Tinnitus Began Overnight — Doctor Suspects Neck/TMJ/Stress/OCD as the Cause

Hey Folks!

34-year-old musician here. I'll start with that. But I will also start with the fact that my ENT says my hearing is perfect and believes that my tinnitus is NOT hearing related. She has said this several times. I know that among these groups, often, we can have the tendency not to trust doctors (and I totally understand and relate to this), but I tend to trust her. She is a well-known specialist on the issue. Let me start with my symptoms, and what's been happening.

When did my symptoms start?
1. About 2 weeks since it started more or less overnight.

What are my symptoms?
1. High pitch hiss, that can change from left ear, to right ear, to center. Sometimes the hiss is a flickering, sometimes its constant.
2. Sometimes all of the symptoms are COMPLETELY gone. Even when I look hard for them.
3. Symptoms seem to get worse at night.
4. Some nights I can sleep. Some nights I can't and I seem to only focus on the sound.

What have I tried?
1. I am seeing a CBT therapist with a history of tinnitus (just so happened), but so far I have not felt that he is helpful.
2. Melatonin for sleep. ReSound masking app. Binaural beats (I get really sleepy, but the warning bells for the tinnitus often keep me asleep, or in light sleep. Sleep is currently my biggest issue.

What did my doctor/ENT say?
1. My tinnitus is not hearing loss related (don't get me wrong, I was skeptical about this, being a music producer and wearing lots of headphones in the past).
2. She believes that my tinnitus is caused by neck issues/TMJ and has referred me to a physical therapist that works mainly with musicians (including a local conductor of the symphony).
3. She also believes it's stress/OCD related. I have a past of palpitations, BFS (benign fasciculation syndrome), panic disorder and more.

What the physical therapist said on the phone before the first treatment session (and naturally of course I am skeptical)?
1. He believes that he can help me. He believes that this is an issue that will flare up, then get better from physical therapy, then flare up again, then get better.

Where am I at?
1. I go from one day thinking it's totally gone to the next day thinking my life is over. I had two recent golf outings where I LITERALLY didn't hear it even when I tried, and that night slept like a baby tinnitus free. But the next day I awoke to the sound again.
2. I am struggling mentally with a future looking like that. But I have overcome medication-induced issues before and habituated to other things that have driven people nuts.

What am I looking for support wise?
1. (Realistic) hope. Can I learn to sleep? Have any of you gotten better?

What am I not looking for?
1. I was hesitant to post this to begin with, as I know forums, where people are suffering, can be bastions of negativity and often people that get better leave, don't come back and don't post, because they simply want to forget it ever happened understandably.

 

Hi Branyan,

I believe the clue to the onset of your tinnitus is in the first line of your post: Musician and playing loud music. Even though you have had tests at ENT and your hearing is fine, this is nothing unusual, as many people with noise induced tinnitus have no hearing loss, including me. You also mention being a regular user of headphones in the passed, which is another indication of noise induced tinnitus for a lot of people. Please click on the links below and read my posts.

Take care
Michael

New to Tinnitus, What to Do? | Tinnitus Talk Support Forum
Tinnitus, A Personal View | Tinnitus Talk Support Forum

 

Respectfully. Do you really believe that my doctor doesn’t know what she’s talking about?

That is one thing I really worry about with these forums is that people often state that they know more than the doctors. I’m not accusing you of that but I was worried when I posted that that people would refute my doctors claims.

Thank you for the information. I really appreciate it. Thank you for the support and I hope I can habituate like you did someday.

 

Hi Branyan,

I would not say that your doctor doesn't know what she is talking about for she is a trained physician and in this regard I have a lot of respect for her expertise. However, most doctors including those that practice in ENT are not tinnitus specialists. A lot of people are not aware of this but it's true. These doctors know about the anatomy of the ear and auditory system. They treat underlying medical problems that cause tinnitus and there are many but they do not treat tinnitus. People that treat and understand tinnitus are usually those that practice in Audiology. Many of these health professionals also have tinnitus. They will have a far greater knowledge and understanding of the way tinnitus affects a person's mental and emotional wellbeing. Tinnitus cannot be learnt from a book, one has to have the condition to have an in-depth understanding of it.

