Feeling of Muscle Tension on Face and Around Ears

For a long time I've had a strong feeling of tension in my face, primarily on the right side, around my temples, cheeks and forehead. This can sometimes extend to a feeling of tension or fullness in my ears. It feels like someone is squeezing my face inward with their hand.

Sometimes it causes tingling in my scalp, a feeling of pseudo-numbness (not numb to the touch, but when not touching it feels similar to having a numb face from dental work), or a sensation of having a sunburn on my face.

When it's bad it is on both the left and right side, but always on the right side even at its mildest. I also have a clicky and often painful TMJ on that side. I went through an episode of very extreme jaw pain recently on that side that occurred when opening my mouth, which has resolved on its own.

My middle ear muscles spasm when I speak as well, most predominantly on the LEFT side, but also affects the right. I believe these spasms are reactive to the bone conductive noise from my voice, and not jaw movement.

Benzos almost completely solve these symptoms, but as my dose gets lower and lower (I am tapering), it gets worse and worse again.

Is there a non-benzo solution that might alleviate these symptoms? They are horrible to live with.

These symptoms started about a year into hyperacusis and tinnitus.

 

Hi Sen,
My ear ringing is pretty much solely caused by my TMJ (at least I'm pretty sure and hopeful of that). I'm 25 and have no hearing loss (got this checked), no ear infections, pretty much ears are healthy. My ear ringing starting August 27th, so it's been almost 3 weeks now. I've had TMJ for two years, and have never treated it properly (shitty doctors up until now). I've lived in jaw pain for those two years pretty much, clicking, face soreness, headaches, ear pains, etc. But the ringing is what really got me to get this thing treated... Basically what I was explained is happening to me is, my jaw is misaligned and putting insane pressure on my middle ear. Everything is swollen and my muscles are freaking out. My jaw/facial muscles are so accustomed to being in a "stressed" state, so now I have to work on rehabilitating this and getting my muscles back to normal to relieve the ear ringing.

I started on prednisone (for swelling), and muscle relaxants about Sept 1, and didn't really notice any difference at all from these (except the muscle relaxants help me sleep). But I got a mouth splint (to reposition my jaw), put in Sept 8, which I am wearing 24/7 , and have started to notice a decrease in volume. I was told it would be at least 2-3 months before I feel a significant difference in the ringing. However the fact that I have already noticed some improvement makes me really hopeful. I am only on a super low dose of prednisone now and only take the muscle relaxant at night, bc the main reason i got TMJ to begin with is I clench my jaw at night due to stress/anxiety I guess. I'm usually a pretty happy person, but I guess after some long days at work (i'm in public accounting), i started clenching my jaw without noticing at night.

So anyways! I think if your jaw is hurting, you should look for a TMJ specialist. I started with an ENT, who really can't do anything to be honest, they just send you to get an MRI to confirm you have TMJ and then they refer you to a specialist. Preferably a neuromuscular tmj specialist, as they really understanding what is happening to all your muscles, joints, and nerves.

 

There is no such thing as a TMJ specialist. The closest thing to that would be an oral surgeon. "Neuromuscular dentistry" is riddled with pseudoscience, and evidence supporting physiotherapy for TMJD is much better. I'm not convinced it's entirely a TMJ issue either. I've seen a dentist who claims to treat TMJ issues and he said my bite was fine. This was also the very first time I've ever had jaw pain.

I haven't had an MRI because I am concerned about how its volume will affect my hyperacusis and/or TTTS. If I do have a problem with the tensor tympani, there is a chance an MRI could worsen my situation considerably.

Either way, I can't afford physiotherapy, nor can I afford neuromuscular dentistry. I am dirt poor and have no money.

 

You would be talking about an orthognathic surgeon. Dentists and orthodontists are better than nothing, but for jaw issues you should at least get the opinion of a orthognathic surgeon. I've spoken to a handful when I was considering jaw surgery (which is now forever on the back-burner due to my tinnitus). My TMJ is due to one of my condyles being longer than the other one and improperly done orthodontics when I was a kid. I actually should have gotten jaw surgery as a teenager, but my orthodontist wanted to keep me all to himself to milk more money off my parents.

For investigating jaw issues they commonly do a CT scan which is quick and quiet.

 

This is another problem. Even one CT scan emits hundreds of times more radiation than a normal X-ray. That's a lot of radiation. Each one increases your total lifetime risk of getting cancer.

I've had 4 already.

And then if they don't find it on a CT scan I'll have to get an MRI anyway.

Too many hard decisions.

 

I've had a handful of CAT scans as well, head and abdominal. I also used to work with radioactive materials. I'm talking 10-20 Curie neutron sources. The medical imaging doesn't concern me too much. Then again I don't plan on living to 90.

