Muscular Involvement in Tinnitus/Hyperacusis — Maybe We Can Know More?

I've been meaning to start this thread for a very long time now, but whenever I get the energy to make it happen it always slips my mind. But here I am today, finally doing this. It is a very dear subject to me, as I feel like the potential importance or impact of this area of research is highly undervalued - probably due to its low status and unintuitional way. Anyway, I want to start of with my story just for a quick reference and why I believe muscular involvment is much more important than the views currently adopted.

I got my tinnitus during a club dance with relatively high music for about 2 hours. It was not obscenly high, just high, back in 2011. Nobody else in that club, at least not to my knowledge complained of getting T. But I got it, and it has stayed with me ever since. I always wondered why?

Now, as a Type A-personality, I tried to find out everything I could about T, read on forums and read it all, you know the drill. Back in sweden, there were very few treatment options (just TRT, and pscyhological counseling). As a "going-to-be" medical student I eventually discovered one man who seemed to have a very controversial part-theory in contrast to the regular "ear-damage-brain-dysfunction"-theory. Now, he didnt say that it was all due to muscular involvement, but he had found that some of his patients got completely cured of their T when injecting a local anesthetic (lidocaine, xylocaine) into the lateral pterygoid muscle during Dentist-work. This was way back in the early 90s, but his research didn't take off. He didn't get any money and only got occasional attention from the media and the otolaryngology-society. As we all know, different branches of research don't cooperate very well and their discussion between fields are infested with status, prestige, money, treatments and job opportunities and few people dedicate their lives with only regard to what's best for patients.

Unfortunately for me, back in 2012, this guy, Assar Bjorne, had past away a few years earlier. What was left from his legacy was only his treatment centers home page http://www.yts.se/ and his former dental nurse. I contacted her back in 2012, and we had some skype-conversations and I did some psychological evaluation with her which I felt was futile (She had no psychological education, and that was not what I was looking for). I was trying to find out the method that Bjorne developed and recieve that treatment. It was a massage-technique with intention to loosen up the jaw-area, and then specifically the lateral pterygoid muscle. But, the method Bjorne Pioneered died with him, and this whole area of research fell into a deep black whole of shadow. Sure, the dentist-community knows that you can ease up or lower your tinnitus with chew-bracers at night that stops you from clenching your jaws. They know that tense jaws can be a cause of tinnitus, but noone has dug deeper than Bjorne did. He speculated about muscular dysfunction resulting in nerve-dysfunction, which the research community back then laughed at. Unless their is clear visible damage, their cannot be any symptom-cause and hence it is "impossible". But to me, as always, what is impossible today will be possible tomorrow.
My search for the magic bullet ended then and there, but Bjornes profile of people who have tinnitus due to muscular dysfuncion in face, jaw, neck and shoulders fit me so perfectly that I couldn't really never forget the thought. Despite the fact that my tinnitus was caused by loud noise. Or triggered? The 100 million dollar question.

Now, speed up a few years and in early 2015 I developed severe CPPS ( Chronic pelvic pain syndrome). I have had slight symptoms since 2012 (probably triggered because of tinnitus/stress/sleep deprevation). I was in a real mess, and still aren't good. But I've had time to think and read about the potential connections between both tinnitus/cpps and let me just say there are more similarities then there are differences.
They are both symtoms, not diseases. The research community is a big ?!?!?!, and CPPS has been speculation of being both this and that. The newest, and most popular, although not extremely widesperad among GPS (who most of the time knows less than google), is that in most cases (with 100% certainty mine) a muscular dysfunction. And suddenly Assar Bjorne popped back in my head.

So I started trying his own methods, with no real idea how to reach in there, or what to do. But I used the standard manual of the CPPS-community for massaging your muscles. In Sweden, there are no treatment facilities that treat CPPS. You are left on your own. The scientific evidence lags behind, but the community and the medical theorist work in symbiosis, not knowing what to do, speculating, without money for double blind random controlled trials and so on. So the patients try what the doctors without proof have to offer. And it seems to be working.

Now, let me state this clearly, my tinnitus has always been dynamic, flexible, adjusting to stress, some days having quite loud, while some days always seemed to be non-existent. I cherished those days, but always wondered why? It always seemed completely random. I have always been able to manipulate my tinnitus with jaw movement, either getting new sounds, higher sound, or more random sounds.

Well, back to my treatment-plan. I massaged on the outside of my jaws, and tried to reach the lateral pterygoid muscle. Checked anatomy books and figured where it "should be". Most of the time I probably just were on other muscles, but oddly enough it seemed to work some days. I started checking my tinnitus, and some days it was better, some days it was the same, but I really got the sense that if I actively massage my jaw muscles I get relief. Now, the effect lags, so it is not like i massage for 5 minutes and afterwards everything is fine. No, its more like, massage, and the next morning it may be better. I did this for a couple of weeks but tired, since my T doesn't bother me that much anymore and it takes quite an effort to use the force needed to make the muscles feel more relaxed. The resultes were very inconsitent too and the parameter of chance is of course great. I can just be anecdotal, but those days when I did it RIGHT I could feel it. I hit the right spot, used the right force, and the next day, what was left was a faint whisper where there before was quite some noice. It was just a feeling, nothing else. But to me, a very convincing feeling. I felt like I had found the missing puzzle piece of why my tinnitus is randomly better some days. Maybe I ate a lot of carrots that made my muscles relax?

