Tinnitus Newbie Desperate for Answers, Trying to Determine the Cause — From Cervical Injuries?

Hi @Greg Sacramento,

Again I cannot thank you enough for this wealth of information. I’m wondering if the concentration of damage between impingements at multiple cervical levels is causing the reactive volume/oscillating type cricket/hissing pitch I hear. I can definitely confirm that the tinnitus is positional and lying down as you describe or different neck modulations can increase or decrease it. It does seem certain flexion positions can reduce it.

Is there by chance a network of Intravenous Radiologists you can refer me to? I am in search of one in my area particularly to investigate nerve blocks or related procedure to those regions (occipital nerve or greater occipital nerve) but am having a difficult time locating them.

 

@IntotheBlue03, muscle spasms straighten your C-spine and there's a few ways on how this could have happened at your young age.

If blunt force is not the cause, then I would get a nerve conduction study or similar study. Reason being your neck injuries could indicate a separate condition causing neck trauma. You can get a list of these conditions by researching - nerve conduction study.

From your first paragraph above, it appears more to do with C1, but it also could easily be impingements or both and possibility of more.

I would see a cervical Interventional Radiologist. They could also test for other conditions causing your neck trauma if blunt force was not the cause. The University of Pennsylvania, Philadelphia has one of the oldest and largest IR programs in the United States. Your tinnitus will most likely be an easy fix.

 

Hi @Greg Sacramento, you are hitting the nail on the head, aside from a very traumatic MVA I had as a child (being struck as a pedestrian by a vehicle which resulted in a concussion) I have had no further traumatic events. Despite that I’ve had spinal injuries continue to develop or worsen, so it is my rheumatologist’s suspicion that I am dealing with an autoimmune disease (considering within the inflammatory arthritis family such as Atlantoaxial Spondyloarthritis, etc).

I’m very relieved to hear you feel this is an easy fix, only challenge I’m having is locating a cervical interventional radiologist, I believe these folks are also known as head and neck IRs? Of course, I’m finding every kind of IR within UPenn except for any experienced in cervical.

 

@IntotheBlue03, good conversation - understand all your mentions above and as to suspected trauma causing a straightened C-spine and more problems developing.

My C-spine straightened from muscle spasms five years ago when lifting head off a dental headrest. From this, I had instant somatic tinnitus (multiple neck damage) and now more problems continue to develop, including Atlantoaxial Spondylarthritis which is increasing my somatic tinnitus. I have other health problems as well - dentist cut nerves which is now destroying gums and loosening teeth. Vein and artery disease, pulsatile tinnitus, hypertension BP that caused blindness in left eye and an abdominal aneurysm, etc. First had hearing loss and tinnitus from getting ears cleaned. All this is ironic as these are some of the areas that I was familiar with within trauma healthcare.

With mention of an easy fix for you - I should had said, beyond impingement and C1 concerns showing recently on MRI appears to be cause of somatic tinnitus that started or increased after Motion X-Rays. These issues may have been developing before exam. There is "possibility of more" from MVA issues or other issues later developing from that. Impingement and alar C1 (Atlantoaxial) can cause somatic tinnitus instantly and often do. With possible inflammatory arthritis and reactive volume/oscillating type cricket/hissing pitch, your alar injury could be cause of tinnitus. It's possible that this could heal on its own, or if needed treated.

Then we had this from bottom of thread page 1. According to MRI notations, you have ventral thecal sac impingement at C3-C4 and C4-C5. As in article this can be treated.

"This sac is filled with cerebrospinal fluid. It helps protect the nerve tissues and it also holds spinal fluid. This fluid is one of the most important parts of our body because it helps us in various ways. When a person suffers from thecal sac impingement, the spinal fluid doesn’t have a normal flow which can lead to pain, tinnitus, and headaches."​

Spinal fluid movement could also cause a reactive volume/oscillating type cricket/hissing pitch.

You need a doctor that can review all your related cervical medical history and study your recent radiological exams. The doctor that wrote the MRI IMPRESSIONS, may believe that ventral thecal sac impingement may be a cause of tinnitus. The doctor that wrote Digital Motion notation may feel what he discovered (including alar ligaments) may be a cause. Maybe try to contact these doctors for review. Discuss both studies with each doctor. Ask them, where do I go from here.

