Does your neck or jaw increase or decrease your tinnitus symptoms?
Tinnitus is defined as the perception of sound without an accompanying external auditory stimulus. Even though tinnitus can normally be caused by actual otologic (ear) conditions, it can also be modulated by somatosensory systems, including the neck and the jaw.
The temporomandibular joint (TMJ) is the most frequent tinnitus modulating region. In fact, the incidence of tinnitus has bene shown to be more than 8-fold higher in patients with than without TMJ disorders. Additionally, Manfredini et al. in 2015 reported a tinnitus prevalence of approximately 30% in patients with TMJ disorders.
The head and neck is the second most frequent tinnitus-modulating region. Considering there are multiple movements and ranges associated with neck movements, the prevalence is not as clearly studied.
See picture below for pie chart to show what parts of the body could modulate tinnitus loudness/pitch based on body part.
Most TMJ maneuvers result in increased tinnitus loudness while a small portion resulted in decreased tinnitus loudness. We recommend self-testing the following to determine if it changes the loudness of your tinnitus.
Clenching of the teeth
Maximal opening of the mouth
Protruding the jaw
About 50% of the time, neck movements increase tinnitus symptoms and about 50% of the time, neck movements decrease tinnitus symptoms. We recommend self-testing the following to determine if it changes the loudness of your tinnitus.
Resistance to pressure applied to occiput
Resistance to pressure applied to left temple
Resistance to pressure applied to right temple
Resistance to pressure applied under mandible
A multimodal cervical and TMJ physical therapy treatment can have a positive effect on tinnitus complaints in some patients with a combination of tinnitus and neck complaints. We recommend 1:1 sessions with your therapist to determine cause:effect of any neck or jaw movements and address those complaints immediately.
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.