Four Days, No Tinnitus — Thanks Greg Sacramento

[Fleegle]

Firstly, I want to shout out to @Greg Sacramento who has made the single best contribution to my well-being through this forum. In fact I would say Greg listened more than specialists and doctors.

I am sure that we are half-a planet away from each other, but Greg provided the right support when I most needed it. See below for the discussion that changed my life.

Now, what am I talking about? If you have picked up on my posts, then you will know what is going on. But recently I re-tried Greg's information and advice. I have tinnitus in (mostly) my left side: a high hissing noise (cicadas, crickets, shrill hissing, etc), but not a "tone".

In the past sometimes my tinnitus has gone from my self-assessed 4/5 down to 1/5 (1 is faint, 4 is loud, and 5 is I-dont-wanna-know). For almost two years now I have not had an extended period of 1-level days. I had enjoyed a 9 day stretch in the past that I have never been able to repeat, and things have been getting so bad that I could not remember the last time that good things happened for me. I used to, in hope of recovery, track my tinnitus everyday. I tracked it for a few years hoping for a pattern that would explain it. And then eventually I gave up on doing this because there were no "good" days and filling out that tracking register was going to be super-easy because it would be 4's forever. Recently life has been #$%^.

But after re-assessing my life and my emotions and frame of mind, I went back to this forum and I re-read my posts and the always-helpful, always-generous advice from others.

Short: you guys are awesome, and please don't stop being awesome.

So what happened?

Recently I "declicked" my neck - as Greg would say the C1/C2 vertebrae etc. But I am guessing.

I was brushing my teeth and I convulsed on the toothbrush (sorry for the TMI but I want to tell you the thing that did it). So I gagged and the gag reflex took over. And something clicked in my neck. Almost instantly the tinnitus was gone. It was quick. By the time I was catching up on what just happened I noticed that the tinnitus was gone.

But then it came back after 1 day. Oh well. Back to level 4 days and nights.

Until Friday when I woke up and it was gone. And my neck felt different - a little bit like something had "settled" and worked itself out. So for four days now my tinnitus has been at a 1 or a 0.1. It is really low. So low that I am right now struggling to hear any tinnitus.

And now I am super mindful of my posture. Neck positions, shoulder lifting, desk leaning, etc. I don't want to go back to where I was.

But I am at the place where I used to be. Where the tinnitus rises when I clench my teeth or hiccup in a funny way or crunch my core muscles. And the sound would go "weee-ooo". I am back at that place now. That is my 1/5 level that I had before.

So I plan to beat my previous 9 day record at this level, and then some.

Thanks again to @Greg Sacramento for the kick in the pants I needed, especially when I cam back here after two years with nothing to show for it, and I came back for a re-kicking.

I bet you have questions. I will see if I can answer.

Cheers.

From all the studies that I have read, I think the quotes from attained 'link below' for physical associated 'tinnitus changing' are most common. Extreme forward head bending and hyper extension (lifting) of head is a common trigger that's not fully discussed in this article. As far as any strange sounds being heard, researchers point to brain reactions, but they are still all over the place with this.

"Although passive and active movements of the neck and shoulder modulated the perception of tinnitus in many subjects, forceful maneuvers were clearly more effective. It is unclear why this is the case, but one possible explanation is that forceful maneuvers unconsciously activate other neural networks involved in breath-holding and flexion of the abdominal muscles, similar to what occurs during the Valsalva maneuver, which increases intracranial pressure and venous return to the heart as well as normalizing middle ear pressure by opening the eustachian tube."

"Our results lend support to previous contentions that movements of the jaw and neck (involving the trigeminal nerve, spinal accessory nerve, and cervical nerves 1 and 2) are the most consistent and most efficacious methods of modulating tinnitus."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633109/

 

[OnceUponaTime]

Until Friday when I woke up and it was gone. And my neck felt different - a little bit like something had "settled" and worked itself out. So for four days now my tinnitus has been at a 1 or a 0.1. It is really low. So low that I am right now struggling to hear any tinnitus.

This is fantastic!
So happy for you!!

 

[NYCGuy]

Great news, enjoy the silence.

 

[Fleegle]

I woke this morning very worried that the tinnitus had come back.

But no. Day 5 now.

 

[illegalmonkey77]

I was hoping for more than "I gagged on my toothbrush and my T was gone"... lol

Recently(like last day or two) my T has shot up for some unknown reason. I haven't done anything different or blasted music for long periods of time. I get a temporary spike on my left side when I look straight down without bending my neck, and a spike on my right side when I jut my lower jaw forward. In general my T was on my right and hadn't been too bad but now it's both sides with the left just coming out of nowhere.