 

Hey @Greg Sacramento,

Hope you are having better days this week my friend. I came across another fascinating post you made in a thread discussing the different types of tinnitus. I happen to have the electrical/hissing high frequency form (14-15 kHz) that is central/bilateral and oscillating. Just curious if that tells you anything further regarding my cervical case? Does that potentially once again point us in the direction of the spine/disc herniations or impingements vs the C1 ligaments?

I also have an evaluation with a physical therapist experienced with somatic tinnitus and dry needling on Monday. He was trained by James Dunning (see article for reference). And there’s one question in particular he asked me that stood out and may to you. In speaking or chewing, does my tinnitus get louder? The answer is yes.

Somatosensory Tinnitus: Neurophysiological Considerations & Treatment Options

 

Yes.

In your article above about neck and upper neck, discussion matches my discussions and tinnitus pathway in this thread. Your upper neck will cause chewing to make tinnitus temporary louder.

I would try warm and cool therapy. Try controlling forward head bending with computer use. Some treatment ideas that could be considered by your radiologists are in links that I gave above, but I wouldn't use stimulation on disc areas until impingements above that heal.

I so much wish you calm.

I'm having a very hard time with multiple areas of pain.

 

Hey @Uklawyer,

So I wish I could say I was doing better but unfortunately I am not. I’m slightly more calm but still very much stuck in fight or flight mode even on the Grandaxin and I hate the thought of going back to the Clonazepam. My tinnitus is lower at least I’m assuming from the Grandaxin but it’s the panic and anxiety that is absolutely ripping me apart. I wonder how anyone survives like this for months as I keep hearing it’s early for me so this is expected.

I’m wondering if I should ask my doctor for another non-addicting anti-anxiety like Buspar? I feel like this isn’t cutting it but not sure how much more effective that would be for the constant panicked state I am in. Would just be great to sit down and breathe. That’s absolutely beyond me at the moment.

 

Hi @IntotheBlue03, I am sorry that things are still tough for you right now. For your information, people do not stay in this state for months - it's an initial phase of panic as you are latching on to something that is foreign to you and is disturbing and your body is telling you that you cannot survive like this.

The unfortunate irony is that is it precisely this way of thinking that creates the panic reaction and, therefore, keeps you in this state - and also, by the way, magnifies the perception of the tinnitus.

This will go down at some point, but in order to hasten a return to a more balanced state, you have to try to break the negative cycle by KNOWING that this state of fear is not permanent - nor is your perception of your tinnitus.

Also, if you can listen to other sounds to mask the noise in some way, then do it. Do what you can to divert your attention from it. I remember I was fixated for 7-8 weeks on it. I had no desire to watch TV or think of anything else. Even when I was in hospital, I no interest in anything else. Finally, I put on something (an episode of Family Guy - if you like that). I kept watching. I listened to what the characters were saying. I listened for the jokes. I laughed a bit.

Perhaps Grandaxin is not strong enough. Perhaps Valium might help and have a different effect to the Clonazepam. I am sorry to say it, but work has to be the LAST THING on your mind right now. Unless it distracts you in a good way, just take some time off. You are unwell, you need a break.

Speak to a psychiatrist if you can. Antidepressants may well help with general mood. I do not know about Buspirone (Buspar) (but I would definitely not take Wellbutrin as that is linked to tinnitus). Maybe Buspar acts a bit more quickly than other antidepressants, but you will have to wait a bit for this stuff to get into your system. In the meantime, a Benzo (like Valium) will work in the short term. Mirtazapine, an atypical antidepressant, would probably help with sleep at a low dose, but it's hard for anyone to recommend a particular drug. Personally, I am more comfortable with long-acting benzos initially to try try to kill this state of shock that you are currently going through, and then thinking about starting an antidepressant alongside it.

SEE A PSYCHIATRIST if you can. Explain your symptoms and the concerns about the effects of antidepressants on tinnitus.

Hang in there. It does get better, I promise you. And with your personality, working on the anxiety would, I imagine, bring great benefit to you.

Best as always.

 

Hey @Uklawyer, thank you so much for checking up on me.

