Tinnitus After Physical Therapy Exercise — Going Insane, It Keeps Getting Worse

Hello,

I am new here and hoping this forum can help me. My journey started last August where I injured my back and as part of my rehab, I started physical therapy. One of my exercises caused me to strain my neck, and I could feel something give in my left ear, and have had pain and a very, very loud high-pitched metallic chirping in my ear. Every day, it has gotten worse. I went to two urgent cares, and talked to my doctor (he refused to see me in person because their office had a COVID-19 outbreak) and got nowhere.

A few days ago, I woke up in so much pain it felt like my entire ear was going to explode, and my tinnitus was unbearable, and went to the ER. They briefly examined my ear and found nothing structurally wrong, and did a CT scan to see if I had a vascular issue (I don't). He seemed to think I have a nerve issue in my inner ear causing it, and gave me Gabapentin for it. I took it and it worked wonders, for a morning, but it's not doing much anymore. The pain is reduced now with a few meds I'm taking, but the tinnitus is back on its original track, getting worse and worse with each passing moment.

I cannot function. I cannot sleep. I cannot work or concentrate on tasks. It's so high pitched and loud no matter what kind of white noise or other noise I put on, I still hear it over it. I have a 5-speaker surround sound system that I put white noise on at the highest level I could tolerate and I still hear my tinnitus over it.

I do not have any hearing loss as far as I can tell, but I'm a little sensitive to high pitched noises. I've been in touch with every ENT within 100 miles of me (and one 130 miles away) except one and the soonest I can get in is in May, despite my doctor putting in referrals as urgent. As one ENT explained to me, they don't consider tinnitus that urgent because you're "stable", and they refer to urgent cases as things like cancer, growths, etc.

I've talked to my physical therapist and she says that because it was likely caused by something physical (me doing the physical therapy exercise), she has some exercises she thinks she can do for it, but that's seemingly the only thing I have until May when I can get just an initial consultation, where actual work will come later.

Meanwhile I'm going insane, not getting sleep, and not being able to concentrate at work. As more of the people around me see what it's doing to me, they're getting concerned about me and I'm getting concerned too. In reading some stories here, I feel bad that I haven't been dealing with this as much as many others, but I need help and am not getting it from the health system in a timely manner and I have a history of depression. I see a therapist which is really helpful, but it's not enough.

I am not really sure what I need (other than this to go away or at least be reduced), but both I and the people around me are concerned and I just need help since I'm not getting it from the health care system.

 

Hi - I have some specific questions based on some experiences over the last few days - maybe this forum can help me.

1) I seem to have developed a pattern over the last five days where I have an absolutely horrible 100,000 metallic high-pitched crickets chirping in my ear that make me cry and scream in agony all day that makes me go to really bad places followed by a day of fewer crickets but really high-spikes every 10 minutes or so that is a little more tolerable overall. Is this normal?

2) I also notice when I wake up, it seems like I can affect my tinnitus a bit by my head position, but only when I wake up. I try and find the best position but I get like 15 seconds. Does anyone have this?

3) My family is really concerned about me - which I understand - but I feel like I have to reassure them everything is fine when it's not. I live alone normally, and it's been nice to have someone around because sometimes they come over just to keep me company, but I feel like they're just seeing if they need to get me to a psych ward or not given my history of depression.

4) My uncle gave me some headphones to try but I've read on here they don't really help and actually hurt - would people generally say that is true?

5) As I mentioned in the first post, I am getting next to no support from the healthcare system. Any advice on how to fix this?

 

SCM muscle ends at ear and might have got injured. Do scans show any injury?

 

@creoena, sorry to hear you are in such distress. I'm afraid I can't give you any more information on what caused this for you and what you should do, apart from waiting it out, trying some supplements and eating healthily.

But the situation you're describing about the healthcare system is absolutely criminal. Not that there are a lot of things doctors can do about tinnitus onset, but they could give you maybe Prednisone or vasodilators. At least check for any sudden hearing loss. Did they test your hearing at least? Also, the fact that Gabapentin helped a bit might be a clue here. Maybe someone more knowledgeable here can help you.

I'm wondering though, can't you go for a proper ENT examination? Like, just make an appointment at their private office. I don't know where you live, but here that I live, it's really easy to just call one and book an appointment for like 50-100 euros in the next few days.

Waiting so long till May might reduce your chances of finding a cause and treating it (hopefully)...

 

I can't get in for any scans other than the CT scan I got at the ER, which came up clean.

