Help! Tinnitus + Pressure and Pain

Hey everyone.

New to this group and it looks like a great resource.

Almost 3 months ago I came down with some serious nerve troubles in my head. They are calling it Occipital Neuralgia and it's basically when nerves are compressed in the neck/head resulting in pain and headaches. It's not fun.

About 6 weeks after the pain started, tinnitus began in my right ear and subsequently my left ear.

It's pretty loud, but I've been pretty good at ignoring it through masking and staying away from quiet areas. However, I'm now also getting intermittent pain in both ears (jabbing pain) as well as 24/7 pressure. It feels like both ears are stopped up and sometimes I'll get a weird crawling feeling inside the ear in both ears. With the pressure + the tinnitus, it feels like my head is buzzing like a generator. It's really unnerving and impossible to ignore. I've seen an ENT who said I have some hearing loss at the 3k-4k range in both ears, but I don't think this came on because of hearing loss, but rather something to do with the compressed nerves in my neck and head.

I took Cymbalta for about a week, but if I remember correctly the tinnitus started (much lower than it is now) before the Cymbalta. I quickly got off the Cymbalta because it could possibly make it worse. I'm currently on Lyrica (about 3 weeks) and it really helps the nerve pain in head but I'm scared it's hurting my ears.

Has anyone here experienced this? Is there a specialist I can see? The pressure seems to be getting worse and I'm not really sure what to do at this point.

Thanks.

 

How about a chiropractor to start with?

Somebody must have diagnosed you; it's that doctor's job to refer you to a specialist.

My advice.

 

In a perfect world, yes.

Unfortunately, I've seen 4-5 neurologists and all have a different opinion. My GP should be "managing" my care, but he's not up to the challenge.

I'm having to do this myself, hence my post here.

 

I'd welcome the insight of anyone dealing with a similar issue.

I went ahead and made an appt. at the Shea Clinic in Memphis. It's 5 hours away so not a bad drive.

 

The trouble is... it's not clear where to start. You need a diagnosis - and that's your doctor's job.

Several possiblities:

1) Tinnitus due to compressed nerves - how likely that is depends in part on the etiology of that condition ie. what caused it in the first place (compression of nerves in the neck can be due to anything from tumours to incorrect sitting positions).
2) The medication you have been taking - certain medication is ototoxic when taken in high doses and/or for long periods of time (although probably not the cause here; the really ototoxic "stuff" is chemotherapy, aminoglycosides+CIPRO, loop diuretics).
3) Hearing loss; dips at 3 or 4 kHz on the audiogram are indicative of NIHL. Depending on the severity of the dips, this could easily be the reason for you tinnitus. Even relatively "innocent" looking dips are significant.

There are a few highly specialized neurology centres around the world who deal with objectively diagnosing subjective tinnitus using specialized scans (these clinics would not be known to the average GP/ENT/Neurologist). There is also an option of getting Procaine injections to the back of the neck (roughly 4-5 cm below hairline) as a trial-and-error method of eliminating somatic tinnitus. This procedure is most often used in tinnitus caused by whiplash.

 

Thanks!

1. Would NIHL explain the pressure/pain?

2. Coincidence it started 6 weeks after my nerves went crazy?

3. I had 4 loud MRIs. Wore earplugs but the right one fell out 1/3 through one of them. (It has slightly more hearing loss they say and tinnitus is greater). Possible cause?

