What is Meniere's Disease?

There is no accepted standard as to what is the cause of Meniere’s disease. Currently one theory is an abnormal amount of fluid in the inner ear. Usually when the diagnosis is given to a patient, it is termed as “Idiopathic”.    (Ideopathic = Unknown Cause) (1)
When a patients is given the diagnosis of Meneire's, the most common combination of symptoms are: (2) 

-Recurring Vertigo.
Typically these come on with no warning, and are not solely based on change of position (i.e. only occur when you sit up and get out of be first thing in the morning). These spells can last 20 minutes to hours. In sever cases, nausea and vomiting can also happen.
-Hearing Loss.
-Tinnitus (ringing in the ear).
-Feeling fullness in the ear.  (Most of the time, Meniere’s only affects on side (one ear)) 

Because there are multiple factors and health problems affecting the patient, the diagnosis can take time to be made. The patient usually has gone to their primary care physician, an EENT specialist, Neurologist, and other specialty clinics before given the answer of "Meniere's". 

How the diagnosis is made. (From Entnet.org)
"For Hearing
•An audiometric examination (hearing test) typically indicates a sensory type of hearing loss in the affected ear. Speech discrimination (the patient’s ability to distinguish between words like “sit” and “fit”) is often diminished in the affected ear.

For balance
•An ENG (electronystagmogram) may be performed to evaluate balance function. In a darkened room, eye movements are recorded as warm and cool water or air are gently introduced into each ear canal. Since the eyes and ears work in coordination through the nervous system, measurement of eye movements can be used to test the balance system. In about 50 percent of patients, the balance function is reduced in the affected ear.
Rotational or balance platform testing, may also be performed to evaluate the balance system.

Other tests
•Electrocochleography (ECoG) may indicate increased inner ear fluid pressure in some cases of Ménière’s disease.
The auditory brain stem response (ABR), a computerized test of the hearing nerves and brain pathways, computed tomography (CT), or magnetic resonance imaging (MRI) may be needed to rule out a tumor occurring on the hearing and balance nerve. Such tumors are rare, but they can cause symptoms similar to Ménière’s disease."

Other factors that may contribute to the frequency and severity of Meniere’s include:
Head Trauma
Whiplash (3)
Migraines
Immune System Compromise
Viral Infections
Improper Fulid draining of the inner ear 

Standard Treatment (4)

When you first go to your primary physician, treatments begin with symptom relief for some or all of the secondary conditions. Normally these are one or a combination of antiemetics, antihistamines or benzodiazepines. (5)
You will also likely be recommended to decrease your salt intake, avoid alcohol and caffeine, and be put on a diuretic.

While these may help decrease some of the symptoms, they work to keep the secondary conditions “under control”, but do not address any underlying causes of what you are feeling.

Patients usually get an MRI to rule out other disease processes at some point in their journey.
After some time when the symptoms persist, the next step may be some type of ablation or surgery. This is typically done in the most severe cases, but moderate to severe hearing loss is expected within 10-15 years.

Long term, symptoms will typically continue to increase in how often it happens (frequency) and how severe the episodes are. People’s lives are usually affected greatly limiting their ability to function (work and home), resulting in fatigue, depression and emotional stress.
 

Our Approach

We always begin with getting to know the person and their health journey. We want to make sure we truly understand the person and what is going on for them.
Typically, when a person first comes in for their consultation, we ask that they bring in any and all previous imaging (X-ray, MRI, CT scans) that they have had done so we can sit down and go through them together.

Precision Chiropractic Vermont Doctor Explains Study Cause of Neck Pain Headaches Upper Cervical.JPG
This allows the patient to understand what is going on with them, and helps us rule out other causes.
By the time we are done, we want to be able to have a high degree of certainty that the Atlas Displacement Complex (ADC) is likely a contributing factor to their Meneire’s Disease and other secondary conditions.
If we determine that we are able to accept the person’s case, we do a complete structural chiropractic exam, including specific structural radiographs (X-rays taken with precision and accuracy to evaluate biomechanics, misalignments of the spine, and anatomy specific to the individual). 

Nucca Precision Chiropractic Vermont Upper Cervical Meneire's Migraine Headaches.JPG

When the ADC is present it needs to be addressed and corrected by a chiropractor specifically trained in Upper Cervical Chiropractic. (We utilize the NUCCA and Orthospinology protocol here at Precision Chiropractic to realign the misaligned spine) (7,8)
When the optimal alignment of the spine is corrected (properly), the structural stress on the physical components of the upper neck, inner ear, and supporting structures (muscles, ligaments and tendons) become balanced.
The blood flow in and out of the brain begins to normalize, and the neurological stress begins to reduce.
Fullness in the ear typically begins to decrease within a few weeks; the ringing in the ear decreases in frequency and intensity over time; and migraines decrease in intensity and frequency. 

Chiropractic Vermont Migraine Headache Meniere's Neck Pain Upper Cervical Chiropractic.png

While our patients typically experience significant relief from their secondary conditions within a few weeks, some may take longer to before the misaligned spine begins to stabilize.
(This is dependent on many variables including: The type of misalignment, the stability of the spine, how much underlying damage (degeneration) is present in the spine, how much wearing on the nerves are present, and how long the condition has been present.)
Our long term goal and expectation for cases we accept is that the person’s symptoms resolve and they are able to return to living their life with as little residual secondary conditions present as possible.

There are only a handful of Upper Cervical Chiropractors in New England. They are listed below, and I encourage you the reach out to any of us for a consultation before giving up hope.

Upper Cervical Chiropractors in New England:

Precision Chiropractic Vermont
Williston, Vermont
www.PrecisionChiroVT.com

Arete Chiropractic

Portsmouth, New Hampshire
www.Aretechiro.com

Precision Chiropractic CT
Branford, Connecticut 
www.PrecisionChiroCT.com

Coastal Chiropractic Group
Bristol, Rhode Island
www.coastalchiropracticgroup.com

References
1. https://medlineplus.gov/menieresdisease.html
2. https://www.mayoclinic.org/diseases-conditions/menieres-disease/symptoms-causes/syc-20374910
3. Burcon MT. Upper Cervical Specific Protocol and Results for 139 Patients with Medically Diagnosed Meniere's Disease. J Vertebral Subluxation Res, November 14, 2010:1-10
https://www.researchgate.net/profile/Charmaine_Herman/post/Can_a_specific_adjustment_to_the_upper_cervical_neck_especially_Atlas_C1_restore_health_to_the_entire_body_and_relieve_back_pain/attachment/59d63e99c49f478072ea9262/AS%3A273770793635841%401442283452026/download/menieres.pdf
4. https://spinalresearch.com.au/research-report-examines-menieres-disease-upper-cervical-subluxation/
5. http://www.menieres-help.com/treatments.php
6. https://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/inner-ear-disorders/meniere-disease
7. Jones MA, Salminen BJ. Meniere’s Disease Symptomatology Resolution with Specific Upper Cervical Care. J
Upper Cervical Chiropr Res, March 29, 2012:31-9.
http://www.mccoypress.net/juccr/docs/2012-1196_menieres.pdf
 
8. Jonathan Chung D.C. & Cory O’Connell, B.S., D.C.  J. Upper Cervical Chiropractic Research – January 9, 2017
Resolution of Symptoms in a Patient Suffering from Meniere’s Disease Following Specific Upper Cervical Chiropractic Care: A Case Study & Review of Literature
http://www.mccoypress.net/juccr/docs/2017-1448_chung_menieres.pdf