From Dr. Natalie Meiri’s Clinical Pearl Stories: Chiropractor West Palm Beach: Dizziness After a Car Accident

This was a 60 year old female patient with a chief complaint of dizziness. To be HIPAA compliant, I will call her Missy instead of her real name. Missy had a history of dizziness and vertigo on and off from various causes for many years. 

This past year, she had suffered dizziness after surgery. So dizziness after surgery is common.  Typically, it is from the anesthesia, pain medication, dehydration, or rapid positional changes. Then a few months later, she was in a car accident and had a whiplash injury.  And her dizziness was triggered again which was much more problematic.  Furthermore, because of her underlying cardiovascular condition, she went to see her primary care doctor.  The doctor ordered a battery of tests (C.T., MRI, blood vessel studies), but didn’t find any cardiovascular issues. In other words, her tests were all normal. Next, the vertigo/ dizziness was so terrible she went to see a ear-nose-throat (ENT) specialist.  This was to rule out any possible complications related to her ear-nose-throat and the dizziness. Missy thought maybe the crystals in her ear were the problem. The canalith repositioning maneuver (e.g. eply) by the ENT specialist wasn’t successful.  Moreover, Missy did the physical therapy/habituation exercises at home.  And She stated, “the exercises didn’t help at all.”

Missy’s Examination & Treatment for Dizziness

Upon examination, I found positive tests for a cervical (neck) sprain with thoracic (midback) myalgia (muscle pain) diagnoses.  Also, a test showed that her neck was causing her dizziness. Missy’s pain in her neck was nothing compared to the dizziness which was her chief complaint.

Firstly, she received chiropractic adjustments/ manipulation to her cervical (neck) and thoracic (mid back) spine.  Soft tissue work (myofascial release, pressure point and various post isometric relaxation procedures) and exercises to continue at home were also rendered as needed. 

Secondly, recommendations were made on diet/lifestyle:

-Distribute food and fluid intake evenly throughout the day.

-Avoid foods and beverages that have a high salt or sugar content.

-Drink adequate amounts of fluid daily.

-Avoid foods and beverages with caffeine.

-Limit or eliminate alcohol consumption.

-Do not use tobacco.

-Ginger may ease vertigo symptoms, like nausea and lightheadedness.

Thirdly, I recommended acupuncture after the 4^th visit to enhance her recovery by working on her peripheral vestibular (inner ear) vertigo.

Missy responded well to her chiropractic treatment for dizziness.  In fact, by the 3^rd visit her dizziness had decreased to 50%. This was a substantial, clinically meaningful improvement.  Missy started her acupuncture treatments along with her chiropractic care and by the 12^th visit her dizziness symptoms subsided!  Missy continued her treatment for her whiplash injury to her neck and mid back thereafter which took more visits to resolve than the dizziness complaint.

Symptoms of Dizziness/Vertigo

You may feel the room is spinning?  You may feel motion imbalance or a lack of coordination while walking? Moreover, you may have lightheadedness or presyncope (sensation of almost fainting)? Symptoms of vertigo are all dependent on each individual. However, some common vertigo symptoms may include:

• Swaying
• Unbalanced
• Headache
• Sweating
• Ringing in ears
• Loss of hearing
• Nausea
• Spinning

Anatomy and Physiology

Your balance and spatial orientation are maintained by an integrated neuronal (relating to nerve cells) feedback loop. Feedback loops are circuits that return output as input to a given system. 

The components of the related systems for balance and spatial orientation: 

(1) The vestibular system includes the parts of the inner ear and brain. It processes the sensory information involved with controlling balance and eye movements.

(2) The visual system constructs a mental representation of the world around us. It includes both the eyes and the brain.

(3) The proprioceptive system is guided by receptors in the body (skin, muscles, joints) that connect with the brain through the nervous system. Proprioception is your body’s ability to sense movement, action, and location.

So a slow adaptation by your nervous system can be made to compensate when input from any of the above components (systems) is dysfunctional.