4. Any thoughts on profusion of you know what it is?

5. Any reason to believe stopping Lyrica a would improve the pressure/pain or ringing?

 

1. In the absence of a concrete diagnosis, NIHL could explain a feeling of fullness in the ear. The feeling is due to osmotic processes that occur when the highly specific salt concentrations of the perilymphatic liquid inside the inner ear cannot be maintained at the correct levels; this dysfunction is associated with a weakening of the inner ear (and is to some extent correlated with a worsening of the audiogram).
2. Your guess is as good as mine. Tinnitus is likely to occur immediately after a trauma (if it occurs at all). However, for subtle injuries (eg. long term incorrect sitting position), tinnitus may take a while to develop; in fact, tinnitus is usually the last symptom to appear (after pain, inflammation, and so on...)
3. Four MRIs in the last 6 weeks?!? What the hell for (no question mark). One should be adequate. I doubt, however, that the MRIs caused your hearing loss at 4 kHz, but they may have caused your tinnitus. MRIs (without ear protection) may cause an acoustic trauma - which shows up as a temporary threshold shift across the entire audiogram (and ususally recovers after 24/48 hours). So if you have a dip at 4 kHz, it must be due to "something else" (eg. concerts, iPod listening, playing in bands, going to night clubs, etc.). You should have interrupted the MRI scan when the earplug fell out (needless to say) - usually an emergency button is held by the patient and can be pressed during the scan. Additionally, if earplugs (and not earmuffs) were offered, these need to be worn correctly for maximum benefit (imporant step for foam-type earplugs is to let them expand inside the ear canal while keeping them pressed in with your fingers for maximum db-reduction benefit).
4. I have absolutely no opinion on that; I am not a doctor.
5. Don't know; my guess is that Lyrica is neither causing your tinnitus, nor would your tinnitus disappear upon termination of the medication. Again, why take the medication in the first place (no question mark). If there is compressed nerves observed, then fix that in the first place (eg. chiropractor). What were the neurologists expecting - that you take medication for the rest of your life instead of fixing the problem...?

You can raise a question at the doctors corner here on the site; I doubt that it will make much difference in your case, however.

 

I got on a plane and severe headaches and stabbing pain Started. I did an MRI of the brain without contrast, then had to do one with contrast (should have been done first time). Then one of cervical spine an later lumbar and thoracic. That's how I got to the diagnosis of ON.

I'm taking Lyrica because it's a nerve medication and it helps ease the nerve pain in my head. I am doing physical therapy for the muscles in case they are the cause but often ON is chronic and therapy doesn't help.

If the MRI caused the tinnitus, I would have thought it should have started rigjt after but maybe not. If that's caused it is it possible it goes away?

 

FYI Tinnitis is a side effect of ON in 40% or so of patients.

 

Also chiropractic adjustment is notoriously bad for ON. Often it makes it worse. Decompression surgery is really the only option unfortunately. I've tried all of the conservative measures at this point.

 

I couldn't post in the Dr. Corner. Perhaps @Dr. Nagler will weight in here. Is that the correct etiquette?

 

Hi @Mike34
I've had similar problems for just over a year, tinnitus in the right ear which appeared at exactly the same time as the nerve pain on the right of my face and back of my head, pressure and pain in my ears. I'm on my 3rd neurologist, but this one is great.
Bit of a long story but I tried Lyrica which helped the pain a little bit, Gabapentin, Topamax, Indomethacin...
Topamax made the tinnitus permanently much worse, the others didn't.
I went to an osteopath who cracked my neck. Worst thing I ever did, the pain got so much worse for weeks after.
Have you tried an occipital nerve block? The pain in the back of my head was greatly reduced with two of them. It was a steroid and local anaesthetic injected into my head. It sounds horrific but it only takes a minute and isn't as painful as it sounds. They were done months ago, and the pain hasn't come back at the back of my head as severely since. I've also since started taking an anti depressant at a low dose for the nerve pain. It's called Dosulepin and out of all the drugs I've tried it has been the best one so far to reduce the pain level.

 

@65vwbus Thanks! I actually have had a nerve block done. It only helped for a couple days. However, after about 3 months the pain in my head has dropped significantly. 1/10 most days and sometimes 0/10.

Found any explanation for the pressure/tinnitus from your neuros?

 

Great news that your pain level has gone down.
Nope, no proper explanation yet. My first neuro said it was a spinal fluid leak, the second- migraine or NDPH, the third thinks it could be related to herniated discs in my neck. I'm seeing him again soon so I'll ask.

