Pulsatile Tinnitus Caused by Neck Whiplash: Is It Curable?

[weab00]

I whiplashed my neck doing a kick in a martial arts class about 2 years ago. The first few weeks I couldn't even turn my head sideways. It healed for a few months until it stopped and to this day I get regular pain and soreness in the affected area of the neck. I've also started getting random pains throughout my arms which I believe is tendinopathy leading from the neck.

I've noticed that if I stretch that area of my neck, I get a whooshing sound in my right ear. This only started recently, and it fleetingly happens when I lie down.

Is there any sort of physical therapy that can be done to fix this whiplash, or am I screwed?

I should also mention that I have noise-induced tinnitus and moderate hyperacusis

 

[Greg Sacramento]

@weab00 Vertebral artery from injury such as from whiplash would relate to pulsatile tinnitus, but most likely one needs to have severe headaches.

Discussion:

It is presently considered a problem when there is mechanical compression during head rotation due to muscular and tendinous insertions, osteophytes, and arthritis around the C1-C2 level. As the vertebral arteries enter the vertebrae around C4, it can also occur at lower levels. As about 50% of c spine rotation occurs around C1, this is likely the reason for the predominance at this level. Araz Server et al (2018) reported reduced flow in the ipsilateral vertebral artery when the head was both hyperextended and rotated.

Occasionally vertebral artery dissections occur, sometimes in a delayed fashion, after a whiplash injury.

Additionally, flexion-extension injuries to the neck, usually associated with an auto accident involving a rear end collision has also been reported to be associated with asymmetrical vertebral artery flow as documented by sophisticated MRA (Kendo et al, 2006). The significance of this observation is presently unclear, but again the suggested mechanism is stretching of the upper portions of the vertebral arteries. Neck injuries have increased in the US in recent years with auto accidents, presumably due to interaction between use of seat-belts and chest restraints. While chest restraints reduce the risk of death, mechanically by restraining the trunk, they can be associated with greater relative movement of the unrestrained head on neck due to simple biomechanics involving momentum transfer.

Whiplash is simply a description of the mechanism of a neck injury. Whiplash might cause cervical "vertigo" in diverse ways, including proprioceptive injury, or injury to the cervical spinal cord. Whiplash is not a subcategory of "proprioception", as suggested by Devaraja (2018) in his review.
http://www.dizziness-and-balance.com/disorders/central/cervical/cervical.html


The vertebral arteries are major arteries of the neck. Typically, the vertebral arteries originate from the subclavian arteries. Each vessel courses superiorly along each side of the neck, merging within the skull to form the single, midline basilar artery. As the supplying component of the vertebrobasilar vascular system, the vertebral arteries supply blood to the upper spinal cord, brainstem, cerebellum, and posterior part of brain.[1]
https://en.wikipedia.org/wiki/Vertebral_artery

There's many other articles and studies that connect the vertebral arteries and subclavian arteries to whiplash causing pulsatile tinnitus. Radiological exams needed and treatments are discussed. Pulsatile tinnitus can happen from this when tinnitus is already present as the brain and ears are on alert.

 

[weab00]

@weab00 Vertebral artery from injury such as from whiplash would relate to pulsatile tinnitus, but most likely one needs to have severe headaches.

Discussion:

It is presently considered a problem when there is mechanical compression during head rotation due to muscular and tendinous insertions, osteophytes, and arthritis around the C1-C2 level. As the vertebral arteries enter the vertebrae around C4, it can also occur at lower levels. As about 50% of c spine rotation occurs around C1, this is likely the reason for the predominance at this level. Araz Server et al (2018) reported reduced flow in the ipsilateral vertebral artery when the head was both hyperextended and rotated.

Occasionally vertebral artery dissections occur, sometimes in a delayed fashion, after a whiplash injury.

