Neck Pain with Dizziness and Tinnitus: Seeking the Right Specialist

Neck pain accompanied by dizziness and tinnitus?

Hello doctor, I am a bus driver.
Around the end of last year, I started experiencing neck pain and tightness due to long hours of driving.
I often forcefully twisted my neck to stretch, which caused joint sounds similar to cracking knuckles.
By March of this year, I began to experience tinnitus (in my left ear, and it lasts all day) and a feeling of dizziness that sometimes severely affects my ability to drive.
I went to a large hospital for examination, and initially, they said I had inner ear imbalance.
Later, they suggested that insufficient blood flow in the carotid artery was causing increased pressure in the inner ear.
However, the opinions of the examining doctor and the attending physician differed.
I have been taking medication, but there has been no improvement.
Could you please advise which specialty I should consult for more in-depth examinations? Thank you.

A Guo, 30~39 year old female. Ask Date: 2016/10/03

Dr. Jiang Junyi reply Neurology

Hello, based on your description of tinnitus symptoms, it is important to first rule out any abnormalities from the middle ear, inner ear, and even up to the brainstem and cerebral cortex.
Common issues include abnormal blood flow and inner ear imbalance.
Additionally, cervical degeneration leading to unstable blood flow should also be considered.
It is recommended to follow up with both the otolaryngology and neurology departments at the same hospital to ensure a comprehensive evaluation of your condition.
Please avoid any forceful neck twisting to prevent potential damage to blood vessels and surrounding tissues.
Wishing you health, safety, and happiness.
Dr.
Tao cares about you.

Reply Date: 2016/10/03

More Info

Hello! Thank you for reaching out with your concerns regarding neck pain, dizziness, and tinnitus. Given your symptoms and the complexity of your situation, it’s important to approach this systematically to identify the underlying causes and find the appropriate treatment.

From your description, it seems that your neck pain has been exacerbated by your job as a bus driver, which likely involves prolonged periods of sitting and possibly poor posture. The fact that you have been forcefully twisting your neck to relieve discomfort may have contributed to your current symptoms. The popping sounds you hear when moving your neck could indicate joint or ligament issues, which are not uncommon in individuals who frequently strain their necks.

The onset of tinnitus (ringing in the ears) and dizziness could be related to several factors, including cervical spine issues, inner ear problems, or even vascular concerns. You mentioned that doctors initially suspected inner ear imbalance and later suggested that reduced blood flow in the carotid artery might be causing increased pressure in your inner ear. This inconsistency in diagnosis can be frustrating, but it highlights the need for a thorough evaluation.

To address your symptoms effectively, I recommend the following steps:
1. Consult a Neurologist: Since your symptoms include dizziness and tinnitus, a neurologist can help assess whether there are any neurological issues contributing to your symptoms. They may perform tests such as a neurological examination, imaging studies (like MRI or CT scans), and possibly vestibular testing to evaluate your inner ear function.

2. Visit an Ear, Nose, and Throat (ENT) Specialist: An ENT specialist can provide a focused evaluation of your tinnitus and dizziness. They can conduct hearing tests and assess the health of your inner ear structures. If there are any abnormalities, they can recommend appropriate treatments or therapies.

3. Consider a Physical Therapist: Given your history of neck pain and the mechanics of your job, a physical therapist specializing in cervical spine issues could help. They can provide exercises to strengthen your neck muscles, improve posture, and reduce strain. They may also use techniques such as manual therapy to alleviate pain and improve mobility.

4. Cardiovascular Evaluation: Since there was mention of carotid artery blood flow issues, it may be beneficial to see a vascular specialist. They can perform Doppler ultrasound studies to assess blood flow in your neck arteries and determine if there are any blockages or abnormalities that could be contributing to your symptoms.

5. Lifestyle Modifications: In addition to seeking medical advice, consider making some lifestyle changes. Ensure that your driving posture is ergonomic, take regular breaks to stretch your neck and shoulders, and practice relaxation techniques to reduce muscle tension.

6. Follow-Up on Medications: If you are currently on medication for your symptoms, discuss with your doctor whether these are still appropriate or if adjustments are needed based on your ongoing symptoms.

In summary, your symptoms warrant a multidisciplinary approach involving neurology, ENT, physical therapy, and possibly vascular evaluation. Each specialist can provide insights into different aspects of your condition, leading to a more comprehensive understanding and effective treatment plan. It’s essential to advocate for yourself and ensure that you receive the thorough evaluation you deserve. Don’t hesitate to seek second opinions if you feel that your concerns are not being adequately addressed. I wish you the best in finding relief and improving your quality of life!

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