 

[Lane]

I get a temporary spike on my left side when I look straight down without bending my neck

Hi @illegalmonkey77 -- I find that very interesting. What I do know is that the very strong sheath that surrounds the brain and spinal cord is the same sheath that makes up the whites of our eyes. It's called the dura mater (tough mother), and from my reading and research can become impinged or spasmed for a variety of reasons.

Some health care practitioners specialize in working out the kinks in the dura mater (Bio Cranial Therapy), sometimes resulting in dramatic improvements in health for the person getting the treatment. -- @hartstreet -- I would not be the least bit surprised if some cases of tinnitus could be traced to some kind of involvement of a dysfunctional dura mater.

 

[Fleegle]

I was hoping for more than "I gagged on my toothbrush and my T was gone"... lol

I did mention the click in my neck?

I have mentioned the entire experience in another post:

https://www.tinnitustalk.com/posts/626533/

 

[Greg Sacramento]

@Fleegle, so glad. Big Hug.

The C2 - C3 junction is where flexion and extension occur (flexion is the movement of the chin toward the chest and extension is the backward movement of the head). C3 vertebra is in line with the lower section of the jaw and hyoid bone, which holds the tongue in place. The flexible C3 vertebrae helps aid in the bending and rotation of the neck.

Say thank you to your tongue/gag reflex as you most likely had a trapped nerve between C3 and C4.

Your tinnitus should be permanently gone.

 

[Fleegle]

Your tinnitus should be permanently gone.

Well it is not.

I went for 5 days, and then it came back. But today it is gone. Again I woke up in a strange position and definitely something in the neck. I am so convinced of it.

But it's like I have to surprise it.
Look over there! What? <crack> (tinnitus gone)
Later...
Look over there! Ahhh not falling for that again.

And just as I am typing this and looking down at the keyboard the tinnitus is gone.
Down gone.
Up back.
Down gone.

This is weird.

I wonder @Greg Sacramento what nerve it could be?

 

[Greg Sacramento]

Down gone.
Up back.
Down gone.

Go to first large photo of Accessory nerve at look at C3. Without pain, it would be a rootlet in (yellow).

Give it time to heal. Two weeks. Then if needed very light flexion - head down a bit (2 inches) and then slowly up to free it. You probably have little space between C2 and C3.

Just try a couple of times a day until it's free.

Accessory nerve (CN XI): Anatomy, pathways and function | Kenhub

 

[Fleegle]

You probably have little space between C2 and C3.

I am not sure which one is C1/C2/C3?

Is C1 the top one that looks joined to C2 with a gap between C2 & C3?

Or is C1 really the two that look joined and C2 & C3 are another one lower down?

 

[Lane]

I am not sure which one is C1/C2/C3?

Is C1 the top one that looks joined to C2 with a gap between C2 & C3?

Or is C1 really the two that look joined and C2 & C3 are another one lower down?

My understanding is that C1 is the uppermost vertebra, often called the atlas; C2 is the 2nd one down, and is often called the axis; C3 is the 3rd one down, and has no specific name other than that as far as I know; C4 is 4th, etc. I think there are a total of 7 cervical vertebrae in total.

 

[David S]

@Fleegle, what is your tinnitus like? High pitched? Tonal? Cicadas? In head or ears?

 

[Fleegle]

@Fleegle, what is your tinnitus like? High pitched? Tonal? Cicadas? In head or ears?

Like cicadas - thousands of them in a forest of cicadas. I clocked it at around 8 kHz. It is a constant sound, from waking to sleeping - takes an effort to sleep though. Louder than main street traffic.
Seems front left in my head. Probably at 10 o'clock position looking 12 ahead and 6 behind.

It has returned after 2 days.

Which reminds me that I am going to give up posting daily updates about it.

But

5 days off
4 days on
2 days off
1 day on = today

I knew that it would come back after the first 5 days. I ate dinner at a low table and watched TV looking up. I knew it knew it knew it knew it that I was hyperflexing and that it would cause it to come back and then next day it did.

So I am going to watch my posture - try some hanging flexion and see it it comes good.

Sometimes on a good day I can here a "chit chit chit" like something is happening and it is coming back but then I tuck my head a little and I can stop it.

 

[Fleegle]

My understanding is that C1 is the uppermost vertebra, often called the atlas; C2 is

Thanks Lane - I was referring to the picture. I can't tell from the picture which vertebrae is C1 as it looks like the C1C2 are one thing or are they separate things?

 

[Greg Sacramento]

@Fleegle, received some medical thoughts from a trauma vein, artery and aortic vessel system and Aag radiologist. He also specializes in hypertension and pulsatile tinnitus, where most of his patients already have bothersome tinnitus.

Very possible... A very small osteophyte pressuring a rootlet, (probably not a CN) at C3 - third cervical vertebrae most probable. With a small amount of hearing loss, but with tinnitus, pressure would grade <5% as no/pain.

