Physical Therapy and Pulsatile Tinnitus

[Baxette]

Hi - I have had PT for about 4-6weeks
I was diagnosed with a herniation at
C6-7. I have been going to PT for a month. The modalities include neck traction, exercises and ice / stim.

I had an overly aggressive Therapist who pushed me beyond my comfort zone. Later my PT increased 10 fold. I was doing chin tucks.

I am wondering if there is a link between the traction and PT? I am going insane. I feel hopeless and do not have a support system at home. I also have TMJ and will have a couple of sessions devoted to TMJ. Insurance naturally does not cover it.

I try a sound machine for masking. No help

I am in line to see someone for tests to rule out serious potential causes of PT. I can't get into a program to learn to habituate until I have tests. I am afraid insurance won't cover the tests though it seems they should if the tests are to rule out underlying conditions.

Can anyone give me hope? A lifeline? My best friend is my cat. Pathetic I know. Please someone help me.

 

[Karen]

Hi, @Baxette,

I totally understand how you are feeling right now, because I have pulsatile tinnitus (as well as a hissing tinnitus) too. You can come here any time for support and understanding. There are many others who share this mysterious condition, and we are all looking for answers!

There are many possible causes for pulsatile tinnitus, so it is very hard to say whether or not the aggressive therapy was the cause. Did you have any other ear issues before the pulsatile tinnitus started? Any other vascular issues?

Yes, it is possible that TMJ could have caused or exacerbated the pulsating. I'll be interested to hear if those sessions are helpful to you.

I'm glad to hear that you are going to a doctor for testing for possible causes of your condition. That is a good idea, if only to give you peace of mind and to rule out any (very rare) possible medical conditions. Most doctors will first suggest an MRI or a CT scan. I've so far had an MRI and MRA (with and without contrast), a CT scan of the temporal bone, and a Doppler of the carotid arteries. Nothing was found for me, but I'm very glad I had the tests.

I have had PT and high-pitched hissing tinnitus for almost 6 years now, and I wanted to let you know that it is possible to live with this condition. It does take longer to habituate to pulsatile tinnitus than it does with regular tinnitus, but it can be done. When mine first started, I couldn't concentrate on anything, couldn't read, couldn't work, etc., but now I am able to live my life pretty normally again.

Some natural supplements I'm taking that help with the tinnitus and help with calming are magnesium (I take magnesium chloride tablets), holy basil, and N-Acetylcistene. The N-Acetylcistene helps protect your ears from further damage, and may help calm tinnitus a little bit, too.

So, in summary, I'd say you are doing the right thing by first going to a doctor for testing, and then, if there are no operable conditions, going to therapy to learn how to live with this condition. You could also try out hearing aids or maskers (free trial for 30 days) to see if they might work for you.

I hope this is helpful to you, and I want you to know that there really is hope! Please keep us posted on how you are doing, the results of the tests, etc.

Very best wishes,
Karen

 

[Baxette]

Karen,

Thank you for your kind response.
I do not have a history of ear or vascular issues as far as I know. I did have my ears flushed prior to the PT intensifying significantly.

I considered going to the er as my anxiety is super high especially since the tests I will most likely have could show a serious issue. Knowing it will be a month before a professional refers me for the test concerns me.

I honestly don't know that I can deal with this. I have OCD which probably intensifies things. I took a couple of Tylenol and put some ice on my neck. I calmed down enough and decided not to go to the ER.

How am I going to survive?

 

[Karen]

Hi, again, @Baxette,

As you mentioned in your first post, maybe there is a chance that your neck problem is actually the cause of your PT. I don't know whether that is possible or not, but PT is such a mysterious condition that many things can cause it. I will be very interested to hear what your doctor says about your condition, and hope you'll post an update after you see him.

If it's any comfort, from what I've heard, the majority of people who are tested for pulsatile tinnitus do not have a life-threatening condition. It is often something like a dehiscence (worn away bone) or a fistula, which can usually be corrected through surgery. I know that your mind can get the better of you when you hear an unnatural sound in your ears 24/7, because I have been that route myself. But after almost six years of this, I've calmed down and settled into a routine.

Have you noticed whether the pulsating is worse at a particular time of day, or after eating certain foods? You can try making some dietary changes, such as limiting caffeine, sugar, and alcohol, to see if that might make a difference. Also, I've found that my tinnitus is calmer in the morning, and worse in the late afternoon, so I plan my activities accordingly.

Another thing you can try is to take calming natural supplements, such as magnesium, to help you settle down at night. Please try not to worry, because that can intensify the pulsating. My pulsating has actually gotten calmer with time, believe it or not! It is possible that yours will, too.

You will make it. Set yourself a small goal every day, or something you can look forward to, such as taking a calming shower or getting a good night's sleep. If you can do that, you will find it easier to cope.