 

@Mr. Cartman you're an expert with this kinda thing...

 

If you wish, you can post your audiogram on this board, and I will be happy to comment on it.

Audiograms cannot diagnose tinnitus directly, but they can provide an indication. I would perhaps also encourage an audiogram which includes the high frequency range (> 8 kHz). Most ENTs simply cover just the speech frequency range (= 0-8 kHz).

I do not have a medical background, so it would be difficult to comment on the medical condition itself.

With the MRIs, I assume the physicians you have been seeing have ruled out anything serious. If you still have problems (and/but it seems that you do not, anymore) then perhaps it could be related to something as simple as incorrect posture at work in an office setting, for example.

I have commented on some exercises and office equipment which promotes good posture here:

https://www.tinnitustalk.com/thread...-etc-possible-treatment.500/page-2#post-50344

I also do recommend - for anyone - to get a check-up with the chiropractor once a year. For people who sit a lot, I also recommend getting your neck and upper back checked for trigger points. There are various types of trigger points such as primary, secondary, and latent trigger points. Most of us have them to some degree - but we don't notice them until a skilled person - such as a chiropractor - touches them. And then we notice...! Trigger points can - in the long term - cause neurological/muscular dysfunctions if left untreated.

If your MRIs showed degenerative disease of the spine, then let me know (and also what the doctors told you in response as for their suggestive remedy). There are possibly options within the emerging field of regenerative medicine which could be helpful in such instances - I will track down what info I can in that case.

At this point, I have travelled approximately 40,000 km for my various experimental treatments. One of the first doctors I decided to see in the Summer of 2013 was Dr. Wilden - an inner ear specialist who uses cold laser therapy to restore normal function within the inner ear. Cold laser therapy is a part of the field of regenerative medicine.

One of the things Dr. Wilden told me (and which I knew in advance from reading his online material) is that there are a number of symptoms of the inner ear which stem from the same overall problem: inner ear overstrain. Within the inner ear is the perilymphatic liquid which is required to be maintained at highly specific salt concentrations in order for the inner ear to function normally. When this function is challenged due to eg. noise, the salt concentrations deviate forcing osmotic processes to kick-in. This very process is what is (often) accountable for the feeling of pressure in the ear (in the absence of a concrete problem/diagnosis of eg. the middle ear or a CAT scan of the airways). Inner ear overstrain typically leads to a number of problems such as a feeling of pressure within the ear, hyperacusis, hearing loss, and tinnitus. These symptoms can to some extent be reversed with cold laser therapy. Pressure of the ear is usually the first of the symptoms to disappear after cold laser therapy.

 

Thanks. I just ordered the Trigger Therapy Workbook by (Claire Davies?) to check out.

Yes, I have degenerative disc disease. I'd love to hear what you've learned about regeneration.

Thanks for that detailed explanation.

I would be "okay" if I just had to deal with the ringing. Honestly, I'm basically habituated to it already. But, the pain, pressure, and hyperacusis are not easy to just forget. Aside from just regular pressure, I also have an undulating hum/vibration that is actually more of a feeling than it is a sound. A couple of weird points about this feeling.

1. I can hear it AND feel it. It sounds like a low "whomp whomp whomp" and makes the side of my head feel numbish almost.
2. When I go into a smaller space like a bathroom or closet, its MUCH more noticable. When I'm outside, I can barely feel it.
3. When I plug my ears, either with earplugs, earmuffs, or even regular over the ear headphones, it goes away. As soon as I take them off, it comes right back. Very strange. My theory is that the problem either has to do with pressure or vibration, and that plugging the ear either equalizes pressure or creates a situation where I can't feel the vibration.

Heard of anything like this?

 

As it happens, I have been through two stem cell treatments myself (for tinnitus). Because my treatments were experimental, I had to go via a broker in order to locate a clinic that would treat me. I will contact the broker, and possibly the first clinic which treated me for their input.

