These tests can help rule in that tinnitus is coming from your neck

Tinnitus is defined as the perception of sound without an accompanying external auditory stimulus.

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Subjective tinnitus, often perceived as a nonspecific buzzing, tonal sound, hissing, humming, ringing, or roaring, can be triggered by a variety of causes. One of these causes is from the neck (cervical spine) or jaw (TMJ) and considered somatosensory tinnitus.

This type of tinnitus often co-occurs with neck complaints. Therefore, this type of tinnitus is evoked or modulated in some individuals by self-moving or clinician provocation of the neck, head or jaw.

In 2015, Michiels et al in a research study determined the following tests should be included in a multidisciplinary assessment of patients with suspected cervical somatosensory tinnitus to help make the diagnosis.

  1. Positive manual rotation test (watch attached video)

2. Positive adapted spurling test

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This test is a segmental provocation test using a combination of cervical extension, lateral flexion, and rotation. This test is positive when, at least on one side, pain increases by 2/10 points on visual analogue scale.

3. Presence of sensitive myofascial trigger points

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A trigger point was identified as positive when the participant scored more than 2/10 on a visual analog scale for pain. The test was considered positive when at least one trigger point was found to be positive.

4. A score > 14 points (out of 70) on the Neck Bournemouth Questionnaire

You can fill out a form here (or either contact our office directly)

From this study, patients and referrers (ENTs, dentist and audiologists) can expect a Neck Bournemouth Questionnaire score of <14 points and the absence of trigger points can help to exclude cervicogenic somatic tinnitus. In contrast, a positive manual rotation test and adapted spurling test can help to include cervicogenic somatic tinnitus. The authors of this study and clinicians at PhysioFit of North Carolina advise that these tests should be included in a multidisciplinary assessment of patients with suspected cervicogenic somatic tinnitus.


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.