Somatic Tinnitus

You probably mean NUCCA or AtlasPROfilax. I recommend you read postings by @Greg Sacramento, there’s a ton of valuable information.

 

I wrote a lot about it in my intro post. I seem to have somatic tinnitus. Can modulate it even with my eyes or by tweaking my left wrist/hand.

Over the summer I started hearing the conk shell air sound, but didn't pay much attention to it. What I really noticed first was a meandering high pitch frequency about 5 weeks ago. I wasn’t sure exactly what modulated it. Sometimes it appeared to move similar to my heartbeat, but not exactly. Often it’s like a pulsing that shimmers in the back of my head, usually more associated with the left ear than right. When that started I also had a period of time where everything was super loud (hyperacusis). When the tinnitus gets louder, it becomes more like the whine of an old tv that’s turned on without any content. Except it changes and wobbles. I also began to notice a faint low pitch hum as well, almost like a generator running in the distance, which often has a typewriter like effect to it, and some weird harmonics in between the tones. I also have heard weird beeping/buzzing in reaction to other sounds like a fan running or white noise sometimes (dysacusis I guess?).

I had a hearing test, and my hearing is great. Eventually I began to notice I could change the pitch with my jaw and head. Not only that, I realized I can change the pitch with my eye movements/eyebrows/tongue, and even my left hand/wrist or by pushing on my head/neck in a lot of spots. A doctor at the ER (where I went for anxiety due to tinnitus) pointed out that he thinks I have a pinched nerve due to the modulation.

The ENT I first went to hadn’t even heard of somatic tinnitus. I don’t seem to really have TMJ, though my dentist has been suspicious that I’ve been clenching due to teeth sensitivity on the left side in the last year. I did have some sort of neck injury about a year ago that has been bothering me roughly in the same timeframe as this. (MRI showed a small bulge on the C5 that was limiting my range of movement.) X-Rays a few days ago looked good. I’m getting the MRI updated soon, and going to see an ENT who specializes in hearing, but it seems like lots of folks don’t know about Somatic tinnitus or how to try and treat it.

In the meantime I got back on an SSRI to try and address the anxiety issue (though I know they can be bad for tinnitus, I needed something. Cymbalta seems to be one of the better ones.) I’ve started going to a chiropractor, who said my neck and jaw muscles were super tight. I guess I should see an upper cervical chiro?

Other details leading up to this starting, I was taking klonopin 0.5mg roughly every other day for 3 weeks leading up to this (the docs think there’s no way I had withdrawal). I also did Ketamine sessions leading up to this, though the last one was separated by nearly a week from this starting. My eustachian tubes have also been problematic, primarily on the same side as the high pitched tinnitus, for awhile now. I have GERD and so sleep on my left side, and I wonder if that's a problem here.

My neck is sore, and that’s hopefully addressable and the core of the problem. Or maybe my jaw even though it’s not super painful. Or maybe it will improve with my anxiety. It does seem to wax and wane sometimes, and I’m not entirely sure why. Usually if it’s going to be quieter, it’s in the morning.

I’m struggling though, and looking for any advice. I don’t know why I suddenly have this, and I’m worried it’s going to keep getting worse.

They want me to see a physical therapist for my neck. I'm seeing the ENT hearing specialist. I feel like if the tinnitus was at least steady I could habituate easier.

What do I do? Who do I go see? I saw a TMJ specialist, but those bite guards were $2400. Is that normal? I saw someone saying ETD is the true issue. There's a guy around here who dilates them. Should I do that? Acupuncture? Neurologist?

Please help.

 

If you place your hand at the back of your head, where all the nerve endings are, then move your eyes far right and left, you can feel movement. Back there are all nerve endings.

You should do a thorough ETD endoscopy with recorded video, read my thread. I’ve booked for one too. Acupuncture is laughable, but an actually good physiotherapist can in fact release knots with needles. He will pinch the knot, insert the needle sideways, you should feel little pain, then a twitch must occur. If you feel heat, it means he is pressing on a nerve so tell him and he will withdraw. The needles are sort of round at the edge so they don’t pierce nerves, they will just push them.

TMJ does not have to be the issue. You can have a normal looking bite but the position can be faulty (read thread).

There is no way we will ever find the exact nerve causing all this. It’s not possible.

