Noise-Induced Tinnitus Gotten Extremely Somatic

[Monica123]

Hi all,

Looking for some advice on my tinnitus on here. I'm 30 years old and first got tinnitus in 2016 after too much noise exposure playing music with a band. So I know for a fact mine was noise induced to begin with.

I freaked out at first but it was pretty mild at the time and I got used to it after about half a year. Still, I always had a fear in the back of my mind it was going to get worse one day, and of course it did.

In the autumn of 2018 I started to notice it was getting louder, around the time I was starting to work a little bit with my music like I did before, I thought it was so weird though cause I was really careful with the volume in the studio, it was very very low. Still my tinnitus started getting worse and I started to get scared and stopped playing music/recording.

So this new tinnitus that came on in 2018 has gradually gotten louder and is like a dial tone coming from my right ear. It never stops if I sit up/have my head in upright position. But last year I made the discovery that this new tinnitus was extremely somatic, I can make it completely go away in many different ways.

• If I press along my right SCM muscle the tinnitus is gone (but my SCM muscle is not tense or painful)
• If I massage the muscles right below the scull on the right side (tinnitus back with same volume the second I stop)
• If I bend over to a horizontal position
• If I press my head toward the right side (press into the neck muscles on the right side)
• Chin tucks reduces tinnitus A LOT, and Ive been doing them like crazy the last while, but no lasting effect, just while I'm doing them.

All these movements make the dial tone appear almost gone, sometimes I cant even hear it if I do one of them while plugging my ears to listen for my the tinnitus. The thing is, it NEVER lasts. It is like turning off and on a switch. It feels like I am stopping the signal, but Im not close to where the problem really is coming from.

Another two things to mention:

• Wearing a neck collar reduces the tinnitus by like 90 % but its back to normal volume the second I take the collar off.
• And I get these weird muscle spasms in my upper right SCM muscle right below the jaw bone. They don't hurt, just feels like a little jump. Happens a couple of times a week.

Also when I open my mouth or press my jaw forward it will take the tinnitus down by a lot. Laying down also makes it quieter, but not by a lot.

So I just don't understand this dial tone tinnitus. Extremely somatic, can pretty much make it disappear.

• I have no hearing loss on a normal audiogram, so I dont get why I would get this kind of low frequency dial tone tinnitus. And also, I understand you can get somatic tinnitus from noise exposure, but AS somatic as this? Where you can eliminate it completely? I feel there has to be something else going on with me as well.
• I have no TMJ problems as far as I am aware of, and recently a dentist didn't find any signs of problems such as bruxism.
• Not any major neck pain, sometimes a little right in the upper neck muscles.

So far Ive tried

• dry needling and acupuncture, with no effect. Whatever tightness I had in the right SCM muscle is gone now, and it really wasn't bad to begin with. No effect on somatic tinnitus. Actually i have more tight muscles on the left side, but no somatic tinnitus in that ear.
• Physio, I tried a couple, and they didn't find anything
• Chiropractor - didn't find anything
• Talked with a dentist - didn't find any sign of TMJ, bruxism
• Neck collar - very good effect while wearing it, but tinnitus is back the second I remove the collar.

So I'm hoping anyone on here has any advice for me on this. Could it be related to nerves? I really really do not want to do and MRI, cause after struggling with the new tinnitus I developed fear and pain hyperacusis in my left ear (the ear without tinnitus). And my phonophobia is pretty bad. I believe this to be mainly my anxiety as it happened after tinnitus got worse but I hadn't figured out how somatic it was, so I was so scared that low volume music could do this to me and started fearing all sound and overprotecting. Even though noise doesn't seem to effect the somatic tinnitus at all.

Should I see a neurologist? Can they even do anything or give any answers when it comes to somatic tinnitus?

Sorry this is so long! It just feels so complicated as I know my tinnitus started with noise exposure but whats the deal with the crazy somatic elements. And it feels like it is getting worse to, slowly, but steady, and there is nothing I can do to stop the worsening.

Any advice would be highly appreciated!

Hope it is ok for me to tag you @Greg Sacramento as I read many of your posts on somatic tinnitus and you seem so knowledgeable on the subject and supportive.

Thank you for any thoughts/tips and ideas on anything I could try!

Mon

 

[Greg Sacramento]

Hi @Monica123

Wearing a neck brace supports the weight of your head, which will temporarily relieve the stress on your SCM muscle.
What is happening is that you are relieving neck torsion from spasm muscles (mainly your SCM on one side) with neck movements.

