Oral Gabapentin and Intradermal Injection of Lidocaine: A Role for the Treatment of Tinnitus?

I am going to my ENT this Thursday AM to get the first round of intradermal ear canal Lidocaine shots. They finally got the right Lidocaine in after waiting over two weeks. I will write back on my experience. I am crossing my fingers it will help not only calm down but reset my current spike from COVID-19, but I understand that is a beyond hopeful wish.

@AverageJoe12, sorry for only getting back to you now. The small dose of Ativan a day seems to help slightly, especially right now as I I’m spiked from COVID-19. I take a very small Remeron dose to go to sleep which seems to help. The biggest thing that helped me “get back out there” and experience my best 4-5 weeks before getting COVID-19 was intensive therapy. I wrote about it on my wall.

 

Good luck, @ErikaS.

 

Erika, about 15 months ago, I was considering a “tympanic neurectomy” for ear pain. As a diagnostic procedure, Lidocaine was injected into my ear canal. The diagnostic procedure made my tinnitus, hyperacusis, and ear pain worse. There are a number of people who have had this done. It is my impression that most did/do not experience the worsening which I did. I don’t mean to scare you, but wanted to share my experience.

 

Was your worsening permanent or temporary?

 

Thank you for sharing this, @JRC1! Just so I am understanding this correctly, you only did the ear canal Lidocaine shots which is what worsened things for you? You did not end up doing the tympanic neurectomy?

 

Anyone listened to the latest Tinnitus Talk Podcast episode? Professor Josef P. Rauschecker said he took Lidocaine for an endoscopy procedure (no intention in treating tinnitus) and his tinnitus was miraculously cured after waking up, though only temporarily. I think they gave him Propofol to sleep.

He cites a statistic claiming that “intravenously injected Lidocaine eliminates the tinnitus sensation in 70% of patients”. Most respond positively. The relief only lasts for a few hours to a day or 2 though. I can't vouch for the accuracy of that statement, but I thought I'd share it here.

 

Thank you for sharing this, @ZFire! This makes me even more interested in Mass. Eye and Ear's current recruitment for their pilot study fMRI Investigation of the Effects of IV Lidocaine on Tinnitus. Anything that has such a high response rate and effect needs to be looked at further and to see if there is any way they can come up with a strategy or method for extended relief.

I mentioned this earlier in the thread, and although more on the side of Eastern medicine, something called neural therapy is used in those with chronic pain conditions and many have found lasting relief. What would make that difficult for a lot of us is the fact that the affected nerves lie deep in the inner ear, not on the surface like pain in a scar or neck pain where the nerves are more accessible.

However, I truly wonder in this study with the intradermal Lidocaine + Gabapentin, if repeated injections in the ear canal is what made a more lasting change at the nerve level, leading to the positive results for many 3-6 months post study. I really wish the study did an intradermal Lidocaine only group so we could compare and it would speak for the significance of the Gabapentin.

 

What clinic in Tennessee is it? I'm interested in trying this.

 

Correct.

 

I suppose that’s why some researchers are still keen on testing existing drugs rather than developing new drugs/treatments. There’s valid reason based on previous studies and supposedly high response rates, with Lidocaine in particular, to look for ways to boost its effectiveness. Making it more potent for lasting relief is what I think they’re aiming for.

Fingers crossed for you with those upcoming intradermal ear canal Lidocaine shots. Hopefully, the first round brings you some relief.

 

It is called Shea Clinic Ear Nose & Throat and it is located in Memphis, TN. From what I remember reading from other members, it is a 3 day treatment of intratympanic Dexamethasone (steroid) shots in the ear as well as IV Lidocaine infusion. He may inject and infuse both? Again, I don't know the specifics.

 

Thank you very much.

 

I'd carry around an IV bag if it meant no more intrusive tinnitus.

 

It would be cool if somebody tested Lidocaine along with use of the Dr. Shore device when it's commercially available.

 

Yes, Professor David Baguley said this. In fact, my ENT said Lidocaine is the best known effective treatment for tinnitus. It's just that intravenous injection is not practical as the effects are so transitory.

However, this thread is not the intravenous therapy and revolves around a combination of intradermal Lidocaine injections, whilst simultaneously taking oral Gabapentin.

 

Hey all! Sorry for only writing back now. I actually just got the first injections this morning in my right ear. I was to go last Thursday, but something came up and I had to reschedule.

