Not All Tinnitus Is Created Equal — My Story

I wanted to share my story on the off chance that it helps someone with their tinnitus.

In mid-July, I had a sudden onset of unexplained neck pain (near the base of the skull) followed by a headache (quite uncommon for me). This persisted for about a day and completely resolved. I never had neck pain again. What didn't resolve though was mild dizziness that started the next day.

The dizziness continued nonstop for 7 full weeks through September 9th. On August 28th however, I woke up at 3am to both of my ears ringing super loudly. I thought nothing of it and managed to fall back asleep and they were fine when I woke up. September 5th I woke up in the morning with both of my ears ringing--it was very high pitched and fairly loud. I figured it too would go away, but it persisted. About 9 days later the right ear stopped ringing, but the left ear continued to ring.

I had already started seeing a neurologist, two different ENT's, and my GP for the dizziness after 4 weeks. They found no cause through multiple MRI's, physical evaluations, an x-ray, and a CT scan. When it switched over to tinnitus they all lost quite a bit of interest in diagnosing it. The ENT sent me to an audiologist who diagnosed me with mild high frequency hearing loss. He quickly attributed it to listening to music loudly, which I never do. He attributed it to concerts, which I don't attend. He then scapegoated me having been to a shooting range years ago even though I wore 2 layers of hearing protection. He said I'd need to learn to live with it, that it would be permanent, and that it would likely get worse.

This was downright shocking to me for two reasons: 1) I've been protective of my hearing my entire life after growing up with a father with severe hearing loss due to working around fighter jets and 2) they showed zero interesting in diagnosing the cause.

I refused to accept this and the tinnitus started driving me insane because it would sometimes be louder, sometimes be quieter, and it had weird behavior. One day I was sitting on the couch and it stopped ringing for 15 minutes, then started up again. I also noticed that laying on my right side would cause my right ear to ring, but the right ear didn't ring at all otherwise. When I got back up from laying down the right ear ringing would stop. Surely something else was going on and my doctors still showed no interest in finding the root cause. My ENT told me to wait "several months" to see if it clears up on its own as he thought it was viral in nature.

Being an engineer, I decided to take matters into my own hands. I used this website to tone match the tinnitus and track the frequencies that I had difficulty hearing. I started doing this on a daily basis (to the chagrin of my doctors who said I need to ignore it) and found that my hearing loss varied in the 8,000-10,000Hz range not only day-to-day but oftentimes hour-by-hour. How could my hearing loss possibly be due to damage if one day I can barely hear 8,000Hz, but the next day I can hear 8,000Hz just fine but 9,400Hz is suddenly 50% quieter whereas the day before it had no issues? This was my first real clue that something was up.

I started doing as much research as I could as to all of the potential causes of tinnitus. I ran across a lot of different papers from doctors to chiropractors calling out potential causes of tinnitus, hearing loss, and vertigo/dizziness: acoustic trauma, acoustic neuroma, pinched nerves, arteries near the vestibulocochlear nerve pressing on it, eustachean tube disorders, head and neck injuries, ototoxic medications, various viruses, etc.. Two that stood out for some reason were a 40-year old woman with 16-months of tinnitus and a man with 20 years of tinnitus -- both had their tinnitus, hearing loss, and dizziness resolved by treating them for a neck injury even though they didn't appear to have neck pain.

I remembered that at the start of all of this I had one weird day of neck pain that I chalked up to sleeping strangely (it's happened before). My plan was to treat myself as though I had a neck injury to see if that would help. My treatment plan followed the two papers I linked above:

- Massage therapy including myofascial release therapy of the muscles of the shoulders, neck, and head
- Icing 2-3x per day
- Stopped weightlifting
- Anti-inflammatory supplements daily to help with any inflammation: NAC, fish oil, cumin
- Continued stationary bike for cardio, but took an Advil after if tinnitus seemed worse as a result
- Intermittent c-collar usage 3x a day for 20-30 minutes at a time to give my neck muscles a break
- Started sleeping on my back with a rolled up towel under my neck
- Complete adjustment of my posture while working at the computer and on the couch

Within the first few days I noticed a significant decrease in the loudness of the tinnitus. I'd say the volume decreased by 50%. After the first week, not only did the volume continue to decrease, but instead of being a distinct "high pitched noise in my left hear" the quality changed to a more general "high pitched buzzing somewhere in the left side of my head." The best way to describe it is the buzzing feeling you get when you hit your funny bone, but much higher pitched and inside the head.

As of writing this, I'm about 2 weeks into treating this as a neck injury and the tinnitus is sometimes completely gone (can not hear it in absolute silence at all) for hours at a time. If I put a lot of strain on my neck lifting something heavy it will return within minutes. If I exercise vigorously it will return within minutes. If I take Advil it'll go away almost completely after an hour. Additional I found something very strange:

- If I play the frequency that I can't hear well and touch my chin to my chest, I completely lose the ability to hear it
- If I play that frequency and tilt my head all the way back, I can hear that frequency 100% as well as all others and the other ear
- I could treat my head position as a volume knob. As I went from tilting all the way back to touching my chin to my chest my ability to hear a particular frequency almost linearly decreases!

I didn't/don't fully understand the root cause of the issue, but I have two theories:

1) Whatever neck injury I seem to have sustained is causing structural issues (e.g. a torn ligament is allowing improper movement). When I tilt my neck forward a vertebrae or something (e.g. swollen soft tissue) is shifting and pressing either on a blood supply or nerve causing the issue

2) There is a theory (Levine and Cheng 2002) that the golgi tendons attaching the suboccipital muscles and other posterior upper neck muscles to the skull can essentially create electrical noise that causes tinnitus (exact method is unknown). This might be why the method of flicking the back of your head with your fingers causes tinnitus to go away for a bit in some people and not others--the act of flicking might be interrupting or resetting the electrical signals in the golgi tendon temporarily. If the flicking method works for you, maybe you have a neck issue causing this? I've also read that people who suffer whiplash from car accidents have disproportionately high rates of tinnitus, hearing loss, and vertigo. Oftentimes they don't experience those symptoms for weeks or months after the accident.

