Motion Sickness
Too much shaking going on
It's that long drive through the mountains, curve after curve after curve. Or a fast, twisty ride at an amusement park. Or a boat in rough seas. In any case, motion sickness can result in nausea, dizziness, and sometimes vomiting.
Motion sickness isn't really a sickness. Instead, it's a loss of equilibrium that makes you feel sick. Irregular or rhythmic movements, or even the sensation of movement (such as on a flight simulator) can do it. Fortunately, the queasy feeling is temporary. When the movement stops, your equilibrium usually returns.
Senior citizens have motion sickness more frequently than younger people, because nerve cells don't reproduce after age 40. Children and toddlers can get motion sickness because they don't yet know how to control their brain's "vomit center." Pregnant women should also beware: a strong bout of motion sickness could be harmful. Consult your physician if you're susceptible or concerned.
Synonyms
- Nausea
- Traveler's malaise
- Mal de mer
Detailed Description
For most people, motion sickness is a normal response to the up-and-down, side-to-side, or generally irregular movements in a car, train, boat, plane, or amusement park ride. An imbalance of the fluid in the inner ear's semicircular canals is the cause.
When the fluid level shifts because of this motion, your inner ear sends signals to the "vomit center" in your brain. Once the motion sickness has made your body do what it had to do (vomit), your recovery is most often as quick as the original onset. Your inner ear is back to normal fluid levels, your nausea has passed, and your vomit center has quieted.
How Common Is Motion Sickness?
Almost everyone has motion sickness at one time or another. About 90% of senior citizens suffer from degenerative nerve changes that affect their balance. It is also quite common in young children.
Possible Underlying Causes
An irregular or unusual motion that shifts the fluid levels in your inner ear's semicircular canals usually causes motion sickness. These canals, in turn, send signals to the vomit center in your brain.
Triggers of Motion Sickness
- Bumpy car rides
- Amusement park rides
- Boat trips
- Airplane trips
- Simulation rides
Diagnosing the Underlying Cause
Motion sickness, by definition, occurs as a result of the motion of a car, boat, plane or other means of transportation -- not from an underlying disease or disorder. If you have an inner-ear infection, being in motion may intensify feelings of dizziness (room-spinning sensation, also known as vertigo) and imbalance.
Diagnostic Procedures
Your doctor can determine whether you suffer from motion sickness by analyzing your symptoms and when they appear. Dizziness, nausea, and headaches resulting from the motion of a car, boat, plane, or other means of transportation are markers of motion sickness.
Goals of Treatment
For most people with motion sickness, the goal of treatment is to minimize the possible occurrence of dizziness or nausea before its appearance. Steps to reduce motion sickness include eating a light meal of bland foods (or not eating at all if you're particularly vulnerable to nausea) before your trip. Avoid alcohol, which may make you dizzy if you drink too much. Sip fluids frequently during your trip to avert dehydration, which can cause you to become sick. Another way to avert traveler's malaise is to "psych" yourself into a positive frame of mind regarding motion sickness. Drugs used work by quieting the signals to the "vomit center" of your brain.
Treatment Options
Drugs most commonly used
- Antivert (meclizine hydrochloride)
- Benadryl (diphenhydramine hydrochloride)
- Compazine (prochlorperazine)
- Dramamine (dimenhydrinate)
- Marezine (cyclizine hydrochloride)
- Phenergan (promethazine hydrochloride)
- Transderm-Scop patches (scopolamine)
Be aware that all of these medicines can make some people quite sleepy and may not be wise to use if you need to be alert with quick response time.
Second choices
- Acupressure wristbands
Dietary modifications
Your diet may play a large role in the prevention of motion sickness. Certain foods and beverages may contribute to nausea once it gets started. Avoid spicy or fried foods and alcohol of any kind.
Herbs
Ginger can help stop seasickness. On a training voyage in heavy seas, Swedish researchers gave 80 new naval recruits either a placebo or ginger capsules (2 g) about an hour before departure. The ginger group experienced 72% less seasickness. [1] Germany's Commission E, the panel of doctors and pharmacists that judges herbal medicines for that nation's counterpart of the Food and Drug Administration, endorses 2 g to 4 g a day for prevention of motion sickness.
Acupressure
Acupressure involves putting pressure along a series of energy channels or paths in the body known as meridians. It stimulates particular areas or systems of the body to promote healing and wellness.
Pericardium 6, an acupressure point on the inner forearm, is the best point for treating motion sickness. Researchers investigated the value of wearing an elastic wristband with a small knob that pressed the P6 point. The researchers placed the knob directly on the P6 point in 108 test subjects and off the P6 point in another 92 subjects. In the off-point group, 41% reported nausea and vomiting. But in the true-point group, the figure was just 23%. [2]
The P6 acupressure point is on the inside of your forearm, about two thumb-widths above your wrist crease. You can press it by hand, or buy an elastic band (like SeaBands or Travel Aides) that presses the point for you. Last updated October 1999.
Sources
1 Grontved, A., et al. "Ginger Root Against Seasickness: a Controlled Trial on the Open Sea," Acta Otolaryngologica (1988) 105:45.
2 Fan, C.F., et al. "Acupressure Treatment for Prevention of Postoperative Nausea and Vomiting," Anesthesia and Analgesia (1997) 84:821.