This is one of my favorite tinnitus links - and this is the easy quick treatment that you need to untense your SCM and relieve your somatic T. In the quote below, the patient is saying that his T is totally gone.

I squeezed his SCM, he almost fainted! I held it (more gently than he suspected) and gradually increased the pressure. After about 5 minutes he looked at me and said "it's starting to fade," and after 10 minutes it was totally gone!

https://julstromethod.com/julie-donnelly-notes/tinnitus-causes/

Find a good PT person and show this article to them. Then after one treatment, you will be able to do it at home yourself if needed. Have someone else around at home when you do it. Let me know how it goes. I have seen a few myself have their tinnitus disappear in ten minutes with this particular treatment.

 

[Monica123]

Thank you for your answer Greg.

The problem is my SCM muscle is not painful or tense in any way.
And even though my tinnitus is pretty much completely gone when I squeeze the muscle I can hold it like that for as long as I want, the tinnitus still comes back immediately when I let go with the same level it was before. Like I said, its like turning on and off a switch. Ive tried three different PTs and none of them found anything wrong with my SCM muscle.

Also, if my SCM muscle was the problem, would I still be able to eliminate my tinnitus when massaging my upper neck muscles?
Are you pretty sure it is muscle related because of the spasms I'm experiencing? Or if it was related to a cranial nerve could that give muscle spasms as well?

Thank you again Greg, really appreciate it!

Monica

 

[Greg Sacramento]

@Monica123, can you describe your tinnitus sound and then we can continue.

The accessory nerve which is a cranial nerve would be loud and high pitched. Of the other regional nerves, only the lesser occipital nerve would cause a tinnitus sound. Small occipital nerve fibers not seen in picture would cause sounds only if you had your the back of your neck pressed to a pillow.

The external carotid would cause a thump or humming sound. The jugular - a hum sound. Both of these would be vascular.

Very possible that there's pressure to the accessory and to the occipital nerve from what you describe in ways that you can make tinnitus go away.

An MRA or CTA exam may not show a problem.

 

[Monica123]

The somatic tinnitus tone sounds like this video:


The same type of sound (a little less intense, but intense enough) and same frequency.

Mon

 

[Lilah]

Hi all,

Looking for some advice on my tinnitus on here. I'm 30 years old and first got tinnitus in 2016 after too much noise exposure playing music with a band. So I know for a fact mine was noise induced to begin with.

I freaked out at first but it was pretty mild at the time and I got used to it after about half a year. Still, I always had a fear in the back of my mind it was going to get worse one day, and of course it did.

In the autumn of 2018 I started to notice it was getting louder, around the time I was starting to work a little bit with my music like I did before, I thought it was so weird though cause I was really careful with the volume in the studio, it was very very low. Still my tinnitus started getting worse and I started to get scared and stopped playing music/recording.

So this new tinnitus that came on in 2018 has gradually gotten louder and is like a dial tone coming from my right ear. It never stops if I sit up/have my head in upright position. But last year I made the discovery that this new tinnitus was extremely somatic, I can make it completely go away in many different ways.

• If I press along my right SCM muscle the tinnitus is gone (but my SCM muscle is not tense or painful)
• If I massage the muscles right below the scull on the right side (tinnitus back with same volume the second I stop)
• If I bend over to a horizontal position
• If I press my head toward the right side (press into the neck muscles on the right side)
• Chin tucks reduces tinnitus A LOT, and Ive been doing them like crazy the last while, but no lasting effect, just while I'm doing them.

All these movements make the dial tone appear almost gone, sometimes I cant even hear it if I do one of them while plugging my ears to listen for my the tinnitus. The thing is, it NEVER lasts. It is like turning off and on a switch. It feels like I am stopping the signal, but Im not close to where the problem really is coming from.

Another two things to mention:

• Wearing a neck collar reduces the tinnitus by like 90 % but its back to normal volume the second I take the collar off.
• And I get these weird muscle spasms in my upper right SCM muscle right below the jaw bone. They don't hurt, just feels like a little jump. Happens a couple of times a week.

Also when I open my mouth or press my jaw forward it will take the tinnitus down by a lot. Laying down also makes it quieter, but not by a lot.

So I just don't understand this dial tone tinnitus. Extremely somatic, can pretty much make it disappear.

