Woman using handheld massage gun to neck
A report of several individuals experiencing sudden episodes of vertigo, or room-spinning dizziness, after use of a handheld massage gun, was published in the May 2024 issue of the Journal of the American Medical Association, Otolaryngology. The authors report on two patients who developed isolated sudden dizziness within hours of using a handheld massage gun to the upper neck/lower scalp area. The type of vertigo described, called benign paroxysmal positional vertigo, or BPPV, is a specific entity associated with room-spinning dizziness triggered by head movement in a particular direction and orientation in space.
Typically, BPPV occurs when tiny particles of calcified crystals move around in the inner ear (or vestibular) balance system, leading to sensation of feeling like the room is spinning. This differs from feeling lightheaded or off-balance, and is very particular in that symptoms are notable with head movement in one direction. Many people, up to one in 30, have experienced symptoms of BPPV. It is more commonly seen in older individuals, over age 50 or 60, as the small inner ear crystals can degenerate and loosen with age. Both patients in the current report were under age 50.
Older individual experiencing dizziness after getting out of bed.
Some episodes of dizziness or vertigo are associated with other symptoms, such as ear ringing or tinnitus, hearing loss, headache, or cardiovascular events such as strokes. But BPPV is an event isolated to the balance system, with no other ear-related or systemic physiologic issues. The treatment for BPPV is one where the position that triggers the vertigo is created, in efforts to ablate the response of the inner ear balance system. These maneuvers, known as the Epley maneuvers, are briefly uncomfortable, due to their creating the vertigo, yet are extremely successful in ridding the patient of the dizziness.
The following video is a demonstration of how the Epley maneuver is performed:
Vertigo triggered by handheld massage guns is thought to be due to the combination of substantial force, up to 32 kilograms, with rapid repetitive movements, up to 5,000 strokes per minute. This may stimulate loosening of crystals in the balance or vestibular system, even in younger individuals. The report mentions that other high-force repetitive vibrational triggers have been described, including electric toothbrush use and dental procedures such as drilling.
Dr. Ronen Nazarian, lead study author and ear specialist in Los Angeles, California, notes that both of the patients described in the report had swift response to treatment with Epley maneuvers. He also recognizes that these handheld massage guns are enjoyed by many, and are used in the neck area by individuals who work at computers or have developed tight muscles in the neck and upper back. He recommends that if one does use the device in the upper neck, to use a lower rotational setting and a lower force level, and of course to stop using the device altogether should any symptoms of vertigo ensue. He also cautions that there are many other causes of sudden or chronic vertigo, and being evaluated to rule out other sources of symptoms is critical.
While this entity is likely rare, given how common handheld massage guns have become, the authors mention that if these presentations increase in frequency, manufacturers may consider including vertigo as a potential user risk in their packaging information, especially when using the device in the upper neck area.
Massage device with high impact and rapid vibrational movement in the neck area may trigger vertigo. ... [+]