Anyway, he did the 4 points in the ear canal, he numbed the surface before doing it with topical liquid Lidocaine so the actual shots were easy and pretty painless. I feel like the 2-3 hours following, my tinnitus was troubleshooting. Like something was breaking its more constant power source and it became more "flickering" rather than continuous. However, after taking a nap, I woke up and it was not only back to its more normal annoyance, but a bit more exacerbated reactivity/sound sensitivity. It has seemed to go in and out of this more exacerbated phase during the evening.

I have to be honest and say I wasn't expecting anything significant with the first shots. What I will be monitoring and reporting back on is if it at all seems to worsen it in the few days ahead. Next shots are scheduled a week from now.

 

Best of luck with this @ErikaS!

 

Sounds promising!

 

My tinnitus has not been great since doing the shots. I’m honestly at a crossroads with more of me feeling like “just go back to not touching your ears”.

I know this sounds weird and not scientific at all, but something very odd with my tinnitus is if I even touch the inside of my right ear canal, it increases the tinnitus in my left ear. This has to be nerve related as me touching is barely a sound. So, the fact that I had a needle puncture the right ear canal four times and now I’m experiencing exacerbation in both ears and my ultra high frequency crap is much more present, I really don’t know what to do. I did enter a spike with my tinnitus and sound reactivity from COVID-19 two weeks ago, so that is a factor as well and I am aware of that, however I felt like before the shot I was experiencing the smallest improvement from that, and now it’s worse again. Hard to pinpoint and know for sure though with such variable tinnitus. All I do know is it was notable better before I got COVID-19

Going to make a decision tomorrow whether I go again this coming Monday or push it off and see how my ears do.

This all sucks, by the way.

 

Sorry to hear that.

About the nerve thing, I wonder if this is why they paired it with Gabapentin?

 

I would personally hold off on doing more if this is the case. I hope it gets better soon.

 

Is this at all similar to the nerve blocking that the clinic in South Korea was doing? I think they were using Lidocaine somewhere around the ear. Some forum members went and tried it and, if I remember correctly, all spiked from it.

 

I know how you've really pushed through and have been braver than most, seeking out the treatments you have. I had hoped this would really be the one for you.

My ear canal does the same, although a slightly different effect as mine hits my throat issues rather than the tinnitus, but again I really do feel that's nerve issue - possibly the auditory arm of the vagus. I also got COVID-19 a month ago and mine definitely took a turn after. It could be your nerves are a little irritated which is strengthening the tinnitus, which may settle down after they calm down.

It could be temporary but no one knows which is the hardest part.

I do wonder if the variable tinnitus we have is due to extra health factors we don't yet know about, or undiagnosed, which is adding additional sounds to a baseline and can cause the daily fluctuations depending on how those symptoms are doing - like nerve irritation due to the shots.

 

The nerve blocking procedure in South Korea always struck me as some kind of ‘special’ acupuncture if I’m being honest. If I recall, they inject the needles behind the earlobe and then move them around physically when need be. The protocol does use Lidocaine injections.

I believe @Chinmoku was one of the members here who was worsened by that procedure in South Korea. Poor dude couldn’t catch a break. Always worsening. I hope he’s alright.

 

Hi @ZFire, I miss you buddy and I hope you are well.

I was thinking of @Chinmoku today. I hope he's alright. If you are listening brother @Chinmoku, you are in our hearts and thoughts.

Brother Z, I'll catch you around. Don't eat to much pizza at 3 am and stay awesome.

Daniel

 

I contacted Dr. Boedts (ex-Brai3n). He claims he is using Lidocaine with good results in tinnitus and hyperacusis patients.

I don't know what injection method he uses but he says he plays it safe. I met him in 2019 and I like him a lot more than Dr. De Ridder and Sven Vanneste trying to push neuromodulation.

Never thought I would let anyone ever touch my ears, but I have nothing to lose.

It's funny that you can find many older studies from the 80s and even earlier that had very good results with Lidocaine but they all seem to have gone another road, wearing blinkers looking at the brain, and now, after 50 years, are starting slowly to walk back.

Remember, they cut auditory nerves in the 80s with VERY good results.

 

As far as I know, Dr. Boedts does not do Bupivacaine injections in the external auditory canal.

 

We need to know the procedure and documented success rates.

Older Lidocaine studies were intravenous and not practical.

Cutting auditory nerve success varies from 20-80% depending on the study. 100% guaranteed deafness.

 

Maybe Pulec was very good at selecting his candidates.

Some still have phantom pain in an amputated leg, but not always. For many it decreases over time.