The two major causes IMO and after reading a lot from @Greg Sacramento and searching myself, are either the atlas OR your Eustachian tubes. We can see this with just logic. ETD means an ear isn’t healthy, healthy ears don’t get tinnitus and ETD itself causes tinnitus and ETD being fixed cures tinnitus. Lots of stories here. The atlas is more complicated. There are a lot of muscles there, you can loosen them sure but you have to check where exactly you’re stiff and where you’re over-loose there. I have seen necks that are just ridiculously bad, no tinnitus. If you see anyone over 40, their necks are messed up. However... I think that it can occur in relation to the jaw. It’s anatomical. I don’t know how exactly, if I did I would be rich. I do think that TENSION plays a role and I’ll test this the following week. It isn’t just tension in the neck. It’s how the head (through the jaw) and the neck work TOGETHER. That’s my thoughts. Why? Because if you turn right, you move both your head in relation to your neck. If you clench, you move your jaw in relation to your neck.

I once thought it may be the vertebrae, the small gap there where veins and nerves pass through, yes? So, one gets pinched or irritated and I get tinnitus. If that’s the case, all you can do is decompression table and strengthen the neck after you loosen the muscles. Yeah but there are necks out there mate that if you see them and read their MRIs you’ll say “nvm I’m good”. They don’t have tinnitus. Even if it IS the neck, we will never find it. It’s literally impossible. All we can do is trial & error.

If someone gets a reduction in his tinnitus by 80% or completely gone through physiotherapy, good. What exactly did happen? We have no data. If we had a thousand people with MRIs doing the same physio, we may have known.

By logic, the root cause of tinnitus has to be close to the ear. Or as close as possible, we can’t go backwards. So, fix your ETD first, restore their function. If you do and that doesn’t solve tinnitus, move forward. The problem is ETD can be FROM ALL THOSE MENTIONED, jaw, muscles, ligaments, neck (front and back), so since it’s neck it’s also upper back etc.

This is why I think one must focus on treating various areas with the GOAL to fix ETD... because think about this too: those people who claim reduction in their somatic tinnitus through physiotherapy, how many also experienced “PRESSURE RELIEF IN THE EARS”? I’ll tell you, all of them. The few videos online with testimonials, also mention that aural fullness / ear pressure was either gone or reduced. Coincidentally, those few who claimed “gone”, said tinnitus is gone too.

In conclusion...

A malfunction to the ear creates tinnitus. In my opinion Eustachian tube dysfunction creating pressure in the middle ear, failing to equalize normally. Remember James Bond old movie with Timothy Dalton, the guy inside the pressure tank? What is the one thing that occurs? A high-pitch tone, same as ours, before the guy explodes. Our middle ear is a tank, pressure rises, tinnitus rises. Pressure fails to equalize, tinnitus begins. Simple.

So, now you have a malfunctioning ear that has a constant environment where tinnitus lies inside. We have ruled out cochlear damage, tumors, Ménière, keratin buildup, wax buildup or tympanic membrane injury, hearing is perfectly normal. So, back to pressure issues.

Now, you have a box, tank, whatever you wanna call it... it is the middle ear cavity. Inside, lies tinnitus (not exactly but let’s simplify it). Now, that cavity is connected (directly or indirectly) with muscles and nerves. Those muscles are tensor tympani connecting to palatini muscle connecting to everything else. The nerves are pretty much all you can think of, one connects to another (sort of). As a result, one can modulate them in a variety of ways and volumes by messing with the muscles and nerves, creating tension. That’s it. Like what, a guy who leg presses a thousand pounds doesn’t create tension? Why doesn’t he have tinnitus? Or why doesn’t his somatic tinnitus go to insane levels while doing the lift?

Because the modulation is temporary. Try modulating your tinnitus by shifting your head right and once it increases, hold it there. It will dissipate shortly after, while you’re still keeping the same shifted position. This reminds me of pre-tinnitus era, when I would get my now permanent one and I would be able to make it dissipate completely by plucking and releasing my ear a few times fast (pushing the tragus to close my ear). What I believe was occurring back then was ETD and I was able to sort of negate the pressure difference. Probably the pressure difference between outer and middle ear was smaller. Who knows. The point is, ETD - from a mechanical cause at least - starts slow. You can’t detect it.

A final point is there isn’t a single person out there with somatic tinnitus (no hearing loss, no serious ear disease, no trauma) who doesn’t have ETD prior to tinnitus onset. If that isn’t enough proof I don’t know what is.