Preventing Motion Sickness
No matter what preventive measures you take, it is unlikely that you can prevent motion sickness altogether. But you can still take steps to minimize its frequency and severity.
Paying attention to where you sit on the plane or boat can help. Try to find a seat near the wing of the plane or midway between the bow and stern of the boat, since these areas don't move as much. The same applies to the front seat of a car.
Wherever you are, though, don't try to read. Instead, relax with your eyes closed, or keep them open and focused on the road, the horizon, or distant objects. Looking at something distant and stationary coaxes the mind's balance center into believing you're not moving. Avoid focusing on rolling ocean waves, a pitching horizon, or the buildings, trees, and fields that flash by. In cars, prop up queasy infants and children in car seats or on phone books so they can see easily out the windows. Do not watch or talk to another traveler who is having motion sickness.
Try reclining in your seat; a relaxed position may provide psychological comfort if you're tense or anxious. Take long, slow, deep breaths. If you're on a plane, rotate the air vent in your direction; the cool air may calm your nerves and provide a welcome, soothing air flow. Take over-the-counter medications before boarding; taking them too late may diminish their effectiveness.
When to Call the Doctor
If motion sickness is accompanied by the following symptoms, you may want to consult a health care professional:
- Occurs without predictable trigger or with increasing intensity, frequency or changes in hearing of headaches.
- Violent vomiting, diarrhea, or other unusual symptoms.
- An incapacitating condition, like dehydration, from prolonged vomiting.
- An injury resulting from a fall influenced by inner-ear imbalance.
- Motion sickness is something you or your child have frequently. It likely just indicates increased sensitivity and need of preventative treatment assistance.
Websites & Organizations
American Academy of Otolaryngology-Head and Neck Surgery
One Prince Street
Alexandria, VA 22314-3357 USA
Phone: 703-836-4444
Viable Herbal Solutions
Sources & Further Reading
Books
Balch, James F. and Balch, Phyllis A. Prescription for Nutritional Healing. Garden City Park, NY: Avery Publishing, 1997.
Bennett, J. Claude and Plum, Fred. Cecil Textbook of Medicine, eds. Philadelphia: W. B. Saunders, 1996.
Hardman, Joel G. and Limbird, Lee E. Goodman and Gilman's The Pharmacological Basis of Therapeutics eds. New York: McGraw-Hill, 1996.
Hurst, J. Willis. Medicine for the Practicing Physician eds. Stamford, CT: Appleton & Lange 1996.
Noble, John. Primary Care Medicine ed. St. Louis: Mosby, 1996.
Physicians' Desk Reference. Montvale, NJ: Medical Economics Co., 1998.
Rakel, Robert E. Conn's Current Therapy eds. Philadelphia: W.B. Saunders, 1998.
Taylor, Robert B. Family Medicine: Principles and Practice. New York: Springer-Verlag, 1998.
Tierney, LM, McPhee, SJ, and Papadakis, MA. Current Medical Diagnosis and Treatment eds. Stamford, CT: Appleton & Lange, 1998.
Articles
Blair DC. "A Week in the Life of a Travel Clinic." Clin Microbiol Rev. 10(4):650-73. Oct 1997.
Coats, AC, WTN. "Immersed False Vertical Room. A New Motion Sickness Model." J Vestib Res. 8(2):135-49. Mar-Apr 1998.
Fan, CF et al. "Acupressure Treatment for Prevention of Postoperative Nausea and Vomiting," Asnesthesia and Analgesia (1997) 84:821.
Golding, JF, JRS. "Comparison of the Effects of a Selective Muscarinic Receptor Antagonist and Hyoscine (Scopolamine) on Motion Sickness, Skin Conductance and Heart Rate." Br J Clin Pharmacol. 43(6):633-7. Jun 1997.
Golding, JF, JRS. "Objective and Subjective Time Courses of Recovery from Motion Sickness Assessed by Repeated Motion Challenges." J Vestib Res. 7(6):421-8. Nov-Dec 1997.
Grontved, A. et al. "Ginger Root Against Seasickness: a Controlled Trial on the Open Sea," Acta Otolaryngologica (1988) 105:45.
Jan, MM, PRC, KG, CSC. "Vomiting after Mild Head Injury is Related to Migraine." J Pediatr. 130(1):134-7. Jan 1997.
Kiernan, BD, IS, ZL, AD, RWM. "A New Nausea Model in Humans Produces Mild Nausea without Electrogastrogram and Vasopressin Changes. Neurogastroenterol Motil." 9(4):257-63. Dec 1997.
Parker, DE. "The Relative Roles of the Otolith Organs and Semicircular Canals in Producing Space Motion Sickness." J Vestib Res. 8(1):57-9. Jan-Feb 1998.
Sharma, K, Aparna. "Prevalence and Correlates of Susceptibility to Motion Sickness." Acta Genet Med Gemellol. 46(2):105-21. 1997.
Weinstein, SE, RMS. "Comparison of Marezine and Dramamine in Preventing Symptoms of Motion Sickness." Aviat Space Environ Med. 68(10):890-4. Oct 1997.
Woodman, PD, MJG. "Effect of Direction of Head Movement on Motion Sickness Caused by Coriolis Stimulation." Aviat Space Environ Med. 68(2):93-8. Feb 1997.