The fact that you are a musician and have used headphones regularly makes me believe your tinnitus is noise induced. I have a lot of experience with noise induced tinnitus, counselling and corresponding with people with this condition. If you weren't a musician and wasn't a regular user of headphones, then I would agree with your doctor that stress, TMJ and other things might be the cause of your tinnitus. This could still be the case so I won't rule them out. However, it is my belief your tinnitus is noise induced.

Hope this helps.
Michael

 

I wouldn't claim to know what the cause of your tinnitus was. Stress on its own can very often make pre-existing tinnitus worse - but the immediate cause is usually another reason - ear infection / ototoxic reaction / loud noise exposure etc. It may be that your doctor is right and that neck issues / TMJ is the immediate cause. On the other hand, your past history as a music producer/headphone use suggests that loud noise exposure is also a possible cause.

More importantly - what to do about it now? These are my suggestions:

1. If you feel that the CBT sessions are not helping you I wouldn't bother continuing them. Many tinnitus sufferers - myself included - feel that CBT is usually a pretty ineffective therapy for tinnitus.

2. Sleeping seems to be a major issue for you - as it was for myself when I first got tinnitus. I would continue with the Melatonin and the sound therapy. You might want to investigate different apps or invest in a sound machine to find a sound therapy which works better for you (best not to try to "mask" the sound of the tinnitus but set the sound level just below that of your tinnitus).

3. As someone who has habituated to tinnitus, the two things which helped me the most were (a) time and (b) being extremely careful around loud noise exposure. The thing which will make it most difficult to habituate to tinnitus over time is if a person repeatedly suffers noise exposure incidents, pushing the tinnitus to a higher level and meaning that habitation needs to start all over again.

 

I have to go with @Michael Leigh. They are good with the cook book experience.

When it comes to tinnitus, their expertise is useless.

 

Thank you. This is very helpful and reassuring.

I noticed when I took antianxiety medication that the sound comes down quite a bit.

My ENT told me fluctuations are very normal.

But I will have fluctuations between eight out of 10 and a .05 out of 10, to a zero out of 10. I will have two or three days where I will have no tinnitus. And then three or four days where it’s really bad. I didn’t appreciate how much fluctuation there could be. I don’t know if that’s any indication of my own journey going forward or if everybody’s is just different.

 

I understand your belief system. And I appreciate your input.

How do you account for some days I have absolutely zero tinnitus, and some days it’s extremely loud?

 

This is not unusual, for you are experiencing variable tinnitus. My tinnitus can be: completely silent, mild, moderate, severe and very severe. I have had tinnitus for 25 years and it changed to variable in 2008 after a 2nd noise trauma.

You are new to tinnitus and I suspect that your variable tinnitus will improve over time probably to a very low level, providing you don't do anything to make it worse. It is a good sign.

Michael

 

Makes sense and thank you for the kind words. Hoping you're right about the good trends! Just got to make it through each day.

How do you manage your bad days? Ativan has been a life saver for me. If its severe 7/10 or more, it takes it down to 1 or less out of 10.

 

You are in the very early stages of tinnitus Ben. It will fluctuate a lot and can be difficult for the brain to adapt to because it is hearing a noise that previously wasn't there. Please read my posts in the links that I have given you, as they focus on positivity and the way to incorporate that into you life. Things will get easier with time. As you learn to relax and direct your thoughts elsewhere, the tinnitus will become less troublesome and habituation will happen.

Take the medication you have been prescribed and keep in contact with your doctor.

All the best
Michael

 

Thanks much, Michael

Just yesterday I had my first day where my tinnitus wasn’t there. Only kicked up during sleep. I finally enjoyed a full day with my wife and some friends without hearing it. Even when I looked for it. It seems the days of this happening are happening more and more.

I literally won’t hear it during the day even when I close my ears. Unlike the beginning. When I lie down for sleep I get flashes of adrenaline because I’m afraid of the tinnitus coming back and paradoxically that kicks it up. I’ve become afraid of sleep and letting go. I need to work through this. My ENT said anxiety is a trigger for my symptoms so she said in one way I have some control.

I’m feeling more optimistic than when I wrote this first thread. If it’s ok, I’m going to use this thread to track my ups and downs.

Cheers all!