• I have no hearing loss on a normal audiogram, so I dont get why I would get this kind of low frequency dial tone tinnitus. And also, I understand you can get somatic tinnitus from noise exposure, but AS somatic as this? Where you can eliminate it completely? I feel there has to be something else going on with me as well.
• I have no TMJ problems as far as I am aware of, and recently a dentist didn't find any signs of problems such as bruxism.
• Not any major neck pain, sometimes a little right in the upper neck muscles.

So far Ive tried

• dry needling and acupuncture, with no effect. Whatever tightness I had in the right SCM muscle is gone now, and it really wasn't bad to begin with. No effect on somatic tinnitus. Actually i have more tight muscles on the left side, but no somatic tinnitus in that ear.
• Physio, I tried a couple, and they didn't find anything
• Chiropractor - didn't find anything
• Talked with a dentist - didn't find any sign of TMJ, bruxism
• Neck collar - very good effect while wearing it, but tinnitus is back the second I remove the collar.

So I'm hoping anyone on here has any advice for me on this. Could it be related to nerves? I really really do not want to do and MRI, cause after struggling with the new tinnitus I developed fear and pain hyperacusis in my left ear (the ear without tinnitus). And my phonophobia is pretty bad. I believe this to be mainly my anxiety as it happened after tinnitus got worse but I hadn't figured out how somatic it was, so I was so scared that low volume music could do this to me and started fearing all sound and overprotecting. Even though noise doesn't seem to effect the somatic tinnitus at all.

Should I see a neurologist? Can they even do anything or give any answers when it comes to somatic tinnitus?

Sorry this is so long! It just feels so complicated as I know my tinnitus started with noise exposure but whats the deal with the crazy somatic elements. And it feels like it is getting worse to, slowly, but steady, and there is nothing I can do to stop the worsening.

Any advice would be highly appreciated!

Hope it is ok for me to tag you @Greg Sacramento as I read many of your posts on somatic tinnitus and you seem so knowledgeable on the subject and supportive.

Thank you for any thoughts/tips and ideas on anything I could try!

Mon

Does your tinnitus increases in volume or pitch when yawning, chewing, stretching, during face/head/neck massages?

 

[Monica123]

Does your tinnitus increases in volume or pitch when yawning, chewing, stretching, during face/head/neck massages?

Yes, it increases in my right ear when I'm yawning. But that's the only time it does increase really, most movements seem to reduce it. I haven't noticed any change when chewing. While massaging various muscles in my neck the tinnitus is reduced. Back with the same volume whenever I stop though. You have the same problem with somatic tinnitus? Any advice?

 

[Lilah]

My tinnitus is very somatic but I haven't experienced reductions the way you do. Movements usually increase the volume and pitch slightly. After exercise, my tinnitus is usually a bit worse. I have been to chiropractor and a physical therapist for about 6 months each and it didn't make a difference. I also have mild hyperacusis/and reactive tinnitus to noise. Mine is probably noise-induced.

 

[Greg Sacramento]

@Monica123 We know that when the SCM muscles are not in balance, they pull on the neck vertebrae and the mastoid area. Your sounds may be from a pitched nerve from narrowed disc space and relief is given when the SCM is in motion with expansion of disc. Or when the C spine is under support as when using a neck brace. Your neck could be out of alignment. You get T relief from this - not increased T.

That's all I can suspect with your situation, including yawning. A question that @Lilah just asked.

You had mentioned that you been to three different PTs and none of them found anything wrong with your SCM muscle. They may or may not be able to tell if your neck is out of alignment. Have you had a X Ray, CT or MRI of neck?

One thousand detailed medical articles is of little help to know for sure what the problem is when there's less T from movement. BUT - if a neck brace helps, then all that I can think of is what I mention in first paragraph. There may be a particular reason where radiological exams might show the problem with notation by a specialized radiologist.

 

[Monica123]

I have not had an X Ray, CT or MRI of my neck. I'm too scared to have an MRI cause of the volume, and I did not know a CT or X Ray could give information of my problem. But you're saying a CT or X Ray could show if the neck is out of aligment? And I wouldn't have to get a CT with contrast ? I'm just scared to make T and H worse in any way, but I guess having an X Ray done is not loud?
Would this be my next step to get these done @gregsacramento ?

Anything else I could try if it is a pinched nerve problem? Or something to know for sure this is my problem? Would this type of problem also give muscle spasms of the SCM? And how would this problem come on as I have only had it for two years, strained neck can cause pinched nerve? I rarely have neck pain, would a pinched nerve give neck pain?

