Recently I have seen more and more patients complain of vertigo or dizziness and I am often asked, what causes dizziness? The causes of dizziness can vary, but the so-called “crystals” in your ear are not always the culprit and I’ll tell you why. While there is a high correlation between neck pain and dizziness as well as stiff neck and dizziness, there is a specific part of the neck that I find to be the common area in need of attention in all patients I see at my office with dizziness as their main complaint. This is all directly related to posture, specifically of the neck. Dizziness treatment and vertigo treatment can be accomplished without the use of medication for dizziness. If you’ve been feeling dizzy and you’re not sure why or what to do about it, keep reading!
Stop Blaming Your Inner Ear!
If you’ve ever gone to a doctor for dizziness they more than likely mentioned the ossicles or bones of your inner ear. I promise I won’t make you become anatomists but you need to understand some basic concepts related to the ear. There are 3 small bones in the ear. When these bones are not properly aligned you end up with balance problems and dizziness. Yes, the inner portion of the ear is important to our balance but what is often neglected is the brain’s function in balance. The portion of the brain that provides balance is the vestibular portion and it communicates with our inner ear to keep us in a balanced state. A malfunction of those ossicles or poor activation of that portion of the brain can result in an imbalanced state henceforth, dizziness. The communication between these two structures is essential, but it can be disrupted by a few different things.
Tight neck muscles, specifically the Sternocleidomastoid (SCM), is the one muscle that shows up tight in patients with dizziness and I attribute its tightness to the use of digital devices. If you are looking down at your phone or laptop, and/or if you are at meetings and looking to one side vs the other more often than not, you are stimulating that muscle more than you realize. To see how it can relate to dizziness let’s understand the muscle better.
How does a tight neck muscle cause dizziness?
Inner ear, dizziness and posture
The Sternocleidomastoid is a neck flexor; it allows you to look down but most importantly its job is to stabilize the neck. It is attached to the collar bone at one end and the back of the jaw bone on the other end. The jaw bone at the TMJ is where the problem is going to take place! You see, there are 3 little bones in the ear called ossicles that are sit at an angle to each other. The purpose of these bones is to provide info to the brain in providing balance in the forward/backward, side to side and right to left directions. That is why when there is an ear infection, many people experience dizziness. The problem with dizziness and tight muscles (specifically SCM) is that there is no infection!
So let’s say the SCM is pulling the ear down, or even slightly forward, this pulls the ossicles in the ear which and give the message of imbalance to the brain. The brain now has to figure out how to not lose the balance and the constant message of imbalance creates the dizziness. Taking nausea medication is not going to fix the problem and neither is taking antibiotics. BTW with so many issues so close to the ear, ear pressure may be present but this pressure or even pain is not from a middle ear infection.
Dizziness and Increased Use of Technology
It’s no secret that, as a society, technology use has not simply increased but has completely taken over our lives. You can literally do almost anything you need to get done from a cell phone. Need groceries, no problem? It’s called Amazon Fresh! It’s truly amazing, but we need to be aware.
Aware of what, you might ask? YOUR POSTURE! You see people walking down the street on the phone, with their head down. Sure, keep your head up so you don’t get hit by a car, but you should really keep your head up for a much more subtle but profound reason. Consistently holding your head in an unnatural forward posture for long periods will result in tight neck flexors and weak neck extensors. The next thing you know, your head is forward, looking down and you’re not even on the phone. That’s because this becomes your default posture. While the fancy name of this action/reaction process is Negative Neuroplasticity, which contributes negatively to the dizziness. Since we are on the subject of cellphone use, watch this video to see how to minimize the amount of damage while using your cellphone.
Now you’re thinking, “But Doctor I can’t be on my phone less, it’s for work.” Here’s the good news, you don’t have to. Just be aware and correct your posture. Start holding your phone with your elbows comfortably at your side and the phone up at eye level. This allows your neck to be in a natural position that it likes. The same goes for using a laptop or desktop, have your screen propped up to eye level while using a cordless keyboard and mouse.
Given how extensive the damage your posture has caused, postural correction may be necessary, which is a part of how dizziness should be treated.
What is the natural treatment for Dizziness?
As mentioned before, a tight SCM is a dead giveaway and should be the first thing addressed. If this muscle remains in a hyperactive (tight) state it will continue to pull the neck forward and more so on one side than the other. Active Release Technique (ART) is what I use to start the process of dizziness treatment. Using ART allows the patient to find some relief from activating the right muscles to do their job and in sync with the surrounding tissues. Movement is a concert and if a concert is not sounding right, assessing individual musicians is only a part of the process. Making sure the right musical instrument is played at the right time, and chimed in at the right part of the concert is the key. Of course, all musicians need to follow the conductor’s cues. The conductor is the brain.
Let me clarify this a bit more.
What is Brain-Based Neurology and Postural Neurology?
If you don’t use your biceps, it will shrink, right? What about your neck extensors? The muscles that are in the back of your neck that when working, allow you to look up? How about the front of the neck muscles that are super activated and in spasm? If there is a map of your body parts in the brain (when it comes to movement and sensation) and we call that homunculus then what happens if this map gets distorted as a result of too much or too little activity?
Brain-Based Neurology and Posture is based on this very question and the examination I use clarifies what the impact of function over the brain map is. We already know that the brain needs 3 things to function:
- Oxygen
- Glycogen
- Activation
If we activate it positively, it responds positively and if it is activated negatively, it responds negatively. In the case of dizziness, all different parts of the brain that have responded negatively to the postural changes and shifts are mapped and activated positively. That is when we move on to the next most important factor in the correction of posture and in this case, dizziness.
Developmental Kinesiology studies how babies develop movement from newborn all the way through the beginning of walking. Look at it this way, if the whole world was a petri dish, and all newborns were the subject of the study, then every test followed the same exact patterns of movement and development before every newborn started to walk. Do you get the picture? We are all born with the tools necessary to move; we all use them at a certain sequence and a certain way to develop strength in each muscle; each part chimes in at the right time when it comes to movement (remember the concert example above?) Why not re-walk the same paths and sequence to re-establish the same patterns of movements? Here is a video of what one of these movement practices I use with my patients looks like.
A movement that babies begin to do at three months of age is how we all develop our neck extensor muscles, which tend to be weak and overstretched in someone with an overactive SCM (hint-hint). This three-month stomach pose shown below is how a baby strengthens the neck extensors to bring their neck back while activating the front of the neck muscles to work together and symmetrically. Both of those requirements are essential to balancing the neck over the body (the imbalance of which can be as a result of tight SCM, leading to dizziness).
Results of Postural Balance
I have yet to see a patient who experiences dizziness with great posture and a healthy SCM. Constantly trying to remind yourself to bring your neck back isn’t going to cut it either. Only 5% of your posture is a decision you make while the other 95% is what the brain figures out is needed to support proper balance. This is also the reason why those gadgets you put on your back to zap you or the braces they sell to pull the shoulders back are a waste of money! If you have to think about it, it’s not going to last. Going back to the basic’s is the key to postural decline. You get adjusted to get the nervous system, the very system that controls every function of your body activated; you exercise the brain with exercises that activate the parts that are weak as a result of the postural failure and rehab the muscles, joints, and tendons going through the process that all infants go through by the time they start walking. This is how your dizziness is addressed. This is how your neck pain is addressed. This is how all musculoskeletal issues are solved.
Remember, you are the Director and the Designer of your own life so direct and design it the way you wish to live it. Use the internet to your advantage and don’t let the media be your only source of information.
Dr. Shakib