I Experience Louder Tinnitus When Pressing Mastoid Bone Behind the Ear?

[Michael-DK]

Hi all!

My story: in December last year, while I was working at home during COVID-19, I suddenly started to hear the noise I otherwise only know from when you are close to an electrical device. I've been to an ear doctor, and she tested my hearing as perfect. And even though I am a teacher, I am not exposed, nor have I been exposed, to a lot of noise. I therefore believe that my tinnitus is somatic. By the way, the ear doctor did an ultrasound scan of the mastoid bone without finding anything. I have also tried massaging the jaw, neck and muscles around the neck, without any difference.

Despite my tinnitus, I'm probably luckier than most, because I don't have a very clear/high tone, and there are even periods when I completely forget my tinnitus. I therefore hope it doesn't escalate, and I'm curious if I myself can take preventive action against just that.

As the title says, my tinnitus becomes louder when I press on the mastoid bone, precisely the mastoid process (picture below), i.e. the small bone that sticks out and points downwards behind the ear.

It's most obvious when take my right arm behind my head and pull the bone behind the left ear, towards the neck (I hope it makes sense).

I have searched to see if others have the same experience as me, but cannot find others with same experience.

Has anyone else had the same experience?

When I bite my teeth hard together, it also makes my tinnitus louder, but isn't that very common? - I don't think I suffer from TMJ.

Thanks for reading this far. I hope to hear from someone.

Kind regards,
Michael, Denmark

 

[Joe Cuber]

Yup, mine is somatic, unilateral in my right ear. I can modulate the pitch and volume when I push on that bone or any of the bones in the vicinity, including my skull bones, like my occipital. I can also readily modulate when I clench my teeth and move my neck around. Apparently many people's tinnitus has a somatic aspect to it, I forget the stat though.

Is your tinnitus otherwise the same baseline pitch and volume every day?

 

[Greg Sacramento]

@Michael-DK, have someone use a stethoscope behind both ears and compare the pulse.

The pulse should be the same, since it's not asymptomatic, other than from touch. With this and having been dopplered, you wouldn't have an abnormal mastoid emissary vein. Mastoid emissary vein - passes through the mastoid foramen to connect each sigmoid sinus with the occipital.

I think you can rule out any venous insufficiencies.

Your hearing is perfect with no ear trauma, so several conditions can be excluded.

When I bite my teeth hard together, it also makes my tinnitus louder

It's possible that your tinnitus was caused from a posture injury to neck, even without discomfort. Consider neck X-rays to view atlantooccipital joints. These are synovial joints comprised of the convex occipital condyles.

 

[Michael-DK]

Yup, mine is somatic, unilateral in my right ear. I can modulate the pitch and volume when I push on that bone or any of the bones in the vicinity, including my skull bones, like my occipital. I can also readily modulate when I clench my teeth and move my neck around. Apparently many people's tinnitus has a somatic aspect to it, I forget the stat though.

Is your tinnitus otherwise the same baseline pitch and volume every day?

Thanks for replying.

My tinnitus has the same pitch every day. Only the volume changes for periods of time. By the way, I only have tinnitus in my left ear. I think. It's a little difficult to locate.

Kind regards,
Michael

 

[Javimaltes]

Me too. I read months ago that 65 % of tinnitus cases are somatic. Even acoustic trauma induced tinnitus is in a lot of cases somatic.

Has anyone else had the same experience?

My advice, and this helped me so much, is not to focus too much on your tinnitus. It is good to know what intensifies it, but once determined, the best strategy is to move on. Two months ago I was scared to death. Today, in my fourth month with this condition, I feel good; tinnitus does not bother me too much.

 

[Michael-DK]

Me too. I read months ago that 65 % of tinnitus cases are somatic. Even acoustic trauma induced tinnitus is in a lot of cases somatic.

My advice, and this helped me so much, is not to focus too much on your tinnitus. It is good to know what intensifies it, but once determined, the best strategy is to move on. Two months ago I was scared to death. Today, in my fourth month with this condition, I feel good; tinnitus does not bother me too much.

Thanks for replying. I'm just looking for what intensifies the tinnitus. I try not to let myself be affected by it, and what I probably fear most is that it will get worse in the future ;-)

I'm glad for you that it's no longer bothersome.