All you may need is a microscope needle - (there's many terms). Area is numbed and you won't notice a thing.

I should have posted this article a long time ago.

https://www.tinnitusjournal.com/articles/upper-cervical-nerves-can-induce-tinnitus.pdf

 

[David S]

@Fleegle, I have cicadas as well. Sometimes a swarm but sometimes just more like low distant Morse-code/tickling. I perceive it more in my ears than the head. I go from 6/10 which is a good day to 8/10 which is harder but still manageable.

Is yours always constant (once you have your tinnitus days)?

Is it reactive to external sounds?

Is it easy to mask by every day sounds or does only like the shower mask it?

Do you find any trigger points that lower your tinnitus or is it only head moments or posture that helps?

Does biting hard or opening your jaw to its maximum position have any effect?

When I bend my head backwards and open and close my cheek, I can modulate my tinnitus but never eliminate it.

I am trying to figure out if my tinnitus is connected to my forward head posture or to cochlear damage. It might just be a bad combination of both. Sorry if I bug you with too many questions...

 

[Sonic17]

@Fleegle, so glad. Big Hug.

The C2 - C3 junction is where flexion and extension occur (flexion is the movement of the chin toward the chest and extension is the backward movement of the head). C3 vertebra is in line with the lower section of the jaw and hyoid bone, which holds the tongue in place. The flexible C3 vertebrae helps aid in the bending and rotation of the neck.

Say thank you to your tongue/gag reflex as you most likely had a trapped nerve between C3 and C4.

Your tinnitus should be permanently gone.

Interesting... I have had tinnitus since I injured my neck in 2017. I wish I could find a way to untrap a pinched nerve if that is what is causing this.

All you may need is a microscope needle - (there's many terms). Area is numbed and you won't notice a thing.

Where could I get this done?

 

[Greg Sacramento]

@Sonic17, you and I had a conversion about this - here. https://www.tinnitustalk.com/posts/588208/

I would consider a consultation with an interventional radiologist that has experience with specified treatment. Some IR's perform this or they may know of another specialist - doctor.

 

[apple core]

@Greg Sacramento, while I believe my tinnitus is primarily noise-induced and I cannot modulate my tinnitus with head/neck/jaw movements I also have strange cervical spine issues - I have constant tingling in my neck and shoulders that produces shaking-like sensations and muscle twitches. I'm unable to clench my teeth perfectly still. This condition predates my tinnitus by about 10 years. The tingling/shaking/twitching is mostly present on the left side and my tinnitus is also mostly left side. I had an X-ray of my cervical spine completed last year and here are the details:

Levocurvature of the cervical spine. Mild (grade 1) retrolisthesis of C3 on C4 and C4 on C5.
No vertebral body compression fracture.
No facet dislocations.
Prevertebral soft tissues are unremarkable.
Craniocervical junction is unremarkable.
The C1-2 junction is unremarkable on the open-mouth view.
Neural foraminal narrowing noted on the right at C5-6.
No osseous masses.

Does any of this sound like a medical intervention might help? Which specialist should I look into? I've tried acupuncture and chiropractor with no success. Or is this lead probably a dead end in my search for relief from tinnitus?

Thank you for your time!

 

[Sonic17]

@Sonic17, you and I had a conversion about this - here. https://www.tinnitustalk.com/posts/588208/

I would consider a consultation with an interventional radiologist that has experience with specified treatment. Some IR's perform this or they may know of another specialist - doctor.

Thank you, somehow I missed your post. You are so knowledgeable, you must be a doctor?

I live in rural Canada and I likely do not have the same options in health care as some other countries, I will pursue this though. I could even make a trip to the Mayo clinic once travel opens up again (COVID-19).

 

[Greg Sacramento]

Hi - since you can't modulate your tinnitus, my guess is that your tinnitus was noise-induced, but what is discussed below, can cause (modulations) somatic tinnitus.

I have constant tingling in my neck and shoulders that produces shaking-like sensations and muscle twitches. I'm unable to clench my teeth perfectly still. This condition predates my tinnitus by about 10 years. The tingling/shaking/twitching is mostly present on the left side and my tinnitus is also mostly left side.

It would not be MS or ulnar nerve damage unless you had same concerns with your hands. More likely a pressured nerve. Read on.

Levocurvature of the cervical spine. Mild (grade 1) retrolisthesis of C3 on C4 and C4 on C5.

You have some degenerative changes of your discs and facets in your neck. Most of us do.

The anterolisthesis (forward slip) of C3 on C4 occurs from facet wear and retrolisthesis at C4-5 is generated from degenerative disc disease. You probably do not have significant ligamentous instability unless there is significant shifting of one vertebra on the other with flexion/extension views.

If you have failed chiropractic treatment and a good course of physical therapy, you should seek out a well experienced interventional PM&R doctor or interventional anesthesiologist for potential injection therapy or bracing as the next step.