There are also cases of PET, constantly open Eustachian tubes, who experience the different type seashell sounds and then they alter their tubes and get high pitch tinnitus. What is the only thing they changed? Their neck is the same, their jaw is the same, their nerves are the same. The one thing they changed was their middle ear pressure.

I will personally do my best to treat mine and hopefully can prove these rumblings aren’t in vein. If it is indeed a tiny nerve ending somewhere in some vertebrae, then we can all just habituate and move on right now, plus we are definitely going to get worse in the future. However... I know personally a lot of people who have no hearing loss and somatic tinnitus for decades. As their neck worsen, their tinnitus does not. However, a single sinus cold gets their tinnitus to a massive CONSTANT spike, until the cold is resolved. So, the additional pressure and probably fluid buildup, leads to a worsening tinnitus. Their neck didn’t change. Need more proof?

Just to wrap this up, think of tinnitus as hair loss. I had it, lost my hair. Back when I was trying to find the cause and cure of hair loss, EVERYTHING was modulating it. Diet, posture, blood flow, hormones, the sun, you name it it’s there. It’s the same with every “no cause no cure” condition. Modulation means nothing, it’s circumstantial. Find the root cause, you’ll find relief.

Plus, not to mention wrong diagnosis. People have cholesteatomas and no ENT sees it. Others have infections slowly creeping towards their ear. Others have eardrum past injuries, others have noise or drug induced tinnitus. It’s chaos. So someone may have no ETD but have messed up his ears some other way, unrelated to it.

 

There is a person here that does ET dilation. Is that a thing I should do? My left ETD is definitely borked. I’m pretty suspicious that it’s from GERD/LPR.

Also should I not be using nasal spray (Flonase) daily? I have been more or less for a couple years. Did I fuck up?

 

@Greg Sacramento i see how generously you give in this forum, and hate to impose, but would you mind giving me direction on what to do next based on my post above / in my intro post? I’m starting physical therapy on Monday, I’ve seen a chiro twice, though I’m thinking of stopping that and seeking an upper chiro. I have an appt with an ENT hearing specialist Wednesday.

Highlights are:
- definitely have neck issues that started with some sort of injury last year and seemed to tweak roughly when the tinnitus really came on 5 weeks ago
- don’t have any serious jaw pain, but maybe doing some clenching and noticed some slight soreness along with teeth sensitivity on one side
- can modulate with eyes and even left wrist, or by pushing on lots of spots on neck. Jaw/temple are only on left side
- ETD issues on left side, maybe due to gerd and sleeping on that side. This was going well before tinnitus though
- sound changes a lot from fairly quiet (just conk shell sound) to insects crawling / little electrical signals being sent, to a louder whine
- x-rays look good other than some minor arthritis at the base of my neck

 

I can manipulate the tone of my tinnitus by moving around my jaw.

My question is, can everyone do that? Or is it a sign that my tinnitus is due primarily to posture/neck/TMJ issues?

Thank you.

 

Yes, this happens to me too. The increase is just for a second then it goes back down, even after holding the turned head position. I have have an increase in tinnitus on my left side though, not my right side. I really do not know the cause of my tinnitus but my hearing is within normal range and I was not exposed to any loud noises.

I had a deep head neck and shoulder massage today and absolutely no change to my tinnitus.

What are your thoughts on why I only get somatic volume changes in my left ear, and if caused by ETD, why is tinnitus all over my brain? On good days, I have no tinnitus coming directly out of my ears but my brain is always going off.

 

I was just wondering if anyone had any thoughts on this. I was walking around the other day a couple years into tinnitus kind of feeling like it is now more of a neurological pathway issue than an active cochlear insult issue but then remembered that I can still change my tone with jaw movements.

It would seem to me that if the sound changes with my jaw the problem must be outside the brain and perhaps still in the cochlea. Thoughts?

 

When I stretch my jaw in certain ways, I can make a really high pitched tone happen in either ear. My normal sound is closer to really high pitched crickets in both ears, almost like a hiss. But if I aggravate it like if I smoke weed or drink caffeine it gets to be more of a tone (and more annoying).

ENT thinks it's TMJ.

Which it could be. I do have a click in my left side when I open my mouth really wide. And recently I felt like a few headaches emanating from that spot as well.

But I also suspect an event a week before my onset where I was listening to earbuds (non noise cancelling) over a car radio. Might have been too loud for too long.