Also, is it possible it is just noise-induced tinnitus being very somatic? Is it possible to have noise-induced tinnitus this somatic?
I find it very coincidental that after getting noise-induced tinnitus back in 2016 I would randomly get this loud somatic one two years later without any relation between the two. What do you think?

So many questions @gregsacramento
Sorry! You dont have to answer them all.
I very much appreciate you taking the time to help me!

Monica

 

[Dr. Jay Hobbs]

@Greg Sacramento is always good for providing detailed and accurate advice.
To answer some of your additional questions @Monica123:

a CT or X Ray could show if the neck is out of aligment?

Anything else I could try if it is a pinched nerve problem? Or something to know for sure this is my problem?

Terminology is important and the way doctors interpret the images.

• When chiropractors say "out of alignment," most of us mean that the joint is fixated or stuck and that lack of proper movement is palpable by use and may be felt as restricted by you. Most of us do not mean that it is really out of place. Therefore, unless you are seeing a NUCCA or Gonstead chiropractor, the x-rays do not tell us what to adjust, and they certainly don't show "pinched nerves."
• What we are usually dealing with is "nerve interference" arising from the altered feedback from the dysfunctional/fixated joint. Actual pinched nerves do occur, and an MRI is a great way to observe those. CT can do this, although usually not as well....and CT uses a gob of radiation. Additionally, pinched nerves (what we could call nerve root compression) will affect the end of where those nerves travel with a tingling, pain, or numbness. (With the crossover of auditory and somatic input, this might also cause a referred perception of tinnitus.)
• Compression of C2 or 3 almost never happens at the spine, but compression of C2, 3 or the Accessory nerve (cranial nerve 11) could happen as it wraps around tight muscles...but less liekly since you said you don't have tight muscles. CT, MRI, or x-ray would all be useful only if there were a mass. Tight muscles compressing a nerve subtly will not show.

Is it possible to have noise-induced tinnitus this somatic?

• Somatic-modulated tinnitus is VERY common, and seems to be present even when not improved with somatic treatment.
• Somatic-caused tinnitus (which I define as tinnitus that is improved when the involved soma (body) is properly/successfully treated) is defined in by a specific evaluation and certain answers to specific questions.

So, I would say, it is possible to have noise-induced tinnitus this [very] somatic, but not that is [your characteristic] tinnitus -- at least not predominately, since it is common to have combinations of causes.

I find it very coincidental that after getting noise-induced tinnitus back in 2016 I would randomly get this loud somatic one two years later without any relation between the two. What do you think?

I agree. Although I questions if your previous tinnitus was predominately noise-induced. I don't know, but we often have somatic (physical) stress at the same times that we have chemical, auditory, or emotional stress.

 

[Jangles001]

@Monica123, can you describe your tinnitus sound and then we can continue.

The accessory nerve which is a cranial nerve would be loud and high pitched. Of the other regional nerves, only the lesser occipital nerve would cause a tinnitus sound. Small occipital nerve fibers not seen in picture would cause sounds only if you had your the back of your neck pressed to a pillow.

The external carotid would cause a thump or humming sound. The jugular - a hum sound. Both of these would be vascular.

Very possible that there's pressure to the accessory and to the occipital nerve from what you describe in ways that you can make tinnitus go away.

An MRA or CTA exam may not show a problem.

View attachment 39818

OMG, this description and photo has blown my mind! 15 months with tinnitus, slowly narrowing things down and this has helped massively. My tinnitus is high pitched 6-8 kHz and changes with any physical sensation (it even goes up and down when I breathe, or touch anything. Now if I press on my accessory nerve CN X it's like I'm hitting the jackpot. Fairly convinced after TMJ issues in the past, rowing neck injuries etc. that it's something gone in my neck. Now just to treat it.

 

[Greg Sacramento]

OMG, this description and photo has blown my mind! 15 months with tinnitus, slowly narrowing things down and this has helped massively. My tinnitus is high pitched 6-8 kHz and changes with any physical sensation (it even goes up and down when I breathe, or touch anything. Now if I it's like I'm hitting the jackpot. Fairly convinced after TMJ issues in the past, rowing neck injuries etc. that it's something gone in my neck. Now just to treat it.

Do you have just one sound? If you like, I would work with you (questions and answers) to see if we can establish what specific imaging may be needed.

 

[Jangles001]

Do you have just one sound? If you like, I would work with you (questions and answers) to see if we can establish what specific imaging may be needed.

Wow that would fantastic. I hear ringing only and it's usually only in the left ear, however I can make it go to the right ear by pushing my head back and tucking in my chin.