Kind regards,
Michael

 

[silentnight]

Hello! Does it also get louder when you jut your jaw forward, past your upper teeth?

My tinnitus sounds similar to yours, although mine has weird extra high pitched instances of extra static. Mine is unilateral in my right ear and gets slightly louder when pressing on the mastoid process too, but it gets the loudest when pressing on my skull above my ear (I think around where the temporal lobe is?). Do you experience this too? It's also really loud when I tilt my head away from the affected side, and quieter when toward the affected side (but sometimes that can make the other side act up too - so weird!).

I've been experiencing my somatic (?) tinnitus for the past 4 months now and it sure is a doozy, because it can sometimes feel like all sorts of things affect it.

I've met with a physical therapist who recommended upper trapezius stretches, levator scapulae stretches, and supine chin tucks (this last one seems to make my tinnitus extra loud whilst doing it). It's too early to tell whether or not these exercises are helping, but if nothing else it would be good to strengthen your neck muscles and correct your posture.

My best advice thus far is to drink chamomile tea at night to calm you and hopefully your neck muscles down, sleep on your back with your body straight and your head in a neutral position and supported by a pillow, and take extra care in maintaining a healthy posture.

Best of luck, and may we all solve our tinnitus together! =^^=

 

[Joe Cuber]

Only the volume changes for periods of time

@Michael-DK - How drastically goes your volume change and how long are these periods of time? I ask because my volume changes drastically by the day, some days very quiet, other days very loud. I've noticed that my loud days are correlated with areas of my scalp feeling tender, like where my occipital connects with my temporal, and also that indented area where my skull meets my neck in the back.

It's possible that your tinnitus was caused from a posture injury to neck, even without discomfort. Consider neck X-rays to view atlantooccipital joints. These are synovial joints comprised of the convex occipital condyles.

Hi @Greg Sacramento - This is interesting. Would you recommend this course of action (including getting dopplered) for anyone who who has somatic tinnitus that can be modulated with neck and jaw movements?

Mine is unilateral in my right ear and gets slightly louder when pressing on the mastoid process too, but it gets the loudest when pressing on my skull above my ear

Hi @silentnight - Mine is unilateral right too and my pitch and volume modulates when I press above my ear, press the mastoid, and press anywhere in the vicinity, even the top of my head. It's quite a symphony when I dry my hair after a shower, like a bunch of dolphins that just joined a choir.

 

[Greg Sacramento]

Would you recommend this course of action (including getting dopplered) for anyone who who has somatic tinnitus that can be modulated with neck and jaw movements?

Joe, I do recommend.

My former healthcare employers have a X-ray room in every affiliated outpatient general practice and neurology doctor's suite. They also have Doppler ultrasound and electrocardiogram.

Positive C spine X-rays notations are very valuable. I once posted a long complete list of relationship conditions/diseases with definitions. Negative results narrow possibilities.

 

[Joe Cuber]

Thanks for the advice @Greg Sacramento, I'll speak with my primary care physician about getting these done. I'll also try to find your post of conditions/diseases (you have a lot of posts!).

One thing I've learned by paying attention to my symptoms is that I feel tenderness at the joint where my occipital, temporal, and parietal bones meet on my right side, which is the side I experience tinnitus. The left side joint feels normal. I also feel tender in the center back of my neck right near my occipital.

 

[silentnight]

@Joe Cuber, does your tinnitus ever decrease after pressing on/massaging those tender/relevant areas of your skull?

In my experience, after massaging these areas the tinnitus tends to decrease for up to the rest of the day. Today I've also tried pressing on my skull where it gets loudest and putting strain on my jaw to where it's loudest at the same time, and so far it's been the quietest it has ever been. As to why, your guess is as good as mine. I wouldn't recommend it because "press on your skull where it strains and makes your tinnitus worse" is not the best sounding advice, but perhaps there's something being pushed into place in this scenario? I'm not sure.

In any case, I really think you would benefit from neck exercises.

What's the texture/sound of your tinnitus, by the way?

