Somatic or Noise Induced? Help Please!

Hey everyone! Sorry this post might be a bit long.

So I started to notice my tinnitus around mid June, and ever since then I've been hyper focused on it and it's been causing me a lot of anxiety. I'm not sure if it's noise induced or somatic. For years I've been going to concerts occasionally. I am also recently in a band, but have always worn ear plugs when playing with the band, usually the foam ones. However, I don't remember any sort of noise incident causing my tinnitus. I saw two ENT docs, with one hearing test, and I was told my hearing test was perfect and that there aren't any issues with my ears. It also might be important to add that I had an ear infection in late April that I had T during but then it went away.

The second ENT doc asked if I clenched my teeth and I said yes, at night. So he told me to go to the dentist, who ultimately gave me a night guard and told me I have TMJ. I've been wearing it for about two weeks, no improvement with tinnitus, and only minor improvement with clenching at night. I still have clicking and stiffness in my jaw when I open my mouth wide. I've been using a heating pad on the jaw occasionally.

I also believe my anxiety is making it worse. Last night I went to a restaurant, came back with the tinnitus slightly elevated, literally went to pop a pimple on my temple..... and BOOM a drastic increase in tinnitus! Tinnitus also increased when I pushed on my jaw. Afterwards, for the first time I tried icing my jaw and went to sleep. The next day I woke up feeling a lot better, and now when I push on my temple or jaw, the tinnitus just increases a little. What gives!

My tinnitus is fairly mild and in both ears. The intensity will fluctuate at times from ear to ear. And the pitch isn't constant, it kind of flows up and down. The right ear will stop for a few seconds if i "pop" it by moving my jaw a bit and breathing out.

I guess I'm just asking for any insight anyone has. I would hate to quit the band, I really love it and am making sure I'm protecting my ears as much as I can. I also am looking for the next steps to take as far as doctors go (follow up with dentist, massage therapy, audiologist, chiropractor?).

Thanks everyone!

Dana

 

Mine spikes when I clench my jaw as well. As a lot of people on this forum will tell you , be patient, it takes time. Protect your ears as best that you can, be patient. And try your best not to stress out, that does not help. I send you my most positive thoughts. Take care

 

Hi Dana,

First of all, I am sorry to hear that you have distress over your tinnitus. You have it a couple of weeks now, and this is usually the period with the most anxiety (when it just starts).

I think its possible to keep doing the band but you have to be very careful to protect your ear. I would get really good earplugs (especially if the music you are playing is really loud). I personally have the Elacin brand, but you can also look into other brands. I am not a big fan of foam plugs, but prefer the custom mold ones as they fit better, easy to put in and you can change the filters (more or less attenuation).

I got T. from playing in (loud) bands, after I got it (some 18 years ago) I kept on playing whilst protecting my hearing. I played about +100 gigs after that without any significant increase (as I protected my hearing the moment I got T). I wouldn't be stingy on the plugs, just get good ones, visit a professional shop and ask for their advice.

Hopefully, it will go down for you (you're just a couple of weeks into it) but rest assured, your life will go back to "normal" no matter what. It will just take time.

Good luck,

Rinz

 

This is what most of us (people on this site, people with T due to lifetime exposure to noise, and due to one-time acoustic traumas) had been told. Most of us have "hidden hearing loss" that is not revealed by the hearing tests.

My T is due to an acoustic trauma, and it gets louder when I move my jaw.

Even if your T is due to TMJ, it is still possible that the sounds that were ok back when you were healthy, are now spiking your T and are interfering with your recovery. If you continue being in a band, you are taking a risk. T is so horrible that it makes sense (to me) to not take any chances. You might consider staying away from the band for at least a year or two, to give your body a chance to recover.

 

I have also tried to get an answer to this simple question.

https://www.tinnitustalk.com/thread...cell-damage-and-somatosensory-tinnitus.25129/

I fear that one can sometimes be misled by jumping onto the somatic track.

On the other hand, it would be helpful to clarify this question, because a protection against noise seems illogical if TMJ problems are in the foreground.

 

My tinnitus started as noise-induced with that familiar ringing sound that never went away. Over time this has morphed into a somatic "hissing" sound which is highly reactive to jaw movements and gets louder as my surroundings get louder. On the other hand the ringing sound is just loud all the time and does not react to my environment.

Most days I just have the somatic tinnitus these days, except if I get a spike then the ringing comes back. Not sure which is worst tbh. At least when I have the steady ringing sound, I know it's not going to get much louder, whereas the somatic hissing can be more annoying. Strangely whilst I've been typing this message, my T has changed from being more of a ringing to more of a hissing!

I tried to convince an ENT doc that my T was noise-induced, even though it also displays this somatic behaviour too, but I don't think he believed me. He said my bruxism caused my T which has got worse over time, but I know for a fact that I've suffered acoustic traumas from loud music which have dramatically increased or caused my tinnitus there and then.

Does anyone else on this forum get both types, and have you noticed any patterns as to when one type gives way to the other?

 

Hi Bill

T is horrible, of course. But for a musician, staying away from music is horrible too. That's the dilemma we face. By staying away completely from playing the piano, my T turned into more of a hiss than a loud ringing, but I was getting so depressed about the loss of my former hobby. Now I have gone back to playing for 10 minutes a day or so with double-protection, avoiding playing louder pieces in general. Sometime it does spike my T for a day or two, but for the sake of my mental health it's a balance worth seeking out, imo.

However I will not be buying any concert tickets or returning to my band practices any time soon (i.e. at least for a year or two).

 

Sounds reasonable.

I guess it wasn't so reasonable, after all. I think this means that you need to give yourself more time to heal.

Can one adjust the volume on a digital keyboard, and if so, can't you switch to using a digital keyboard?

 

Do you have hyperacusis? That's a good way of knowing whether it is noise induced.

 

Most noise induced tinnitus has a somatic component; true somatic tinnitus with zero hearing loss at any frequency seems to be extremely rare.

The degree of somatic involvement, and hearing loss, varies person to person; different people have more or less success reducing the sound with tissue and tension work, but very few actually eliminate it. @Greg Sacramento is a sort of resident expert on that side of things, as far as I can tell!

 

True.

78% with tinnitus either have or will develop a somatic component.

New research shows that the molecule cytokine tumor necrosis factor alpha, a cell signaling protein (cytokine) involved in systemic inflammation, is necessary for noise-induced neuroinflammation, tinnitus and synaptic imbalance - an altered pattern of signaling between neurons. This is also key between noise-induced and physical somatic which also involves neuroinflammatory response to the primary auditory cortex (brain).

What happens with tinnitus crossing over to somatic is cranial nerves and blood flow sources - arteries of neck, jaw and face receive trauma. This happens from muscle strain of neck and jaw. Muscle strain can cause additional somatic tinnitus. In my own study, I have not found a single person with additional somatic tinnitus that does not have a history of hyperextending of neck forward.