I think the ringing volume and pitch change but from the audiogram it was circa 6-8 kHz.

 

[Greg Sacramento]

OMG, this description and photo has blown my mind! 15 months with tinnitus, slowly narrowing things down and this has helped massively. My tinnitus is high pitched 6-8 kHz and changes with any physical sensation (it even goes up and down when I breathe, or touch anything. Now if I press on my accessory nerve CN X it's like I'm hitting the jackpot. Fairly convinced after TMJ issues in the past, rowing neck injuries etc. that it's something gone in my neck. Now just to treat it.

Correct - Accessory nerve interference of some sort could be cause of your physical sensations and somatic tinnitus. CT is needed to see what interference, but whatever it may be - is probably shown in post #4 above on left side of screen picture.

Accessory nerve may be pressing a motor nerve in green and your sternocleidomastoid could be swollen or tight?

Can we rule out shoulder pain? Does somatic tinnitus increase when laying on back - with top of back side of head to pillow?

Trapped nerves are often associated with the onset of pain in back of head due to nerve damage by a compression. Do you have pain in back of head?

Cervicogenic headache is commonly caused by posture and neck injuries to the neck joints. The pain can be pinpointed to one side of the head and radiate to the forehead. Do you have headaches?

You have narrowed things down - Now a CT or MRI is needed. With some hearing loss, I go for a CT.

Stay in touch.

 

[Jangles001]

Correct - Accessory nerve interference of some sort could be cause of your physical sensations and somatic tinnitus. CT is needed to see what interference, but whatever it may be - is probably shown in post #4 above on left side of screen picture.

Accessory nerve may be pressing a motor nerve in green and your sternocleidomastoid could be swollen or tight?

Can we rule out shoulder pain? Does somatic tinnitus increase when laying on back - with top of back side of head to pillow?

Trapped nerves are often associated with the onset of pain in back of head due to nerve damage by a compression. Do you have pain in back of head?

Cervicogenic headache is commonly caused by posture and neck injuries to the neck joints. The pain can be pinpointed to one side of the head and radiate to the forehead. Do you have headaches?

You have narrowed things down - Now a CT or MRI is needed. With some hearing loss, I go for a CT.

Stay in touch.

Firstly, thank you a million times over Greg, and this forum which has been such a valuable place. I've of course gone through various rabbit holes, doom scrolling etc which everybody does on here but there's a real quantifiable knowledge base and support network which is genuinely incredible.

I don't realise any shoulder pain currently but I've had fairly bad, shoulder, neck and jaw pain at various points throughout my life (being mid 30's now). The more I think about the muscles involved the more I think I managed to pinch a nerve when I was going flat out on the rowing machine. My phone connects with my rowing machine and all of my sessions are logged, normally I would do long and slow 5-10k workouts but I did an interval workout to see what the fuss was about and absolutely ruined myself (though don't remember any specific woes I definitely stopped rowing for a while).

Approximately 4 weeks later I can see I googled tinnitus for the first time (I looked through my google activity) and I know I had been hearing the ringing prior to that search. Also, fittingly, approximately 5 years ago before I had really bad jaw problems (right hand side) I think this was down to reaaaaally messing up rowing technique when I was first starting (rowing one time only with my head tucked down throughout the catch, drive on the highest setting... like an idiot).

I do occasionally get migraines (which feel like middle of the forehead) / tension head aches around the side of my head and this definitely sounds likes it could be a Cervicogenic headache. Weirdly though, this occurs on my right hand side and my tinnitus is typically only on my left hand side.

I'm waiting on a CT through NHS, yet they have basically said I'm in for a long wait however I thought they would cost like £1,000 privately but I've recently heard they're more like £200 so that could be a xmas present to myself.

Side note, my sternocleidomastoid muscles are really quite tight towards my jaw. I had seen an osteopath who had a poke around for a few sessions around my jaw but all I would get is headaches and he wasn't really doing much with my neck / shoulders. My jaw still clicks but doesn't cause my the grief it did 5 years ago. I stopped seeing him as, like most people I've seen, they see tinnitus and think 'who knows?' I'll just do something, which becomes expensive when privately shooting in the dark for a cause. The one curious thing they did say was my clavicle on my right hand side was raised.

I'll stay in touch and let you know what happens. In the mean time I'm going to continued 'flossing' my accessory nerve and I may even break out the clavicle brace from the draw of massage equipment that time forgot.