Chiropractor West Palm Beach: How Does Chiropractic Help Dizziness and Vertigo?

It is unclear how many cases are due to neck proprioceptors versus the vestibular apparatus or vascular supply to the head and neck. Nevertheless, proprioceptive information from the upper cervical musculature and joints do play a major role in your perception of balance. The high density of receptors in the spine may have effects on these reflexes for balance. Also, if there is damage to the vestibular apparatus, these spinal reflexes may help compensate. 

Firstly, cervicogenic vertigo is a result of cervical joint dysfunction, muscle strain, or injury from trauma such as a whiplash-like accident. Over-stimulation from joint dysfunction, muscle spasm or damage to the upper cervical proprioceptors can result in an imbalance of proprioceptive information. Secondly, the basic science support for this comes from numerous studies that have shown ataxia (lack of voluntary coordination of muscle movements), nystagmus (fast, uncontrollable movements of the eyes), and/or dysequilibrium (sensation of being off-balance) with strained muscles or upper cervical nerve roots. Thirdly, vibration of muscle tendons or the head can create a “postural illusion” leading to nystagmus and motion sickness. 

Lastly, there is an overlap between cervicogenic (spinal) vertigo and other peripheral (not central nervous system) vestibular vertigos such as Benign paroxysmal positional vertigo (BBPV) and Meniere’s disease. In conclusion, the theory is joint dysfunction may produce reflex muscle spasm or alter input to the vestibular nuclei (nerve complex) in the hindbrain. The vestibular nuclei function in the maintenance of equilibrium and posture, the perception of head position and acceleration, as well as general muscle tone. Second, the chiropractic approach is to reduce muscle spasm and free restricted movement through manipulation/adjustments. Research supports a positive effect with cervical adjusting alone or in combination with vertigo exercises to correct this. 

Chiropractor West Palm Beach: How Does Acupuncture Help Dizziness and Vertigo?

Firstly, Acupuncture has been used for relief of acute illness, such as pain, dizziness and vertigo in traditional Chinese medicine for thousands of years. One case report demonstrated that acupuncture therapy was very helpful for a patient with peripheral vestibular (inner ear) vertigo. Moreover, it appears Acupuncture may be an option for patients who are intolerant to drug therapy.

Secondly, Acupuncture can reduce balance disorders caused by disorders of the inner ear. Furthermore, acupuncture targets the emotional disturbances or stress.  These are factors that can exacerbate or start an incident of dizziness and vertigo.

Thirdly, Acupuncture improves blood flow and calms the nervous system.  Researchers believe when an acupuncture needle is inserted, the sensory and proprioceptive nerves are stimulated. This sends a message to our brain and nervous system. In vertigo caused by abnormalities of the vestibular system, acupuncture can play a role in reducing dizziness through increasing microcirculation in the inner ear.

Chiropractor West Palm Beach: Dizziness After a Car Accident

Meiri Chiropractic serving West Palm Beach and the surrounding areas offers excellent chiropractic and acupuncture treatments for dizziness and vertigo. Call us in West Palm Beach at 561-253-8984 to schedule an appointment or to find out more about Chiropractor West Palm Beach: Dizziness After a Car Accident.

This post is about Chiropractor West Palm Beach: Acupuncture for Mid Back Pain Relief.  Symptoms of thoracic spinal (mid back) conditions include dull aches, sharp/stabbing sensations, or burning between the shoulder blades and rib cage. Additionally, you may have muscle stiffness and spasms. This will cause reduced mobility.  Moreover, mid back pain may radiate to the neck, shoulders, or ribs. So Mid-back pain (thoracic spine) may result from poor posture, overuse, or a traumatic injury. Fortunately, if you have mid back pain, acupuncture can provide relief!  We’ve got some great information to share below.