I wish you well, and hope you have a relaxing evening.

Hugs,
Karen

 

[Baxette]

Hi Karen -

I can't thank you enough for your guidance.
My TN was really bad this morning. Last night I got dizzy when I was in the shower. I fell but the curtain prevented me from falling out of the tub.

I have decided to call the ENT tomorrow. Perhaps she can refer me for imaging studies now. My anxiety is getting the best of me. Sitting for a month worrying is going to be very difficult. My neck is so sore. Feel like the muscles in my neck were ripped. That's why I am concerned about the neck traction etc.

You mentioned you have had MRIs and CT scans and a Doppler. Can you can give me an idea of what to expect and what they are looking for? My heartbeat seems way to fast.

I don't drink or smoke. I am fat but I'm working on it. I gave up refined sugar.

I think I'll try the holy basil. Thank you. I read there is a better formula? Begins w a T.

Thank you. I don't feel so alone now. Billie 48 was right: you are awesome.

Alexandra

 

[Karen]

Hi, @Baxette (Alexandra),

Thanks for the update on your condition. I'm so sorry you fell last night due to dizziness; that is very scary, and I hope your doctor will be able to help you. I had dizziness when my PT first started; mine probably didn't have the same cause as yours, but I am wondering if there is a connection. Back when mine first started, I had several episodes of vertigo, where the whole room feels like it is spinning. Scary!! The good news is, I no longer have the dizziness or the vertigo, so the same thing may happen to you, as your body adjusts to this new condition.

To answer your question about the tests: The MRI and MRA are of the entire head, and I think the purpose was to look for tumors or blockages in that area. An MRA is for arteries, and an MRV is for veins (which I didn't have because I didn't know about it). An MRI is noisy, but it's over in about 1/2 hour, and it didn't make my tinnitus any worse. A CT scan does involve radiation, but it is over very quickly. I had a CT scan of the temporal bone, which is supposed to check for any dehiscence (thinning of the bone). A Doppler of the carotid arteries is simple and over very quickly, and it is to check to see if the carotid arteries are clogged.

About holy basil: Another name for holy basil is "tulsi" (an Indian word), and a very good brand worth trying is NOW Foods. Holy basil is an adaptogenic herb, which is supposed to help you adapt, or cope, better. It seems to help one's feeling of well-being. Or at least, it did for me. If you try it, give it some time to work, maybe as much as a couple weeks, to see how it affects you.

Good luck with your ENT tomorrow, and I hope you are feeling better this evening.

Best wishes,
Karen

 

[Baxette]

Good morning Karen

Thank you for your reply. I feel better about the possible tests now.

I called the ENT and told them I was concerned about my symptoms and waiting for a month to see a doctor. They are able to see me today. I will let you know how that goes.

The tulsi holy basil is the one I was trying to remember. I will see if I can find it.

I distracted myself for a bit this morning watching my birds. I live in WI and am ready for spring. My flocks of red wing blackbirds and starlings are visiting my feeder. A lot of people consider them nuisance birds but I love them all. My bluejays did their best to shoo them as did my flock of house sparrows. I have a flock of pigeons who visit everyday. If I don't fill their bowls before 9 they dance and coo on my roof. It's a nice way to wake up.

Thanks for listening

Have a nice day.

 

[Baxette]

Hi Karen -

ENT has referred me for MRI of my brain and Dopplers. I will have them next Tuesday. She said I may need to fight the insurance company for payment. Will see what happens.

Today was a better day w the PT. I was busy most of the day. When things settled down the PT was roaring.

Thank you for your guidance.

Alexandra

 

[Karen]

Hi, Alexandra,

Thanks for the update. I hope the tests will yield some answers for you.

Yes, it seems to help to stay busy during the day. Mine is always worst in the late afternoon, after I come home from work. Then, it seems to settle down again later in the evening. Such a mysterious condition!

Take care,
Karen

 

[Baxette]

Still driving me crazy! It seems to increase as the day goes on for me too.

 

[Baxette]

Karen -
Hope you are well. My MRI and Doppler studies were negative. I am happy about that. I don't want to keep having tests if not necessary. I am resigning myself to the probability that I will never know. I guess it's time to focus on habituating to the PT. I see the doctor in charge of the TRT on April 2nd. Hopefully I don't get sent for more tests. In your experience do you think the tests I've had are sufficient? I am so sick of this already ! I miss quiet!

 

[Karen]

Hi, @Baxette,

I'm glad to hear that both of your tests were negative. That is good news!

Were those tests sufficient? Well, it depends on whom you ask. On Whooshers.com, they would suggest that you keep trying until you find a cause for your PT. There are other tests, including a CT scan, that might show something in areas that an MRI might not.

