Ménière's Disease

Ménière’s disease, an inner ear disorder, can be managed by conservative care and chiropractic treatments.

What is Ménière’s Disease?

Patients with Ménière’s disease have a disorder of their inner ear. An episode, which could last “20 minutes to four hours”, may consist of a feeling of fullness in the ear, followed by tinnitus (ear ringing), then severe vertigo (spinning sensation), and perhaps nausea or vomiting. Episodes may appear in clusters, and there may or may not be remission in between. Any of the symptoms can range from mild to severe, and the duration and frequency also vary. The people most likely to be affected are those in middle age, but this can affect anyone, and it is a chronic condition. It is important to seek professional help when the symptoms of Ménière’s disease occur, to rule out other conditions. Vertigo may also be a sign of multiple sclerosis, cardiovascular disease, brain tumor, and stroke, for example. If vertigo is accompanied by chest pain, numbness, tingling, falling, leg or arm weakness, loss of consciousness, double vision, unusual or severe headache, or speech impairment, it is necessary to seek immediate help.¹

Causes

Ménière’s disease might be caused by “the abnormal volume or composition of fluid in the inner ear”, which consists of connected cavities and passages (a labyrinth). Hair-like sensors in the ear react to fluid movement. The fluid must remain at “a certain volume, pressure and chemical composition” for the inner ear sensors to work properly. If there is an abnormality in anatomy or a blockage that doesn’t allow for proper fluid drainage, if the immune system isn’t working correctly, if there is a viral infection, allergies, migraines, or head trauma, or if there is a genetic predisposition, Ménière’s disease may be triggered. Episodes of vertigo are problematic, and they can cause time off from work, emotional stress, car accidents, depression, falls, and even permanent hearing loss.² Ménière’s disease may also be worsened by obstructive sleep apnea, and it can be influenced by migraines, smoking, and atherosclerosis, which are conditions that reduce vascular functioning in the brain.³

Traditional Treatment Options

Doctors might prescribe medications to relieve the dizziness and nausea of Ménière’s disease. They may also recommend limiting salt in the diet and taking water pills (diuretics) to reduce the amount of fluid in the body and relieve inner ear pressure. There are some claims that symptoms are worsened by chocolate, caffeine, and smoking. There are also injected medications that may be prescribed, such as gentamicin, but that antibiotic could cause hearing loss. Instead, doctors may inject a corticosteroid to lessen the dizziness. The most invasive medical option is surgery. More conservative treatments, besides dietary changes, also include cognitive therapy to reduce anxiety, and pressure pulse treatment, which uses a device that “delivers intermittent air pressure pulses to the middle ear” to reduce dizziness by acting on the endolymph fluid.⁴ Patients should avoid driving, ladders, and swimming if their symptoms are not under control.⁵ Some patients may need a hearing aid.⁶ Chiropractic treatment is another options for patients with Ménière’s disease. In a case study, a 40 year old woman with Ménière’s disease received spinal manipulation, soft tissue trigger point therapy, and had stretching exercises prescribed. The tinnitus was resolved in 2 weeks, and the other symptoms, including the vertigo, headaches, and neck pain, subsided within 3 months. A chiropractor is an option for patients seeking conservative care.⁷ Rehabilitation exercises at home, such as vestibular rehabilitation therapy, can help patients with balance.⁸