I can't get into an ENT because they said it is not urgent because it is tinnitus and the soonest openings are in May and June for them. I've called every ENT within 100 miles of me except one which wasn't open this week and most say they can't do anything without a referral and that process is taking time. I am not having any hearing loss, but I'm sensitive to high-pitched noises. I have one that is willing to do a hearing test next week but said it's unlikely I can get in for more than that. The test won't be helpful, but I'm basically going to use it to beg and plead my case to get in ASAP. I'm becoming less and less convinced Gabapentin is helping given how inconsistent my symptoms are.

 

@creoena, maybe if you tell them you suspect you have some loss of hearing? Prednisone (one of the few things that can help with ear stuff) gets less and less effective as time passes. I really can't comprehend this system with the referrals and such... What the f*ck will they be doing all these 6 months that they put you on waiting for a hearing examination...

I only can suggest you try out supplements such as Magnesium, Zinc, Vitamin D / C / B1-12 and Ginkgo Biloba, and a diet with more antioxidant / anti-inflammatory food.

I hope you find relief soon! Someone might give better insight than me my friend...

 

Thanks - I appreciate it. I have no idea what they are doing but it's just absolutely maddening. I feel like I am being tortured and getting very little help from the people who are supposed to help. I know straining my neck caused it, and my neck muscles are sore at times (I just went for a drive and aggravated everything and now I have pulsating high pitched noises and a really sore neck). Given I have a good idea of what is going on, you'd think it would be simpler to move forward.

 

What about seeing an upper cervical osteopath? Even get someone to come and give you a massage, concentrating on the neck area...

 

Hi @creoena.

I just placed eye drops, so I'm unable to see well, but I hope to be able to comment more later.

You appear to have muscle spasms pressuring your C-spine. A lot can be involved with this.

I suggest no neck movements beyond resistance - no lifting of head from a flat surface and no forward head bending.

Try cool moist compresses without too much pressure (washcloth) and after each 5-minute application use cool for another 5-minutes. Liquid Magnesium Glycinate may help. Use a small amount three to six times a day. Use no more than 400 mg total a day. Using magnesium once a day will not help. Do not use headphones.

I have written much about neck problem/somatic tinnitus and provided many links including the associations with ears. You could place Greg Sacramento into site search.

A friend, a retired cervical and tinnitus Interventional Radiologist and MD - only one of two on the West Coast will be visiting me later today. I'll ask him to review.

 

Thanks - that seems to be closest to what is happening for me. My ringing is definitely partially dependent on my neck position, and my neck has been sore, like it feels very tired when I try and just keep it straight, like with sitting. It is worse when laying down though. I drove about 45 minutes today as the car is nice for covering up the ringing, but it really aggravated my neck, and became worse.

I was thinking to call a chiropractor anyway on Monday as I'm told they may be able to help, but it sounds like that may be a good way to go? I also have a physical therapist I can work with.

When you say "cool moist compresses", what does that mean? Just wetting a wash cloth at cold temperatures?

Also, do you think a neck brace/cervical collar would be helpful?

I would appreciate anything your friend can suggest! I'll also look up some of your other posts.

 

@creoena, I would work with a physical therapist.

Yes, then rinse it out - so the washcloth doesn't drip.

If any increase pain or soreness after using warm, just do cool treatment for a few days until your physical therapist can physically exam.

The physical therapist may recommend wrapped ice, but warm is needed before muscle therapy. The physical therapist will do measurements, such as leg height and check to see if shoulders are balanced. The physical therapist will examine tension in shoulders muscles. The physical therapist will check resistance in turning head.

Most with neck and shoulders problems where it gets worse are not using correct computer use posture. Ninety-five percent of people don't use correct computer posture. Depending on the physical therapist's findings, use of a neck brace/cervical collar may be recommended for 30 minutes to one hour per day.

The physical therapist will examine all neck muscles and shoulder muscles.

If there are neck problems with onset of tinnitus, then focus needs to be with neck, shoulders and posture. For you it's probably tensed muscles. I wouldn't spend a lot of time researching alternative treatments. You may never have a perfect neck - most don't - but neck, shoulder and posture focus are needed to solve your tinnitus.

Keep us updated.

 

Upper cervical chiropractic may help since your tinnitus seems to come from upper neck injury from exercise. You can do internet searches on it as a treatment for tinnitus. They should have much less wait time. ENT usually can't help unless your tinnitus is caused by ear problems. The worst thing is they often say nothing can help. Just live with it. Mine is even worse, saying that the only way he can stop my tinnitus is to shoot me. Such horrible experience. Good luck. God bless.

