This is my story/history: Low back injury 1999 with herniated discs L4-L5, L5-S1. In PT on and off for over 9 years, never had surgery. Thought yoga helped. Felt like it saved my life.

In 2005 I experienced a sudden onset of extreme neck muscle spasm anterior and posterior. I went through intense PT, massages and was on high doses of muscle relaxants, (Soma). My neck has never been back to baseline and has always felt very tight and strained since.

In the summer of 2008I experienced sudden shooting numbness down my L arm to my fingers. After 3 months, I made an appointment with my PT and had a few sessions. On the morning of September 8, 2008 I woke up and started doing my stretches and exercises on the floor by my bed as I always did. After turning over onto the hand and knee position I became severely dizzy, room spinning, stumbling, wobbly dizzy. Of course I thought it would pass....and I'm still waiting. I went to my PT appointment and she thought it may be PPBV. I then saw a PT who specializes in vestibular disorders and she tested me and did the Epley maneuvers on me. She was not sure which side I was most affected by or even if this was the cause. In a day or so the vertigo went from severe to moderate and I have continued to struggle with it on a daily basis. I saw an ENT neurologist and my inner ear was ruled out as a cause. The ENT doctor seemed to think the vertigo was migraine associated vertigo.

Yes, I suffer from migraine headaches as well. They first started in 2005 with 9 consecutive weeks of hell. At the time I did not even know I was experiencing migraines because I never had one before. I also suffer from TMJ and have an asymmetrical jaw and L TMJ deformity from a childhood injury which the Orofacial Pain Specialist diagnosed as being caused by damage to my growth plate after sustaining trauma to my chin as a baby.

All the while I was suffering from a 24/7 continuous migraine a splint was being made to hold my jaw in alignment. I put that on and in less than 2 days my migraine went away. Remember though this was all back in 2005. The vertigo started in 2008.

I’ll have you know that I have also been quite “addicted” to Motrin and Tylenol for....ever, pretty much since my low back injury. For the migraines I was taking the Excedrin Migraine around the clock (after 2008). In 2005 I didn't know what was the matter with me.

Last summer (2010) my neck was just out of control painfully tight so I treated myself to a massage. The therapist was very concerned for me and had never seen anyone in such bad shape. I then called my PT and she worked on my neck like there was no tomorrow. I was starting to think that this had to be the cause of my vertigo and I learned about cervical vertigo. I had probably 6 sessions with her. It was the most bizarre experience. She only worked on my neck and head and I was seeing purple and black circles that grew in size. (I did experience seeing purple/black circles in 2005 as well with PT on my neck). I don't know what the treatments she did on me were called but I was literally incapacitated afterward sleeping, practically unconscious, most of the rest of the day. I was a total mess last summer. During the first few PT sessions I was thinking this is going to help and that my extreme exhaustion afterward was my body's way of healing. Well, the vertigo soon became way worse to the point I was very nauseous. My PT would not work on me any longer until I had a full workup. Then, I finally had the head and neck MRI's. Thankfully a lot of scary things were ruled out since nothing showed up on my brain images and the only thing that showed up on my neck was that I have C5-6 and C6-7 disc herniations with central spinal canal stenosis and bilateral neuroforaminal stenosis. The left C5 nerve root is also displaced. To say the least, I was shocked. To think of all I went through with my lower back and I persevered and did not have surgery which was an option a couple of times.

Let me update you on what a neurologist has said. Number one was to get off the Tylenol and Motrin. That my head aches could be a combination (migraine, tension, and sinus) but also taking daily medication, even over the counter medication, could be causing me to be experiencing rebound headaches. They also said that, yes I have had long stretches of migraines and that my vertigo is understandably worse with the migraines but that the vertigo alone could also be a form of a migraine head ache. The neurologists put me on Nortriptyline for migraine prevention. I just want to explain that at the time the vertigo was 24/7. Even at night I had bed spins every time I turned my head, or rolled over in bed. To say the least I was not sleeping well, I was exhausted all the time and on edge. I had little tolerance for any movement near or around me. I basically had a low tolerance for everything. I have also noticed that the vertigo is worse in the morning and after getting up from a rest. I'd sometimes start to feel a little better later in the day around 2:00-3:00. So every day when I got up in the morning I had no idea what I was in for or how bad a day it was going to be. The vertigo has always been there but the severity changes and when it's really bad the symptoms are hard to translate. Sometimes I feel very heavy and tired like gravity is working against me and sometimes I have felt weight less, like anti gravity, how I would envision walking on the moon would feel. This weight less sensations happened many times in the grocery store where there is so much sensory stimulation.

Along with the vertigo I have experienced significant visual changes. I have seen an eye doctor and it’s hard to say what’s causing what because I am at the age one would ecpect visual changes to occur. I’m now 46. I have at times had strange visual disturbances of everything being foggy or smoky. I’d come down stairs and the whole house looked like it was filled with smoke but there was no smell of smoke.

I have felt better after being off Tylenol and Motrin and taking Nortriptyline. I definitely sleep better at night. The vertigo is still there, some days worse than others and always worse with migraine headaches. I still get migraines 1-2 times every week or two. They last 1-1/2 days and Excedrin Migraine has helped control them. All and all I'm feeling better but not nearly "normal" yet.

Yesterday I had an appointment with an orthopedic surgeon for a consult for "minimally invasive" cervical spine surgery. He didn't like the diagnosis vertigo because he sees it as a symptom. I told him that's how I have always thought of it and I have been searching for the cause of my symptoms called vertigo. After seeing my MRI's he diagnosed me as having myelopathy and that spinal canal stenosis could in fact be contributing to my vertigo symptoms. Of course there are no promises that with surgery I would feel "normal" again.

The main reason I am even considering surgery on my neck is because of my TMJ and future jaw surgery. I am now undergoing orthodontics and will have quite invasive jaw surgery before the end of this year. I really can't imagine the stress and aggravation having surgery will cause on my neck when just holding my head up every day is hard enough work. The positioning (hyper extension) for airway management/intubation could cause real aggravation/injury, not to mention the recovery process after having jaw surgery. Bottom line is, that I don't want the disease in my cervical spine to become dramatically worse after jaw surgery and then I'd end up fixing my neck after my jaw any way and be in a lot worse pain.

My question for you is, have you heard of myelopathy causing vertigo like symptoms and the C5 nerve root displacement/impingement be at the level which could contribute to my vertigo symptom's? The surgeon has seen people with balance disturbances especially in the dark or with their eyes closed, and imbalances and disturbances similar to feeling drunk. I do feel like I'm "on something" a lot of the time definitely a feeling of impairment.

Just so you know, I have managed to work, and I don't believe I have missed a day. I'm stubborn because of everything I went through with by back to basically get my life back. I also have 3 boys ages 15, 13 and 10 and my husband has been supportive. The hard thing is that no one can really understand unless they experienced it. Just like no one who hasn't lived with chronic pain understands those people who do. No one who has never experienced vertigo symptoms can understand what it's like. Pain and vertigo are both invisible to everyone who sees you. If you were to look at me you'd never know how horrible I feel most days. I'm tired and I have dark circles under my eyes but I live my life and muddle through similar to most people.

I am so very sorry how long this is. I have never written down "my story" and once I got started I kept going. I hope to be able to somehow print it and next time I see a doctor I can have them read it.

So, what do you think is causing my vertigo and should I seriously be considering cervical spine surgery?

Thank you if you took the time to read this and thank you for any advice you have to offer.



Dorothea