I’m not sure if it’s the medication at this point or if I’ve finally made some dent in the fight or flight mode but I started to calm down as of last night. I still am unable to leave my home for too long but I do feel about 75% better since last evening, and my tinnitus is extremely low. I took your advice and had a friend come by and we watched some social media clips on very, very low (I’m a fan of Family Guy but rarely watch TV) and that distraction definitely seemed to help. I had been avoiding absolutely everything for the past 7 weeks except this forum so maybe just activities like this can give me a sense of normalcy I have been missing. Just the ability to sit or lie in bed without the severe urge to “flee” or pace has been absolutely amazing. I really hope this is a turning point even though I do expect setbacks of course.

I think the most valuable insight is exactly what you described as far as how panic both amplifies the sound and focuses your attention to it. So I am actively trying to make sure I visualize disengaging this, almost like a switch in my brain that I’m physically “turning off” which has also helped. I’ve been reading a bit about panic disorder as well and it seems, while I wasn’t as panicked in the beginning, overtime I think I developed this chronic response so it’s been helpful knowing how the body can start forming those pathways too, as awful as that is.

I will definitely inquire about Valium as I now understand this is one of the longer acting benzos which I think would be more helpful to me than having to take short acting Grandaxin 3x a day. I am thankful that it is currently lowering my tinnitus which is a godsend since I cannot mask it and makes the reactivity seem lower. If I could get comfortable I could see myself taking the Valium 3x a week and maybe that would also reduce dependency over the next couple months.

I also did sign up for both TRT with a well known audiologist here and she referred me to a CBT psychiatrist who she refers all her tinnitus patients to so I feel better about that. I don’t know if this is the same in the UK but of course in the USA there’s no urgency to these folks when it comes to starting therapy even though I’m in tears and clearly in crisis on the phone. Appointments are always 2-4 weeks out for anything. It’s like being in the middle of a heart attack and calling around for the best treatment that’s booked out over a month. *Sigh*

I will definitely inquire about the antidepressant and agree with you that long acting benzos are the way to go to hopefully disable this panic disorder for good.

Have you heard of Phenazepam? I saw another poster mention it’s a fairly safe long acting benzo and I will be ordering it if that’s the case to cycle through the week as opposed to daily.

Thanks again as your posts have been life saving during what has been the biggest crisis in my life, and hopefully as I get better my posts will get shorter. These horrific conditions should definitely be reserved for anyone who isn’t Type A personalities or GAD sufferers like us!

 

Hi @IntotheBlue03 - wow. That is amazing news. Something has shifted and that it making a huge difference. Correct me if I am wrong, but this change has not coincided directly with your consumption of benzos - as you tried Clonazepam before and started the Grandaxin a good few days before feeling like this, right?

You have done really well to switch focus and to get out of this mindset in which you are glued to your tinnitus and to the the feelings of anxiety triggered by your evaluation of the worst case scenario. I would encourage you to try to build on this by doing some additional activity that you can manage that takes your mind elsewhere. You can start thinking about something in detail: a TV show, a nice holiday you took etc; get lost in it - and you might be surprised to find that you mind has become absorbed in this imagery and temporarily left your tinnitus behind.

The "disengaging", whilst similar, is another technique that can be very helpful. You likened it to flipping a switch. You can also imagine turning down a volume control and the noise fading with it. You can also sit there for a moment or two and say "I can handle this. It's not so bad. It comes and it goes." It's certainly not easy - it's like brain training, where you actively work on seeing things a bit differently; on giving yourself some breathing space; appreciating that space and looking past or through the noise to quieter periods; to calm. I think that if you can start doing that a bit more, you are moving in the right direction.

And it is good that you are thinking about some medication that can help you - i.e. the positives, without dwelling on the negatives and getting stuck. Give things a chance. Believe in things helping and getting better.

I actually had someone get in touch with me pretty quickly about CBT after I saw the audiologist. But I did not book an appointment with him, so do not know when the therapy would have started. In the UK, if you have private health insurance, you can usually start stuff quite quickly. Free care through our welfare National Health Service, however, is a different matter.

I have not heard of Phenazepam, but typing into Google, I see things like "Russia," "powerful" and "schizophrenia" - so I am not sure about that one. I would feel safer with those I have tried in the UK and France. I cannot speak to the efficacy of others. A GP in France did, however, prescribe a drug called Etifoxine (Stresam) to me. I did not take it, but it is supposed to help with anxiety and be less powerful than benzos. You can always have a look on Google or ask about this one.