 

@Greg Sacramento, thanks - I'll keep you updated. I have a physical therapy appt in a few hours.

Last night was absolute agony. I woke up after about an hour of sleep in the worst pain/pressure I've ever experienced, and the chirping in my ear was off-the-charts. I collapsed on the floor yelling and screaming, basically couldn't even talk, and then experienced a really bad cold chill. I ended up calling a relative as I thought I had to go to the ER again, and while it got slightly better to the point I didn't go to the ER, I had a rough night and it was still probably the worst day so far. I had another wave about an hour later, not quite as bad, but still brutal and was screaming into a pillow (my relative was still keeping me company). I had another cold chill afterward and took my temperature and it was 95.7. I found a setup by laying in a reclined position vs. completely flat that wasn't aggravating it. I was finally able to fall asleep in (with help from sleep meds) for about 3 hrs off and on. FML.

 

@creoena, I would strongly suggest you get some serious care for your neck, i.e. an upper cervical chiropractor, NUCCA chiropractor, or even better Atlas Orthogonal or AtlasPROfilax treatment.

 

Hi @creoena, I'm really sorry to hear about your tinnitus, especially since you've acquired yours in fairly similar way I did my first tinnitus noise. I agree with the other people here suggesting you try looking into finding a chiropractic and make sure the one you pick is well-versed in head and neck manipulation. As for ENTs I've had similar experiences as @billi48 - happy to take your money but pretty much out of their depth when it comes to treatment other than "There is nothing wrong with your ears, so it's got to be all in your head. Here, chug a bunch of psychotropic drugs! What do you mean, you don't want that? But that's all I can offer, I guess that means you'll just have to live with your tinnitus."

I'm keeping my fingers crossed your tinnitus will only be a temporary occurrence and that with some rest and the right kind of therapy you'll be rid of this nightmare again. I know it is a very hard thing to do in the early stages of tinnitus but, if at all possible, try to stay calm and focus on things other than the ringing in your ears. Because the more attention you pay it, the worse it will get. You're already doing the things I would recommend myself, like listening to masking sounds and finding activities that offer some kind of relief. Keep doing so and try to stay active, being outside / going for walks makes my tinnitus more bearable. I'd try to stay away from sports that could further aggravate your neck and maybe get a soft collar to give your neck some support.

All the best and let us know how things are playing for you,
Leila

 

A physical therapist will examine for trauma and inflammation. I would not seek any other assistance at this time, unless by hospital doctors and a private doctor for follow-ups. Doctors and surgeons work with physical therapy.

When you can, keep me informed.

 

Thank you - I wasn't aware there was different types of chiropractors. After some internet sleuthing, I found there is only one NUCCA chiro in my state and I'm not getting any hits for upper cervical chiropractors, and the nearest Atlas provider is two states and over 300 miles away. I got in a consultation with the NUCCA chiro next Monday, but it is not in my insurance network, so hopefully it will not be too expensive.

What are the cons with working with a 'normal' chiro that may be closer and in my insurance network (the NUCCA chiro is about 50 miles away and will aggravate things being in the car that long)?

 

@creoena, did you see a physical therapist today?

A CT does not always note a vascular problem or many other problems. MRA is much better. X-Rays will show clear views of the C spine and lumbar spine.

An Interventional Radiologist may be needed to examine soft tissue, spine, nerves and arteries/veins. For you all this may need to be examined by radiological testing.

I can't tell you how many times we had ambulances roll up to our ER trauma level 1 bays with someone with your situation that went to a non-physical therapist first. I worked in two level 1 trauma hospitals for 28 years. These hospitals had several helicopter landing areas on the roofs.

It will be hit or miss with these other guys for you. If it's a miss, I don't want to take responsibility for that. I would let a physical therapist examine you and then decide what treatment and by whom is needed.

 

I made an effort to comment yesterday, which was difficult after using eye drops that give me blurry vision in my good eye. I saw concern with your situation and thought that you may have a rough night.

The retired cervical and tinnitus Interventional Radiologist and MD that I spoke is also a neuro Interventional Radiologist. His remark today was that a good physical therapist, that wasn't sure about what damage muscle spasms has done to a C spine and other anatomy, would recommend seeing an Interventional Radiologist first before going to a chiropractor, NUCCA or any Atlas provider. He reviewed your comments. He said you could get lucky with one of these providers or you could not. The vertebral artery is encased in the C spine, and you don't want to chance that getting damaged or other veins and arteries.

 

Hi @creoena!