 

Have you considered getting your Tensor Tympani or Stapedial muscles cut? I read somewhere on another site that this can alleviate the symptoms of TTTS. I'm pretty sure all the things you're mentioning are coming from the trigeminal nerve being triggered by the middle ear muscles. I believe that's why I'm experiencing my symptoms.

 

Yeah, I have. That's a big decision, because not only is there no real evidence that this surgery eliminates TTTS symptoms, but I also don't really have evidence that TTTS is causing my problems. It could be TMJD, trigeminal neuralgia, vestibular migraine, or a slew of other known or unknown problems. I really don't want to guinea pig myself into an even worse situation than I'm in now.

 

What does your tinnitus sound like? Mine is like a regular tv beep(which I'm somewhat habituated to) plus a slight flutter in both ears. This flutter is coming from some muscle in my ear going absolutely haywire 24/7. I mean what else can it be? Sometimes it becomes like a gushing sound. Which is either the muscle or blood flowing. I also feel pressure in my ears often which is the muslces contracting I believe. What else could it be?

Like you I'm also hesistant to undergo the surgery. For one I don't experience pain very much. I sometimes feel a deep ache. And I do get a headache after exposure to really loud sounds. But I'm 90% sure it's the muscles. I also feel contant tension in my neck. If it becomes so bad I can't function properly on a daily I'd cut them probably

 

A harsh, piercing, electrical, jet engine type sound. I'm pretty much habituated to mine as well.

 

That's the surgery I have been offered too, and the doctor said is quite new, specially the one that cuts the muscle attached to the hammer bone. I dont have much info about the surgery but I understand it cannot be reverted and it is not guaranteed that it is going to solve the problem. And it needs an MRI done too.

As you, I feel like my eyes are being pulled inward when I develop extreme pressure deep inside my ears after being exposed to the odd loud noise. It is very annoying because it is taking me like 3 weeks or more to recover from a single noise exposure. My recovery times (the time in which my hearing becomes more or less stable and pressure and pain go down) are getting longer and that is a very bad sign. Also my hearing is deteriorating. I can totally relate to most of the symptoms you are describing and in my case they did not improve over the years, but got worse, and also my hearing. Also, when I feel pressure in my ears and behind my eyes, my sight tends to strain more. In those days at home, if I hear something is annoying, distorted or painful, and if I try to read I get tired a lot faster.

 

Hi @Juan. Are your facial symptoms predominantly one sided? Mine are on both sides, but are overwhelmingly worse on the right side. If both sides were like the left side I wouldn't mind too much.

These symptoms are 24/7 for me, and they worsen seemingly at random, not necessarily through noise exposure. Although, noise definitely worsens them too. They fluctuate up and down all day, every day. They improve while I sleep, and are usually mild when I wake up, but get worse again when I get up in the morning and start moving around.

They peak around the middle of the day, and then usually improve a bit in the evening (but not always).

Do benzodiazepines help your symptoms? For me, they take them away almost completely. I still have hyperacusis and middle ear spasms on benzos, but none of the weird facial symptoms.

I am going to see my audiologist soon to update all my testing, LDLs and hearing, etc. It's been a long time. I'm also seeing a psychiatrist and will likely try antidepressants to see if they reduce my anxiety. If the symptoms are caused by anxiety (TTTS), this should theoretically be helpful. The issue with antidepressants is that they cause weird side effects like dry mouth and bruxism, both of which will adversely affect my gum recession and suspected TMJD. I don't know how I will handle that.

I'm going to seek out TMJD treatment and see if any of my recent jaw troubles are at fault for bringing these symptoms back (in case the benzo withdrawal could just be a coincidence, and not the cause). Another thing I'm considering after I'm off benzos is seeking out real TRT.

I suspect TRT+TMJD treatment will put me and my family $10,000 in debt or more and probably not help me. But my situation is quite dire and I need to act.

 

My symptoms tend to be more acute in one side of my face. I went to check my jaw several times in the last few years and doctors said it was ok. I guess it all has to be with H triggered by noise, which in turn triggers tension in neck, shoulders, jaw etc.. in the end all those muscles are connected, from the back and shoulders, up the neck, the jack, and they affect how we hear and also can worsen H and tense our bodies.

I find doctors quite lost as to offer solutions for H. I want to think it is a matter of time to come up with a cure, but it is quite disappointing to see that there is literature about T, that very lightly discuss hearing sensitivity too, and it is like 30 years old, and today there is still no major improvement, not even a good progress in this field.

If hyperacusis had to do with nerves, and these nerves, like the hearing nerve werent affected by something very obvious that can be fixed through surgery (like acoustic neuroma) I dont think there are many other options today.

 

Is it always worse in one side, or does the worst side switch?

 

It is always worse in one side. The worse side does not switch.

Let us know how the MRI goes and whether doctors find something relevant.

 

Also, I have lost hearing over time, specially in the last year and a half. This is what worries me most, since now I have low tolerance to loud sounds and problems to hear low and some normal sounds, the TV, some voices depending on the pitch etc

 

That is really odd.

