Dizziness and Numbness: When to Seek Medical Help

Q: Dizziness and Numbness: When to Seek Medical Help

Hello Mr. <br>Li： <br>You mentioned that "it feels like the whole body is swaying side to side, but when standing, it doesn't sway much. <br>I feel sleepy, and my neck and shoulders are stiff. <br>When I slightly twist, there's a loud cracking sound, and when lying down to sleep,

Dizziness with occasional numbness?

I have been experiencing occasional dizziness since July 28.
Previously, I felt tightness in my head or around my temples, and I have had a few instances of facial numbness.
Recently, aside from the tightness, I feel like I'm swaying while sitting.
Just yesterday, while sitting in a chair at home, it felt like my whole body was rocking side to side, but I don't feel much swaying when standing.
I also feel sleepy, and my neck and shoulders are stiff; when I turn slightly, there is a loud cracking sound.
Additionally, when lying down to sleep, I often feel a pulsing sensation in my head.
Doctor, what could this situation be? Should I see a doctor, and should I go to a clinic or a hospital, or can I just improve my lifestyle habits? Thank you for your help.

Li Zimin, 20~29 year old female. Ask Date: 2022/08/29

Dr. Jiang Junyi reply Neurology

Hello Mr.
Li:
You mentioned that "it feels like the whole body is swaying side to side, but when standing, it doesn't sway much.
I feel sleepy, and my neck and shoulders are stiff.
When I slightly twist, there's a loud cracking sound, and when lying down to sleep, I often feel a pulsing sensation in my head." Your symptoms may suggest cervicogenic dizziness, which refers to dizziness originating from the cervical spine.
You may experience dizziness or nausea when moving or resting.
Symptoms can last from a few minutes to several hours.
Some patients may feel a loss of balance; however, those with cervicogenic dizziness typically do not have difficulty describing their symptoms.
Cervicogenic dizziness is often accompanied by neck pain, restricted range of motion, stiffness, and a history of neck strain due to whiplash from a rear-end collision.
It is advisable to pay attention to your posture and reduce looking down frequently.
If symptoms persist, cervical traction may help improve them, but an X-ray should be performed first to confirm joint stability before traction.
I recommend consulting with a neurologist or a rehabilitation specialist to discuss further evaluation and treatment.
Thank you for your inquiry, and feel free to discuss further.
Wishing you good health, peace, and joy.

Dr.
Jiang Junyi, Taoyuan Medical Center, cares for you.

Reply Date: 2022/08/29

More Info

Dizziness and numbness can be concerning symptoms that may indicate a variety of underlying medical conditions. Based on your description, it sounds like you have been experiencing episodes of dizziness, facial numbness, and tightness in your head, along with some neck stiffness and unusual sounds when moving your neck. These symptoms can be attributed to several potential causes, and it is essential to approach them with caution.

Possible Causes of Your Symptoms
1. Cervical Spine Issues: Given your mention of neck stiffness and the popping sounds when you move your neck, it is possible that you may have cervical spine issues, such as cervical spondylosis or a herniated disc. These conditions can lead to nerve compression, which may cause dizziness and numbness in the face or extremities.

2. Vestibular Disorders: Dizziness can also stem from issues related to the inner ear, which is responsible for balance. Conditions such as benign paroxysmal positional vertigo (BPPV) or vestibular neuritis can cause episodes of dizziness that may feel like the room is spinning or swaying.

3. Migraines: Some individuals experience migraines with aura, which can include dizziness, visual disturbances, and numbness. If you have a history of migraines, this could be a potential explanation for your symptoms.

4. Anxiety and Stress: Psychological factors such as anxiety can manifest physically, leading to symptoms like dizziness, tightness in the head, and numbness. Stress can also contribute to muscle tension in the neck and shoulders, exacerbating discomfort.

5. Circulatory Issues: Conditions affecting blood flow, such as orthostatic hypotension (a drop in blood pressure when standing up), can lead to dizziness. If you feel lightheaded upon standing, this may be a factor.

When to Seek Medical Help
Given the range of potential causes for your symptoms, it is advisable to seek medical attention. Here are some guidelines on when to see a doctor:
- Persistent Symptoms: If your dizziness and numbness persist or worsen, it is crucial to consult a healthcare professional.

- Accompanying Symptoms: If you experience additional symptoms such as severe headache, vision changes, difficulty speaking, weakness in limbs, or loss of consciousness, seek immediate medical attention.

- Impact on Daily Life: If your symptoms interfere with your daily activities or quality of life, it is essential to get evaluated.

Where to Go for Help
You can start by visiting a primary care physician or a neurologist, as they can perform a thorough evaluation and determine if further testing is necessary. Depending on your symptoms, they may recommend imaging studies like an MRI or CT scan to assess your cervical spine or brain.
If your symptoms are related to anxiety or stress, a mental health professional may also be beneficial. Additionally, if you suspect that your symptoms are due to a vestibular issue, an appointment with an ear, nose, and throat (ENT) specialist or a vestibular rehabilitation therapist may be warranted.

Lifestyle Modifications
While seeking medical help is important, there are also lifestyle changes you can consider to help manage your symptoms:
- Hydration: Ensure you are well-hydrated, as dehydration can contribute to dizziness.

- Posture: Pay attention to your posture, especially when sitting for long periods. Ergonomic adjustments to your workspace may help alleviate neck stiffness.

- Stress Management: Engage in relaxation techniques such as deep breathing, yoga, or meditation to help manage stress and anxiety.

- Regular Exercise: Gentle exercises, particularly those that improve neck strength and flexibility, can be beneficial.

In conclusion, your symptoms warrant a thorough evaluation by a healthcare professional to determine the underlying cause and appropriate treatment. Do not hesitate to seek help, as early intervention can lead to better outcomes.

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