Dizziness and the Epley Maneuver

Recently we wrote about the importance of chiropractic treatment after a moving vehicle accident. Whiplash is the most common injury in these cases, but it’s more than just hurting your neck. While there is more than one symptom of whiplash, dizziness is one of the most common.

Statistics show that dizziness occurs in 20-60% of whiplash cases and can last a number of years. According to Radanov (et. al. 1994), 75% of patients are relieved of symptoms within 1 year. Chronic problems are more prevalent in those who have been involved in serious collisions.

Research on the connection between dizziness and neck injuries indicates one of the possibilities is joint error position (where natural head position is not possible after extension and rotation). A report by Treleaven, Jull and Sterling (2003) states that individuals who suffer from Whiplash-Associated-Disorders have much larger joint position errors when compared to control subjects. The most probable cause of dizziness was found to be cervical mechanoreceptor dysfunction.

While dizziness often occurs after a neck injury, there is controversy in regards to the frequency in which cervical vertigo is experienced. Some research suggests that it occurs due to vascular compression while other theories suggest it is due to the alteration of sensory input to the vestibular system.

Other research, such as Vibert (et. al. 2003), has stated that dizziness related to whiplash is more likely to occur because of vestibular injury and not neck or brain trauma. The vestibular system provides the majority of control in regards to movement and orientation. It is located in the vestibulum in the inner ear.

However, the receptors of the cervical spine also affect spacial awareness and tie in with the vestibular system. When whiplash occurs, receptors are displaced and cause many of the same symptoms of Vestibular Disorder.

Symptoms from whiplash or vestibular injuries usually show within days or weeks following the trauma. They may not appear for months after the injury though. These symptoms can vary and include the following:

• Dizziness
• Motion Sickness
• Nausea
• Vertigo
• Vomiting
• Ear Pain
• Tinnitus
• Hearing Loss
• Slurred Speech
• Fatigue
• Forgetfulness
• Confusion and Disorientation
• Depression

Changes to daily activities may be necessary to cope with the dizziness and other symptoms. Use multiple pillows at night avoid sleeping on the “bad” side. When getting out of bed, do it slowly and sit on the edge for a minute. Avoid bending to pick up things or stretching the neck as if to retrieve something from a tall cabinet. Caution is required when in the dentist’s chair, at the salon while having your hair washed, when exercising and while lying flat on your back.

The most effective treatment for these symptoms is called the Epley Maneuver and can be performed in the doctor’s office provided they are trained in the technique. It is very effective, with an approximate 80% cure rate, according to a study by Herdman and others (1993). It is important to receive treatment from a Doctor of Chiropractic that is trained and has extensive experience in this technique.

The goal of the maneuver is to move debris or “ear rocks” from the sensitive part of your ear (posterior canal) to a less sensitive location. This takes about 15 minutes or less to complete. The recurrence rate of the above symptoms after this treatment is approximately 30% after one year. On occasion, a second treatment may be necessary.

If your chiropractor is not familiar with this technique, please contact our office. Dr. Lynn Kerew is very experienced in this maneuver and has had much success. She can help you deal with these symptoms.

For further information about this topic, please contact Dr. Lynn Kerew directly at drlynn@lynnkerew.com or visit her website at http://www.lynnkerew.com.