Additionally, flexion-extension injuries to the neck, usually associated with an auto accident involving a rear end collision has also been reported to be associated with asymmetrical vertebral artery flow as documented by sophisticated MRA (Kendo et al, 2006). The significance of this observation is presently unclear, but again the suggested mechanism is stretching of the upper portions of the vertebral arteries. Neck injuries have increased in the US in recent years with auto accidents, presumably due to interaction between use of seat-belts and chest restraints. While chest restraints reduce the risk of death, mechanically by restraining the trunk, they can be associated with greater relative movement of the unrestrained head on neck due to simple biomechanics involving momentum transfer.

Whiplash is simply a description of the mechanism of a neck injury. Whiplash might cause cervical "vertigo" in diverse ways, including proprioceptive injury, or injury to the cervical spinal cord. Whiplash is not a subcategory of "proprioception", as suggested by Devaraja (2018) in his review.
http://www.dizziness-and-balance.com/disorders/central/cervical/cervical.html


The vertebral arteries are major arteries of the neck. Typically, the vertebral arteries originate from the subclavian arteries. Each vessel courses superiorly along each side of the neck, merging within the skull to form the single, midline basilar artery. As the supplying component of the vertebrobasilar vascular system, the vertebral arteries supply blood to the upper spinal cord, brainstem, cerebellum, and posterior part of brain.[1]
https://en.wikipedia.org/wiki/Vertebral_artery

There's many other articles and studies that connect the vertebral arteries and subclavian arteries to whiplash causing pulsatile tinnitus. Radiological exams needed and treatments are discussed. Pulsatile tinnitus can happen from this when tinnitus is already present as the brain and ears are on alert.

Ok so is there a good chance to get cured? I'm fairly certain it's from the whiplash so I don't want to spend money on a doctor if they're going to tell me what I already know without a cure. What measures could be taken to fix this?

 

[Greg Sacramento]

@weab00 I read your posting history and trying to place a timeline of events. You mention that you received whiplash a little over two years ago and developed some arm pain - tendinopathy. Since then you mention tinnitus from May of 2019 due to music exposure and developed sound distortions and other complications. Recently you noticed that you get a whooshing sound in right ear and it fleetingly happens when you lie down.

With whiplash, the ears often become sensitive to noise and tinnitus can happen from that or it can happen just from whiplash or a combination of both. The whooshing fleeting sound when laying down may be associated to your neck injury (arteries - including arteries discussed in post above) with a delayed reaction. Whatever is causing the whooshing may be vascular blood flow.

You should see a neurologist for whiplash and there is treatment for that, but you should be examined by an interventional radiologist before whiplash treatment where tests will be given. Also see an ENT and audiologist. Whiplash treatment may help with tinnitus, but cause of whooshing should be examined to be fixed. I would be very optimistic that whiplash complications and tinnitus can be improved and whooshing solved.

 

[weab00]

@weab00 I read your posting history and trying to place a timeline of events. You mention that you received whiplash a little over two years ago and developed some arm pain - tendinopathy. Since then you mention tinnitus from May of 2019 due to music exposure and developed sound distortions and other complications. Recently you noticed that you get a whooshing sound in right ear and it fleetingly happens when you lie down.

With whiplash, the ears often become sensitive to noise and tinnitus can happen from that or it can happen just from whiplash or a combination of both. The whooshing fleeting sound when laying down may be associated to your neck injury (arteries - including arteries discussed in post above) with a delayed reaction. Whatever is causing the whooshing may be vascular blood flow.

You should see a neurologist for whiplash and there is treatment for that, but you should be examined by an interventional radiologist before whiplash treatment where tests will be given. Also see an ENT and audiologist. Whiplash treatment may help with tinnitus, but cause of whooshing should be examined to be fixed. I would be very optimistic that whiplash complications and tinnitus can be improved and whooshing solved.

Thanks man this is potentially good news to hear, haven't had that in a while. So it'll be ENT->neurologist->radiologist? I also figure I'll have to get an MRI/MRA but am apprehensive to that because I've heard it can go up to 100dB and people report permanent worsenings of tinnitus and hyperacusis even with hearing protection. Any way to get a quiet one?

 

[Greg Sacramento]

MRA. Call hospital radiology departments or private and try to find a Toshiba Pianissimo MRI or call the company and they can tell you where locations are in your area. Bring plugs with no metal.