Anatomy of the Thoracic (mid back) Spine and Ribs

12 Vertebrae (spinal bones) compose the thoracic vertebral column or spine. Your spine protects the spinal cord, nerves, supports your thorax and enables movement of your body. The intervertebral discs, along with the laminae, pedicles, and articular processes of adjacent vertebrae, create a space through which spinal nerves exit. A typical vertebra also contains four articular (joint) processes, two superior and two inferior, which contact the inferior and superior articular processes of adjacent vertebrae, respectively. The point at which superior and articular facets meet is known as a facet, or zygapophyseal, joint (synovial joint).  These maintain vertebral alignment, control the range of motion, and are weight-bearing in certain positions. 

Thoracic vertebrae are unique in that they have the additional role of providing attachments for the ribs.  One special feature of thoracic vertebrae is the presence of costovertebral and costotransverse joints, which form the articulations for the ribs. The costovertebral joints (demifacets) are located on either side of the vertebral body to form an articulation with the heads of the ribs. The costotransverse joints are located on the anterior (front) aspects of the transverse processes of vertebrae to articulate with the tubercles of the ribs.

Anteriorly (front), the first seven ribs connect to the sternum (breast plate) directly, and the eighth, ninth, and tenth ribs attach indirectly via the costocartilage. The eleventh and twelfth ribs are free floating, with no anterior attachment. The anterior articulations move mainly because of the elastic quality of the costocartilage. 

Chiropractor West Palm Beach: Acupuncture for Mid Back Pain Relief- Research

Firstly, in the treatment of mid back pain, the first option is a conservative approach using conventional medications (CMs) such as nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, opioid analgesics, and corticosteroids. However, these have provided limited pain relief.  Furthermore, these have been often accompanied by adverse effects.  These include dizziness, drowsiness, intoxication, allergic reactions, hepatic and gastrointestinal dysfunctions.

Secondly, results of one study showed that acupuncture may be more effective than NSAIDs (e.g. ibuprofen) in decreasing the patient’s pain level. The study also stated, “acupuncture may enhance the effect of medications in pain relief. To patients with thoracic (mid back) pain, acupuncture points appear more effective than nonacupoints”.

Thirdly, in one study, Acupuncture was shown to be superior to various interventions. In this study, it stated ” BACK PAIN is among the most prevalent health complaints of mankind. It is, therefore, associated with much individual suffering and considerable socioeconomic consequences. Back pain is also the most frequent indication for using unconventional therapies. Survey data suggested that back pain is one of the most common indications for referral to acupuncturists”. Furthermore, collectively, the data suggested that acupuncture is an effective treatment for back pain. (1)

Chiropractor West Palm Beach: Acupuncture for Mid Back Pain Relief

Acupuncture has been used for over 4000 years to treat pain and other health problems safely and effectively. The acupuncture treatment stimulates the imbalanced pathways called meridians. This activates the body’s natural healing abilities.  Ultimately, this brings balance back to your body. Acupuncture has a beneficial effect when treating many diseases and painful conditions.

Meiri Chiropractic offers acupuncture for mid back pain and many other ailments. Dr. Natalie Meiri is a chiropractic physician, board certified in acupuncture with over 20 years of experience.  Call today for your acupuncture treatment for mid back pain at 561-253-8984.

References: (1) Acupuncture for Back PainA Meta-Analysis of Randomized Controlled Trials

Edzard Ernst, MD, PhD, FRCP(Edin); Adrian R. White MD. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/210231

West Palm Beach Chiropractor: Acupuncture for Obesity is about the chronic problems of obesity.  Obesity is often a chronic problem.  Being overweight puts limits on daily activities. It can even lead to organ dysfunction.  According to the World Health Organization, in 2022, 2.5 billion adults were overweight.  Of these, 890 million were obese, meaning that 43 % of adults were overweight, and 16 % were obese.  In conclusion, the numbers more than doubled since 1990.

Causes of Weight Gain

Firstly, the most common cause of weight gain is an increase in caloric intake or a decrease in energy expenditure.  Secondly, changes in weight are common within a few pounds and generally reflect fluid retention and loss. Thirdly, cyclic fluctuations can occur commonly in women in relation to menstruation. Fourthly, about 10% of obese patients have an underlying neurologic, endocrine, or genetic cause. So hypothyroidism may account for small increases in weight due to a slowed metabolic rate. Fifthly, familial (genetic) obesity and low resting metabolic rates can have an effect. So, the good news is, you or your loved one can do something about loosing weight through acupuncture.

