ME/CFS After Whiplash: A Neck Artery Pinched by Movement
Laura worked in healthcare at a high level and was very active, until a whiplash injury. Now she faints, gets excruciating headaches, and lives with chronic pain. She had to stop working, and she spends most days in bed. She arrives in sunglasses with her hood up, just trying to get through the visit.
What Laura was told: ME/CFS
Laura works in healthcare, so she has access to literally anyone, and she's used it. She walks away with an ME/CFS diagnosis, and she's still stuck in bed.
What we found
When her neck moves, a carotid artery gets squeezed from the outside, and the blood flow to her brain drops. That's what makes her faint.
Moving her neck pinches an artery
Her whiplash left the 7 bones of her neck moving together as one stiff block. When she tips her head back, or turns or tilts it left, that faulty movement presses on a carotid artery from the outside, near the hard structures at the base of the skull. Her lower blood pressure makes the artery easier to squash, the way a garden soaker hose flattens more easily than a fire hose. Each of those movements drops the blood flow to her brain, and that's when she faints. Many people hear "compression in the neck" and jump to a label: craniocervical instability, which often comes with talk of permanent, life-altering surgery. The interesting part is that Laura's compression only happens with certain head positions. A still image like a standard MRI, taken with the head in one position, can miss that. We found it by watching the blood flow to her brain with the ultrasound while her head moved, in real time.
How we got Laura better (A couple of weeks)
Laura's plan taught her neck to move without pinching off her blood supply. It sounds almost too simple. In the most complicated cases, the smallest inputs often make the biggest difference.
- Light hands-on input (Very light, with breaks). First, very light hands-on input to the joints of her neck, so the 7 bones start moving one at a time again. For the first 3 days, she'd start to shake, and we'd give her a break. Each day she could go a little longer.
- Coaching each movement (Turning, tipping, and tilting). Next, we coach her neck through each movement, so she can turn her head, tip it back, and move it all around without losing blood supply to her brain. Soon, turning her head still dropped her blood flow, but not as far.
- Neck bracing (While her back gets stronger). A brace holds her head in position while the muscles of her mid and low back get stronger, so they can support her neck and give her head the freedom to move.
Laura, a few days in
- Smaller drops with every head movement
- Riding to the clinic without throwing up, a few days in
- Running at the clinic within a couple of weeks
A few days in, she rode to the clinic without throwing up. The sunglasses came off, and she started talking with people. Within a couple of weeks, she was running at the clinic.
Watch the case video
