Holistic chiropractor on dizziness, vertigo, and all things related

What you're going to get from this is a better understanding of what's happening with you and why - a perspective. Isn't that what all of us are hungry for? Isn't that what our doctor's appointments lack? This interview is full of actionable tips based on hands-on experience and wide range of knowledge of an honest and humble health professional with over 200,000 sessions with his clients.

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Dr. Sandy Bhasin
Pavel Kotlykov
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Inner Ear and Neck-Spine Connection

Q: How would you say the inner ear environment is connected to the spine-neck problems, in what way, and how would you describe it in layman terms?

A: That's a beautiful question, and I think we haven't really answered that. Basically, what I would say is that we have to start with a major premise that brain and spinal cord controls and coordinates everything. What we have to remember is that when we look at crystals or the inner ear, what's controlling all that is the nerve system.

How do we interpret the world? Even if the information's coming to the ears or they eyes, how do we process that? Through the nervous system. If the nerve system is balanced and healthy and can process external stimuli, well - life is good.

Let's say someone doesn't have a balanced system. They can feel overwhelmed, underwhelmed, not getting information, there's too much they need to kind of protect themselves, but if the nervous system is working the way it should, it'll get that information, give a healthy message to the brain, and then the body can work better.

You can have the best crystal's position, the best inner ear environment, but if the nervous system's not working, information is still not getting to the brain in a way it should be.

We need to open up that communication - the relationship between brain and inner ear through the nervous system. You can have the best brain, you can have the best ear, but if the connection is not clear - the whole thing isn't working. We know this from our houses. When the internet's not working, everything shuts down. I can have the best computer, I can have the best modem, but if they're not talking, it's useless.

That's what our job is. It's reconnecting, re-communication. That's the job of a true, true neurological-based chiropractor, in my opinion.

Understanding Pressure in Your Head: explain to us what is happening.

Q: How would you address this very confusing concern - "I feel pressure in my head, in my ear, in my eye."

A: I would say, look at the neurological side. Get that assessed. Through word of mouth or through their own research - find a chiropractor who works specifically with the spine, not generally, but specifically. It's important to find a place where you feel comfortable, where there's a lot of use of technology, a lot of assessments. There should be some type of computer scan, surface EMG, and probably x-rays to do a thorough exam. Wherever you choose to go, when there's a pressure in the head, you have to look at neurology. That's the starting point.

Q: Understandable. What causes that pressure? Could you help us understand that in layman terms?

A: So again, I'm going to talk from a neurological point of view. There could be other causes but those neurological roots accompany probably a good 80% of cases. Now, there could be sinus issues, congestion issues, etc. Those are different. But I'm going to have my bias, because I see this over and over in my practice.

So, I would say there's three categories we know in the research.

  • Physical. If there's been any type of head trauma, car accidents, slips or falls, even a long time in front of a computer - all of it can contribute to the problem.
  • Diet, nutrition, chemical stress. Too much caffeine, processed food, sugars, alcohol - all can definitely effect the system.
  • I would say the biggest thing, what I've seen clinically, and what to share with your audience, is the emotional stress. That's the big one. The problem is that for most of us it's very difficult to realize that our job, our relationships, our financial concerns, can, and will, affect our health.
Some people have trouble seeing how their emotions, their inner world, can impact their body. But if that gets constantly stimulated under stress, you will see a lot of things happen. Especially if someone feels like it came out of nowhere, there's a good chance it's stress-related.

Marijuana and its effects to cope with pain and stress in case of vertigo, or other types of dizziness.

Q: What is your take on effects of marijuana? I mean, can we reach for it in order to cope with stress? Overall, does it make problem worse, or better?

A: My feeling is with the marijuana is that it may give someone the sense of temporary relief, but again, it's almost like taking over-the-counter medication or a painkiller. I think it's masking a root problem. If someone's in extreme stress and they can't even function, I understand, but I think in long-term there has to be a different solution. To keep saying, "I'm gonna use the marijuana for these conditions" - isn't going to help much. I think we have to go deeper. So, I would hope that someone would look at other options or be open to it. Not think that's the end all. Keep looking.