Now, I want to elaborate more on this, due to its surface-similiarity to CPPS. I have had this theory for a while, that some tinnitus-cases (and probably hyperacusis) can be explained to be the equivalent of pelvic muscular dysfunction in cpps. An initial injury (loud nice) causes the muscles that protects the ear from high noice (tensor tympanii, stapedius muscle) to contract forcefully to the point beyond dysfunction. What happends next, is that the muscles STAY contracted after the event (as in CPPS). What is important here, is the possible implication of jaw/neck/shoulder muscles. The face/ear/neck/should muscles/nerves are VERY intrically connected. In cpps, you can get problems with peeing/defecation/erection/pain due to a muscle contraction in your quadriceps (thigh). This causes an inflammation in surrounding blood vessels/lympathic tissues/nerves which end up in a self-sustaining loop where the inflammation keeps the muscles tense and the tense muscles keep the inflammation going. It can even cause surrounding muscles to compensate by contratcing and opposing muscles forcing to relaxing growing weak and so on and so forth.

Apply this to tinnitus and the ear muscles have created a loop with the jaw disturbing the nerves (trigeminal, vagus) reaching for the ear hence producing a sound that doesn't exist. How this happens, I cannot think of, but maybe the inner ear cells get some signals distorted due to wrong information from protectional muscles, or the nerve send double messages/no messages. It's hard to tell.

All I can say is that I am convinced of the importance of muscular implication in some tinnitus/hyperacusis.

So please, help me with researchers/scientist that address this area. Or just discuss. What are your thoughts on this? Maybe we could know more?

Best wishes and regards

FutureDreams

 

Futuredreams.

So I had TMJD and was when I got tinnitus. BUT, my tinnitus is definitely from loud noise. I speculate that my hearing organs were already inflamed and with the addition of loud noise damaged the already weakened stereocilia. That is probably what happened to you. All of us have good days and bad, that doesn't mean it goes away and comes back. It's more psychological related.

Are you still fighting acceptance?

 

Hi Mricha37, and thanks for your reply.

However, I don't appreciate your very rude attitude. You obviously haven't read what I have written and your answer is just plain nonsense.

First of all - you "speculate" that your hearing organs were already inflamed, and then you have the nerve to define my tinnitus experience just because your experience is something else, and that has to be that everyones tinnitus is because of the same thing. It is absolutely immature, and I sincerely hope you apologise. Just because your tinnitus is "definite" or "static" doesn't mean that everyones is. I know several people both from this forum and other support forum that have flexible, dynamic, changing tinnitus, which are truely habitutated and extremely strongly suspect and feel that it is not from psychological reasons but from purely physiological. I have medical case reports about that as well, but since it is extremely hard to prove noone really knows.

My T doesnt go away certain days, but that wasn't what I discussed, had you read my post. I said it was LOWER. By the way, I have read of several people who have had tinnitus that is there 2-4 days, and then goes away for 2-3 days. So there goes your argument again, there are people who have it like that. Understand that every tinnitus case is not the same, dear god. It is a SYMTOM, not a disease.

I have had tinnitus for 5 years and know that there can be shifts during stress and the alike, but I haven't bothered with my T for several years. All my days are good, in regard to T. So don't you dare to tell me how I feel or what the reasons might be for my T to change. You don't know nothing about that, as well as I don't.

In addition, the reason I strongly suspect that there has been a shift, is because I simply have measured the masking-level. Maybe somewhat crudely, and I said that in my posts, there are many factors that might shadow the result.
But what does it matter? If I can truely tell that my masking level of my T is say 6 dB lower one day (as measured by computer volume sound- same sound, with a possibility to change the sound by 1/10000 strength. Doesn't that mean anything? If I can repeat it , say 10000 times, wouldn't that account for anything? I haven't done that,

Second of all, I also wrote in my text that my tinnitus definitely was TRIGGERED by loud noise. I had nothing before my "noise-event", but that doesn't completely rule out that the root cause that upholds it may be something else.
Why do some people get a couple of weeks of tinnitus, while others get it chronic? Is it just a matter of noise exposure or may there be other variables involed?

What if your TMJD might be the REASON for you getting T, compared to other people not getting T exposing themselves to similiar noise levels? What if you haven't had T if you haven't had TMJD? You don't know that. You may, as you said, speculate. Which I as well may do, speculate. The thing is, neither of us know what our tinnitus come frome or what the root cause is. You may have a strong feeling or suspicion or thought, but that doesn't mean that it is the ultimate truth. I can agree that the onset of your tinnitus was because of loud noise, but that's about it. What if your tinnitus had vanished within a couple of weeks if you hadn't got TMJD? Or a couple of days? As I said earlier, you don't know that.