I'm seeing my audiologist at the end of the month to have all the basic tests done, including LDLs and hearing thresholds. I wonder if any changes have occurred since 2012.

 

Sounds to me like it's a normal benzo withdrawal symptom. I finished tapering benzos 5 months ago and am still having benzo withdrawal symptoms. Are you doing a slow taper?

 

Yes, very slow. I began over a year ago and I've been below 3mg of diazepam since July 2017. Right now I'm at 1.5mg daily.

I hope you are right that it's just withdrawal, but it feels way too intense to be that, in my opinion. The fact that it's almost entirely one sided is scary. I've also had this symptom several times in the past, including a time I wasn't taking benzos every day (although it was only a few months post taper). It seems more like a symptom that benzos alleviate, as opposed to a symptom caused by withdrawal.

I really, really hope it is just withdrawal, though.

 

Well done. Benzos are so hard to come off. Just go very slow the last bit can be the hardest. Have you read the Ashton manual? it might help. How are you feeling now?

 

Yes, I'm very familiar with the Ashton manual. This is the 3rd time in my life that I've done a slow benzo taper. So far this has been the slowest.

Right now I am feeling awful. The right side of my face feels like it's being pinched and twisted, and I feel a sensation of heat like a sunburn on and around my outer ear. My ear itself feels full and raw.

I'm fighting horrible depression and health anxiety. I struggle to get through TV shows and go for walks because of hyperacusis increasing the fullness in my right ear. My H has increased significantly in the past month.

One thing I have to be thankful for is that my headaches and dizziness have been gone for several months now. Both of these symptoms have caused me a considerable amount of agony in the past, so the fact that I don't have to deal with that simultaneously to these facial symptoms is somewhat of a blessing. Knock on wood.

 

The burning sensation is very normal I get it on my legs and feet. I think benzo withdrawal can make T and H worse until we heal from benzos. That's what I have read on a benzo forum and heard in facebook groups. I am also struggling with all sounds at the moment beacuse of H. If you ever need someone to talk I am here.

 

Hi... have you tried placing warm packs on your face and ears?

 

Yes, I have an electric heat pad that I have used, but it doesn't really help.

 

@Sen There's several theories to the tensions that you are feeling. It's possible that one with the lower jaw larger than the upper could have these types of tension, but I doubt in most cases. I also doubt that misalignment of the bite is a cause because this condition often takes place before any tinnitus. The pterygoids that are attached to the end of the jawbone which forms the TM joint to the sphenoid bone may be a reason.

The sphenoid bone contains the pituitary gland also called the master endocrine gland and that has membranes attached. If you wake up with swollen gums and teeth movement even while wearing a guard, then this may be the cause of headaches, jaw, facial pain and even neck pain. A full upper mouth guard covering all teeth may be needed. I kind of think that maybe it should not cover any wisdom teeth. Depending on side of cranium, compression of the temporal and malar bones with focus to sphenoid torsion. This could continue to happen during the day as well.

Cranial manipulation may help. Some type of current simulation used with myofascial release should help spastic muscles. A mouth guard will help with cranial stress and I heard that to detoxify the liver helps, but this may also be a whatever. So again try wearing a mouth guard day/night as much as possible that covers your back teeth, but maybe not wisdom teeth. Sleep on back.

Other thoughts: Tension may be coming from the trigeminal nerve and masticatory muscle causing hyperactivity. I can only see this happening during sleep.

I really think the tension is related to the neck being off balance and/or where vertebrates are straining the mastoid area that causes one sided tempomandibular problems. If wisdom teeth are still in, this may extend the problem.

 

From my understanding, this facial tension is aggravated by noise right? Or is it a symptom unaffected by noise?

 

@Lex I believe that facial tension can be caused by noise as well. Tension can signal from the sensory muscles and from the sensory trigeminal nerve and masticatory muscle causing hyperactivity. There may be more, but I don't have any knowledge beyond this.

 

It's honestly hard to tell. It seems like noise affects it sometimes, and other times it seems like it just becomes aggravated on its own. Chewing seems like it affects it as well.

It's also possible that it's completely random and I'm just trying to assign a pattern to it, which is part of human nature.

One thing that seems certain is that it's at its mildest when I wake up in the morning. When I get up and start moving and doing things, it becomes worse.

 

@Sen. Ah I guess exploring possible treatments is worthwhile in your case.

After my setback, I experience similar sensations. My worse ear, the right ear, aches then the right side of my face tightens. My temple on that side also feels tender. They come and go with the noise so I know they're noise-induced. I was wondering if it's still worth getting my TMJ checked and other usual suggestions given I know what the trigger is for me.

 

I have one of these. It doesn't really help at all. I never noticed myself clenching before I started using it, but when I used it I noticed that I would wake up clenching on it, which I think just makes things worse.