A 37 year-old male presented with intermittent dizziness that he first experienced after a long flight to Australia. He was referred to Myopain Solutions by a spine center to treat and/or rule out soft-tissue contributions to symptoms. He described a ‘weird feeling’ of something crackling out of his head, like ‘antennae.’ He had been seen by many specialists and had an MRI, CT scan, and vestibular testing. Results were negative for disease pathologies and benign positional vertigo.
Evaluation, clinical reasoning & treatment strategizing
Postural analysis showed rounding of both shoulders and reduced cervical lordotic curve (i.e. flattening of the neck). Dizziness worsened with bilateral head rotation, extension and flexion. Pain increased with stress, travel, computer and smartphone use.
The sternocleidomastoid (SCM) is a common culprit for dizzy symptoms. In this case, poor neck positioning during the long plane ride could have caused active trigger points to form in the SCM. Stress and faulty posture reinforced the pain pattern. Thus, NMT treatment began by checking all neck muscles that might reproduce dizziness and head pain.
Three months of bi-weekly treatments deactivated trigger points referrals in the sternocleidomastoid, upper trapezius, suboccipital group, and scalene group. Corrective postural activities were recommended along with self-treatment techniques and modifications to activities of daily living. Additional therapy on the pectoralis major and minor, trapezius, rhomboids, and levator scapula muscles helped to maintain posture improvements.
Outcomes and follow-up
The patient’s symptoms reduced on a pain scale of 1-10 from an 8 to a 2. He modified his ergonomics on the tablet computer he used during long flights. Physical therapy was recommended to reinforce the soft-tissue changes and strengthen the posterior neck. NMT maintenance treatments are ongoing to prevent recurrence.