Question
I was in a car accident in Dec. '04 and began experiencing 'dizzy moments' in Jan. '05. Feb. of that year, I ended up falling on my face. I couldn't keep my head up. Every time I tried to stand I would fall and my body would be dead weight. I get severe head swims by just walking normally. I even get head swims if I lay on my back or on my right side and even whem I'm at my computer. I had three sessions of vestibular rehab...no luck. I've been diagnosed with Meniere's Disease, Benign Positional Vertigo, Cervical Vertigo, Bi-lateral Vestibular Dysfunction, and Labyrinthitis.  Five medications all left me severely drowsy. One medication increased my vertigo. Since I have a low tolerance for meds I can't take anything to keep my head from swimming. I can't drive or anything. Any normal activity results in severe dizzy spells. Also the more I move the tighter my shoulder and low back muscles get.  I can't get them to loosen for anything.  I've been to the chiropractor but she can't get my muscles to loosen either.  Acupuncture worked once.  After four more sessions, nothing.  Here it is 2007 and I'm still having severe dizzy spells.  How can I get rid of my dizzy spells and tightness of muscles if meds and rehab don't work?

Answer
Dear M.P.,

Vertigo/dizziness is a complaint that has been documented as a finding after car crashes in the scientific literature.  One source stated that 15% of car crash victims will experience vertiginous symptoms and 4% will have associated tinnitis (ringing in the ears).  this is especially true in the case of rear impact collisions.  

The main problem is the fact that many doctors, chiropractic and medical, have difficulty accurately diagnosing the cause of the problem.  Concerning your mechanism of injury it is more likely that the problem is related to the vestibular system and nerves, the mechanisms of the inner ear, or the receptors of the upper cervical spine.  This needs to be figured out by testing all of these individuals systems separately to ascertain what is the offending tissue source.  In addition, the brain stem and the cerebellum could be contributory. there are specific orthopedic tests which are directed at cerebellar function, dorsal column function (brain tracts), cervical spine function, and inner ear function that should be utilized, and a possible MRI of the brain may be indicated depending on the findings.  there is something called a nystagmus (rotationonal or horizontal movements of the eyes) which should be documented as well...this aids in the identification of central vs peripheral causes of pathology.

I doubt that you have Meniere's disease as you have not reported any hearing loss, and Meniere's not a sequela of a trauma, but rather an increase in the fluid of the inner ear.  Moreover, you are not complaining of nausea and vomiting which are hallmarks of Meniere's disease. The other diagnoses are possibilities, but again one needs to be correctly identified.  Only then can a course of action be set in place to reduce the dizzy spells.

Concerning the muscle tightness, chiropractic care does not specifically address this issue unless there is some active tissue mobilization techniques being employed such as graston technique, active release, or deep tissue massage work.  The chiropractor you saw should have also instructed you on proper stretching protocols that could be utilized at home.

For more detailed information on the above, and concerning the mechanisms of injury in car crash, check out these websites:   www.srisd.com , www.grastontechnique.com , and www.activerelease.com.  Hope this helps.

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