And yeah - anxiety plus tinnitus is horrific. What I am trying to tell myself now is that if I can get through this - I will be much better with anxiety and life in general. Dealing with this will certainly make you stronger and more resilient when you come out on the other side. It's great to talk to you on here, but hopefully, at some point, you will not feel any need to stick around. Me too for that matter!

We got you, @IntotheBlue03!

 

@IntotheBlue03, I posted on here as this was too long for comment on @danielthor's profile post.

Citalopram is an antidepressant - SSRI - a bit like Escitalopram. I didn't get along with it and found Escitalopram to be more effective. I think in general that Escitalopram is believed to be superior to Citalopram for anxiety (or maybe GAD). Also some people have reported tinnitus onset or worsening with Citalopram - but others have said the same for Escitalopram - as well as pretty much all other antidepressants, so it's a lottery on that front.

 

Hey @Uklawyer -- Great post. Just wanted to mention that I took Clonazepam regularly for about 3 years about 20 years ago. I then went through a somewhat difficult tapering process lasting about 15 months. I've discovered a few things since that time that I wish I'd known about that I feel would have helped me through that tapering process.

One of these was a micro-current device called Alpha-Stim. Another very helpful one was mHBOT, which turned out to be a turning point for me in finally being able to calm my neurological system post tinnitus onset. The third one is one that I just discovered recently, and fortunately, is very inexpensive and easy to try. Namely, poppy seeds. They contain small amounts of a wide variety of opioids, and I read that making a tea out of them can have a calming effect. I tried this 3-4 years ago, and did notice it helped very modestly--at times.

I discovered more recently that mixing 1-2 oz. of poppy seeds in some yogert before going to bed at night helps me sleep much better, and allows me to wake up feeling relaxed in the morning. In fact, when I wake in the morning and first become aware of my tinnitus, my reaction is more one of indifference than anything else. It also feels like my overall tinnitus has gone down a notch since I started this regimen about a month ago. Not only do I think this is safer than using any type of benzo, but is more effective as well.

 

Hey @Lane,

Can you tell us more about the Alpha Stim device? Wondering if it can be used in conjunction to relieve anxiety with my medication (Grandaxin).

Also what model MHBOT do you have for home use? This probably isn’t realistic for me but I was curious based on your posts.

I’m on LDN so unfortunately poppy seeds will not work in my case.

 

Spinal fluid is most likely causing central oscillating along with injuries. Healing of anatomy discussed is of importance. Neck muscles and ligaments need to be loose.

There's two ways to accomplish this.

Emotional aspects- watch comedy or a happy movie - one for patients was Notting Hill - we had it on 24/7 hospital TV. After the first time with calming/enjoyable focus, you may find that your tinnitus lowers.

Hawthorn Berry and other supplements may help. Glycinate Magnesium 400 mg total a day. Cut into small pieces and use 3-6 times a day or use the liquid form. This will loosen muscles and it also has a calming effect.

Others on this thread including @Uklawyer have posted special considerations.

Visit:
https://www.calmclinic.com/anxiety-guide

Physical aspects- Control forward head bending and turning head against resistance. Lifting head exercises are not recommended.

At this time, nerve fibers are also upset around the ears, so over ear sound therapy may not be wise. Anything like a TENS unit should be avoided.

Warm compress - try a warm, not hot towel from the dryer. Fold it the long way and place behind neck and let the rest of it hang.

Several highly professional studies showed complete healing and tinnitus 12/12 with your conditions with use of a soft collar that extends to back, especially with alar injury. However, there's one single patient report where a soft collar made alar injury worse because the collar didn't extend to back and the patient also had a very inwards C-spine.

 

Hi @Lane, thanks for the tips. I will have to look into poppy seeds.

I also wonder, like @IntotheBlue03, how the Alpha-Stim helped with your neurological issues. What issues were they? How did they help, concretely?

@Greg Sacramento, do you really think that tinnitus can subside with a psychological/emotional shift? I still wonder why mine all but disappeared whilst I was in the psychiatric hospital, whilst it has not at home with equivalent dosing of benzos and ADs. It's really annoying me.

