Somatic Tinnitus Causes (TMJ, Neck, etc.): Is There a Way to Tell?

@KWC If your jaw hurts when lying down, place "why does my jaw hurt when laying down" into an internet search. Very informative articles will surface on this, including tooth pain when lying down. Some articles will list exact jaw and area problems, if pain is reveived with lying down. Some article discuss a matress being too soft or too hard and the same with pillow. Some need a low pillow and others need a high pillow, but never should there be space between neck and pillow.

If you do get more jaw/tooth pain when lying down and want 3 0r 4 good articles, let me know and I will post links.

 

@Greg Sacramento thank you.

 

@just1morething did the prolotherapy help your tinnitus?

Do either you or @Greg Sacramento use any masking?

My sound has changed over time to a high pitch continuous tone that gets louder every time I flex my jaw. Not sure if the change has to do with the splints. Pain has ramped up too. Not sure if that is related to the jaw realigning or TMJ getting worse.

My doctor put me on Indomethacin for pain and inflammation.

Each day as I am sure you know is a struggle.

 

I just had a higher pitch ringing occur in my right ear that was higher in pitch than what I constantly hear. It also felt deeper inside my head. Lasted a few seconds, then went away back to what I normally hear. Not sure if there is a difference.

 

That's called fleeting tinnitus.

 

@KWC Where is your pain - top - bottom - both and does it move around on right side? Are you sure that your splint is 3mm and not 2mm ? You appear to being getting nerve pressure and need to figure out if it's hinge joint nerve pressure or upper right wisdom tooth. Both could cause referred pain in both jaws on right side. Does cold water cause pain?

 

Pain is consistent in TMJ area at joint on right side and below along jawline below the ear. I have been having more tingling in hand. Not sure about the size of the splint. I do not have wisdom teeth. Cold water does not cause pain.

 

Same with me for the last three weeks. Clenching while sleeping is part of it, but what's causing me to clench is neck muscles. I have not been getting neck or lower spine/back therapy, but sometimes improper therapy with having TMJ needs to be a suspect. My neck hurts from imbalance.

When the spine curves, nerves that run to various parts of the body can become pinched. The most commonly pinched nerves are the brachial nerves that extend to the hands and fingers. Symptoms of a pinch in the brachial nerves are tingling, pain, or numbness in the fingers.

https://www.alexbelldental.com/tingling-in-hands-tmj-centerville/

TMJ can cause tingling and numbness in the hands because it sets off an imbalance in the neck vertebrae. The jaw and jaw muscles are partly responsible for holding the neck upright, and when the jaw is out of balance, the neck corrects by tilting in a complementary direction. This tilt causes the vertebrae to close together on one side of the neck. This can put pressure on the nerves that emerge from between the vertebrae, including the nerves that supply sensation to the fingers. This mild pressure leads to sensations of tingling and numbness in the hand. Normally one hand is affected.

https://www.riveredgedental.com/tingling-and-numbness/

In professional studies, with mention to the above, neck vertebrae can push jaw out of balance more. This can then work against a splint, where the spilt has too work harder with alignment. Sometimes month bacterial infection causes more harm - more so if there's gum problems. Whiplash can cause all of the above. Neck posture while sleeping - no air space between pillow and neck is needed. Soft pillows - non foam and medium firmness mattress may help. I use two medium size pillows with one hanging forward over the other. I try to sleep with no air space between neck and pillow and when I'm not doing that, my jaw will receive pain. I change sides often to balance out gravity and compression. Warm and cool compresses for face/jaw and neck may help. Soft foods eaten on non TMJ side - such as light + fit Greek, mashed potatoes or egg salad may give some temp relief to nerve circulation. Holding warm water - with no movement for 5 seconds on one side at a time may help temp.

Does any of this work for me, except having no space between neck and pillow - not all that much as I had major notes on my radiological mouth/jaw exam from dental whiplash. Your notations show little wrong, except lower jaw being back too far and with this and from this, clenching from neck vertebrae tilt causes a nerve supply problem. This is why you feel tingling in your fingers which may be more in palm, baby finger and index finger and not so much in middle fingers - as mentioned in many studies with brachial nerves.

Often, in the ER, is patients asking for pain meds for TMJ. Many have recently seen a chiropractor for neck and lower spine therapy. Muscles may have not been loosened by warm compress first. Pressure to muscle therapy was given and not outward extension therapy. A therapist with a doctorate needs to be seen as TMJ function with neck will be considered.

 

Continued... Many professional studies point out that a splint - mouth guard has limitations if correct posture isn't being used. @oceanofsound26 has posted much about posture and body mechanics. Sometimes, one side of body is lower than the other. Even a shoe pad for lower side can make some difference.

Forward head posture and favoring lower body side can effect the TMJ. If head tips towards the high shoulder, pulling the trapezius and pulls on the temporal muscles, then TMJ will be strained. Sucking on a straw on side of lip of lower body height with TMJ muscles and joint problems, more damage and pain can happen.