 

[Joe Cuber]

@Joe Cuber, does your tinnitus ever decrease after pressing on/massaging those tender/relevant areas of your skull?

In my experience, after massaging these areas the tinnitus tends to decrease for up to the rest of the day. Today I've also tried pressing on my skull where it gets loudest and putting strain on my jaw to where it's loudest at the same time, and so far it's been the quietest it has ever been. As to why, your guess is as good as mine. I wouldn't recommend it because "press on your skull where it strains and makes your tinnitus worse" is not the best sounding advice, but perhaps there's something being pushed into place in this scenario? I'm not sure.

In any case, I really think you would benefit from neck exercises.

What's the texture/sound of your tinnitus, by the way?

@silentnight - That's great that you found a technique that can quiet yours. I have tried pushing in various places to see if it would quiet mine, but pushing doesn't seem to make the volume go down for me. I have tried sitting and slouching forward with my elbows on my knees and letting my head droop down. That made my tinnitus go away for the day one time. I've also laid in bed on my back with my head on my pillow or on my side with my right ear on my pillow, and several times my tinnitus went away for the day.

I do think mine is neck-related, so neck exercises may very well help. I think mine is neck-related because how my position is when I sleep seems to be correlated with whether I hear my tinnitus when I get up.

So my tinnitus sounds like a loud electric hiss right inside my right ear, like the way an electrical appliance might sound if it were loud and annoying, like if I'm in a room full of loud, whiny refrigerators, haha. But I don't hear it every day. For some reason, many times, I wake up and don't hear it for the whole day. This happens on average every other day.

How does yours sound? And does yours fluctuate day by day?

 

[Greg Sacramento]

Thanks for the advice @Greg Sacramento, I'll speak with my primary care physician about getting these done. I'll also try to find your post of conditions/diseases (you have a lot of posts!).

One thing I've learned by paying attention to my symptoms is that I feel tenderness at the joint where my occipital, temporal, and parietal bones meet on my right side, which is the side I experience tinnitus. The left side joint feels normal. I also feel tender in the center back of my neck right near my occipital.

@Joe Cuber, near the base of the skull are a group of muscles - suboccipital muscles. There are 4 paired muscles that attach to the upper two cervical bones.

Loose ligaments - can cause irritation to the suboccipital muscles, facet joints, discs, and nerves.

Atlantoaxial Instability - bones move around too much/tilt, usually due to irritated ligaments. In the C spine, this can cause nerves to bang into joints. In the craniocervical junction, instability can cause the upper cervical spinal nerves to get irritated, leading to a sensitive scalp. In addition, the C0-C1 and C1-C2 facet joints can also get irritated. There's other nerves that exit the skull here that can get irritated.

A facet cartilage-lined joint - there's a right and left C2/3 and C3/4 facet joint - near where the occipital connects with temporal.

Yes, get non-motion C-spine X-rays. Post notations and, if possible, the scans. I should be able to note the somatic tinnitus connection/source, just from bone scans.

Decided upon treatment, should greatly benefit.

 

[silentnight]

@silentnight - That's great that you found a technique that can quiet yours. I have tried pushing in various places to see if it would quiet mine, but pushing doesn't seem to make the volume go down for me. I have tried sitting and slouching forward with my elbows on my knees and letting my head droop down. That made my tinnitus go away for the day one time. I've also laid in bed on my back with my head on my pillow or on my side with my right ear on my pillow, and several times my tinnitus went away for the day.

I do think mine is neck-related, so neck exercises may very well help. I think mine is neck-related because how my position is when I sleep seems to be correlated with whether I hear my tinnitus when I get up.

So my tinnitus sounds like a loud electric hiss right inside my right ear, like the way an electrical appliance might sound if it were loud and annoying, like if I'm in a room full of loud, whiny refrigerators, haha. But I don't hear it every day. For some reason, many times, I wake up and don't hear it for the whole day. This happens on average every other day.

How does yours sound? And does yours fluctuate day by day?

@Joe Cuber, satisfaction is only temporary, unfortunately. it always ends up coming back in some form or another. In my experience, it's always present, perhaps because mine has multiple causes? Recently I've been experiencing the electronic hiss you mentioned, but usually it's layered with intermittent static blips and, rarely, clicks.