Q: I know first-hand how it masks the problem leaving you wandering in the foggy reality that sucks all wonder and motivation out of you.

A: It masks it. I find when I've looked at the research that it seems to sedate people. It doesn't seem like they thrive or be as active, so again I think we kind of substituting one issue for another. In my opinion, we're not getting to the root cause.

Ringing in ears and Pressure in Head. How to listen to your body. Journaling.

Q: "Sometimes I feel just pressure in my head. Sometimes it's accompanied by ringing in my ears. Sometimes I go without ringing for months, but with the pressure. Sometimes the opposite. I cannot determine what's connected to my activities and what is happening".

A: So, what I would say to that person - start thinking holistically. The same nerves that go into your eyes, ears, nose, throat. They're all interrelated. So, depending on where that suppression on your nerve is, you get ringing. Another time it reflects as a feeling of pressure. Sometimes it can be both but they're actually related. It's your body. Learn to listen. Your body is begging for help.

Q: Okay. Then, how to listen to our bodies? How do we find a way to interpret its "call"?

A: I'd say sleep position is critical. So, if you sleep the wrong way, lack of sleep, poor quality of sleep, that's huge. Take note of it. Maybe that one night you had red wine, you usually have white. You did something different in the diet. You had more sugar than you should've. You had some more ice cream or whatever. Maybe that weekend, or on a Wednesday, you got into a fight with your spouse, your kids stressed you out, something happened at work.

Sometimes it feels like it's out of control and we feel there's no triggers but if you can take a moment - we would find it. And I would keep a journal, "Okay, Tuesday was a fantastic day. Wednesday was a horrible day. I guess it's random."

I can tell you ninety percent of the time you'll probably come up with something. But do the work. Investigate.

Q: I can tell that journaling had been, and still remains, one of the best discoveries in my life. It's a self-made fuel for the real change.

A: Journaling. Then you want to do two things. You want to study the bad days but you want to study the good days also. Say, "Oh, I slept before twelve! I have no caffeine and drank a lot of water and did my deep breathing routine". So we should study the good days as much as the bad days. The point is too look for the patterns.

Connection of Dizziness (vertigo, pressure, headaches) and TMJ.

Q: To the next question. Very high percentage of people come to this website looking for explanation of TMJ problem and many of them have been unsuccessfully treated by their dentists. They still experience the same symptoms. So, they search and find that the answer may be hidden in the connection between TMJ/TMD and neck, as well as spine. Could you elaborate on this?

A: So the TMJ and upper-cervical spine - C1, C2, and you skull - is a triad which is continuously talking to each other. TMJ is a very powerful point. It's where everything gets connected and if that's off, we get headaches, dizziness, pressure in the head.

Even with chiropractic care you can have a situation where the spine might be completely balanced but TMJ isn't in its proper condition. Or, it can be vice-versa, when TMJ is not where it should be but the spine is not balanced. Optimally you should have both balanced. I can't emphasize this enough. In my years of practice I realize more and more that if you can work on TMJ, you see see a lot of breakthroughs.

But again, some dentists have more advanced training with neurological aspect. The ideal scenario is dentist working with chiro. We've seen that happen as well.


Daily Activities which can make our problem worse, or better.

Q: Which of our daily activities can make things worse? What we might be doing routinely that promotes the problem?

A: So, using same three categories. Physically, if someone has a job which is very difficult on the cervical, neck, or shoulders, they want to be careful. If someone is doing heavy weight lifting, they should be careful with that.

Chemically, it's their diet. Again, if I had to say, caffeine might be very bad for certain individuals. You want to try to reduce it to see what difference that will make. Obviously, drink more water. Alcohol, of course, is very negative. Sugars as well. But I'd have to say, if you ask me - what is the one action step they can make today - if they could please cut down on caffeine, they should notice changes. I believe so.

