Not long ago, one of the patients complained to me about the fact that he felt dizzy after a massage of the cervical spine. It was this fact that gave me the idea to write this article. So, why does dizziness develop after a massage (especially after a massage of the cervical spine), how to avoid this unpleasant sensation, is it possible to do a massage if you are dizzy? I will try to answer these, as well as some other questions.
Causes
I’ll probably start again with the patient who asked me a question about massage and dizziness, and in answering why he had dizziness, I’ll give the first reason: a drop in blood pressure. Active massage movements can lead to an effect on blood pressure levels, both lowering and increasing it. This in itself can cause a feeling of dizziness, as well as decompensate for existing vascular disease.
The second reason for dizziness during neck massage is destabilization of the location of the vertebrae. Violation of the stability of the vertebrae with active and frankly illiterate massage can lead to a short-term effect on the vertebral artery system, if such an effect was noted earlier, and also, because of this, can cause dizziness. Although this reason is usually inseparable from the first.
Dizziness after a massage can be caused by overstimulation of proprioceptors (deep sensitivity) of the muscles and ligaments of the neck, which are known to be one of the components of the sense of balance (they determine the position of the head relative to the body by stretching the muscles and ligaments on one side and contracting them on the other ).
Also, theoretically, dizziness can be caused by fear and the development of a psychogenic state due to the general fear of medical manipulations, as well as due to the presence of pain when performing a massage.
More serious conditions cannot be ruled out: for example, the rupture of an unstable plaque in the carotid arteries, but, as they say, this is rather a fantastic casuistic reason, which is not even described in the scientific literature.
Feeling dizzy? Check your spine!
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Sometimes a person suffers from headaches, dizziness, and visual impairment for a long time and does not suspect that the cause is in the spine. And, in particular, in the occurrence of the so-called vertebral artery syndrome, VAS, against the background of spinal ill health. Today we continue our conversation about diseases associated with the spine with Doctor of Medical Sciences, Professor, Head of the Department of Medical Rehabilitation and Sports Medicine of the South Ural State Medical University Artur Sabiryanov. — Arthur Raisovich, what is meant by vertebral artery syndrome? - Our brain is fed by four arteries, two carotid and two vertebral, which enter the brain and create the arterial circulation. At the same time, the carotid arteries are mostly responsible for supplying blood to the frontal, parietal, and temporal lobes of the brain, and the vertebral arteries primarily supply blood to the posterior parts of the brain - the occipital, cerebellum and a very important area - the brain stem. Along with the cerebral cortex, the brain stem regulates the activities of our entire body, the cerebellum controls our movements. And when blood flow through the vertebral arteries is suddenly disrupted, a significant disruption occurs in the activity of the nervous system. This is what is called vertebral artery syndrome. — What can cause blood flow problems? — The main reason is vertebrogenic influences, that is, emanating from the spine, in particular from its cervical region. A less common cause is atherosclerosis of the vertebral arteries. With osteochondrosis of the cervical spine, protrusions, herniated discs, and vertebral instability, the lumen of the vertebral artery decreases due to the mechanical effect on it, and blood flow is disrupted. Sometimes the cause of lack of blood supply can be muscle hypertonicity in this area. — As a consequence, insufficient blood supply to the brain and the resulting symptoms? — Yes, the posterior parts of the brain suffer and the corresponding signs of vertebral artery syndrome, SPA, appear. This syndrome is considered an acute form of cerebrovascular accident; in medical language it is called vertebrobasilar insufficiency. Headaches in the back of the head, dizziness occur, visual function is impaired, and gait instability may occur due to disruption of the cerebellum. Suffering of the brain stem leads to autonomic disorders - nausea, vomiting, sweating, tachycardia, cardiac dysfunction, even arrhythmia. — Is it difficult to diagnose vertebral artery syndrome? — There is no great difficulty in diagnosis. The combination of three main clinical factors usually confirms the diagnosis: headache, dizziness, visual disturbances - blurredness, loss of color. But