I do find comfort depending on my sleeping position, but I don't believe it persists into the morning (or perhaps I just move too much in my sleep?). Specifically, it's quietest when lying on my back with my head on my pillow and my body perfectly straight, and with my shoulders back to take strain off of the base of my neck. I'm still testing all sorts of different modulations and techniques because I haven't lost hope yet, and I hope you haven't either. Best of luck!

P.S. I have reason to believe that my tinnitus is neck‐related because I have a habit of using my laptop on my bed with myself belly down, so that probably has been putting a lot of strain on my neck and shoulders. I'm not sure.

P.P.S. Do you have any other neck pains or soreness? Any symptoms of cervical instability or pinched nerves or the like? I don't believe I have any symptoms of my tinnitus being caused by my neck, just my ability to modulate it with my neck and history of bad posture. Hopefully your scans show a clear indication of something wrong. I'll try to get the same scans done that @Greg Sacramento mentioned. We're in this together!

 

[Joe Cuber]

@Joe Cuber, satisfaction is only temporary, unfortunately. it always ends up coming back in some form or another. In my experience, it's always present, perhaps because mine has multiple causes? Recently I've been experiencing the electronic hiss you mentioned, but usually it's layered with intermittent static blips and, rarely, clicks.

I do find comfort depending on my sleeping position, but I don't believe it persists into the morning (or perhaps I just move too much in my sleep?). Specifically, it's quietest when lying on my back with my head on my pillow and my body perfectly straight, and with my shoulders back to take strain off of the base of my neck. I'm still testing all sorts of different modulations and techniques because I haven't lost hope yet, and I hope you haven't either. Best of luck!

P.S. I have reason to believe that my tinnitus is neck‐related because I have a habit of using my laptop on my bed with myself belly down, so that probably has been putting a lot of strain on my neck and shoulders. I'm not sure.

P.P.S. Do you have any other neck pains or soreness? Any symptoms of cervical instability or pinched nerves or the like? I don't believe I have any symptoms of my tinnitus being caused by my neck, just my ability to modulate it with my neck and history of bad posture. Hopefully your scans show a clear indication of something wrong. I'll try to get the same scans done that @Greg Sacramento mentioned. We're in this together!

You bet @silentnight, it's really nice to be able to discuss these symptoms with someone. I have not lost hope either! I have two sleeping positions that work for me. One is on my back with my head on my pillow so that my neck curled forward. The other is on my right side. If I sleep on my left, my tinnitus sometimes spikes.

I too have a history of bad posture. I have a scoliotic curve in my lower back, kyphosis in my mid-back, and my neck doesn't have the nice curve it's supposed to have. I don't have any other neck pains or soreness or pinched nerves in my neck. However, I sometimes get a tingly feeling in my left arm/hand if I lay or sit wrong. Another thing I've noticed is that my neck bones make a crunchy sound when I turn my head left and right, like when you scrunch a bag of potato chips. One thing is for certain, I can modulate the heck out of my tinnitus by moving my neck, clenching my jaw or chewing, and pressing on many of my skull bones.

 

[Joe Cuber]

@Joe Cuber, near the base of the skull are a group of muscles - suboccipital muscles. There are 4 paired muscles that attach to the upper two cervical bones.

Loose ligaments - can cause irritation to the suboccipital muscles, facet joints, discs, and nerves.

Atlantoaxial Instability - bones move around too much/tilt, usually due to irritated ligaments. In the C spine, this can cause nerves to bang into joints. In the craniocervical junction, instability can cause the upper cervical spinal nerves to get irritated, leading to a sensitive scalp. In addition, the C0-C1 and C1-C2 facet joints can also get irritated. There's other nerves that exit the skull here that can get irritated.

A facet cartilage-lined joint - there's a right and left C2/3 and C3/4 facet joint - near where the occipital connects with temporal.

Yes, get non-motion C-spine X-rays. Post notations and, if possible, the scans. I should be able to note the somatic tinnitus connection/source, just from bone scans.

Decided upon treatment, should greatly benefit.

@Greg Sacramento, thank you so much for taking the time to educate us, instruct us, and help us out.

