Head, Neck, Eyes & Ears: How Chiropractors Can Assess & Treat This Diagnostic Puzzle

Since we reopened the doors to Choice Health Centre after the COVID-19 closures I have been noticing a LOT more people with certain symptoms during recent chiropractic assessments. It seems most people are surprised that chiropractors can assess and treat these symptoms! Yet it’s one of the areas that we are best at because often they relate to the head and neck.

What symptoms am I referring to?

  • Dizziness, unsteadiness, or lightheadedness (1,2,3);
  • Feeling like you are spinning or the room is spinning around you (1);
  • Not feeling right or ‘off’ with certain head movements such as looking up, looking side to side, or with sudden head/neck movements (1,2,3);
  • Trouble refocusing the eyes when looking at screens or reading then looking away (2,5);
  • Eye strain, pressure, or eye ‘tiredness’ when doing activities requiring concentration (2);
  • Sensitivity to light and/or noise (2,3);
  • Sounds that seem to come from the ears such as ringing, buzzing, hissing, whooshing, roaring, pulsing (3).

People can also have more than one of the above symptoms, and often have one or more of these symptoms in combination with headaches, neck pain or stiffness and aching tightness in the neck, face, jaw / around the ears.

In this article, I will discuss a few of these symptoms, how they are often related to each other, and how chiropractors can assess and treat them or make a referral to another healthcare professional for further investigation if needed.

Sensorimotor control:

Sensorimotor control is our brain’s ability to take incoming sensory information, process it, and use it to guide our motor behaviour (1,2,3,4). The three main pillars of our sensorimotor control include:

  1. Proprioception
  2. Oculomotor control
  3. Postural stability

If any of these three pillars of sensorimotor control are impaired, you can feel ‘off’ (1,2,3,4). Especially if the richly supplied cervical spine and associated musculature/joints are affected because the neck has a significant amount of neurological connections to the central nervous system to provide the appropriate motor output for control of head and eye movements and postural stability (2,3,4). Putting it simply – our muscles move bones, and our brain moves muscles. Our brain is very tuned into to any alterations in these processing systems.

Now, our body is also an incredibly efficient, resilient, and adaptable system and tries to resolve any issues that arise when something is ‘off’ and it can often be successful and symptoms resolve on their own. However, if the issue persists and goes unassessed and untreated it could get worse. I often hear patient state that they ‘just got used to’ the change and it became their new normal until it became too annoying or debilitating to tolerate and they seek help. Therefore, I’m here to tell you that these symptoms are commonly reported but are NOT normal and can be quite frustrating to deal with and be functionally limiting to our daily activities and lives.

How can these systems become impaired?

There is a wide range of possible causes including but not limited to stress, inner ear issues, hearing loss, an underlying (sometimes undiagnosed) medical condition, medication use, blood flow abnormalities, neurologic disorders, and – mostly commonly seen by myself as a chiropractorprolonged postures or a history of recent or previous injury to the head or body such as a whiplash, slip and fall, direct or indirect hit, or sports injury (1,2,3,5). An injury also doesn’t have to be severe – it is known that incidents of relatively low force can contribute to functional impairment of the many neck joint and muscle structures and receptors (3).

The functional disturbance can be immediate, but it could be initially subtle and become more apparent over time especially when our daily activities include prolonged sitting, repetitive tasks, and there is postural stress and tension in our head, neck, and body. There are a lot of muscles associated with the head, neck, and upper body which all can be affected and contribute to certain patterns of headaches and neck pain.

A recent study looked at people with and without neck pain who have computer visual symptoms such as eye fatigue and concluded that people with neck pain have high incidence of computer visual symptoms, these symptoms are related to neck pain and dizziness, and the computer visual symptoms rated in people with neck pain might reflect visual problems relating to the neck rather than to computer use (5).

What can I do about it?

Following assessment and diagnosis, chiropractic treatments often include soft tissue therapy, joint manipulation, acupuncture, education and advice, and prescription of stretching and mobility exercises. For symptoms relating to any functional impairment of the sensorimotor systems there are also rehabilitation exercises for the specific symptoms and are often very effective at improving these symptoms in combination with treatments.

What should you take away from this blog post?

No symptom or feeling that patients experience is ever too small to mention to your chiropractor or healthcare practitioner during an assessmentwe want to know how you feel in order to best help you! Symptoms are not good or bad – they are information and make up the pieces of each individual’s diagnostic puzzle during assessment. We want to help you by determining WHY these symptoms are occurring and get at the underlying cause. Chiropractors can help treat these symptoms because many of them are closely related to head, neck and spine function which we have extensive training in assessing and treating. We love what we do! If this sounds familiar to you or your family or friends, we would love to help you with any of these symptoms whether it is a new or nagging issue.

References

  1. Complete Concussion Management Inc. (2019). Complete Concussion Management: Online Practitioner Certification Course [Course notes]. Retrieved from completeconcussions.com.
  2. Treleaven J, Takasaki H. Characteristics of visual disturbances reported by subjects with neck pain. Manual 2014 June. 19(3):203-207. Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S1356689X1400006X.
  3. Treleaven J. Dizziness, undsteadiness, visual disturbances, and sensorimotor control in traumatic neck pain. J Orthop Sports Phys Ther. 2017;47(7):492-502. Retrieved from: https://www.jospt.org/doi/full/10.2519/jospt.2017.7052.
  4. Perception & Action Lab. Sensorimotor control. 2013. University of Rochester. Retrieved from: http://www.cvs.rochester.edu/knill_lab/research/sensorimotor-control.html.
  5. Teo C, Giffard P, Johnston V, Treleanven J. Computer vision symptoms in people with and without neck pain. Applied Ergonomics. 2019 Oct;80(n/a):50-56. Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S000368701930078X?via%3Dihu.
  6. Ingram JN, Wolpert DM. Enhancing performance for action and perception. Progress in Brain Research. 2011; 191(n/a):3-29. Retrieved from: https://www.sciencedirect.com/science/article/pii/B9780444537522000163.

Images:

  1. https://healyourposture.com/blog/2011/11/stiff-eyes-and-neck-pain.
  2. Finando D and Finando S. Trigger point therapy for myofascial pain: the practice of informed touch. Healing Arts Press. 1999, 2005. Rochester, Vermont.

© 2022 Choice Health Centre. All Rights Reserved   |   Website designed and developed by Red Ear Media.