If you've pulled a muscle then I think physical therapy might help (although that seems to be the source of your issues). You mention that it isn't vascular, so that is good.

If you think that your atlas vertebrae might have been knocked out of place, which is very possible, then go see an upper cervical chiro. They will provide x-rays and see if there are any abnormalities. Most people have a subluxated atlas, but many don't exhibit symptoms. Since you are having neck pain & tinnitus it is very likely this is the cause. You can certainly get an assessment first and decide if you want to seek treatment.

NUCCA is an upper cervical chiro that uses a very gentle push on your atlas to wiggle it back into place, it can be slow going as the muscle might not hold it. Same with an upper cervical chiro, although the adjustment is a little bit more forceful. My experience was not uncomfortable and certainly not the usual cracking you may experience with a regular chiro. IMO I wouldn't say that a normal chiro will address your issue appropriately. You can call around and see if regular chiros offer this treatment, funnily some don't advertise it as such. They will likely want to see you at least once per month, maybe more. After treatment it is best to relax and walk around for maybe 30 minutes afterward and try not to turn your head.

Alternatively, there is Atlas Orthogonal which used a machine that sends a vibration through to your atlas which allows it to fall into place (aligning with the axis, it's natural home). These are harder to find and again, there is the chance that it won't hold easily and you will have to seek more treatment.

Finally, there is the AtlasPROfilax (make sure they are registered on the website). It is a simple non-invasive procedure whereby the sub occipital muscles are massaged with a special vibrational massage instrument that relaxes the muscles enough to allow the atlas to align with the axis. For most people, one treatment is all that is needed, because when the muscle goes back to it's natural state the atlas is already in place. Another trauma can always cause it to go out again. I have done both NUCCA and UCC and have found some success, however, x-rays show that my atlas is still not in position. I am having this treatment tomorrow for chronic neck/back pain, migraines and hopefully tinnitus (though I'm not counting on that).

It sounds like you've got some research to do and decide the best course of action, but I think a consultation will obviously help you decide. I wish you the best of luck and will report back on my treatment. My tinnitus is similar in that the volume changes from day to day. My biggest issue is the pain right now, and I will be forever grateful if I can have some improvement.

Sarah

 

I did and she did a formal assessment. She seems to think it's solvable via physical therapy and some changes to behavior/posture. I have some home exercises I'm doing every two hours and I'm seeing her 2x/week for a few weeks where she'll continue adjusting my plan. She said a chiro could help. She has a plan to address the 100,000 crickets in my ear and my ear pain first, then the neck pain. I'd feel a little more comfortable doing an x-ray and/or MRI to confirm but she worked wonders on my lower back pain despite this injury. I may end up forcing the issue there.

I appreciate your information! I know next to nothing about physiology and the medical fields and professionals available to help You and everyone here have been such a great help, and a heck of a lot more help than my PCP. I hope you are able to find some improvement in your situation. I have such respect for people who are living with this every day. I've been dealing with this a relatively short time and even if I'm not having a 9/10 pain/pressure day, I still break down at least twice a day.

 

Hello,

Just wanted to provide an update. We're starting to make some progress understanding what is going on, and thanks in part to the wonderful people here who have made great suggestions, I'm starting to work with seemingly competent people. In working with my physical therapist and back specialist from my original lower back injury, we are pretty confident I have a pinched nerve in my neck with some sort of misalignment. The tinnitus has changed a bit and now sounds like I have 100,000 crickets in my neck vs. my ear. They are also not quite as high-pitched as they once were. Some of my physical therapy exercises are starting to provide a little relief, though I'm a long way from normal. I met with a NUCCA chiro today and am getting an exam tomorrow and the first correction in a couple weeks.

I also have a 2nd issue, but luckily it's a symptom not a root cause. I've been doing Invisalign for a while, and due to a comedy of issues, I've had to be on the same tray for over two months while a correction is made. I wasn't thinking that was not contributing to my issues, but I have a tendency to grind my teeth when I am stressed. As an experiment, I took my Invisalign out for an hour and a half and felt a lot of tension release. I talked to my dentist and he confirmed where I am at now, I have a left-bias on my bite (when I bite, my left side bites down first before my right), meaning when I'm grinding my teeth, I'm putting a lot of strain and pressure on the left side of my face. Having the trays in makes it a bit worse. I've worked to not grind my teeth and that has helped the ear pain immensely.

Overall, I'm starting to get a bit optimistic, knock on wood. Sleep is still very much a problem, but otherwise, I'm starting to get a little easement of symptoms. Thank you to everyone who contributed to this thread and helping me!