What could be the potential culprit in a case like this?
Osteoarthritis is a common companion as one begins to age, affecting more Canadians than every other form of arthritis combined. Arthritis is an umbrella term for inflammation of the joints with many other sub-classes of arthritis falling under that term. According to the 2009 Survey on Living with Chronic Diseases in Canada, it was determined that about 10% of Canadians over the age of 15 battle some form of osteoarthritis. Out of those diagnosed with general arthritis, 37% reported experiencing osteoarthritis specifically, with rates rising in direct relation to age amongst other risk factors.
What are the other symptoms besides joint inflammation?
Osteoarthritis is specifically a degenerative form of arthritis, the mechanism of which is explained further on. Between the bones, at the areas known as joints, like a cushion of tissue - known as cartilage - allows the bones to glide past one another without friction. As the cartilage wears down, the bones begin to grind leading to sensations of pain, stiffness, swelling and typically a reduction in function.
How do bones degenerate?
Imagine building a home, a task that required you to stack bricks to form the walls. As you labour intensively, your building partner decides that for every brick you put up, they're going to take two away. You try your very best to keep up with him, but the wall you so carefully built begins to come undone. In your haste, you start placing bricks in random places to hopefully stave off the damage to your wall. This can create gaps, areas of weakness, or maybe areas where there are simply too many bricks and they start placing pressure on parts of the home nearby.
The 'brick-layers' of our story are known as osteoblasts, responsible for generating bone while the unhelpful friend represents the osteoclasts, responsible for breaking down bone. Both agents play a critical role in bone formation and typically play quite a balanced dance. This dance becomes more one-sided in certain situations such as when the body detects low levels of calcium, whereupon it may ramp up osteoclast activity in order to release this mineral into the body.
How does this relate to the sensation of dizziness?
When the bones of the neck begin to degenerate, the body tries to manage what has been lost. Like our hard-working, and well-meaning brick builders, this can eventually cause bone to form in places it shouldn't. The additional bone can place pressure on nerve roots and blood vessels that pass between the vertebrae of the spine. Additionally, the degeneration can cause the spaces between the vertebrae to become smaller, also placing pressure on these structures. The weakness in the bones and joint spaces can also make the individual more prone to injury, including strains and sprains.
The vertigo is thought to be caused by neurological and vascular concerns. When certain nerve roots are compressed, this affects the signals going toward the brain, including those for your sense of vestibular tone leading to dizziness and vertigo. The vascular portion of this symptom is due to compression of the vertebral artery, one of the main highways of blood to the brain. As this artery is compressed, blood flow to the vestibulocochlear organ, the one responsible for balance, is reduced.
What are risk factors of osteoarthritis?
- Age. As discussed, aging plays a large role due to the inevitable decline in muscle strength and the rate of turnover of bone.
- Sex. Women are more prone to develop certain types of osteoarthritis such as in the hip and knee, but men tend to be more prone to developing the condition in the cervical region.
- Obesity. The added weight places increased stress on the joint spaces, leading to accelerated degeneration. This also seems to hold true for osteoarthritis of the neck, although the association is not as strong as that with the hip or knees. Obese individuals were also more likely to report more severe pain and disability.
I understand there isn't a magic wand to regenerate the bone I have already lost, but is there anything I can use to reduce the pain?
An herbal helper to consider is known as Arnica montana, a plant that hails from Europe, Siberia, and the northwestern United States. A study on osteoarthritis of the hands was conducted in 2006 and compared the use of ibuprofen gel 5% against Absolüt Arnica, a product created from the plant. The two were comparable for the reduction of pain and stiffness, improvement in function, and few adverse reactions. Another study conducted in 2002 demonstrated an improvement in the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) scores of the participants.
What else will help with the sensation of dizziness?
It may be worth opening a discussion with your primary care provider about having radiographs taken of the neck to determine the severity of the degeneration. It is also important to rule out other causes of the sensation, such as a condition known as benign paroxysmal positional vertigo (BPPV) which can be assessed using the Dix-Hallpike maneuver and corrected by a professional familiar with the Epley maneuver.
Don't wait to have your dizziness assessed. Seek out a professional if you begin to experience sensations of vertigo.
References:
https://www150.statcan.gc.ca
https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/osteoarthritis
https://www.ema.europa.eu/en/documents/herbal-report/
https://www.gmjournal.co.uk/cervical-spondylosis-a-cause-of-dizziness
https://www.ijorl.com/index.php/ijorl/article/view/1266
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5334737/
https://www.ncbi.nlm.nih.gov/pubmed/15978850
https://www.ncbi.nlm.nih.gov/pubmed/16564396