I recall the broker mentioning a while back in a newsletter that a new stem cell clinic had opened in the US. What a clinic in the US would be allowed to treat is quite restrictive, however.

This was the clinic that was mentioned (I have not checked it out - I am simply mentioning this information for "what it is"; no more, no less): www.intellicellbiosciences.com

However, I need to dig into some more detail if you are interested in locating a US based option.

I will get back to you.

[The degenerative disease is in the upper spine, I assume (C?, T?).]

I could comment on it. But - again - I am not a doctor; I think it is best to go see a professional (eg. an otologist) and describe in detail what you experience.

My suggestion.

 

i have DDD in my cervical spine too.... as a matter of fact, my problems started in my neck at first, then tinnitus started, i also have a hemangioma on my c5 where my disc disease is too. just found out about the tumor, and neurologist said i have overactive nerves in my neck,,,,

 

Yeah I've seen several ENTs and two neuro-otologists. No one will comment on what the issue it is. It really feels like they have no idea. They jus say I need to see a neurologist - which I've seem several.

 

My DDD is in C, T, and L. I have problems at each level.

Sounds a lot like me. I think hyper action of nerves in the head and tinnitus go hand in hand as they share similar pain pathways. How are you being treated?

 

Here's the thing: whenever something is cyclic/rythmic/pulsating in nature such as the "whomp whomp whomp" you describe, it could easily mean that there is a blood vessel problem of some kind. Somehow you are picking up somatic sounds. Possibly.

Again, I am not a doctor, but it is "back to basics":

1) extended tympanometry test
2) CAT scan of the airways (if indicated)
3) visual inspection of the eustachian tube (if indicated)
4) hearing test...

Your eardrum also needs an exam + movement of jaw bone (eg. done by moving your jaw up and down while having a dentist sticking his/her fingers in your ear canal).

There are also other tests out there (such as angiograms - but all of that depends on the diagnosis and some of the stuff is rather invasive...).

Not so sure about that. But your doctor would - hopefully - know more about it than I do...

[I cannot really comment anymore than I have done; I will get back to you on the regenerative medicine aspect; there is always the option of doing stem cells intravenously - which will have "some effect", but for maximum benefit, the stem cells need to be delivered at the site - and I am not sure that they do this for degenerative disc disease of the spine (they would if it was the knee, for example). I will get back to you with an update...]

 

im supposed to be taking Cymbalta, 30 mg, for overactive nerves but it makes me feel weird... I took it for 3 days... made me sick to stomache..... I have just regular tinnitus, and mild hearing loss too. the tumor in my c5 is intewined bloos vessels which they usually do nothing about, as they say your born with it, which I don't believe . I never had problems before..

 

Any progress?

 

Karen-

Thanks! I did go to the Shea clinic and they said I looked normal except for some hearing loss. I also saw a neuro-otologist after and he said the same thing (+ I may have some type of central nervous system sensitization).

The pressure I feel really is more of a humming/buzzing feeling. So strange. It makes the side of my head almost feel numb. Other strange things:

1. I can feel it and hear it.
2. In smaller spaces like bathrooms and closets it's overwhelming. Outside I barely feel it.
3. When I plug my ears it goes away.

Does this sound like your pressure or have you heard of anything like this? I will gladly live with tinnitus if the buzzing goes away!

 

Karen -

Thanks! I wanted to be clear that he tinnitus (ringing) and the buzzing feeling are totally separate. I have 3 pure tones and a hissing/dog whistle all time. They never go away and I hear them outside and inside.

The buzzing is totally separate. It started off really low and gradually increased. That's then one that goes away if I plug ears.

Does that change anything? Is that common?

 

I too have DDD and have a hemangioma in my neck also. I am looking into neck caused tinnitus like you.

 

@attheedgeofscience

Are you sure you're not some medical nerd?
Maybe you were in your previous life!
If you know all this medical stuff I can imagine how brilliant you must be in a field of finances.
Your intellect is simply impressive!

Sorry to go off topic but I couldn't resist!