in any case, if vertebrobasilar insufficiency is suspected, an examination is necessary to establish the exact cause. — Is manual therapy indicated for this disease? - Depending on the reason. If the cause is in the spine or muscle hypertonicity, it is indicated. If the problem is atherosclerosis of the artery, then there is a completely different treatment tactic. As a rule, to clarify the diagnosis, an ultrasound of the neck is performed, Doppler ultrasound is performed, that is, an ultrasound examination of the vessels of the neck, which clearly shows whether there is a narrowing of the blood vessels. The condition of the spine is shown by X-rays and magnetic resonance imaging, MRI. Treatment in any case is complex. — That is, several specialists are involved in it? - Yes. Dizziness and headache are severe cerebral ischemia. Our brain is very patient, but if it makes itself felt, then we need to help it, and first of all with medication. The patient is prescribed vasodilators, drugs that improve the metabolism of nerve cells in the brain, and this is usually done by a neurologist. Manual therapy, as I already said, solves its problems: relieves muscle tone, helps stabilize the vertebrae, eliminates functional blocks that increase the load on the vertebrae in certain segments. But there are also strict contraindications for manual therapy, for example, uncovertebral arthrosis, which is characterized by the growth of vertebral bodies towards the vertebral arteries, and then manipulation is unacceptable. All indications and contraindications are taken into account by the chiropractor. Treatment in collaboration will give the desired long-term effectiveness. But in especially difficult cases, when both neurology and manual therapy are powerless, surgery is indicated, and then neurosurgeons become involved. — How often does this disease occur? Is it always provoked by something or is there some kind of predisposition to it? — Most often, vertebral artery syndrome occurs in people who lead a sedentary lifestyle and work at a desk. Cervical osteochondrosis, which often occurs, can lead to circulatory failure. There is also a predisposition if there is a congenital anomaly of the structure of the spine. The cause of the development of SPA may be childhood uncorrected vertebral instability. SPA occurs more often in women than in men. The psycho-emotional component of the disease is also difficult. A person with SPA feels like life has stopped. Particularly painful are autonomic disorders that cause an unsteady gait, when sudden movements can lead to a fall. This is an uncomfortable state, the person is confused, does not know what to do, the only correct solution is to contact a specialist. — What should you do to avoid bringing yourself to such acute states? — The basis is the prevention of cervical osteochondrosis. And the main thing here is sufficient physical activity and strengthening the muscle corset. Over the years of practice, I have become more and more a supporter of physical activity as a prevention of diseases associated with the spine. The health that we receive from birth is spent very quickly, and then we earn it, and this is not so easy. We are accustomed to expecting miracles from medications, but we forget that our body is a self-regulating system; it only needs a little help. — Artur Raisovich, can you recommend to our readers a few effective exercises in therapeutic gymnastics? — Of course, since, as I already said, it is important for us to prevent cervical osteochondrosis, there are also appropriate exercises for this part of the spine. Here are some easy options. First of all, I would like to note that the neck does not like bending forward; this is a heavy load for it, especially if the cervical vertebrae are unstable. The main muscles that strengthen the vertebrae are located at the back and sides of the neck. I often see on the Internet static gymnastics for the neck, when a hand is applied to the forehead or the back of the head and pressing movements are performed forward or backward. This, in my opinion, is very reckless. To be sure, at home you need to focus on dynamic exercises. For example, lying on your stomach, move your head from the edge of the sofa and first lower it a little, and then lift it without throwing it back. If it’s difficult, your arms should be placed along your body. The more we move our arms forward, the greater the load. Movements with excessive flexion and extension of the neck, and rotation of the head around an axis are not necessary. One more exercise. From a lying position on a sofa or couch on your side, hang your head slightly and do lateral bends. Instability of the vertebrae is formed due to their movements back and forth, so lateral tilts are not so fraught. That is, we lie on the shoulder, the head is lowered, and we raise it. At