Does your ear ring louder when you clench your jaw?
Ringing in your ear could be tinnitus. Tinnitus is defined as the conscious perception and reaction to a sound in the absence of a matching external acoustic stimulus, commonly described as a phantom perception.
A subtype of tinnitus is called somatosensory tinnitus. In a certain percentage of people, modulation of tinnitus can be made through jaw, head and neck movements., such as clenching your jaw. Patients at risk for somatosensory tinnitus may not only have tinnitus but also headches, neck pain, dizziness, otalgia (ear pain), and/or TMD (temporomandibular disorders).
Our physical therapists utilize clinical reasoning and current guidelines to assist in making a diagnosis and treatment of somatosensory tinnitus. We incorporate evidence and our treatments are specific to individual patient presentation.
Evidence points to a high prevalence of somatosensory tinnitus. If your tinnitus is modulated through neck maneuvers or jaw maneuvers, such as decreasing and increasing tinnitus loudness, you could have this condition. In fact, It was found by Simmons et al in 2008 that 90% of patients with somatosensory tinnitus could increase loudness or alter pitch of tinnitus by clenching their jaw.
One thing to consider is that in most people, clenching jaw or moving the neck can alter the loudness or pitch of tinnitus. However, what if you notice a change when you go to the dentist, physical therapist, chiropractor or even massage therapist?
In a certain percentage of patients, muscular palpation on myofascial trigger points in and around the jaw or neck and massage to these areas can modulate tinnitus loudness or pitch.
Studies on the use of physical therapy (physiotherapy) improve the symptoms of tinnitus by addressing dysfunctions in the temporomandibular joint (TMJ) and/or neck pain. At PhysioFit of North Carolina, we utilize a multimodal approach including manual therapy and exercise to help you.
Therapeutic intervention combining simultaneously several types of treatment approaches to the jaw and neck may bring the best results for tinnitus relief. To name a few procedures, relief through manual therapy can include joint mobilization/manipulation to the jaw and neck and muscular relaxation (through massage and stretching exercises).
Once ear disorders and neurological diseases are excluded, we recommend you get an evaluation of the temporomandibular joint and subsequent treatment to determine if all or a component of your tinnitus is coming from the somatosensory system.
It may not be possible to cure your tinnitus with our approach, but could be a component of multidisciplinary care. Talk to your dentist or audiologist / ENT to see if you are a candidate. It could very well further help suppression of tinnitus in your ear.
Harrison Vaughan is a physical therapist and co-owner of PhysioFit of North Carolina. He provides physical therapy assessment and treatment of somatosensory tinnitus in Wake Forest, NC. He utilizes patient education, ergonomic changes, cervical spine strengthening and/or mobility training, and local TMJ manual therapy procedures to help you.