And then the emotional component. That's more difficult to work on. The one easy thing I can recommend for stress is to start practicing some deep breathing techniques. Also, journaling. Getting that stress out on paper is very helpful. Maybe listening to your favorite music to unwind. Going for a walk. Talking to some friends - to someone they trust.

Meditation, prayer, depending on what they feel comfortable with. That would be a biggie.

--- Just to add to this, there's an abbreviation to remember those stress-inducing substances. SADC - sugar, alcohol, dairy, caffeine. It was very easy and helpful for me to memorize.

Our common tendency to postpone the problem until it's not interfering with our daily lives.

Q: Okay, in my own case I haven't noticed a problem for a long time. It just gradually had become more intense to the point where I couldn't function properly in the world. So I began looking for the reason. Why don't we recognize this early and how important is it that we become aware of this kind of issue?

A: I think it's very critical. I think we're all busy, especially in North America - it's very "go, go, go". For most people it has to get to the point where it interferes with their life. Then, we want to take action. It has to get bad enough for us to move in the direction of dealing with the problem. For some reason, if we're managing, unless it's really bad, we won't take action.

So, another take-home message is: take care of the body before something extreme develops. Simply put, your chance of success is lower when you wait too long. When some issue shows up, surfaces so to speak, that's when you should go all-in. That's when you go aggressive and you can get really amazing results.

What can I do myself? Before (or even instead) coming to the doctor.

Q: Now, here's a beautiful question from one of our readers: "I think I begin to understand that this "dizziness" problem is a really complex one and everything is connected. I'd like to learn about the bigger picture so I can do something myself, even before I try to seek professional help".

A: I would still say, do your research and just find the practitioner. But, before you do that, you might think: "I got to get better". I think the first thing I would address is - look at your sleep. Have a consistent sleep schedule. Definitely sleep before midnight, unless you have a night shift job. Revisit your caffeine intake. Also, before visiting a good practitioner, start studying deep breathing techniques. I think those are incredibly powerful tools available to all of us. Again, journaling.

But if I had to choose the one thing they can do before seeing the chiro: deep breathing exercises. I think that will be life changing. This is the one thing I would choose.

Q: What about diet and nutrition?

A: Absolutely. See, my philosophy is to approach the problem from as many angles as possible. So, we're going to do the deep breathing. Check your neurology. Your nutrition is huge and the longer I practice, I see it getting reflected in the body. So, drop the alcohol. Definitely do it if you want to live a better life. Drop the sugars. Drop fast food. That would be huge by itself. I think that having some daily activity, as long as you don't feel dizzy and they're safe, even if you can start with just going for a walk, is tremendously helpful.

Basically, if you get enough good inputs to the body, in my opinion, no matter how complex your issue is, it's going to overturn it. Maybe you won't get it to one hundred percent because you had it for years, but if you begin to do several good things at once, the body will have no choice but to start to heal itself.

Q: What would be the best home-based exercises or stretches that one can do?

A: See, it depends. I think if people can start to focus with the neck, very, very gently, whatever they can handle, is a great start. Just doing left and right range of motions, very gently, within their own tolerance. Of course, if they have any type of dizziness, stiffness, sharp pain, they should stop right away. But if they don't, we always like to tell our patients, to practice stretches at least three times a day.

One thing that concerns me with the future, there's a ton of people spending a lot of time in front of the computer. They used to say sixty minutes is a maximum sitting time, then they said forty-five. I've been reading research recently saying every thirty minutes you should be getting up. So that's a very simple thing. Plus, I forgot to mention that before, you should be hydrating. Water is huge for the spine. The spinal cord is actually floating in cerebral spinal fluid, so hydration is king. Take the breaks, have the water.

So, get up, stretch, drink, sit back.