the same time, the “scalene” muscles work and the muscle corset is strengthened. In people with instability of the vertebrae, when performing this exercise, they seem to be centered, eliminating displacement. As you train, you can weight the exercises with your arm to strengthen the muscles more. The exercises are performed on one side and the other. And the third exercise is to raise your shoulders while standing. This is training the upper trapezius muscle, strengthening the shoulder girdle. To make it more difficult, you can pick up a bottle of water. Such gymnastics is safe both for existing osteochondrosis of the cervical spine and for mild stages of vertebral artery syndrome. All other subtleties of therapeutic exercises must be agreed upon with the exercise therapy instructor. — Is it possible to attend massage courses independently for preventive purposes? - Certainly. But there are healing massages, and there are therapeutic ones. A wellness massage is done when a person is not bothered by anything. It, like physical education, is useful for everyone. If there are any manifestations of ill health on the part of the spine, then therapeutic massage should be carried out only after a preliminary examination; the technique is different. — Arthur Raisovich, orthopedic pillows are often recommended to patients, how do you feel about this? - I have my own opinion on this matter. I think it’s not for nothing that our ancestors from century to century, and we before, used feather pillows. They are the most comfortable, the most physiological, they take any shape, such a pillow can be adjusted to any position of the head. If the feather pillow is worn out, you just need to buy a new one. There is no need to get carried away with orthopedic pillows with various fillings. In a pillow, it is important that our head is not raised too much relative to our body. It should be located approximately level with the body, slightly rising, only then the blood flow is normal. Small children also need a pillow, low but comfortable. - So, the more convenient it is for us, the more useful it is? — Of course, our body is capable of adapting to many things. However, there is no need to create unnecessary difficulties for him, and he will be grateful to us.
Natalya Ivanovna.
Based on materials from the newspaper “On Health” (issue No. 14, September 2014)
Print version
How to avoid dizziness during massage?
How to avoid developing dizziness during massage? There may be several answers. The first one is banal. Don't go for a massage. But this is more of a joke.
The second, although similar to the first, is still the most correct - do not go for a massage to an illiterate specialist. How to determine which massage therapist or chiropractor is competent? The answer is very complicated. Here you need to take into account the recommendations of doctors, relatives, acquaintances, you can sometimes even take into account reviews on the Internet, and a competent massage therapist usually asks to see the doctor’s conclusions, and also asks to see the results of studies (x-ray of the cervical spine, MSCT, MRI, etc.). In my opinion, the correct answer can only be given by a combination of such information collection, with possible emphasis on the opinion of the attending physician.
The third option is not to do any active actions on the collar area, except for stroking and rubbing, although, in this case, the meaning of the massage as such is practically lost.
Is it permissible to have a massage if you have dizziness?
Acceptable in some cases. If dizziness is caused by BPPV, where the main treatment method is “manual” in the form of otolith reposition maneuver, non-progressive vascular disorder (dyscirculatory encephalopathy), venous insufficiency, psychogenic state, multiple sclerosis. And it is unacceptable to massage the collar zone in the acute/subacute period of a stroke, in the presence of reliably confirmed vertebral artery syndrome, in a brain tumor, as well as malignant neoplasms of other localization, in pathology of the thyroid gland, in the presence of a tendency to orthostatic reactions. The most correct thing would be to contact a healthcare professional to determine the presence of indications/contraindications for massage.
After the massage, my back and neck hurt - is this normal?
First of all, such sensations can manifest themselves as a result of insufficient physical training, as well as due to mistakes by the massage therapists themselves during the procedure.
Pain after massage: causes
First, you need to understand that there can be many reasons for the occurrence of pain, and you need to immediately contact a specialist if they occur. For massage to be useful, an individual approach to a person and his problem is important. It is necessary to choose a high-quality and effective massage technique.
