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What is Ménière’s Disease?
Meniere’s disease is a disorder of the inner ear, affecting the vestibular system.
This disease causes episodes of vertigo, dizziness, and loss of balance, a feeling of fullness in the ear, tinnitus and hearing loss. This is a chronic condition that usually starts after a physical accident, injuring the head or neck (80% of cases).
It then gradually builds up over time, usually affecting one ear, and resulting in deterioration in hearing and quality of life for sufferers. Research shows the average time between the initial injury and the symptoms start is 15 years!
Symptoms of Ménière’s Disease
There is no established cause in medicine. However, the majority of cases start after some physical trauma to the head or neck. This could be a car accident, a fall on ice, a fight or even a sports injury. At the time, there may have been pain, or the accident may have appeared ‘harmless’. However, this injury often causes damage that worsens over time as the body degenerates.
Meniere’s Disease Symptoms:
- Vertigo attacks (dizziness with spinning sensation)
- Balance problems
- Nausea and Vomiting
- Buzzing, ringing or roaring in one ear
- Affected Balance and Hearing
However, it is important to note that the disease symptoms vary from person to person. Hence, it is important to have the symptoms diagnosed at an early stage or as soon as possible. Your doctor may conduct a hearing test to identify deafness and other communication issues as a result of fluid in the inner ear.
What Causes Ménière’s Disease?
The symptoms of this disease are caused by an imbalance of the fluid resulting in pressure in the inner ear. There is an abnormal amount of fluid (called endolymph) in the inner ear compared to normal for the sufferer. This liquid will stimulate parts of the balance control centres in the inner ear, disturbing their normal function. This creates this feeling of unsteadiness and spinning, especially on rest or particular movements of the head and neck.
As well as physical injury, other causes linked to Meniere’s disease include:
- Inflammation of the Subluxated Atlanto Occipital Articulation (where the skull attaches to the top of the neck) with swelling putting pressure on the adjacent middle ear structures
- Immune deficiencies
- Traction of the cranial nerves
- Cerebrospinal fluid flow problems
- Irritation of sympathetic nerves
- Viral infection
- Congenital or genetic
It is likely to be caused by a combination of factors. An injury to the top of the neck can damage the nerves that supply the inner ear. Therefore, correcting the upper neck may help reduce pressure on the Atlanto Occipital Articulation, remove the feeling of pressure on the cranial and sympathetic nerves and restore normal cerebrospinal fluid flow.
Other symptoms of Meniere’s disease may include; headaches, fatigue, vomiting, nausea, visual and concentration problems, diarrhoea and depression.
What Triggers Ménière’s Disease?
While the causes of this disease are usually an accumulation of factors, there are some more recognised risk factors for Ménière’s disease attacks:
1. Stress
Stress plays a big factor for most people with Ménière’s disease. When stressed the brain is working harder on mental and emotional tasks. With this reduced capacity, there is less focus on maintaining the body in its healthy balance, including regulating liquid in the ear and maintaining proper nerve function.
2. Head Movements
When moving the head quickly it will shift the endolymph liquid inside of the inner ear. When moving too fast it may incur dizziness and vertigo, as people with Meniere’s disease are more sensitive to the movements.
This can also occur due to movements of the neck. The nerves in the neck supply information to the head and inner ear. If the neck movement pinches the nerves it may stimulate a part of the inner ear, triggering a Ménière’s disease attack. This is particularly likely if there has been a head or neck injury in the patient’s medical history.
3. Weather
Changes in weather and temperature have been reported to trigger Ménière’s disease attacks. This may be due to the weather affecting the liquid in the inner ear and the body not responding in time, due to the imbalance already being present.
4. Lack of sleep
If the body doesn’t get adequate rest, the immune system will be weakened and the body will not be able to heal itself efficiently.
How is Ménière’s Disease Diagnosed?
The current diagnosis for treatment of Ménière’s disease includes a medical history with 2 episodes of vertigo, hearing loss and a feeling of fullness in the inner ear. When signs and symptoms of vertigo appear the first action may be to take MRI or CT scans to exclude serious conditions, like a tumour in the inner ear.
Hearing Loss With Ménière’s Disease
Hearing loss is one of the most troubling symptoms of Meniere’s disease. Low-frequency hearing loss may result in greater difficulty to hear low-pitched sounds such as the bass in music. The fluctuating hearing loss often makes it difficult for patients to be diagnosed. Permanent hearing loss isn’t uncommon for those diagnosed with Meniere’s disease. Most people with Meniere’s disease will experience some degree of hearing loss particularly early on in the symptoms.