 

That is great news Ben and I'm pleased for you. Just take things in your stride and continue using low level sound enrichment, especially at night.

Take care
Michael

 

My tinnitus also came out of nowhere 12 days ago. I had been making great progress where it seemed it was going away, but I spiked last night in my sleep out of nowhere. However, this morning it's down again. WTF lol.

 

That seems to be my exact pattern too!

I will have long periods during the day, let’s say four out of seven days, where it will not even be audible whatsoever. Even if I look for it. Then at night in spikes and I can’t fall asleep, and then end up getting very little sleep. Then the next day it’s a little bit louder. Then the cycle repeats. But it does seem like it’s beginning to trend towards more days where I’m able to be fully present. So that’s a good sign to me.

When I don’t go into that place of fear and panic, things begin to get better again.

 

I have very similar symptoms as you described, and my ENT said the same thing. Neck issues, TMJ or allergies. Or possibly all of the above. And I believe my ENT because I do not have any hearing loss in the ear in which I experience most of these symptoms. I have hearing loss in my left ear and I also have tinnitus in that ear as a result, and that sound is very different than what you described and what my other symptoms are.

The high pitched tinnitus started in May of last year. It persisted through early fall and then completely stopped. It came back again in March of this year. I’m trying to figure out what may have changed for me to bring the sound back. I do know that I was working a lot more in my bedroom and leaning forward and hanging my neck. So I’ve moved my workstation to something that’s more ergonomically correct. I am also trying to manage my stress better so I don’t grind at night and where my retainers. I would definitely explore the TMJ or neck issue.

I get how annoying it is. Right now I can hear it above the TV. Sometimes it keeps me up at night. It can be loud and quiet all in the same day. I actually think Melatonin makes mine worse. I’m in an experimental phase with that.

Do what you can to get sleep and work on the issues described above and hopefully this tinnitus will resolve for you.

 

I was feeling borderline suicidal yesterday. I finally got some sleep last night due to muscle relaxer. And I feel a lot better today. My ENT said that I need to hold out until we treat the root causes which she believes will be up to physical therapy and possibly a chiropractor. Trying to keep the faith. It’s up and down every day. From new symptoms to severe symptoms. No patterns at the moment. Thanks for all the support

I have to remind myself that the spikes don’t last. Period.

 

This has been a nightmare since the onset of my tinnitus three weeks ago out of the blue. I can’t really sleep. I’ve tried over-the-counter sleeping aids. Lorazepam. Muscle relaxers. Nothing seems to be working. I need to get sleep or I cannot function. Not sure what to do about that.

All I know is that every day the tinnitus will fluctuate between 0/10 and 7/10 loud. usually this is the second I try to sleep.

in the beginning it was to 2 tone. Then hissing. Then one tone. Then light white noise. Then nothing. And then back through all of these.

My neck is really messed up. And in a lot of pain. I am waiting for my physical therapy appointment that my ENT prescribed until May 17. I don’t know how I’m going to make it until then if I can’t sleep.

I am still in the bargaining stage. Part of me thinks it can get better and go away. Part of me thinks this is permanent. I’m really scared. Any advice?

 

I went to the physical therapist yesterday that my ENT prescribed. He diagnosed me with this exact issue. He said I was a classic case of tinnitus caused by C1 and C2 misalignment from bad posture over years. He has assigned me to correct my posture. That was yesterday. So I will see what happens.

I can go from no tinnitus to severe tinnitus to mild tinnitus. All in one day. He said this is not random and that I was lucky I was sent to him as he is one of the few people that does what he does in the country. He said most ENTs don't send people to doctors like him because it's not profitable and the science isn't on the forefront of most ENTs minds after they work for 20 years. They are just following the motions.