When it is warranted, doctors do sometimes suggest an angiogram, which is considered the "gold standard" of tests for this condition. However, this test is considered invasive, so it's not for everyone. I haven't had it done myself, so I cannot comment on its effectiveness or the side effects of the test, but it is often successful in finding a cause, if there is a physical cause for the PT.

As for me, I have pretty much given up on the testing, and am trying to live with the condition. Unless my PT worsens, that's what I plan to do, too, just like you.

I will be interested to hear how the TRT works for you. I've heard that it can work for pulsatile tinnitus, as well as regular tinnitus.

Take care, and please do update me after you've tried the TRT!

Best wishes,
Karen

 

[Baxette]

Thank you Karen. I will keep you posted.

 

[PeterL]

Hi, @Baxette,

I totally understand how you are feeling right now, because I have pulsatile tinnitus (as well as a hissing tinnitus) too. You can come here any time for support and understanding. There are many others who share this mysterious condition, and we are all looking for answers!

There are many possible causes for pulsatile tinnitus, so it is very hard to say whether or not the aggressive therapy was the cause. Did you have any other ear issues before the pulsatile tinnitus started? Any other vascular issues?

Yes, it is possible that TMJ could have caused or exacerbated the pulsating. I'll be interested to hear if those sessions are helpful to you.

I'm glad to hear that you are going to a doctor for testing for possible causes of your condition. That is a good idea, if only to give you peace of mind and to rule out any (very rare) possible medical conditions. Most doctors will first suggest an MRI or a CT scan. I've so far had an MRI and MRA (with and without contrast), a CT scan of the temporal bone, and a Doppler of the carotid arteries. Nothing was found for me, but I'm very glad I had the tests.

I have had PT and high-pitched hissing tinnitus for almost 6 years now, and I wanted to let you know that it is possible to live with this condition. It does take longer to habituate to pulsatile tinnitus than it does with regular tinnitus, but it can be done. When mine first started, I couldn't concentrate on anything, couldn't read, couldn't work, etc., but now I am able to live my life pretty normally again.

Some natural supplements I'm taking that help with the tinnitus and help with calming are magnesium (I take magnesium chloride tablets), holy basil, and N-Acetylcistene. The N-Acetylcistene helps protect your ears from further damage, and may help calm tinnitus a little bit, too.

So, in summary, I'd say you are doing the right thing by first going to a doctor for testing, and then, if there are no operable conditions, going to therapy to learn how to live with this condition. You could also try out hearing aids or maskers (free trial for 30 days) to see if they might work for you.

I hope this is helpful to you, and I want you to know that there really is hope! Please keep us posted on how you are doing, the results of the tests, etc.

Very best wishes,
Karen

Karen, I know this is an old chat topic, but may I ask why you stated that PT is harder to habituate to then regular tinnitus. I have never seen any literature that makes this statement

 

[Karen]

Hi, @PeterL ,

Thanks for asking about my comments. I don't know if there is any literature to back up my observation. That is purely from my own experience. For me, the regular tinnitus I'm experiencing is a steady hissing tone. The pulsatile tinnitus, for me, however, was and still is more challenging to live with.

When my PT first started, I could feel it throughout my body when I was trying to sleep. I have gone beyond that now, but there are still some nights when it is hard to sleep. Because the pulsating is a vibration, I feel it is more challenging to deal with.

I'd like to hear about your PT. Do you know what might have caused it to begin, and what is the experience like for you? Have you had any tests, or seen any specialists?

Best wishes,
Karen

 

[Mathew Gould]

Hi, @Baxette,

I'm glad to hear that both of your tests were negative. That is good news!

Were those tests sufficient? Well, it depends on whom you ask. On Whooshers.com, they would suggest that you keep trying until you find a cause for your PT. There are other tests, including a CT scan, that might show something in areas that an MRI might not.

When it is warranted, doctors do sometimes suggest an angiogram, which is considered the "gold standard" of tests for this condition. However, this test is considered invasive, so it's not for everyone. I haven't had it done myself, so I cannot comment on its effectiveness or the side effects of the test, but it is often successful in finding a cause, if there is a physical cause for the PT.

As for me, I have pretty much given up on the testing, and am trying to live with the condition. Unless my PT worsens, that's what I plan to do, too, just like you.

I will be interested to hear how the TRT works for you. I've heard that it can work for pulsatile tinnitus, as well as regular tinnitus.

Take care, and please do update me after you've tried the TRT!

Best wishes,
Karen

What type of imaging would you recommend for me? I have tinnitus due to neck and jaw issues. I have good and bad days of tinnitus...

Can physical therapy for the neck and jaw make tinnitus worse in the beginning of therapy?