To check #1: I'm seeing a physiatrist this week to review my last neck MRI which was only looked at under the guise of "what's causing dizziness?" to see if there are structural issues.

To check #2: yesterday I woke up with zero tinnitus (exactly 7 weeks after it started). I had a massage appointment in the morning--when I got there I still had zero tinnitus. I asked my massage therapist to use his myofascial scraping tool (metal instrument) to generate as much tension as he could in the muscles and tendons of both my right and left subocciptals. When he did it in the right, I felt a very mild buzzing in my head but no tinnitus. When he did it in the left, as he created more tension and moved from the muscle to the tendon my left ear started to ring and get louder and louder! When he released the pressure, the tinnitus almost completely went away. The ear continued to ring a bit, but over the course of an hour gradually went away.

I'm still not 100% certain of the root cause, but it definitely appears to be due to some neck issue. I'll update this as I discover more.

Summary: 2x ENTs, a GP, an audiologist, and a neurologist all said my randomly onset tinnitus and mild hearing loss were sensorineural in nature likely due to damage to my hearing organs or due to something viral. In reality, I have some sort of dysfunction in my neck causing the issue and treating it as such is significantly and fairly rapidly resolving it.

Hopefully this helps someone who has a similar issue. Along the way I came across this website which aims to help promote neural plasticity to help lessen the symptoms of tinnitus. I found that 2-3 minutes of playing the game helped quiet or completely eliminate the tinnitus for up to 30 minutes at a time.

 

Hi Anonymoose,

Thanks for this. I'm new here and I have had tinnitus since January this year after a bout of glue ear - first in the left ear then the right ear started shortly after. I have since noticed that I can influence the pitch and volume of my T in the left ear when I put my neck into certain positions, especially bending it forward so my chin touches my chest. Also by certain jaw movements.
I have worked on construction sites for 31 years and get aches and pains quite regularly especially in the back of my neck/top of my spine. I'm convinced that my neck and possibly jaw may have issues which is exacerbating my T. I start some sessions tomorrow with an osteopath in the hope of reducing the intensity of my T.

 

I'm fairly convinced that neck-related tinnitus is heavily under-diagnosed, which is why I shared my findings.

Being able to modulate the pitch and volume of the tinnitus with neck positions, to me, is a tipoff that the cause of yours might be related to your neck. Have you done any neck imaging (CT, x-ray, MRI)?

 

No not yet - literally just starting out investigating my neck as possible cause. I’m currently having a spike which triggered the planned consultation with the osteopath. Normally my T is relatively mild.
Will post back here with any answers.

 

Wanted to give a quick (or maybe long) update.

I've been seeing two physical therapists at Beacon Physical Therapy in San Francisco, CA. They don't specialize in somatosensory tinnitus, but they are insanely good at what they do so I trusted that they'll get to the bottom of this if it's a musculoskeletal/neural issue.

Long story short, we've whittled away at structural issues: sheared/rotated C1/C2 vertebrae, weak deep neck muscles causing forward head posture, thoracic/cervical postural issues and general stiffness/lack of mobility in these areas. We've mostly addressed the cervical issues and my tinnitus has gone from near-constant high pitched ringing that gets worse when I put any tension (e.g. weightlifting) on my left shoulder/neck, to on-and-off high pitched but very low volume tinnitus that I mostly don't even notice. A few weeks ago I went a full 8 days with zero tinnitus. It came back over the course of a few days when I wasn't good about stretching my neck muscles per their treatment plan.

The latest finding is that my first rib on the left side (the tinnitus side) is very elevated and stiff. This often results in thoracic outlet syndrome (issues with the left arm, numbness/tingling/weakness), but they think in mild cases and depending on a person's personal build this can possibly put light pressure on the vagus nerve, which is known to sometimes cause tinnitus.

My quality of life has significantly improved. I went a full 9 months (in the 12 months I've had tinnitus now) without being able to exercise because of how loud the tinnitus would get in the hours-to-days after exercising. I've been working out again for well over a month (5-6 days/week) with very little affect in my tinnitus post-exercise!

Cliffs: physical therapy on my head/neck/shoulders (suboccipital muscles, scalenes, trapezius) has put me on the path to completely curing my tinnitus. If you have somatosensory tinnitus and you suspect it's from a head/neck/shoulder injury I highly recommend seeing multiple physical therapists.

 

@anonymoose, I know that you have not been on this forum for some time now but I hope that you might come across this post since your description of your symptoms and how the tinnitus came about is the closest match I could find to my own after months of research. There are no shortage of examples of people with tinnitus caused by neck issues but yours is the only one I could find that faced the issue of tension in the shoulders and neck from e.g. lifting causing the tinnitus to spike for hours and days afterwards

I have tinnitus that came on after a no impact neck injury and suboccipital pain. Multiple MRIs and X-rays show no issue.

Any neck stretches or exercises or anything that causes increased tension in my neck and/or upper trapezius changes the pitch of my tinnitus for hours afterwards which often make sleeping difficult as a result. Therefore I cannot do the typical exercises that people with cervical tinnitus do in order to help their symptoms.

It could be the case that I need to persevere with certain exercises so I was hoping you could let me know some examples of the exercises that improved your tinnitus the most and whether or not you experienced temporary spikes following the exercises.

Thank you.