Thankfully, I've got no hearing loss, at least according to my audiogram. I suspect I might have slightly less super highs in my right ear (which has been slightly the worse ear), judging from really amateurishly testing myself with a tone generator online. The tone I'm hearing is maybe 16 kHz or more?

Meanwhile, I'm taking a muscle relaxant (Myonal) and doing a little therapy with some hot compresses on my face as per my dentist's advice. I can't tell if it's helping or not, it's definitely softer now than it used to be but still.

I also took some Arcoxia, an NSAID, for 5 days, 2 weeks before my onset. It was for carpal tunnel syndrome. My hands are OK now, though. I can play guitar again lol.

I told my ENT about all of this, and he still thinks it's TMJ, but he's a human too.

So it seems everyone's story is unique, but I'm just really hoping to see if anyone has had something similar. If you can affect your tinnitus with your jaw please comment and tell me about it and what your cause is (hopefully TMJ, and my ENT is right).

It's just kind of frustrating that for me the cause is still not solidly confirmed.

 

Hi @Gemini Crickets, I am sure that my tinnitus, which began 3 months ago, is caused by TMJD. If I just had known that this causes tinnitus, I would have given more attention to my Bruxism!

I can influence my tinnitus heavily with jaw movements. Additionally, my
Temporomandibular Joint is always falling "out" on the right side.

It is just annoying and I am anxious that the tinnitus will get worse over time.

My tinnitus changes in pitch and loudness all the time (almost every hour...).

I have had a mouthguard now for 1 month... Let's see what will happen. I hope that I didn't damage my jaw irreversibly.

How are you doing?

 

Well @MrAttention, I'm also wearing a mouthguard. The TMJ appliance. It's been around a month for me as well. I'm not sure if it's helping or not. It falls out sometimes, even after wrapping a strap around my chin lol.

I too have signs of Bruxism on my teeth.

Going to get an MRI soon to rule out acoustic neuroma.

I'm slowly getting used to it though. It's not loud enough to really drive me nuts, thankfully. But I miss coffee, weed and headphones.

Right now I'm just hoping it goes away. I read somewhere most tinnitus cases resolve themselves within 6-12 months of onset. Plus there are stories on here that have people recovering even years later. I'm literally just trying to will that into existence. Law of attraction and all that.

 

Does my tinnitus count as somatic if I can make it completely silent by plugging my tragus with some pressure? It's like there is an off button somewhere in there. I don't understand it.

I do have TMJ clicking on the side of my tinnitus (unilateral right side) and some odd extra crunching sounds when I flex my right ear muscle. My main tinnitus sound is a pure tone at around 1.7 kHz.

 

Yo, big update.

I met a TMJ dentist and got a real custom mouthguard. My tinnitus is caused by my TMJ according to her. My tinnitus is different from yours, really high pitched, and higher than 8 kHz.

Basically if your jaw clicks, you should get that checked out. Mine also clicks. You're going to want to find a TMJ dentist. See an ENT first though, of course.

 

Did anyone here who can modulate their tinnitus by pushing on your face or moving your neck try a nerve block of either the Occipital. Trigeminal or Facial nerves?

 

Geebuz!

How come I didn't see this before?

I also am from Brisbane and have been searching Tinnitus Talk for EXACTLY this POST from someone who was going to say "Doctor in Brisbane".

How did you find him and how did you know to find him?

Every doctor is like "well you know there is no c..." ENT's, OPG, MRI, auditory, everything.

I have TMJ, bruxism, and some funky neck stuff going on.

I will see how I go.

THANK YOU! THANK YOU! THANK YOU!

 

Hello,

In your opinion, is somatosensory modulated tinnitus (lowering or raising the tone) related to muscle tension, jaw, neck tension/pressure, nerves?

OR

Is this tinnitus (which can increase during the day) related to the sound environment?

Thank you.

 

Is somatic tinnitus something we should be worrying about? I mean, we chew our food with our jaw, tighten our neck muscles when we look left or right etc.

Are the tinnitus noises caused by the somatic aspect going to make our overall tinnitus problem worse? As in, push our baselines forward if we chew too much gum or go to the gym too much? A lot of jaw, head and neck tension goes on there.

Do somatic effects merely have an effect on the overall tinnitus noise we hear at any particular moment but don't actually have any cumulative impact on the seriousness of our baseline or our tinnitus like a further acoustic trauma would?

 

Can someone please help me with highly somatic tinnitus that has destroyed my life?