They will also consider - a bit of cervical spondylosis (arthritis) and if there's a pinched nerve in the neck/shoulder from development from neural foraminal narrowing on the right at C5-6.

 

[hartstreet]

Hi @illegalmonkey77 -- I find that very interesting. What I do know is that the very strong sheath that surrounds the brain and spinal cord is the same sheath that makes up the whites of our eyes. It's called the dura mater (tough mother), and from my reading and research can become impinged or spasmed for a variety of reasons.

Some health care practitioners specialize in working out the kinks in the dura mater (Bio Cranial Therapy), sometimes resulting in dramatic improvements in health for the person getting the treatment. -- @hartstreet -- I would not be the least bit surprised if some cases of tinnitus could be traced to some kind of involvement of a dysfunctional dura mater.

Thanks for the shout here. I'm excited for the possible relief, to tinnitus and/or my other symptoms, that may be possible. Seeing a physical therapist for some trigger point/myofascial massage later this week before getting into some chiro treatment.

 

[Fleegle]

Is yours always constant (once you have your tinnitus days)?

Mine is always constant but your question supposes that the tinnitus is on some days and off other days - it is not. Only recently has it turned "off" for a few days but I have not been able to correct it, so it continues almost everyday.

Is is reactive to external sounds?

No, definitely not. However, I know I am sensitive to loud noise. So much so that I experience headache and cringe at these sounds.

Is it easy to mask by every day sounds or does only like the shower mask it?

Shower is probably masking it, and music perhaps. I have an app that really helps.

Do you find any trigger points that lower your tinnitus or is it only head moments or posture that helps?

Nothing triggers it to lower, only physical it seems. So a bit of yard work or physical activity MAY stop it, but not always and it seems if I try to do something about it then it doesn't work. But if I don't pay attention then sometimes it goes away.

Does biting hard or opening your jaw to its maximum position have any effect?

Yes, both make it flare up from the "off" to "on". Also abdominal crunches and a certain type of hiccup will make it momentarily flare "on".

When I bend my head backwards and open and close my cheek, I can modulate my tinnitus but never eliminate it.

Sometimes I can do this when bending my head down - also never eliminate it.

I am trying to figure out if my tinnitus is connected to my forward head posture or to cochlear damage. It might just be a bad combination of both.

Or one only. I have kind of a "blocked" ear on one side, and it feels like a blocked tube or something. I might have had an infection in that ear and maybe still do. But I don't know it is related or not.

Sorry if I bug you with too many questions...

A: No, please. Bug me with questions. When we are limited in our experience and search for answers, we look to others who may have similar experiences and perhaps the answers we need.

I would like to know more about your experience to help me too - this is what Tinnitus Talk is for as well. Together we can all come to understand what we are looking for and I don't think we all will have the same answer because tinnitus is varied and different for a lot of people.

 

[Greg Sacramento]

@apple core and @Sonic17, how are the both of you doing?

It's been difficult for me to stay in touch with tags/questions with what I have physically going on, but will try if I can.

Medical discussion on the internet has some faults as not being live person to person and often someone will add more information and history later.

For @Fleegle and @IntotheBlue03, I contacted Interventional Radiologists with both tinnitus and pulsatile tinnitus knowledege for their thoughts. Much that goes on physically with physical tinnitus and pulsatile tinnitus can be more categorized from those without tinnitus.

 

[IntotheBlue03]

Hi @Greg Sacramento,

Hope you are doing well.

Thanks for checking in with the interventional radiologists. This is actually news to me when it comes to a treatment for tinnitus. Is it only pulsatile tinnitus that is treatable or physical tinnitus as well?

I've had a few facet blocks in my day before the prolotherapy (and before the tinnitus).

 

[Fleegle]

This morning I woke with severe tinnitus as usual. Maybe 6 hours sleep.

I went through my morning routine and then no tinnitus. Nothing.

A half hour later there was a crackle in my left ear and I felt that I should move my head slightly to avoid it coming back. And it never did.

This is not a cognitive exercise of not thinking about it and it will go away. No. It is gone.

12 hours later it has not returned. In a few hours I will sleep and it will be back. Or not.

EDIT #1:

I slept 4 hours. With masking earplugs. Tinnitus woke me louder than my original scoring system. I am now at 5/5 and unilateral. Level 5 was the number where I was going to give up.

EDIT #2:

I found that there is a slim chance that I can turn my head in bed - to the right and down off the pillow. After propping my head up on the pillow slanted against the headboard, watching YouTube for an hour, then sliding down and lying on my right side and head down off the pillow, maybe, just maybe, the tinnitus goes away.

Or not.

When I try to make it work, it doesn't, and I lose hope once again.

What is this stupid thing that I am trying to fix and why doesn't it work?