I'm looking into a possible correlation of some types of chronic pain (those related to ptsd and mood disorders) correlating with balance issues, one-sided pain, or inner ear damage. Thanks for any help!
Whoops sorry about above answer"interuptus".
What an interesting question.
Anecdotally C. P. patients seem unusually prone to aggravating their pain syndromes by falls etc. This seems to occur with or without psycho-active/sedative drugs on board. Whether this is just the intense distraction of chronic pain, altered sensory (proprioceptive) input/truncal instability or has a component of vestibular input would seem worthy of elucidation. I am not aware of PTSD connection to vestibular dysfunction but childhood abuse seems overly represented in C. P. patients and apparently can trigger a lifelong chr. inflammatory state.
Sorry not much help above as to actual published information.
Fascinating question. Given that a sizeable proportion of complex PTSD patients would have suffered head and or ear injuries duing a traumatic childhood, it would be difficult to remove that confounder from a study. These patients also dissociate regularly so the subjective experience of balance issues might be difficult to define.
Maybe you could try to tease out the impact of the psychosocial meaning of the pain by comparing childhoos trauma survivors with PTSD and blunt force trauma to the head resulting in vertigo/balance issues, compared to adults with similar injuries acquired without the associated betrayal. Would the betrayal by a caretaker result in disequilibrium plus chronic pain more often than in people injured as an adult? You might also add a third group of people with similar injuries without PTSD, ie recurrent head injuries in athletes, again looking for chronic pain + disequilibrium compared with disequilibrium alone.
Thank you all for your input! It will definitely help me with the parameters of the study! Susan Tyler-Freer Simon Bruce Perrin Tony Hall
Again not a specific answer to this interesting question, but perhaps there is something to be learnt from the migraine process. Increasingly migraine is being seen from the perspective of brain hyperexcitability (with a specific interest in cortical hyperexcitability).
Mood disorders are comorbid with migraines, as by extension PTSD is likely to be. Vestibular disorders are common, and can be serious enough to be described as 'vestibular migraines'. This is without vestibular damage.
I wonder whether you should widen your fields of exploration beyond vestibular damage to vestibular dysfunction
On a separate front, it is now well recognised that chronic systemic inflammatory conditions where the inflammatory markers are raised (CRP + ESR), are associated with CP. This may well be related to the increased level of sympathetic activation, and in migraines at least, in brain hyperexcitability.
One last thought to add, small intestine gut flora resulting in leaky gut is increasingly being recognised. The partially digested proinflammatory peptides enter the gut wall where they can stimulate the complex plexus of both sympathetic and parasympathetic endings. Arguably the stimulation of the sympathetic pathways raises the level of brain hyperexcitability leading to increased CP
Just some thoughts to add some potential hyperexcitement to your own brain! :)
Lara I don’t believe you’ll find it, and that anecdotal reports are correlational, not causative.
In order to investigate this, you would need to suggest a viable causal mechanism and back that with sound evidence.
I agree with the facts of Christine Sutherland's comments but I'm wondering whether she is sounding a little pessimistic! At this stage one is thought-mapping a new idea...
I've written above that CP + temporary vestibular dysfunction are associated with migraines, and how migraines can be related to depression/anxiety, and possibly by extension to PTSD . The hallmarks of these will be intermittent symptoms, while vestibular damage is likely to be continuous. It is difficult to see how structural local vestibular damage is directly related PTSD or mood disorders
Have you looked at studies including the VA population? Im not familiar with any specifically noting vestibular problems but I know the chronic pain and mental health overlap has been documented in this population. Good luck!
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