Finally, I'd recommend to your audience, if they can handle it and as long as it doesn't bother the head, would be a wobble cushion. So, the real secret is movement. If you're in motion, if you're moving, if you get up and down, if you're rotating, the body will thrive. A lot of these sicknesses and all these things that are developing is because people are not moving enough. I would stay away from things where you're jumping up and down. Honestly, anything with thrusting the head back and forth is a no-no. Look for flowing motions. I would also say to your audience, be careful being underwater. That may aggravate things.

Q: Amazing! While you're in the flow, any more tips?

A: Hmm, sure. This one is huge actually. For anyone feeling dizzy, pressure in the head, anything like that, please look at how you sleep, I mean your sleep position. Anyone who has an issue with vertigo or dizziness, seems to notice it being aggravated in the morning, so lie in the bed like you're going to read a book, with a few pillows behind your back. Your wouldn't want to be all the way flat, maybe at 45 degrees, 70 degrees. That would be the safest thing to do.

Another thing I would say as well, of someone is going through some kind of condition, they may have to talk to their HR manager. They shouldn't be working more than 40 hours a week in my opinion. Maybe work from home some days. If you're getting head issues, and putting 60,70,90 hours a week, it's going to very tough from the body to recover.

How important is the Pillow for our problem?

Q: One question just came up to my head. What about the right kind of pillow? Should we choose something specific?

A: Yes, so I'm very biased again. I'm just going to share my own experience. Buy buckwheat pillow. They are the best. Why? They are different from every other pillow on the market because it is firm. It will shape itself to your head, and it supports you. On most pillows your head will sink. Buckwheat ones are tough. I've tried a lot of various pillows. I've been using buckwheat for about 10 years and I won't use anything else.

My whole family uses them. They support you. I actually wake up in the morning feeling fresh. The only time I have issues now is when I travel and stay in a hotel.

Professional help

When you would need Immediate Help.

Q: In which case should we seek help immediately? I mean, which signs indicate we must seek emergency kind of help?

A: I would say, if a person's getting to the point where there's an extreme pain, ten-out-of-ten, nothing's helping, blood pressure's going up for sure. I would say anything crossing 140, you should investigate it.. Also, if they feel like they're gonna collapse, extreme vomiting that doesn't stop, extreme fevers - those would all be an emergency type of situations. Oh, also if vision gets effected. That would be a big one as well.

Misdiagnosis. Difficulty of finding the root of the problem.

Q: Why people so often are misdiagnosed when pressure in the head, or dizziness, or vertigo, is the case? Why is it so difficult to find the correct cause of these problems when talking to a doctor?

A: Well, I want to start with this: I feel that general practitioners are great people. I think they are doing their best. I just think that that's a category they are not as familiar with how to handle, or diagnose. I think they have other strong points, but I think neurologically it's more difficult for the doctor to define the problem because you can't touch or see it.

You know, looking for a solution go to someone where they can say, "I've seen this. I understand it". But what I find in medical community, I guess with the training they have, they don't go deep enough. I think doctors are good, I just don't know on what level is their training level.

Q: Yeah, it seems like "not-knowing" - or better, "not-understanding" - the cause is the major point of frustration for people looking for answers.

A: Not only is it a point of frustration for patients but for medical doctors as well. They must also feel frustrated because they're not sure sometimes how to diagnose. They want to provide a treatment but don't know what to do. I just don't think that the training is there to approach it. It can be tricky, if you don't look at the neurology in my opinion.

How do we find a good chiropractor? Or, any health specialist for that matter?

Q: To the next question. How to find the right practitioner? How to separate "good" chiropractor from the crowd?

A: First, you can simply Google it. Look at the reviews as a step one. Step two would be testing. Call them up. Go meet them in person. So the idea is to collect all the data you can. Make a list of choices. But then, you have to go with you gut or your heart. It just has to feel like the right person and the right place. Is their philosophy similar to yours? Is there a nagging feeling that something is not ok? Try to find the alignment of values.

You start with data collection, but your ultimate last decision should be based on your gut feeling.

Q: So, if I have chosen somebody, should I doubt every decision, or advice, that practitioner gives?

