Our patient is a 30 year-old male with head trauma, suffering from persistent vertigo and neck pain. Prior attempts to resolve his condition had been unsuccessful, primarily due to misdiagnosis and ineffective treatments. Apparently the musculoskeletal component of vertigo had been overlooked.
Immediately recognizing the potential link between the patient’s neck pain and vertigo, we used high-resolution ultrasound imaging to explore the neck region. Imaging revealed trigger points in the suboccipital muscles and the broader neck region.
We needed to devise a strategy to effectively target the trigger points while minimizing any risks related to the patient’s skull trauma.
We employed ultrasound-guided dry needling to eliminate the trigger points in the patient’s neck muscles. During the procedure, one needle unintentionally touched the dura mater – the tough membrane layer beneath the skull and vertebral column – causing a referred pain reaction. This event speaks to the importance of precision in dry needling procedures.
Ultrasound-guided dry needling of trigger points in the patient’s neck muscles immediately relieved his vertigo symptoms and eliminated his neck pain.
While ultrasound-guided dry needling is primarily used for musculoskeletal pain, it can also impact vertigo symptoms by addressing trigger points in the neck region. Our treatment approach emphasizes the importance of careful planning and consideration in cases involving head trauma. It also highlights the significance of personalized treatment, viewing each patient as a unique case. Skill and accuracy during needling procedures is essential for successful treatment of trigger points, and risks must be carefully weighed.
Dr. Lev Kalika is a world-recognized expert in musculoskeletal ultrasonography, with 20+ years of clinical experience in advanced rehabilitative medicine. In addition to operating his clinical practice in Manhattan, he regularly publishes peer-reviewed research on ultrasound-guided therapies and procedures.
Dr. Kalika is an esteemed member of the International Society for Medical Shockwave Treatment ((SMST), and the only clinician in New York certified by the ISMST to perform extracorporeal shockwave therapy. He is also an active member of the American Institute of Ultrasound in Medicine (AIUM), and has developed his own unique approach to dynamic functional and fascial ultrasonography.