I'll request X-rays. Should they be taken from the back, front and sides? I have some taken from the front and side about 4 months ago. I'm trying to get a hold of them from my doctor.

 

[silentnight]

@Joe Cuber, @Greg Sacramento:

I visited a NUCCA chiropractor today and got X-rays! I won't be given an analysis or adjustment of my spine till Monday, though. Thoughts on the scans?

Some interesting things I learned: I put 9 pounds more weight on my left side and my pelvis angle is 2 degrees off Interesting!

 

[Greg Sacramento]

I sometimes get a tingly feeling in my left arm/hand if I lay or sit wrong.

Caused by poor sleeping posture from bad daytime posture. This is causing nerves in the back of the neck, arms and armpits to be compressed. Compression set-ups (cause) from bad day posture and the (effect) "deal is sealed' when sleeping - placement of one leg on the other. Posture during the day may be incorrect forward head posture and favoring one side. If you use a computer, you may be forward head bending and not balanced behind the keyboard and screen. Or because of other one side favoritisms, such as when walking or with activities such as brushing teeth. This is similar to Thoractic Syndrome. This tends to run in families - heredity.

Another thing I've noticed is that my neck bones make a crunchy sound when I turn my head left and right

Crunching sound in neck when i turn my head - SoundAcademy

Treatment:

Sight lilt of head backwards (not by much) and hold for 3 seconds. Once - twice a day.

Sight neck movement to one side and a minute later slighty move neck to other side. Do not force resistance.

May want to use liquid 'Pure Encapsulation Glycinate Magnesium' one hour before exercises.

May want to use a moist warm (not hot) compress just before exercise. Rinse a washcloth out.

@silentnight, X-Rays are negative - fine.

 

[Joe Cuber]

Thanks @Greg Sacramento, I really appreciate the info! I'll follow your advice.

Caused by poor sleeping posture from bad daytime posture.

This describes me very well. I have kyphosis in the thoracic and forward head posture. And I sleep on my side typically due to sleep apnea (but I have a CPAP machine now).

"deal is sealed' when sleeping - placement of one leg on the other

Are you saying that sleeping on my side and placing one leg on the other is bad for my neck? I actually would like to sleep more on my back, so I'd be happy to change to sleeping on my back instead of on my side, especially now that I use a CPAP machine.

I don't have the X-rays from my doctor back yet, but here are the test results for my cervical spine X-rays:

XR Cervical Spine 2 Views

Narrative
Cervical spine radiographs dated 4/18/2022
HISTORY: Scoliosis
FINDINGS:
The normal cervical ptosis is well maintained.
No evidence of usual cervical spine levoscoliosis or dextroscoliosis.
The vertebral body heights are intact.
No evidence of compression fracture or deformity.
Mild multilevel discogenic degenerative changes with small anterior and posterior osteophytes. At most minimal multilevel posterior hypertrophic changes. No findings to suggest appreciable significant central canal stenosis.
The prevertebral and posterior vertebral soft tissues are within normal limits.

Impression
1. No evidence of acute fracture, subluxation, or compression fracture/deformity. Normal cervical lordosis is well maintained. No evidence of levoscoliosis or dextroscoliosis.

2. Mild multilevel discogenic degenerative changes with small anterior and posterior osteophytes. Possible minimal posterior hypertrophic changes at multiple levels. No findings to suggest appreciable central canal stenosis on this limited 2 view exam.

Thanks again for your help!

 

[Greg Sacramento]

@Joe Cuber, your neck and head symptoms within this thread appear to be suspect, but your XR Cervical Findings don't show a hearingloss/tinnitus cause. Your lumber spine - Scoliosis is also probably not tinnitus/hearing loss cause or pathogenesis.

I've also laid in bed on my back with my head on my pillow or on my side with my right ear on my pillow, and several times my tinnitus went away for the day.

I would keep using your CPAP machine.

 

[Joe Cuber]

Thanks for all of your time @Greg Sacramento! I agree with you, my neck is suspect. I've been heeding your advice. I've been trying to maintain good posture during the day. And at night, I've been sleeping on my back with my CPAP machine. So far, I've had a couple of decent days. I'll see if this trend continues.