 

@Greg Sacramento, very good information as always. I had TMJ follow up today and imaging shows condyle in correct position with splint. Appeared to look good. I'm still dealing with pain. I'm assuming TMJ pain is with realignment. Doctor showed me the scan, he sees issues with my cervical. At C1 he can see a shift. More space on one side. I believe realignment of jaw affected neck and is causing tingling. He wants me to see an osteopath. I will also will pursue orthopedist as well.

Once again thank you for your feedback.

Hope you are doing as well as can be.

 

Been reading a bit about jaw and maxilla stuff. Came to this post “condyle presses against nerve endings and strains aligaments by the ear, and this causes the tinnitus”

@KWC I have no idea how exactly to fix that but apparently it’s a known issue and stems from a recessed lower jaw. That recession also causes ETD, confirmed. How exactly I don’t know, mechanical, but it does resolve once the recession resolves.

I’m pretty sure @Greg Sacramento will have mentioned this same thing about ten times but my brain is mush right now.

It does make sense though. I instigated facial changes that led to tinnitus and I think to a lot of the discomfort on my neck.

Damn. ETD theory almost ruined xd

 

@donotringatme thx.

Hopefully the splints will help.

 

Does anyone else have high pitched tinnitus that only gets louder, not from moving your jaw, neck, or ear, but by putting pressure on your jaw and pushing on it? The direction doesn't matter at all, up down left right top bottom, all directions increase my tinnitus.

Is this some sort of pressure point or specific muscle that's being affected?

 

Hello @Greg Sacramento @donotringatme @just1morething.

Hope you guys are doing ok. Any improvements on each of your end?

@donotringatme saw your posts and am happy for you, congrats!

I am about the same. The ringing stays relatively constant, never improving. A high pitch continuous sound. I would say my jaw and TMJ pain at the joint area has improved, jaw is sore. The knot behind my jawline below my ear no one has been able to tell what they think it is, beyond TMJ doc saying stylomandibular ligament.

I visited a audiologist and am trying white noise therapy. Basically have run out of what to do next. Each day is a struggle like many others.

I believe my splints did change my sound and did improve the TMJ pain so guessing it was needed.

@Greg Sacramento do you think it is possible that the splint realignment of my jaw causes the swollen area in my neck below my jawline?

Thinking about stopping using the splints but not sure.

Hope all are as well as can be.

Ken

 

The swollen area in neck would be from jaw muscles. Cause is jaw pressure - either by splint or without. Pressing teeth together, even slightly, for 5 or 10 seconds can bring this on.

Your panoramic views show anterior open bite with a special relationship that shows your resultant posterior joint is slightly wide. I don't think that your mandibular plane is a problem or centering, but condyle is slightly anterior to the center of the fossa. Your palatal vault is fine up to the alveolar ridge. You have no cortical thickening and your TMJs are rounded (good) without evidence of subchondral defects.

So I believe that you are applying pressure in a sideways motion and then pushing back. Often this tension can cause pain in ear as well. You could become tinnitus free or almost free, if you can control emotional tension causing physical tension - teeth pressure. This upsets with what you have above (very common) - nerves from jaw that goes to ear. Controlling blood pressure will also be a must.

A test: Take a spoon and slightly tap a pan once or twice - metal to metal movement - and if your tinnitus lets up for seconds to a few minutes then involvement may be nerves from jaw to ears.

@PeteJ - consider this - minus any hearing loss from noise.

 

@Greg Sacramento very good information as always, thank you. I do have pain in my ear as well.

Part of me is wondering just doing splints at night for a week to see what happens.

How are you doing?

 

@just1morething how are you?

I am trying to remember did steroid injections help your TMJ pain at all?

Thanks,
Ken

 

Thanks. At 17 weeks my TMJ imaging the other day with the splint in the doctor said condyle positioning looked good in the fossa. The pain in my TMJ joint and the headaches have definitely improved. More some soreness now in those areas and my neck area and delves into my ear as well. My ringing is not a eeeeeeeeeeeee but sounds like a high pitch static, now continuous, that is easy to modulate with any jaw flexion.

Question for you. The swollen area on my neck right below ear feeling with slight pressure (starts about 1/2" below ear and about 1" in length), the only "way" I can flex that area is by pressing my tongue down against my back molar with pressure... what muscle groups is that? What is the best way to self treat? (heat, cold, stretching, etc.)

I am trying white noise maskers to try to help me habituate as I still sort out the medical. I would agree with you about swollen neck muscles (sore). As of right now the neck CT scan came back clear and my ENT is not sure what to do next (he said not sure about biopsy, etc. since CT is clear). Maybe I need a second opinion.

Just like most, I am still struggling with the anxiety and stress dealing with this. Hope you are doing well as can be and thanks for everything you do.

@donotringatme keeping up with your posts, glad you continue to progress. @just1morething hope your static will improve.