Research

Modern research has shown that acupuncture treats obesity.  Acupuncture works with the hypothalamus.  And the hypothalamus coordinates the autonomic nervous system and the activity of the pituitary.  This controls body temperature, thirst, hunger, and other homeostatic system coordination.  Additionally, acupuncture works with the sympathetic and parasympathetic nervous system. This part of the autonomic nervous system manages involuntary bodily functions to maintain homeostasis.  Also, acupuncture helps with the expression of hormones such as leptin (satiety hormone) and insulin.  Finally, this affects metabolism, diet, and many other mechanisms. The number of studies which investigate acupuncture in the treatment of obesity continues to increase.

Being obese carries some increased risk in several areas of health 

Mortality rates are higher for obese patients compared with normal-weight individuals. The risk of death was higher from all causes including cardiovascular disease, cancer, and other diseases if you are obese such as:

-3 to 10 times more likely to develop adult-onset diabetes (insulin resistance increases with weight gain).

-Higher incidence of cardiovascular disease, hypertension, dyslipidemia (imbalance of lipids), and stroke.

-More likely to have sleep apnea or hypersomnolence syndrome (medical conditions in which you repeatedly feel excessively tired during the day called excessive daytime sleepiness) or sleep longer than usual at night. It is different from feeling tired due to lack of or interrupted sleep at night. Hypersomnolence carries with it the risk of arrhythmias, hypoxemia (oxygen levels in the blood are low), or pulmonary hypertension (high blood pressure effecting lungs).

-More likely to have degenerative joint disease if you are obese, especially in the hips and knees. It is also a risk factor for low back pain.

-Increased risk for cholelithiasis (reduced bile flow), thromboembolism (blood clot), and varicose veins.

West Palm Beach Chiropractor: Acupuncture for Obesity/ Weight-loss 

Indeed, there are many centers that specialize in weight loss. These centers do not focus on diet alone, but address issues of mental attitude, motivation, and exercise. Quick fixes with diet drinks or fad diets are not effective. Statistically, most people who diet eventually gain back weight in about a year or two.

There is a definite need to control the rising of obesity. In conventional medicine, obesity is treated through lifestyle interventions, medications, and surgeries. In complementary/alternative medicine, acupuncture is widely used around the world.  In one case study, a 53 year old 300 pound woman  with a “voracious appetite and shortness of breath which was worse on exertion” presented for acupuncture. After the first 2 treatments in the first week, she felt very well.  Her appetite was reduced. Her body weight was reduced by 4 pounds. She felt confident. With more than 20 treatments, her weight was reduced by 3–4 pounds each week and in total 42 pounds. The symptoms of palpitations and shortness of breath disappeared. She was advised to be on a diet of more vegetables and less oily food, and do more exercises. She was in a good mood through out the process.(1) 

Moreover, acupuncture is used in various forms, including body acupuncture, electro-acupuncture and auricular (ear) acupuncture. Different forms of acupuncture may be beneficial for weight loss.

West Palm Beach Chiropractor: Acupuncture for Obesity

Acupuncture can drastically improve your quality of life. Perhaps there is something you are not doing in life due to your weight gain?

Overall, it’s best to think of your acupuncture visits as part of an overall healthy lifestyle. If you’re looking to lose weight, you’ll have to incorporate other parts of that healthy lifestyle.  For instance, a balanced diet and regular exercise is crucial.  Loose weight and get healthier!  Don’t you think you deserve it? Call 561-253-8984 today to make an appointment or to find out more about West Palm Beach Chiropractor: Acupuncture for Obesity.

References: (1) TAN XIAOHONG’S MEDICAL RECORD; Zhu, Bing; Wang, Hongcai. Case Studies from the Medical Records of Leading Chinese Acupuncture Experts (International Acupuncture Textbooks, 2011