaches and dizziness - self management and long term outcome?

[Fiona Mellor]

Hi All,

I somtimes feel randomly dizzy - not full on, just feels like a minor head spin and it only lasts a couple of seconds. No pattern to its onset (any time of day, at rest or during exercise, no link to work stress that I can identify).

I Initially thought it was a low grade ear infection and saw my GP who told me to see the chiropractors I work with and they diagnosed cervicogenic dizziness. Once I realised what it was I wasn't concerned and began to just live with it. This has been going on for about 2 years now.

I am also intermittently seeing the chiro's for tense shoulder muslces (I am a desk worker) when every so often (about once every 3 months) they need a deep massage and some triger point therapy. Added to that I sometimes experience a '2pm headache' which is definitely posture and work stress related. Again I see the chiro's when this happens and make more effort to take time away from my desk.

Maintenance wise I regularly do exercises to loosen my traps, I ride my horse 3 times a week (which stops me slouching), I am hugely aware of my posture and make sure I stretch my pectorals daily.

Despite this, recently I've had a few attacks of intense headache, much stronger than normal, which come on later in the evening (about 6pm, same distribution as the cervicogenic headache - crushing pain around my temples relieved a bit when I squash my temples between my hands). This is followed by debilitating vertigo through the night (when I turn over in bed I wake up with horrid spinning). This lasts into the next morning, abating by lunchtime-ish. I've also started to experience intermittent tingling in my index finger and thumb on my right hand (just twice in the last two months).

I'm guessing this is all linked to the 'cervicogenic' diagnosis, but my question is what exactly is likely to be going on? I'm also wondering how I can self manage this other than what I'm already doing (horse riding, posture maintenance, breaks from desk etc). Is it likely to get worse or can I do anything to prevent it? I can see my chiro AFTER I've suffered these attacks, but what about preventing them in the first place?

The morning vertgio is particularly distressing, I literally cannot get out of bed and sometimes I am spinning whilst laying still and not moving my head! I know it passes, I know its not serious, but during the 'attack' it is horrid.

Thanks in advance for your thoughts and opinions

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[physiobob]

Just for interest take a look at the following post and see if any of this relates to your presentation: http://www.physiobob.com/forum/patie...down-line.html

You can also search this forum on BPPV to read other posts on vertigo/dizziness and vestibular influences. It might also be interested to see your sugar levels at the times when the symtoms are most vibrant to assess any physiological influences on that.

[Fiona Mellor]

Thanks will take a look. I was tested for BPPV which was negative at the time of the test. Re: blood sugar levels - the mild dizziness seems to come along at any time of day regardless of when I've last eaten, the debilitating vertigo however has been on a morning when waking up so blod sugar could be an issue not yet thought of. How can I self test blood sugar to find out?

I'm suffering this morning hence my research online before I can see the chiro, last night I ate late as usual (about 9pm), nothing out of the ordinary -veg sausages in bread and treacle tart. I was already suffering from the headache at thsi point (came on at 6pm).

[Fiona Mellor]

That post was very useful indeed, a 'self test' of lying on my right side with my head off the end of my bed and turned to the floor is causing the room to spin massively - not so obvious on the left however (a little bit but no where near as obvious as on the right). I've just attempted the self help ebley manouvre but I cannot stand to lay on my back with my head extended and to the right - that really brings on the vertigo - but now I know what movement is aggravating it I can avoid that for the day and attempt to get on with stuff. I've still got the headache today too (3/10 after paracetamol) - are they both linked or is the BPPV related to my ears and the headache to a tense neck?

Hopefully seeing the chiro tomorrow will help. Would like ideas on what can I do to stop it happening in the future though if anyone has any.

Thanks indeed.

[physiobob]

That's great news indeed. The headache may be a symptom related to this so these may resolve when the other gets treated. As you react on one side and not so much on the other then this is a very good and positive test result. You should explain and reporduce this for your chiropractor. I would then perhaps see your GP and get referred to an ENT or specialist that deals in that area. As well as self treatment there are some meds that will assist if BPPV is the cause here.