The medical examination for Meniere’s disease includes a hearing test and possible balance tests to identify balance problems and to stress the inner ear and cranial nerves, such as Videonystagmography.
An x-ray should be taken for ALL Meniere’s cases to assess the upper neck for its condition and for the presence of Atlanto Occipital Subluxation.
Patients diagnosed with Meniere’s disease often struggle most with unexpected episodes of vertigo and the possibility of permanent hearing loss. The loss of balance and hearing may result in lifestyle changes for people with Meniere’s. While the use of a hearing aid can counteract short-term hearing loss, the long-term effects of the disease may cause lifestyle changes. Patients of this disease may also experience nausea and vomiting, hence it is advisable to avoid operating heavy machinery. Seeking treatment for Meniere’s disease may help reduce fatigue and stress caused by the interruption of one’s daily life.
How Is Ménière’s Disease Treated?
Treatment for Meniere’s disease currently consists of medications, injections and possible surgery. The medications are anti-nausea and motion sickness prescriptions aimed to counter the disease’s symptoms and injections may be antibiotics or steroids. Surgery would be to force balance in the inner ear. For example, Inner ear injections of Gentamycin, an antibiotic, helps to deal with dizziness. However, the injection of this antibiotic may potentially risk further hearing loss. Similarly, inner ear injections of steroids can be used to deal with inflammation. Though it is less effective than Gentamacine, there is a lower risk of further hearing loss.
To this date, Medicine has not produced long-term cures for Meniere’s disease or treatments for hearing loss. Most of the treatments and therapies deal with short-term symptoms or in some cases do not work. If the pressure remains on the sympathetic and cranial nerves due to the Atlanto Occipital Subluxation, the symptoms will return. Other approaches include using a hearing aid and rehabilitation. Both of these help to manage the symptoms but cannot correct the problem or counter the hearing loss. Other non-medical alternatives can help to cure Meniere’s disease.
Endolymphatic Sac Decompression
Endolymphatic sac decompression is a treatment that is performed to reverse the damage of Meniere’s disease to the ear while maintaining a healthy balance to the patient’s hearing levels.
The decompression procedure can be carried out on an outpatient basis or in an ambulatory surgery centre under general anaesthesia. It has been proven effective for patients with Meniere’s disease experiencing vertigo.
There are, however, risks associated with Endolymphatic sac decompression. The procedure carries implications such as the aggravation in vertigo attacks, further hearing loss and in rare cases, tinnitus.
Are There Ménière’s Disease Exercises?
Meniere’s disease exercises can be performed to help support other care from your health care provider. These include movements of the neck in all directions which do not cause symptoms or dizziness. This would also involve performing actions while moving the neck; such as walking, sitting to standing or with the arms held in front of the body.
While these exercises can support care and help maintain results, they will not fix the underlying inner ear problem caused by the nerve compression in the neck (cervical spine). Consult with your Upper Cervical Chiropractor before starting any new Meniere’s disease exercises.
Vestibular Rehabilitation
Vestibular Rehabilitation Therapy is an alternative treatment for those diagnosed with vertigo, Meniere’s syndrome, Benign Paroxysmal Positional Vertigo (BPPV) dizziness, imbalance and migraines.
This form of therapy is often engaged to target secondary problems caused by vestibular nerve issues. This therapy uses exercise and movements to target symptoms of vertigo and dizziness such as imbalance and increased risk of falls. It is a way to retrain the balance system to order to reduce the severity and frequency of the problems experienced.
How Can Chiropractors Help Ménière’s Disease?
A study showed that the average time between injury and the start of symptoms of Ménière’s disease was 15 years. This indicates that even an old injury, which may not seem important, may have been the initial trigger for the condition.
Research from the Burcon institute shows dramatic improvements to Meniere’s disease. In a study of 300 patients, 97% were able to get their vertigo under control within 6 weeks. Over the full course of treatment, there was over a 90% improvement of their symptoms.
At Vitality Chiropractic we specialise in Upper Cervical care. We are the first to bring this technique to South East Asia and the only clinic in Singapore. We use unique computed infrared thermography nerves scans and bio-mechanical x-rays to accurately diagnose the problem and provide treatment for Ménière’s disease.
Our Doctor, Dr Shaan, has undergone post-graduate work, has years of experience and has a history of helping patients to treat Ménière’s disease symptoms. Click Here to Read Reviews or Hear Testimonials from our patients.
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