By the way, what is stress? Why is tinnitus worse during stress? Is it only psychological, or may it be physiological too? The thing is, noone really knows. There are only THEORIES and this was a thread of THEORIZING regarding potential impact of muscle impact. During stress, one significant thing is muscular tension, and that is another similiarity to CPPS. In CPPS, CPPS get much worse during stress, and tinnitus is the same. Is it only the experience, or may it actually be that the sound is actually higher?

Had you read my text had you seen that I did the comparison to CPPS because in CPPS there is also often a TRIGGER which has nothing to do with what makes it continue. The trigger is an injury which in most people just heals and nothing happens, but due to a plethora of reasons some people are just genetically, psychologically, physiologically more prone to keeping that endless loop going. By that said, it doesn't mean that there aren't reasons to suspect you cannot close that loop, or that that loop is because of different reasons.

Thirdly, I never said in my post that I don't think there are several different reasons why people have T. Maybe there are people who only have T because of noise exposure. Maybe there only are people that only have T because of Neck injury, or virus, or jaw-problems. Or, it might be, that all things are interconnected and only different reasons that attribute to your whole-experience.

There was a Reason I took up Assar Bjorne and his research, and there was a Reason he found results. That you may think otherwise is fine, but don't tell me it is the truth. You don't know that. You are just speculating, as well is I.

I will post potential scientific articles as soon as I have time, probably tomorrow.

Best regards

Futuredreams

 

I bet you're just a hoot at parties.

 

Futuredreams, I think there is a link between muscle tension and my tinnitus and would be interested to know of any research in this area. Thanks for posting.

 

This video is worth watching; it explores how (probably) neuroplastic changes in the dorsal cochlear nucleus, result in muscle sensory data "crossing over" into the auditory stream.

Assuming this research is correct, it implies that muscle nerves are probably involved in most tinnitus (at least, most tinnitus resulting from auditory trauma or ototoxicity) -- but also implies that just doing muscle work is unlikely to resolve the tinnitus, because the problem is not simply muscle tension, but that touch sense is able to cross over into audio in the first place.

"The Neural Bases and Neuroengineering of...

 

@linearb Thank you very much for posting this. I have it bookmarked to view later when I have more time. Just your description alone makes sense. What remains hopeful to me is that neuroplasticity, almost (or maybe in some cases certainly) by definition, is a process that can occur in multiple directions. Perhaps a calming down of the auditory trauma, so to speak, can also help to shut down/taper off the "cross over" connections?

As an unrelated but interesting example, I've read that the reason people get a caffeine withdrawal headache for a couple of weeks when they quit drinking coffee is because there are caffeine molecule receptors that build up in the brain when you are a coffee drinker. When you quit, these receptors go "unfilled" and cause a headache. They gradually begin to disintegrate over a few weeks and after that, no more headache.

Neuroplasticity is ... plastic.

 

that video goes on to discuss a theory about how to do exactly that, and the research lab that produced it has concluded one human trial of an experimental device based on this model, and is seeking grant funding for a second, larger trial. I was actually a lab rat in that trial, if you want to know more feel free to PM me.

 

Totally agree. I have experienced this very thing where syncopation within sound presents as a tactile feeling. If middle ear myo/tonicity is a thing here, then close proximity of the facial nerve would easily result in that nerve being activated.

 

There is obviously a physical connection to T and H. When one rises the other gets worse as well. There connected.

 

Some optimism for 2017:

http://journals.lww.com/thehearingj...l_2017_Produce_a_Hearing_Breakthrough_.1.aspx

And:

"Like Spoor, Rudden expressed the importance of more collaboration between researchers and independent practices. “As the profession's entrepreneurs, private practitioners are often the first to look outside the box’ and find creative ways to maximize patient care AND cost-effectiveness.” Citing some examples, “Practicing audiologists could participate even more directly with researchers to design clinical protocols and practical documentation methods,"

Yes that would speed matters up.

 

@futuredreams
I am convinced there is a link...well, for me at least. I have a history of jaw, neck and shoulder muscle pain. This was created by Twenty years hunching over a drafting board, followed by Ten years drafting on a computer. Until a year ago I had never had any T. I thought it was something ageing rock starts got. I went to the dentist for a normal tooth filling. A procedure that involved some jaw pushing and pulling and a bit of tension in my neck. Within hours of having the filling my high pitched 'hissy, missy' T started and is still with me a year on. If I put my jaw in some odd positions ( that would get you arrested if seen in public...) my T can subside to almost complete quiet. Sadly I cant hold those positions for long. All I know for sure is T is one hell of a mistress and if you don't learn to love her and feel special rather than persecuted then life is a misery. Wishing all you folk a quiet day sometime soon X

 

I think that Robert Arron Levine and Assar Bjornes contributed the most to tinnitus research. My neuro said that he has been reading threads on TT on Saturday afternoons until the end of last year. This is his favorite thread and feels that @futuredreams nailed the major most common causes of tinnitus over a year ago. "muscular dysfunction resulting in nerve dysfunction" and this crosses over into the auditory system.

 

Thanks linearb for that gem of a video !

It seems that they, or Susan Shore, have had successful testing in Phase 1 studies of their treatment:

https://newatlas.com/tinnitus-cure-treatment-headset/52854/