 

I didn't purchase the Alpha-Stim until about 6 months after I ended my Clonazepam taper. I purchased it because even though I had tapered very, very carefully, withdrawing from the last little smidgen turned out to be more difficult than some of the much larger taper amounts I had done at the beginning.

Once I started using the Alpha-Stim, I immediately realized it would have been very helpful if I had had it when I first started the taper. It felt that within a month or so, I had finally successfully done away with the lingering feelings of agitation and anxiety that are common withdrawal symptoms.

I continued to use it however, because I found it very helpful for my many pretty extreme sensitivities, including hyperacusis, multiple chemical sensitivities, and so many other things that are difficult for people with sensory processing disorders. I believe my sensory process disorder was a result of a serious head injury as a teenager.

So the primary way I used the Alpha-Stim was to use it when coming home from some kind of outing. The noise, pollution, and noise from traffic, and similar things from the stores I would visit could easily overwhelm me, leaving me in a state of physical and emotional disshevelment. It was amazing how quickly the Alpha-Stim would restore my sense of calm and equnimity. I could usually accomplishs this without the Alpha-Stim, but it would normally take much longer.

When I research the Alpha-Stim, I read accounts of people using it for a wide variety of "brain disorders", such as depression, anxiety, even Alzheimer's and dementia. People with dementia in particular can become very agitated, and it was impressive to see how the Alpha-Stim could even calm that severe of a condition. -- I believe Alpha-Stim has a 30-day return policy in case you decide not to keep it. I suspect there could be some kind of restocking fee however.

If I recall correctly, I think the Alpha-Stim may have also had different pathes that attach to the skin to provide pain relief. I hurt my back pretty bad at one point, and recall that it really did seem to help with that. -- BTW, my own device got destroyed in one of those Southern Oregon fires back in September, 2020, so haven't used one recently.

 

Honestly with the amount you post here, I don’t see why you couldn’t work. You can obviously think clearly enough to gather all this info and regurgitate it.

 

@Lane, did you try in around your ears? Nothing for tinnitus?

@IntotheBlue03, were you told that LDN could help with C2 (or upper cervical issues)?

 

@IntotheBlue03, can you tell me if your physical therapist reviewed your latest radiological exams? Does your physical therapist understand your injuries and provided proper treatments? The treatments and suggestions that I have given you should help with healing, anxiety and tinnitus, but you have not commented per them.

 

That's a great feel-good movie.

 

I appreciate the nod of encouragement but 1) returning back to an office with severe reactivity will not be an option from which I will likely be eliminated, and 2) it’s a little easier posting here than managing financial and IT work which is what my job entails for which I have always required extreme concentration and collaboration which seems impossible now.

I want nothing more than to be able to continue working but unfortunately the state of this tinnitus is a huge threat in this shitty country of ours that lacks any labor protections for people like me. I would have much rather favored being out on disability for 3-6 months to hopefully learn how to function again from this but my position would be quickly eliminated. We are still home based due to COVID-19 but are expected to return back in the spring, which I will not be able to do unless my reactivity completely resolves and again I may also be eliminated for this reason.

I love my job, just sucks that getting sick in the USA means you have to lose.

 

Hey @Uklawyer, so I wasn’t told that LDN could do much for C1-C2 but I do have some PRP treatments lined up for upper cervical which should strengthen the damaged capsules and ligaments I have in that area. It’s anyone’s guess as to if it will improve my tinnitus (fingers crossed). I keep reading about how centralized tinnitus is located in the brain so I’m wondering if I’m in the camp whose tinnitus will remain even if the cause is treated (here I go again fangirling over Dr. Susan Shore) which is where Shore’s device comes in to treat the DCN.

I’m on Day 2 of Alpha-Stim. No effect on tinnitus which I’m fine with but not much in the way of anxiety either (not even placebo). Hoping I notice something in the next few days.

 

Hospital patient advocacy and myself have seen tinnitus lowered when in a hospital. A psychological/emotional shift is part of it.

For the second time, I asked my former trauma team associates including a radiologist - IR, who specializes in tinnitus, two cervical neurosurgeons and two cervical trauma specialists to view a Tinnitus Talk member's situation - @IntotheBlue03. I retired just over ten years ago with onset of tinnitus, but most of the others just retired. They assisted me with a plan for you on what to do and not to do.

