3 Months Into Tinnitus — Developing Jaw Pain

Hello everyone,

Like many on here, I have gone down a rabbit hole of possible causes for my Tinnitus after several disappointing ENT visits. I do have past exposure to noise, but nothing I'd say exceeds that of an average mid-twenties person with an average social life (a couple concerts a year, bars, headphone use). I also just want to say that I do understand that it can really take one instance to get permanent Tinnitus so I'm not brushing off my past noise exposure as the cause.

3 months into this thing and I'm starting to notice a severe ache in my jaw, and particularly on my "bad ear"(BE) side and by bad ear I mean the one that feels extremely full, itchy and very uncomfortable all day long. I feel like there is something pulling in there. My ears also both pop fairly severely when I swallow, but my BE has this sticky, clicking sensation. I can something in that ear when I chew, and it physically feels uncomfortable, like there is honey or something wet and sticky in there. The popping isn't just light either, I can physically feel some pressure relieved fairly often throughout the day (I can distinguish a normal pop from the pops that actually bother me if that makes sense).

My jaw is growing increasingly uncomfortable to the point where even speaking feels uncomfortable at times, and I have pressure/mild pain in my cheek areas (under my eyes/cheeks is the best I can describe it. I also get a tingly/numb sensation along my jaw.

I also have significant back/neck pain, often which is accompanied by a tingly sensation along my spine. It's gotten bad where going to sleep is a bit painful and uncomfortable sometimes as far as finding a comfy position to sleep in.

I am a young, healthy person but I have been working a desk job for several years now where I'm stuck at a computer literally for 8 hours a day and a lot of this time is spent bent down looking at my phone on my desk.

My tinnitus started as a multiple of sounds, but nowadays is a loud hiss with random tones that come and go. It's highly variable daily. I have never experienced "temporary tinnitus" after a loud night out.

I do think I have some hyperacusis to some level, for the following reasons:

1.) If someone speaks loudly close to me it feels like with each "hit" of the loud noise, something in my ear pulsates a bit which I believe is my tensor tympani. I can tolerate dishes being put away and traffic noise but I'm afraid of this worsening as time goes by.

2.) Certain sounds like fans and blowdryers have this additional noise over them, and it comes it only appears when the sound is present. So for example we have a large old heater at work, and when it's on I hear this tone, and if I plug my ear it goes away entirely. If I move/position my head a certain way I can make it go away.

I've read hyperacusis and TMJ can be related.

I had a dental implant put in a few years ago (lower back tooth). In the process, I got a second round of braces (before I got my implant put in) and my orthodontist messed up a bit because now my top and bottom lateral incisors are always under pressure when I close my mouth (I don't have this issue with my left side teeth). He claimed it was because he didn't have much room to work with due to the position of the screw for my implant. I'm now constantly in the habit of biting on the inner skin of my mouth underneath my lip for relief from the pressure from those two incisors touching down.

I constantly have an ache in that spot, and my gum above my top lateral incisor is swollen. I feel like I'm always clenching my teeth but specifically on that side. It's hard for me to clench my back teeth because these two front teeth hit each other, but when I can manage to clench, my Tinnitus gets louder. I can't get braces again for a third time because of my dental implant (it was an expensive 3 year process to get this done). I also developed a mandibular tori where my dental implant is.

I have had my hearing tested and my hearing test came back perfect, but I do understand they can't really test for hidden hearing loss which is where the issues with T usually lie.

Could it be that I had undiagnosed TMD and an undetectable level of Tinnitus was exasperated by untreated TMD issues? Or perhaps I developed jaw issues from the stress that Tinnitus brought on?

I know I need to get a professional to look at all of this but does anyone on here have any sort of insight/experience anything similar?

Thank you for reading!

 

I think I had a similar experience, the reason I'm on the website today. Zero jaw problems prior to tinnitus, but after an acoustic event (two years ago at this point), 3 weeks in I started to develop jaw pain. I found I was clenching all day at work and at night and had to actively think about not doing so, focus on relaxing my jaw, letting it hang, not try to hold it closed. Before bedtime, I would give myself affirmations not to clench. For me the initial pain was like I overused my jaw muscle or like a sprain.

It disappeared for a while, then has slowly been coming back over the past months to the point where it is perhaps one of the more annoying parts of tinnitus. Severity not like original, just this off-and-on awareness, discomfort, sometimes misalignment. Muscles in my cheeks at this point are I think overly strong and somehow that is causing subtle misalignments. I often have to stretch my jaw (fake yawns). I find heavy concentration on a task makes it worse.

From what I read (long ago, perhaps a bit wrong), the nerves that control the jaw muscles pass by or are bundled with the auditory nerve bundle so there is cross over and that link strengthens with activity and time (long-term potentiation as the neurologists may say). Massaging those muscles helps me temporarily, and again, focusing on relaxing the jaw.

Since my perception this is starting from a neurological source, my hope is that some of the in-the-works bi-modal stimulation techniques may help where both sound and nerve stimulation are carefully timed to (at least temporarily) reduce all this wayward neural potentiation. My hope is that if the tone is less, then the nerve excitation to my jaw would be less. There are times where the feeling just completely disappears for a bit and I remember what my face used to feel like without tension or anything (just amazing when I think of it), then it comes back; that tells me there is something else driving it (neural), not mere mechanical issues with my jaw/muscles/ligaments/etc.

So for now I wait and use my coping mechanisms. My primary doctor knows about this, but I haven't taken it further. I think my problem falls in the crack between disciplines. I wouldn't say not to see a doctor, but they can take you down a rabbit hole if you don't control the course of action. If you truly perceive there is a relation between your tinnitus onsite and your jaw pain, then your doctor needs to express that understanding and be able to explain in that context how any recommended treatment would truly help (vs. spend money and time).

 

Hi @Orions Pain -

Welcome to the forum and sorry to hear about your tinnitus and accompanying problems with it. With the exception of your dental/orthodontic history, your progression sounds similar to mine and mirrors a lot of what I went thru during summer and fall 2019. My tinnitus started after two nights using a night guard for grinding and things cascaded from there - back/shoulder/neck/flank pain, ear pain and hyperacusis, etc... My tinnitus is most likely caused by some combination of musculoskeletal misalignment and neuromuscular imbalances. Simply put, if you have bad posture and you habitually put your body into awkward positions, then those awkward positions become the new normal and your body will misalign, rotate, and/or counter rotate to keep your eyes on the horizon. All this leaves muscles around the afflicted areas chronically tight, contracted, weakened, inhibited, underused, overused, and/or that need to be activated. Problems with the muscles then radiate outward, upward, and downward. Given your description of your symptoms and the problems you have from the neck up to the jaw, I would wager your tinnitus and other accompanying problems are at least in part caused by the same thing. A problem with your jaw and/or C-spine may be causing your tinnitus especially if all this is stuff you developed at the same time or in quick progression one after another. Working hunched over a computer and a phone 8 hours a day further supports what I suspect.

After developing tinnitus, I went thru all the usual conventional doctors - GPs, Audiologists, ENTs, and Neurologists. Then I moved onto alternative medical specialists - Neuromuscular Dentists, Massage Therapists, Chiropractors, and Acupuncturists. The problem with tinnitus is that most conventional medical specialists do not view the condition outside of the dogmatic view of their discipline, alternative and conventional medical practitioners rarely cross-talk, and when there is dialogue between them, they do not speak the same language. All this has resulted in the continued absence of guide to the treatment and management of tinnitus that leverages both conventional and alternative medical approaches. On the patient side of things, I think quite a few people who develop tinnitus take too long to get over the shock of developing tinnitus (not an easy thing to do in the first place) and do not have the training or experience necessary to work to develop a holistic and iterative systematic treatment approach to their own tinnitus and develop a treatment from there. I was a personal trainer and power lifter in college and work as a scientist. Fitness and science backgrounds are good things to have to do this.

At my tinnitus onset in July 2018, I was 6'2" and 235 pounds and my right leg was 1.5" shorter than my right leg and had an anterior pelvic, right lateral pelvic tilt, misaligned shoulders sloping downward to the right, misaligned atlas, misaligned jaw sloping downward to the left, and TMJ. I also had forward head posture and rounded shoulders. Forward posture is a big indicator of potential jaw problems and predisposition for tinnitus, and if you have forward posture then there is a good chance something else is being thrust forward as well. A body's forward lean can start at the ankles, knees, hips, thorax (around the bottom of the rib cage near the serratus anterior muscles and deltoids; these muscles are very important for posture), shoulders, and neck. Any forward lean can cause compensatory misalignment elsewhere (e.g., anterior pelvic tilt can cause flared ribs and pulls your thorax spine out of proper alignment). After 4ish months of adhering to my treatment plan, the only things I still have occasional problems with are the anterior pelvic tilt and right lateral pelvic tilt, and my tinnitus has improved significantly. However, this treatment is iterative, and fixing these things has uncovered my flared ribs (finally lost my gut and 5" from my waist) and thoracic offset with rotation (aka Functional Scoliosis which is fixable) which I firmly believe is the root of my problem and can cause most if not all the problems mentioned in the beginning of the paragraph. When working at sea with CTDs and other equipment, I regularly bent over and twisted my torso at the same time consistently for about 10 months (which also something you should never do). If you can identify likely causes of your misalignment/imbalances, part of your treatment should be to stop doing them and use proper posture and technique to do anything else that is still required for your job, personal life, etc...

The good news is I am now ~193 lbs and have mostly recovered from my problems and my tinnitus that is now very minimal and continues to improve. I still stretch, run, practice good sleep hygiene, adhere to a much healthier diet, and continue to stick with my lifestyle changes which are all part of my treatment plan.

First - You need to learn to sleep again. Sleep helps to heal the body and assists with memory consolidation and emotional processing. Sleep will be essential in fixing your tinnitus or at least help you to deal with it better. I authored this post a couple of months ago - https://www.tinnitustalk.com/threads/tinnitus-from-musculoskeletal-misalignment-imbalances-—-achieving-better-sleep.39047/#post-514393. It seems like you are having problems with sleep position. When sleeping, maintain a neutral pelvis, keep your spine in a supine position (lumbar support and cervical neck pillows are good for this), and do not rotate your pelvis relative to your shoulders (this will contribute to the development of functional scoliosis). Check out the sleeping position link in that thread. I rotate between the starfish and log positions. Practice good sleep hygiene and prioritize sleep for the next 4-6 weeks.

Second - If you are an unhealthy weight, take steps to lose weight. Adopt a healthier (and if necessary, more neutral) diet ASAP. I abstain from alcohol, soda, sugary sports drinks, and tobacco. I eat all my food raw except meat, fish, and eggs and opt to boil over any other cooking method. I minimize sodium intake and consumption of processed foods. Most sugar in my diet is now just from fruits and yogurt. Start to move around - walk, run, swim, or do something else for light cardio.

Third - Once you are able, start to stretch. The following routine is what I started with.

Conservatively, you can start with some foundational training (see video below).

Foundation Training original 12 minutes

After you are comfortable with this, move onto the bird dog pose (see video below.

JD McCoy, DC CCSP - Chiropractor - Bird Dog...

Then, work to improve your thoracic spine - https://posturedirect.com/17-exercises-to-improve-your-thoracic-spine/.

Fourth - Restore bilateral balance. If you tend to do everything with your dominant hand/wrist/arm all the time. Switch it up and use the other one for things like picking stuff up, brushing your teeth, and using your PC mouse at home and work.

Fifth - It sounds like you might one or several common postural deviations. Do some homework and find out which ones you suffer from. These include (non-scientific names) misaligned jaw, forward head posture, hunchback posture, rounded shoulders, shoulder impingement, misaligned shoulders, thoracic hinge, flared ribs, anterior pelvic tilt, lateral pelvic tilt, posterior pelvic tilt, hyperlordosis, swayback posture, and knee valgus. If left untreated and uncorrected long enough, a rotated pelvis or thoracic/pelvic counter rotation can develop. Also, folks often have several of these issues like I do/did. Simple postural deviations can escalate to serious medical problems if left untreated.

Do some homework and research and get some imaging and tests done to figure out what your problems are. Chiropractors and physical therapists can help with physical exams and imaging. If you notice muscle tension anywhere, see your GP for appropriate referrals. Once I brought this Some tips -

1) Sport a toothy smile and look in the mirror. Is your jaw misaligned?

2) Stand with your body against the wall with your "normal" posture and have someone take a postural photo? Is one shoulder higher than the other? I am right-handed and overuse my right arm, so my right shoulder was lower.

3) Check for pelvic tilts and rotation. If it is obvious, you should be able to spot them just standing in front of the mirror. I could with mine.

4) Lay down on your back with your feet together and have someone check to see if your legs are the same length. If not, you have a leg length discrepancy.

If any misalignment is spotted in tests 1-4, you likely have misalignment elsewhere or are susceptible to further misalignment/imbalances if you did start treating your problems.

More tests to spot these things on your own can be found on various pages of this website - https://posturedirect.com/.

Also check out posts by @linearb, @Lane, @Bill Bauer, @Greg Sacramento, @ryand, and @Kaelon. Their posts were extremely helpful to me early on in my tinnitus journey.

I would happy to help you develop a musculoskeletal/neuromuscular tinnitus survival kit and treatment plan that will work for you if you suspect you have it/ Please keep in mind, I can only offer suggestions and advice on things to try and explore and these should not replace the advice and information from your docs. Once you figure what the issues are, docs are actually decently helpful. Some other threads for you to look over -

https://www.tinnitustalk.com/thread...eck-adjustment-3-weeks-ago.40098/#post-516578

https://www.tinnitustalk.com/threads/how-do-you-know-if-tinnitus-is-from-tmj.36685/

https://www.tinnitustalk.com/threads/tinnitus-in-right-ear-hyperacusis-in-left-ear-—-tmj-and-arthritis-in-jaw.37582/#post-499933

https://www.tinnitustalk.com/thread...d-will-my-tinnitus-go-away.37056/#post-479061

https://www.tinnitustalk.com/thread...ractic-adjustments-for-tmj.36535/#post-472997

https://www.tinnitustalk.com/threads/hi-guys-new-here-tinnitus-in-left-ear.36914/#post-474216

Feel free to follow-up as you feel is necessary. Good luck with the tinnitus treatments.

All the best,

-Oceanofsound26

 

@Orions Pain I can give more detail later, but check out my recent thread here: https://www.tinnitustalk.com/threads/ear-fullness-and-spikes-after-ceasing-use-of-tmj-guard.40250/ -- tl;dr I sleep with a bite guard and when I stop that I get the symptoms you describe and more.

There's connections between TMJ somatic problems and tinnitus which are not well understood. While you'd sort of intuitively expect that severe problems with the jaw joint can cause hearing issues, since they are so close, it's more bizarre and harder to explain why a hearing problem caused by noise would lead to TMJ problems. @Greg Sacramento might know if there's stuff that's been researched there; I could speculate, but it would just be armchair bullshit.

Bottom line, though, it sounds like you have TMJ symptoms; treat them with TMJ treatments. Hot compresses, correct (gentle) neck and jaw stretches and exercises. TMJ self-help books about. Bite splints can be extremely helpful in some cases but IMO are not a good starting point -- keep in mind that I have years of clenching/grinding in my history pre-tinnitus.

 

Hello again @Orions Pain -

A few other notes -

All this sounds like you have TMJ or other problems with your jaw. Definitely check if the lower jaw is misaligned. The lower jaw will align to the upper jaw, so if your upper jaw is off then so will your lower jaw be. If your upper jaw is off, then this opens the door to a misaligned atlas and potential C-spine issues. Popping ears can also be a sign of Eustachian Tube dysfunction. If one end of your jaw is misaligned and that TM joint is out of the joint space, the rotation and translation of the jaw might be compressing/opening the Eustachian Tubes as you do things like open you mouth and chew. I do things several times a day to clear my Eustachian Tubes. See these threads -

https://www.tinnitustalk.com/threads/blocked-eustachian-tube-—-what-can-be-done-to-treat-it.37226/#post-477824

https://www.tinnitustalk.com/threads/here-is-how-i-solved-my-tinnitus-—-new-protocols-and-supplements-to-try.6514/.

Sinus problems often co-occur with TMJ and other jaw problems. You might have issues with your maxillary an sphenoid sinuses (https://www.health.harvard.edu/a_to_z/acute-sinusitis-a-to-z). As part of TMJ treatment, a Cone Beam CT Scan revealed some sinus issues. During my TMJ treatment, I stumbled across this video for lateral pterygoid release -

Lateral Pterygoid Muscle - Trigger Point...

After doing it 3x per day for about a week, my sinus congestion improved significantly and my jaww opening increased by ~5ish mm. Be careful and gentle with this release as it can be painful. Also, might worth it to try to stretch the digrastic muscle (see video below).

How to stretch your digastric muscle

Trying steam inhalation or sinus irrigation might be a good idea along with a nasal spray and/or decongestant to help your sinus problems in the short-term while you sort out everything (see threads above).

See thread about sleep in the previous thread. If you have TMJ, then it is generally recommended that you do not sleep on that side. Since you have other symptoms like back and neck pain and tingling down the spine, then your problem might extend beyond TMJ like mine did.

Again you might have misalignment/imbalance that TMJ could stem from that needs to be addressed.

Fully agree with @linearb. TMJ treatments with orthotics/splints was part of my treatment and it helped a lot. Just wanted to mention other things to keep in mind above. TMJ can be a downstream effect (effect) of a larger upstream issue (cause) as it was with me.

 

Agree with @Glenn Schon here as well.

 

Thanks for the invite @linearb and @oceanofsound26. Responses to @Orions Pain from the both of you are accurate and real. The two of you top my MVP list. I need to be brief tonight as my oral cavity is in great pain, but I will write more later.

Orion Pain, I first got tinnitus from ear syringing, but all heck happened when I receive a dental implant for lower jaw. Received high pitched somatic tinnitus within seconds. I received dental jaw and neck whiplash and everything above my shoulders got messed up. My mouth became severely messed up. Neck muscle spasms straightened my from C spine from implant pressure. This sent me on a thousand hours of research over the next 4 years where I saved 1200 research and discussion articles.

First get a 3D cone beam scan for upper and lower jaw. Sinuses, throat and airway and so much more is also examined, but not a complete neck study. Besides myself, oceanofsound had one done also. Place cone beam scan into page search and read our messages about it. A cone beam scan is a quick CT sitting scan that takes about 30 seconds and is not loud, but wear ear plugs. Noise blocking headphones can't be used as the arm of the scan when moving would hit them. Sit very still. Ask for a radiation protection jacket for your thyroid and chest. When you get the report, let me know. There are several ways to go about getting this scan. Some dental offices have this unit, but the better ones are in radiological centers where you can make your own appointment and the radiologist's notes and pictures are sent to your home address. Some radiological centers also request that a dentist receive the notes. Some also request a referral from a dentist.

Second is to get X Rays of your C spine. You may not need more advanced radiological testing such as MRI, MRA or CTA.

Hugs

 

@Orions Pain Continued from my post above...

Forget the neck X Rays, but consider the cone beam study. I just read your posting history.

I believe that I found what is causing most of yours problems and that may also include original tinnitus. Also included would be hyperacusis, ear and hearing situations, pulsatile tinnitus - carotid artery that would refer to eye and vision.