Ken

 

Hey @Greg Sacramento, I hope you are well as can be. I saw my ENT as a follow up and he told me the swollen area was a lymph node. He told me he could remove it but he was concerned because of it being near the facial nerve. Basically he said just to leave it alone... I am not sure it's just that only. All I know to do now is just wait and see. The pain in my TMJ joint has improved to a soreness that delves into inner ear... Tinnitus is the same and am trying white noise generators to see if I can adapt to the sound.

@just1morething has your jaw or tinnitus issues improved any??

Ken

 

No. I’m back to the same left ear hissing. It really wears me out. Solid hiss today. Still searching for someone to help me. Did you ever try a steroid injection to your bad TMJ? If that would stop your noise it would probably prove it’s caused by inflammation. My noise is very loud.

I am working with a TMJ physical therapist but only had one visit so far.

 

@just1morething, I've had no injection yet. The pain has improved in joint with splints to more soreness that delves into ear and under jaw line on neck. I would have to figure out who could give me the injection since there is not a lot of pain.

What did you think of the appointment with the TMJ therapist?

 

It was okay. I'm supposed to go back Monday. Time will tell if there is tinnitus improvement. I had an airplane barotrauma in 2008 that affected my left ear. I keep going back and forth on if that or TMJ D is causing the noise. I think you said you had an ear infection on the same side as your TMJ.

Is your noise the loudest upon awakening from a nap or overnight?

 

Yes in January I had an ear infection and the jaw pain started all on right side.

My noise is pretty consistent all the time.

 

Completely agree @just1morething. I feel just beaten down. At a loss what to do next.

I saw that you did the Schulman protocol mix, are you still doing that?

I have been trying to wean myself off the benzo. COVID-19 has an impact as well as the more doctors I see the more exposure risk there is. I'm not sure what to try, meds, steroid injections in TMJ or what. I'm still wearing splints and still have TMJ pain, inner ear soreness, pain down side of the neck and trap.

Ken

 

The physical therapist did say it would take time for the noise to go away. I’m going to try to get another steroid injection to my left jaw sooner than the end of November. Noise drives me nuts.

 

I still take Gabapentin plus Clonazepam but it seems it doesn’t work for me. I even talked to Shulman by phone in the past. He is 90 and probably retired now. I’m going to concentrate on my left jaw at this time. I’m pretty sure that is the source of my noise.

Found this on Facebook TMD group:

Similar... my tinnitus symptom has been increasing in my right ear... more now that I'm having earache and muscle spasms on my cheek... Ear feels full too... Just started taking a steroid as Doc says its due to inflammation of the joint and interferes with the Ear Canal....

 

In plain English or non biological terms:
Your joints are normal size and shape.
TMJs are smooth and rounded without defects.
--------------------------------------------------------------------------------------------
BUT:
Your mandibular plane and vault is a little deep and narrow. This is just you - probably from birth or teenage development when wisdom teeth developed. Removal of wisdom teeth probably isn't a factor, but can not say for sure.

Joint space is wide in the right TMJ and you have an open bite. Probably caused from trauma - forward head lifting - forward motion - either from a dental experience or a minor whiplash. But forward head posture probably is also in your history. Will discuss this in conclusion below.

You have lots of muscle in neck and facial regions. This can have same effect as not having much muscle to get pain down side of neck and trap. So this relates to the 3 BUT's mentions above. Your tongue also may have not have good posture.

Conclusion: Age is a factor. Your stylist - your jaw frame - your C spine - your C1 - may be pushing forward from a trauma mentioned above and now with a history of forward head posture is causing muscle input to neck and trap. This is what is probably causing your tinnitus, It's not just your jaw - it's your stylist, your neck - C1 and neck muscles. I don't think that clenching is a major factor.

TREATMENT: Keep using your splint. When sleeping, spend some time on back with head slightly tilted to non TMJ side. Now may be the time for some neck treatment. Neck muscles should have only outward extension therapy. This means no pressing muscles to your C spine - frame - stylist. C1 may need mild rotation - no neck adjustment with this - a device or a therapist's palm of hand with a gentle sideways motion only. Therapist needs to have knowledge of your X rays and neck CT.

 

@just1morething I hope it goes well for you. For concerns of COVID-19 I will have to wait on seeing any more specialists.

I thought about trying this combination but really concerned as they are heavy duty drugs.

 

Thanks @Greg Sacramento.

I found these neck exercises for tinnitus on youtube. If you do a search for "nekoefeningen tinnitus" you should see the videos.

For PT I presume you are referring to a therapist that specializes on the neck.

For now I may have to do PT on my own for concerns of COVID-19 risk. If you are aware links to any exercises I can do, I would appreciate the feedback. I hope you are as well as can be.

Thanks,
Ken

 

They used to knock out my tinnitus until I fell asleep and awakened. I have also HF hearing loss and cervical spondylosis so it’s hard to pinpoint noise. I don’t consider gabapentin or clonazepam having the side effects of antidepressants. Some may disagree.