Question
QUESTION: Hello.  Three days ago I had a full body massage for relaxation.  After having my neck and shoulders massaged, I was told to turn over onto my back.  Within a couple minutes, I had a severe bout of vertigo.  I have had massages before but never experienced this.  The woman giving the massage had worked my cervical and upper back, shoulder areas a lot.  She had done some "stretching and pulling" motions that my other therapists did not do.  Later that day and ever since, I have been having symptoms that seem to be getting worse:  dizziness and a constant feeling of unsteadiness;  a sharp "burning" pain on the upper left side of my skull (started last night); visual disturbances (blurred vision and seeing fog/smoke-like incidences - started today); sharp pain in arms and hands; twitchiness in arms and hands; soreness on shoulders, upper back, neck, and base of head; eye twitching.   I told the chiropractor who works in the office and he said it was because of toxins being released, but I had been going for massages almost weekly before then with no problem.  I can't imagine toxins causing these symptoms.  For the last three days, I have been icing the area and also using heat.  I've been taking Naproxen and Tylenol but the symptoms are still there and seem to be getting worse.  I also am having lower back discomfort but I'm more concerned about the cervical area at this time.  I have never had serious problems in this area and was feeling fine before walking into the office. What could have happened during the massage to do this? Is this something that will heal on its own?  If I should see a specialist about this, whom do you suggest I see - a neurologist?  Thank you so much for your time and expertise.  I am very upset about this and need some good advice.

ANSWER: Your symptoms are requiring further diagnosis. An MRI of the brain and cervical spine is appropriate if symptoms have not subsided. The relationship to the massage is questionable, but in part it may have accelerated the problem. Muscle pain and a bruised sensation may occur after a deep tissue massage; dizziness is very atypical. There are many preexisting conditions that should be investigated with MRI. A vascular insult or disc degeneration will be readily apparent on advanced imaging. After a diagnosis is completed it will be easier for me to suggest treatment or options.

Dr. True

---------- FOLLOW-UP ----------

QUESTION: Thanks for your response.  I went into the ER the other day because the visual disturbances (which now included multiple floaters) were scaring me.  Bottom line:  it's probably a pinched nerve.  I forgot to mention that a thermal scan done on the day of the massage (by the chiropractor) indicated that my cervical area was a problem area, so I probably had some disc degeneration that got aggravated by the aggressive massage.  The ER doc said there was a tiny chance it was a vascular tear but not likely, so i got sent home with prescriptions for dizziness and pain.  I also forgot to mention that the massage therapist was a student, even though I was not told this, so she very well could have done something wrong.  I will follow up with my family doctor tomorrow, hoping that he'll order an MRI and physical therapy.  My follow-up questions to you are - Are the symptoms of slight dizziness, dull ache on the back of the neck, and sharp pains in the upper and lower limps indicative of a pinched nerve in the neck?  Also, I have some weakness in the legs - could this indicate either a pinched nerve or slipped disc in the lower back?  Thanks again.

Answer
Hi Peggy, Your visual disturbance should be evaluated by an ophthalmologist. Dizziness can result from neck problems, its called cervicogenic vertigo. A dull ache in the back of the head or neck is certainly common with neck pain. Having sharp pains in the arms and legs can indicate a compressed nerve root; it is rare however to have pain in both arm and legs unless you have bone spurs and degeneration or a large central disc herniation in the neck. Weakness in the legs can be a combination of problems. The problem may be a combination of disorders such as back problems and low thyroid and other issues should be investigated, not just from your back. Please let me know the conclusion of the MRI findings. Your primary doctor may want labwork as well.

Dr. True