• It came on approx two weeks after suffering pain in my cervical spine just under the skull and radiating headaches from the back of my head after working out. My neck and upper back stiffened up for a few days after the initial injury and after a week or so the headaches were gone.
• It is bilateral but on good days is concentrated on right ear.
• My tinnitus changes from day to day but consists of a rhythmic sound like eeee-oooo-eeee-oooo that can be heard only when tinnitus is relatively calm and a second more intrusive tone that is a rhythmic ringing like du-du-du-du-du that drowns out the first tone.
• My tinnitus immediately gets worse when lying down. If on that day the tinnitus is relatively good, when I lie down I can hear the first eeee-ooo-eee-ooo but after a minute or so I start to hear the du-du-du-du emerging, it may come and go over a few minutes but eventually it becomes louder and louder and the du-du-du-du seems to increase in speed until it becomes a very loud bilateral ringing. My sleep has been destroyed.
• On many occasions my tinnitus has changed in nature as I moved my head around at night.
• There are many things I can do to aggravate my tinnitus but the most clearly demonstrable one is to perform SCM stretches i.e. repeatedly turn head to the side and gently pull my head down so that the ear almost touches the shoulder. When I do this, my tinnitus almost immediately explodes and I experience tingling on the back of my head, behind and under the ears. It takes more than a week for the tinnitus to calm down after this. A dull pain in my cervical spine just under the skull where I previously hurt it comes on a day or two after performing the stretches.
• Some days I experience ear fullness some not, and I also suffer mild sensitivity to sound, which is worse when my tinnitus is at a higher pitch. Some days my tinnitus is more reactive than others.

I had hoped that my tinnitus might be due to a muscle issue following the injury but I suspect that it is due to something around the upper spine due to various observations:

• SCM stretches cause a massive spike.
• SCM and trap trigger point release - spike (not sure how much as my tinnitus was already bad at the time).
• Prone cervical extension/contractions - massive week long spike.
• Running - multi day spike.
• Tingling where the auricular and occipital nerves meet the head when my tinnitus is bad.
• Wiggling jaw from side to side, like you do when using your tongue to get food out from between teeth - spike that lasts a few hours.
• My young son jumped on my lap giving me a fright causing me to jolt my head back. I felt my neck move internally in a strange way and was woken from sleep by a spike that night.
• I had a similar sensation to the above when I pressed my head into the pillow one night and my tinnitus escalated immediately.

Strange observations:

• Raising and holding my hands in a "hands up" position causes my tinnitus to increase.
• Getting into a squat position (no weight) and holding it causes my tinnitus to increase.

An MRI taken shortly after the initial injury did not show up anything but was assessed with a view to finding the reason for headaches rather than tinnitus.

If anyone has any ideas about what could be causing this or what I should do, I would greatly appreciate them!

 

Hi all,

Thanks so much for all your comments on this thread - I've found them to be incredibly insightful.

I've had unilateral tinnitus for around 3 months now and I'm at a loss as to what the cause may be.

For reference:

• I'm 28 years old.
• Tinnitus started suddenly one night in bed and has stayed since!
• I hadn't attended any loud concerts prior.
• I wasn't particularly stressed in the days/weeks prior to tinnitus.
• No hearing loss identified in tests.
• MRI came back as normal.
• No fluid in ears.
• I took a steroid spray for first 6 weeks but no change.
• Tinnitus in left ear and on occasions appears in right.
• Multiple tones, mainly medium pitch. Main tone that's unchanging sounds like a distant morse code.
• I can't modulate my tinnitus through jaw or neck movements.

Other symptoms that may or may not be linked:

• Clicking and crackling when opening and closing jaw. No pain in jaw.
• Left ear pops when jumping. If I press under my left jaw, the ear popping stops.
• Sway back posture. Job involves working at a laptop all day.
• Tingling in left hand (although this is suspected to be from ganglion cyst in wrist).
• Deviated uvula (deviated to the right - research shows this may be linked to vagus nerve issues).
• Always had neck pain and tight trap muscles.
• Head 'rumbles' when doing chin tucks and chin to chest.

ENT suspects ETD and has recommended daily nasal rinses. I'm currently taking Sterimar nasal spray but haven't noticed any change. I've taken Sudafed and allergy medication for a few days but neither helped.

If anyone has had a similar experience to me or any helpful tips and advice, I'd love to hear from you!

I've always found Tinnitus Talk to be incredibly supportive and a great community.