These were my notes from the visit (I will be going to follow up visits):

1. Forward head posture squeezing brain stem - immediately felt like he knew the problem when I came in
2. Possible teeth grinding
3. Without changing posture it will come back
4. Sending me to TMD/jaw/sleep apnea specialist
5. C1,C2 is tilted
6. Manual mobilization worked on it in meantime, but I have to do work to keep it
7. Don’t cross legs / don’t wear wallet in back pocket
8. Pull head back no head forward sit up straight
9. Bring phone up - use head axis not shoulder axis to tilt/nod
10. Sit up driving - have head on headrest - tilt chin down - it’s not comfortable for you to have good posture because of years of bad posture
11. Lumbar cushion
12. No phone or laptop in bed
13. Sit all the way up and back up
14. Couches no good, as they pull you back
15. It’s not random
16. It’s mechanical
17. Good prognoses - good I came when I did
18. ENTs don’t refer to people like him because it’s not profitable
19. Thought twitching could be nerve related possibly
20. Feels it’s 80% mechanical and 20% mental at this point, but that mental part of the pie could get bigger if we don't treat the mechanical

 

Please keep us updated!

 

Will do thx ❤️

 

I suspect mine has a similar cause, as mine is unilateral and I also have many other symptoms on the side of my tinnitus (headache, neck tension, jaw clicking/soreness).

 

Well I have some good news to report. I’ve been able to get 6 good sleep days in a row. I was worried at first that I’d never sleep again.

 

I have the same issues! xx

 

So happy you are sleeping again xx

Thank you for sharing too! I hope you find it beneficial! Xx

 

Hi @Branyan.

I'm sorry to hear about your tinnitus and how hard it's been for you to adapt to the new sound in your head.

Since I owe my first tinnitus noise to a chiropractic treatment gone wrong I wanted to tell you to really, really make sure to find a therapist who knows what they are doing and who's had tinnitus patients before.

If your doctor thinks your tinnitus is neck related, take a "quiet" moment and try to figure out if you can pinpoint an area that's more sensitive / harder to move / turn /... and communicate these things to your therapist so they can take them into consideration in addition to you letter of reference and pictures.

I have been very reluctant to see another physio therapist / chiropractor but have done so eventually a couple of weeks back. Unfortunately the treatment didn't help much with my tinnitus but I could tell immediately that this person knew what they were doing because they didn't just listen to me but also adapted their treatment from session to session according to my needs.

Please make sure you find somebody like this!

As for this forum an skepticism when it comes to medical professionals - I think everybody here started out positive and hopeful because that's the kind of experiences we've all had before when it comes to doctors. With an invisible illness,however, things become sad and depressing very quick. And it's not because the professionals we seek out are bad at what they're doing but because there is so very little that can be done.

I hope that your tinnitus will turn out to be temporary or, at the very least, manageable because it's when nothing seems to help and all you're being fed is platitudes is when skepticism sets in.

And on a personal note, I have always felt extremely well supported in this forum and the threats where people go to vent and therefore hold the most wariness and frustration are clearly labeled and can be avoided. Though, at times it's a great comfort to have / know where to find a place like this

Best regards, Leila

 

Totally understand and respect everything you are saying and I get that frustration. I don't mean to talk anyone down. I too can go to that place.

To be clear the physiotherapist is NOT a chiropractor, although he does palpation. He mostly works with tinnitus patients and was highly regarded by my Harvard Medical School trained ENT (who is also a tinnitus expert). So I am in good company. He (the physiotherapist) mostly has me working on posture stuff, and working with a TMD therapist. I got a nightguard and the tinnitus has been 90% gone the last 2 days. I got my wisdom teeth out in December. My wisdom teeth had been FULLY in for over 10 years, so the TMD therapist thinks that my mouth never got used to it. I also can manipulate the sound like crazy with my jaw.

We will see if this lasts. In any case, I am just trying to be appreciative of the quiet moments I get. I get quite a few of them.

Hugs and good health to everyone going through this.

 

Thank you! Hugs and health to you <3

 

That's great news - fingers crossed the remaining 10%, too, will be gone soon!

I suspected as much I just put them together in one sentence because I wasn't sure which one you were planning to see.

All the best and let us know how the treatments you're seeking are working out for you.

 

Thank you! It’s pretty much gone except for when I lie down. Day or night when I lie down, the radio tuner sound start up. Like literally when I lie down. Any time of day. That part almost feels mental at this point. The rest I feel (like the physiotherapist and TMD doctor) is mechanical. Who knows hahaha, it’s been a ride!

EDIT: And it's back. Oh well. I guess I am lucky that I get these fluctuations and moments of relief. I should be grateful for that.

Although this week is MUCH better than last week, mentally and emotionally, and overall suffering levels.