A: No, and so, let's go into that. If the patient is hesitant, if there's something in you saying "I can't go forward", I wouldn't even start. It doesn't make sense. It can't be a type of war. You have to be on the same page.

Another thing. Let's say you went to a chiro and it didn't work out. Ok, that's fine. But don't write off the whole profession, please. Even within the profession, you have to look at the technique, the philosophy, and honestly, part of it is also a personality.

I've seen this in medicine for example. Doctors have an amazing reputation clinically, but they've been very criticized for their bedside manner. I know that I want someone who's great but also someone with whom I can easily engage. They might the best in the world but, if they're very abrupt with me, or who's not patient with me, or not answering my questions (because answering questions is part of the healing), it's not gonna work. I'll go somewhere else. It's got to feel like the right decision. If in healing, you're forcing or pushing, in my opinion, it doesn't work.

Maintenance during and after treatment.

Q: I appreciate it very much. It makes total sense. How can we ensure, after we went through the treatment, or currently going through it, that we will not relapse afterwards, wrongfully feeling that we are finally better, as we all tend to do?

A: The following has to be a shift in health care. We have to overcome the paradigm of crisis management. In my opinion, good practitioner will help you, will teach you skills to take of yourself but also - should offer some kind of maintenance. It's more than just: "Look, we're here for you. We're going to teach you some skills". It's more about, "Here's a way to maintain what you have gained".

For example, in our office, during the treatment we might see someone frequently and then - they might be here once or twice a month. It's an option. They can decide. As a bare bone minimum, if practitioners don't offer that, they have a duty and responsibility to teach their patients the ways to take of themselves. That has to be there.

So, the should be some shift in lifestyle after treatment. If someone gets well and keeps current lifestyle that got them in this situation in the first place, it's guaranteed to come back. And then there can be a lot of blaming: "Well, I went to this guy. You know, it worked for a bit. But then it all got back". Yeah, but did you change your lifestyle? If practitioner shows a change of lifestyle then that could have been done better.

If you don't change you lifestyle, if you don't change your thinking, the diet, the feeling, all those things, of course it's going to come back. It's just logical, isn't it?

Q: Sure. I think it would yield phenomenal results if more and more practitioners will design their treatment that way.

Vector-based Adjustment. What is that?

Q: To wrap this interview up, let me ask something that is of interest for me personally and maybe our audience will like it too. I know that in your practice you combine different approaches to adjustment including so-called vector-based adjusting. Can you talk about that?

A: I love that entire profession. What I love is the way we're looking at the body. I believe in being specific and being detail oriented. That's how you get results, especially with your audience. They're dealing with the head: dizziness, balance issues, headaches. It's the most delicate part of the human body. It's the most delicate part of the spine, so looking for a practitioner, regardless of what they do, you want someone who's specific.

I can tell you as a chiropractor, there's a huge difference between adjusting the skull, C1, or C2. Now, if you do the measurements, they're literally within a few millimeters of each other, but if you're on the right spot, you'll make amazing changes. If someone's just guessing, it may not make a change. Worse case scenario, it can cause aggravation. It's all about being specific.

With vector-based adjusting, we're asking the question that not only do we want to move a bone, we want to set it in the right place. Manipulation means movement, and adjustment means to set into the right place. Those are two different things, so chiropractic, when it first started, what they said is that we need to know where the bone should go. I don't know what happened over time but many people confuse those two terms. I guess with some professions they just lose some of that, and I've heard of certain doctors where it's very general, it's not very specific, and I think the results will not be as consistent, but if you look at the doctors who are getting people well on consistent basis, amazing patient satisfaction, it's because they have a system.

Anything in life if you look at it, even if you look at Mother Nature, there are systems, you can repeat them, but if there's no system, it's kind of like, "Well, it happened this time. It didn't happen this time," and if you go to a doctor who's specific and they keep practicing that technique over time, they will know and they will filter patients who will qualify, who's going to get the best results, by how much, but you want to go to a doctor who's not general but specific.



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