To accurately find out the diagnosis, you need to pass all the tests and go for an x-ray, as well as a computed tomography and MRI. Monitor how you feel after massage sessions. If the technique is incorrect or the master makes serious mistakes, you will feel tired and painful, which will increase with each new session.
To reduce muscle hypertonicity, use relaxation techniques, which are mainly aimed at reducing pain and spasm. With incorrect techniques, you feel constant pain and stiffness in your muscles. It is important to remember that the massage master must become familiar with the characteristics of the person’s disease in order to choose the right technique.
Contraindications to back and cervical massage
spine massage
does not always have a positive result. There are a number of cases in which any manipulation in the form of massage movements is contraindicated. There are masters who conduct sessions at home and do not have special medical education. As a result, they perform massages without studying the patient’s disease, the characteristics of his spine or cervical spine, etc.
The most common contraindication is the development of chronic diseases, where exacerbation usually takes from 4 to 11 days. Until the acute pain ends, any impact on the back and neck, as well as any physical activity or heavy physical labor, is strictly prohibited.
Remember that any incorrect influences can lead to inflammatory processes, which are sometimes accompanied by severe pain.
There are several other contraindications to back massage:
- There are tumors and a cyst in the spine.
- Blood circulation pathologies.
- Infectious diseases in the body.
- Back and neck injuries.
- Neurotic and mental disorders.
Massage therapist's gross mistakes
It is important to start with carefully selecting a massage therapist, because he must be a professional in his field, and also have a medical education as a neurologist.
When a massage is prescribed by your healthcare provider, the procedure must take place in a treatment room in a hospital. Do not forget that massage therapists in beauty salons and those who receive people at home do not always have a medical education. An incorrectly performed procedure can not only shift the spinal and cervical discs, but also damage soft tissues or even lead to fractures of the spinal bones.
In order to understand that the massage is being done incorrectly, you need to listen to the sensations after each session. Gross mistakes are made by the massage therapist if after the session you feel:
- Severe pain for more than 48 hours.
- Increased pain with exercise and movement.
- Painkillers don't help.
Pay attention to the color of the skin on your back after the massage: if the redness does not go away within 24 hours, then an inflammatory process has begun in the body.
Is it possible that pain after a massage is normal?
This is possible if before the massage a person did not engage in any physical activity, led a sedentary lifestyle, and his body is simply not ready for such influences. Therefore, after the procedure, a large amount of lactic acid accumulates in the muscles, which leads to pain. It also happens that keeping muscles in a spasmodic state for a long time leads to painful sensations, and in order for them to go away, it is necessary to undergo from 3 to 5 procedures.
Pain is normal if after each session its intensity decreases, after the massage the pain goes away within 48 hours, and there is no inflammation, redness or swelling.
The most painful sensations occur during the first two procedures, after the 4th session the pain becomes weaker. Depending on the degree of the disease, the number of courses is prescribed, each of which contains 10 procedures. Usually 2 to 4 courses are enough.
Medicines to help relieve pain
If you are still bothered by pain after a massage, you can relieve it with medicinal ointments and creams, but before use you should consult your doctor. Several good medications for pain relief.
- Ibuprofen is an anti-inflammatory drug with an analgesic effect that works ideally in combination with Nise ointment.
- "Ketorol" - perfectly relieves pain and inflammation.
- Ointments “Vibrosal”, “Doctor MOM” and “Golden Star”.
Ointments and creams should be applied to painful areas with light circular movements until completely absorbed, 2-3 times a day. Remember that medications in the form of tablets should be taken for no more than 4 days; if the pain does not stop during this time, contact your doctor at the hospital to rule out pathologies.
Remember about your health, undergo regular preventive examinations.
If you experience pain, consult a doctor immediately. Do not put off visiting a specialist if you feel pain or other discomfort in your back or neck. It is best to prevent the formation of a problem and prevent the development of the disease in the early stages! Be healthy! Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr