Can Pulsatile Tinnitus Be Caused by TMJ Issues and/or Inordinate Amounts of Bed Rest?

Can pulsatile tinnitus be mostly caused by TMJ issues and / or inordinate amounts of time spent in bed?

I understand that it has to do with the blood flow being sensed by the ear but could it be exacerbated by muscles in the neck being too tight or by TMJ issues?

I ask because I have been mostly confined to bed for the last couple of months due to chronic pain. As a result, my head has been mostly lying on pillows for a very long time and not upright much at all.

Could this be a cause or contributing factor as my pulsatile tinnitus was not that bad a few months ago?

 

It's... possible? Take whatever I say with a grain of salt, as I am neither an expert nor entirely sure of anything.

I like to refer to the diagnostic flowchart for questions such as this. I am not sure to what extent it is robust, but I have seen it advertised many times here on the forum, and it has the backing of research behind it.

From what I can see, TMJ-related symptoms are not pulsatile in nature. The time spent in bed, however, could be responsible if it is causing vascular issues.

Considering you've been lying down so much, you might have a great deal of strain in the neck which can contribute to symptoms.

 

@Greg Sacramento
Can you comment on this please?
I would value your opinion.

I would also note that my pulsatile tinnitus is at its quietest in the morning and just seems to get worse throughout the day. At nighttime, I can often not to get sleep for hours because of how loud it is. If / when I finally get some sleep, it helps to quiet the pulsatile tinnitus for the morning.

 

Need to know your age and sex for mention of pulsatile tinnitus with mention of abdominal nerves. Have you had moments of high anxiety - raising blood pressure? Do you smoke? TMD would not be cause of pulsatile tinnitus, but probable cause is something else. MES caused by Nortriptyline is very questionable to cause pulsatile tinnitus. MES - more likely anxiety with possible hearing loss.

Have you had radiological testing of abdominal aortic and neck?

 

@Greg Sacramento
Thanks for the quick response.

Male, early 60s.

I probably had slight tinnitus in my left ear before, but not pulsatile. My last audiologist exam a few years ago said I had appropriate hearing for my age, but still tried to sell me a hearing aid(!)

My abdominal nerve issues long (5+ years) predate this.

I had somewhat unsuccessful surgery for it about 3 months ago and was on various pain meds for several weeks, including Hydromorphone, Acetaminophen, Ibuprofen without any auditory issues. I went on the 4 days of Nortriptyline while I was still taking Hydromorphone, but I stopped both after the MES started.
I have now switched to taking a single tablet of Oxycodone per day, and often try to get by with just a half a tablet.

Recently, my MES went away for a few days, but returned when I had to travel by car for a medical appointment and I was subjected to a constant low hum. In fact, the first time I ever heard the MES was over the drone of a heater fan in my bedroom.

My blood pressure is very good, usually 120/80 (I measure it myself).

I am a very analytical person, but not OCD and not that anxious, but tinnitus has me hyper focused on trying to solve this problem.

Never smoked.

However, in relatively poor physical condition since I can’t exercise at all due to the nerve pain and spend all of the day in bed. I’ve lost more than 10 pounds of muscle since the surgery 3 months ago.

No radiological testing at all yet, and probably not for quite a while because of COVID-19 and being in Canada and needing a referral from my family doctor.

 

See link below.

This combination could cause a hum, but could disappear in time. This hum wouldn't be pulsatile tinnitus.

https://healthjade.net/musical-ear-syndrome/

I know quite a lot about abdominal injuries - nerves, arteries, vessels and muscles. We can talk more about this and TMJ if you wish.

 

I looked at the link above and tricyclics are listed as causative. Once MES has been established, is there any chance that it will go away on its own? They do have a list of drugs that might be helpful but since antidepressants themselves are listed as potentially helpful, I’m very leery of trying anymore drugs in case it actually makes things worse.

Back to my pulsatile tinnitus. Is TMJ still a possibility, or perhaps some sort of neck issue from spending so much time lying in bed? I don’t even spend much time sitting up since that puts pressure on my abdomen and increases my pain.

I would love to discuss my abdominal nerve pain issues with you as that is how this all started. But is this forum the appropriate place for such a discussion?

 

@Greg Sacramento
See above. ^^
Also, if you were to suggest a drug to counteract the MES effects of Nortriptyline, which one would it be?