All of this is part heredity and maybe from dental experiences causing discomfort and stress. I believe that you have moments, maybe just brief occasional moments of changes in blood pressure - hypertension.

8% percent in your age group have hypertension and 28% of the US population has hypertension. More so with tinnitus or a physical disability/pain.

I count about 30 mentions of problems by you where all can associate to hypertension. There is a pattern that I believe cannot be mistaken to hypertension.

You can improve your life and conditions with some changes, although some meds may be needed and dental care.
Exercise - walking, drink enough fluids and use the DASH diet. Caution with your neck, ever so much when under any stress. We can talk more, but others with thoughts for controlling hypertension please respond.

 

Thank you for the detailed post. I am 99% sure my hyperacusis and tinnitus are both from overexposure to noise. My dilemma is that from what I've read both TMJ and hyperacusis can have very similar symptoms. I guess I would have to try to treat the TMJ first since it actually has more active treatments I can try out but my worry is that all of these pains are coming from some sort of nerve damage from hyperacusis.

 

Hi @Orions Pain -

Tinnitus caused by noise exposure can fade over time although it could take a year or more. Hyperacusis possibly as well depending on the cause.

Tinnitus, hyperacusis, and TMJ can all be related especially if the TM joints are out of the joint space and discs are being displaced in one direction or another (might be causing the clicking noises you hear). My jaw was misaligned and higher on the right before I started treatment and clicking, pain, and tinnitus was far worse on the right side for me. When you open your jaw, if it swings one direction before coming back to center, you most likely have TMJ. If you hyper-extend your jaw and one TM joint pops out before the other (usually following swinging jaw action), you also most likely have TMJ. The trigeminal nerve also innervates the medial/lateral pterygoid muscles used in mastication, and entrapment of this nerve due to jaw issues can cause both pain and tinnitus (not sure about hyperacusis though).

Sounds like your implant was on one of your lower molars which are near the TM joint. If you have poor occlusion where your molars are located and/or any tight muscles in the neck/shoulders/upper back, then your phonetic jaw position might be changing because of the former and tight, contracted muscles might be pulling part of C-spine out of alignment and therefore possibly your jaw as well because of the latter. If you grind or clench at night, you might be making things worse for yourself. Trying things like raising the temperature, running a humidifier, or controlling cortisol levels can help with this. Check out the sleep thread earlier in this discussion for more information.

Try the things @linearb suggested for a couple of weeks to see if things help. Also practice good posture and maybe get a standing desk at work or set up your work station to be more ergonomic. Find your mastoid bone (big bump) behind your bad ear. Branches of the SCM and digastric muscles pass right below the mastoid bone. If these muscles feel tender and/or tight, try to release and stretch muscles in the neck. Go slow and do not overdo it. Some of my favorites below.

Anterior Neck Release Stretch (SCM &...

Wicked Neck Stretch for Fast Relief of Tight...

Mastoid SCM Release Stretch for Neck Pain...

Pro Lordotic Neck Exerciser with Adam Fields, DC

Again check if you have forward head posture. This will predispose you to jaw problems. If you have it, start to do some forward head posture exercises. Plug "forward head posture exercises" into Youtube and you should find what you need.

Agree with @Greg Sacramento here as well. Seek out a neuromuscular or maxillofacial dentist specializing in TMJ. They can help you to determine if you have TMJ, what the actual problem/s is/are, and how serious your TMJ is. Reflect on the point @Glenn Schon made about weighing potential benefit against the time and money treatment will require. TMJ specialists often offer consultations/evaulations where things like a Cone Beam CT Scan can be done to diagnose TMJ that are much less expensive than the actual treatments (costs for TMJ treatment pile up real quick) that follow them. You might need referrals from your GP for some of these things.

Hope you find some relief in the future and good luck with whatever you decide to do.

-Oceanofsound26

 

Someone should seriously start making a list of threads and posts regarding “somatic tinnitus”.

This forum literally has EVERYTHING mentioned, it’s crazy.

Bump.