Palpation of C1 and nausea

[kongen]

I evaluated a patient today, with complaint of both neck, thoracic and lumbar pain. Most active movements of the trunk were painful, nerv tension tests (SLR, Slump) positive etc. No red flags.
But, at the end of the exam, with the patient seated, I palpated (with light pressure) the lateral transverse processes of C1, the left one being quite tender. The patient got visibly distressed, a little red faced and reported feeling nauseous. It subsided within 30 seconds.

Anyone experienced something similiar? Any ideas why the patient would react that way? I'm thinking defence..

[Erica]

Anders,
I have seen that happen with thoracic spine work, occasionally. A few years back, I had a patient who almost vomitted on the table after she got up. Maybe your patient had a latent response to upright sitting?
Erica

[nari]

Way back in the early 90s several patients of mine experienced nausea and became rather pink; the area around COC1 and/or mid-thoracic in each case. Chiros here call T6 the 'spew' button.
Not sure why some people are sensitive to nausea, as some actually felt a sense of wellbeing and relief with specific work to this area.

Nari

[kongen]

Thanks for your insights. Just prior to palpating C1 in sitting, I had her prone, and prodded around the th4-th8 area (also very tender) and the upper cervicals. Maybe latent? I'll start some gentle treatment next week. Will keep a bucket available.. (kidding:))

[emad]

Hi all :
I experienced the same complaints from some of my patients espicially after the fist evaluation ,however most of them gone under aggressive massage and physiotherapy before I see them and when approaching using Gentle Touch and examination they complain Nausea , I put a thread here 2 weeks ago at that time , I thought of the Vagus nerve , may be I sensitised it through the touch in the face .and also I reached to this link regarding Sickness Motion (http://en.wikipedia.org/wiki/Motion_sickness)
My Last Hypothesis is That is North complaint ..hahaaha

cheers
Emad

[oljoha]

Seen quite severe dizzyness with the only physical finding of unilateral "dysfunctional" inferior oblique. The dizzyness resolved after "stretching" that muscle (ART style). Those muscles in the upper Cx are filled with proprioceptors. Had one patient become lightheaded after working on the superior oblique (which is in the area of the vertebral artery). Rectus capitus (I think minor) has a slip (a ligamentous connection) to the dura.

Just my $0.02.