 

@IntotheBlue03, I've been on Keppra for about 60 days. No change.

 

Steroids could upset tissues, but PRP would be safer than PICL with Centeno-Schultz in Colorado to treat the Alar & accessory ligaments.

Since you have increased ADT space in reference to transverse ligaments, a Philadelphia collar for short-term use may help permanently.

 

Yes sir, I have been screenshotting and following your recommendations including liquid Magnesium Glycinate and hot compresses for my neck. I have to check into Hawthorne berries though.

Yes, my physical therapist has reviewed my MRIs/Digital Motion Xray and is trained in dry needling for somatic tinnitus directly under James Dunning who penned that article I sent you:

Somatosensory Tinnitus: Neurophysiological Considerations & Treatment Options

I was lucky to find him and have had 2 sessions so far. We have discovered aside from obvious reproduction of increased tinnitus with stimulation in the upper cervical that I have very tight jaw muscles. No reproduction/increase of tinnitus has occurred in these areas though. Unfortunately there has been no reduction in tinnitus after our sessions. I will have a few more sessions to see what changes.

I know you had other specialists review my case but I am highly honored and impressed that all of those professionals were able to review my case. Thank you so much for taking the time despite what you are going through! I can’t thank you enough.

I finally have my cervical PRP and upper cervical PRP scheduled over the next couple weeks. This unfortunately was delayed due to my steroid use and scheduling. I’m hoping I can make the trek since I am working through having developed a panic disorder around leaving home with tinnitus. Not having the ability to mask with severe reactive tinnitus means I’m at the mercy of all noises leaving the house and that has really effected me. I still pray for the ability to mask which I hope comes in time.

I appreciate the anti-anxiety recommendations you have given as well. After 2 months of no music, TV or any other sounds at home really I have finally started watching short clips on social media on low which have given me a little more normalcy. Movies are very much beyond me at this point and the Grandaxin takes the edge off but I still have difficulty with sitting in one place for too long. I invested in the Alpha-Stim hoping for a non-drug option that could help stimulate relaxation. You and @Uklawyer are absolutely both correct, my tinnitus lowers considerably when I am calm. It’s my theory that if there was no reactivity it would be less than 5/10 daily but that reactivity creates a night and day difference unfortunately.

Curious if you have any recommendations on Alpha-Stim vs tDCS, or other devices?

Also can you recommend what brand of cervical collar I should use? I’ve purchased a couple standard cervical collars based on that single study of improvement but they have had no effect wearing for 20 minutes at a time:

Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar

Also curious as I have seen posts about this across the forum but no actual data, have you heard of centralized “brain” tinnitus being more difficult to treat? In other words once the cause is treated that this type of tinnitus remains in the brain? My tinnitus was centralized at onset but hoping there isn’t much evidence of this concept.

Thanks again Greg. I’ll continue providing updates on my case as I’m looking forward to that 12/12 resolution.

 

@Greg Sacramento, have you seen it lowered to that extent - i.e. pretty much gone aside from the occasional fleeting episode? I asked my psychiatrist whether it could have been from an accumulation of Valium from preceding weeks (or the preceding week), but by the time I left, I had got down to, basically, 2 mg per day - and since being out, I have had as much as 10 mg per day for a good few weeks, which leaves me doubtful that this could be the reason. My psychiatrist thinks it was because of the feeling of being safe in the hospital (or maybe coming to terms with what I thought was my impending death).

 

Hi @IntotheBlue03 -- You may want to check out this thread:

Three Supplements to Treat Severe Anxiety Symptoms

 

Thanks @Lane. I actually have 2 out of the 3. I will have to check out Turmeric as opposed to Curcumin which I currently take.

 

@IntotheBlue03, when I used the words "for the second time" I meant it was the second time that I consulted others for another person, but my wording may be seen different. If so, I'm sorry.

PRP - try again.

Halo vest - might help in decompressing canal space since yours is < 6mm. Probably hold off on this for now.

Last if no improvement - PICL with Centeno -Schultz in Colorado.

https://www.ncbi.nlm.nih.gov/books/NBK493135/

You got caring friends - we are here.

-----------------------------

Maybe so.

I'll be back later. Need to treat mouth nerve damage and blood clots in legs.

HUGS to my friends.