Ringing for 6 Months, but It's OK.

[PrimeCyclist]

Short version: mildish ringing in both ears for the past 6 months, probably due to supertense jaw and neck muscles.

Long version

Background: I'm a male in my 30s. Always taken care of my ears (I like to vacuum with earmuffs on). Never go to concerts or bars since my ears have always been sensitive: during a recent wedding I couldn't even be in the same room as the band while everyone else didn't seem to mind.

Have been listening to music via sound-isolating earbuds at low volume since forever. How low? When cycling I can hear cars driving up behind me. After getting tinnitus and not using earbuds I was shocked at how loud city traffic really is.

At home I always have some music going on. I also love cycling. Last year I spent the whole summer cycling 50-100 km every other day. For you imperial that's about 400 miles a day or something.

A year ago I checked for tinnitus, and for that I had to go to the bathroom (quietest room) and I could hear a faint ringing in both ears. Assumed, and still assume, that some ringing is completely normal in dead quiet rooms.

The start: So 6 months ago I was enjoying myself at the computer, listening to music for 3 few hours via wireless, open-backed headphones. Woke up the next day, felt fine and went to go work out. In the evening I started noticing a ringing in both ears. What happened was normal: panic, regret, etc etc etc. Did I destroy my hearing with them headphones?

The ringing is a hissing, electrical noise. My left ear used to have an extra tone but that seems to have disappeared. My right ear has a tone that I can only really hear in really quiet rooms. The noise is masked by light or medium traffic - or, indeed, music out of my pc speakers at medium volume.

A quick 8kHz ENT audiogram showed nothing out of the ordinary. I tested at home using a tone generator I can hear up to about 13kHz or so - after that I either can't hear or my computer speakers can produce sound. Music and voices sound as they did before the tinnitus.

Luckily, I was smart enough to start writing a tinnitus diary. I kept track, sometimes several times a day, of what I heard and how I felt. I've got 6 months worth of diary entries. The general theme of the diary is irritation. My ears feel irritated, almost asking to be scratched on the inside. Cycling on uneven surfaces sometimes resulted in pretty bad pain, usually one side at a time (one time could be left, the next time it could be right that's hurting). The bicycle ear pain seems to have calmed down. I had two bouts of hyperacusis the first 2-3 months - weird how normal sounds can hurt.

Most of the diary is filled with entries about which ear I perceive as ringing the loudest (they liked to take turns for about 160 days or so), whether they hurt and any other discoveries. For example:

• Until recently, I used to get several "equalizations" per day (temporary loud ringing that goes back to normal after a few moments), something that happened only rarely before.
• Headaches every once in a while, something I almost never had before (day 29)
  
• The extra tone in my right pauses when I take a step or when I hold my breath (day 33)
• "Very, very interesting. The power tools used when changing tires, which didn't previously bother me now actually hurt. Very, very interesting. I know they didn't hurt before." (day 51)
  
• Chewing makes the ringing louder (day 53)
  
• Grabbing a hold of my head and twisting and turning makes the ringing softer or louder (day 53)
  
• Burping makes a weird gurgling sound in my ears that I haven't previously experienced (day 55)
• "Interesting. I clicked my neck (head slightly backwards) while walking and that resulting in a 10-15 second long beep/tone in my right ear. Interesting…" (day 63)
• "Slept weirdly, so I kinda have a stiff neck, except it's more the front of my neck/shoulder. Right is really loud compared to left. Moving around hurts my shoulder." (day 74)
• During a visit to a smoking friend (he and his gf smoked inside) I didn't hear my tinnitus at all for an hour or two, even when actively trying to listen to it. Or outside, in the light rain either. Amazing, but hasn't happened since (day 79)

Other things of note:

• Jaw always likes clicking when I open my mouth wide - has it always been this way or did I only recently notice?
  
• As I mentioned, headaches have become more common now.
• Sometimes pain in the whole side of my head around the ear area.
• Often shoulder and neck pain - quite bad neck pain right now, in fact.

I can upload my diary if anyone feels like reading it. It's relatively repetitive but has been great to look things up to compare. My memory isn't the best, you see...

On day 164 I visited my dentist, since one ENT I visited suggested that I might have jaw problems. A few years previously a dentist noted that my lower teeth have been ground down, but I didn't remember clenching my teeth much neither while asleep or while awake. My current dentist said the same thing about a year or so ago. Thinking about it now, I remember catching myself a few months ago waking up with my jaw really clenched. Anyways, so I visit the dentist and explain about the ringing.

He starts feeling around the inside of my mouth and he's pressing down pretty hard on various muscles... or so I thought. He explained that he was only lightly touching me, but it felt like he was bearing down on me. Feeling around my jaw and my neck was the same: it felt like he was wanting me to feel uncomfortable. He had previously checked my last year, when he noted my ground down teeth, but although I felt the same uncomfortable feeling then I didn't say anything since I thought it was normal. Either it's not that painful, or I've become accustomed to the pain.

He made me a mouth guard that fits over my top teeth. It's made me more observant as to how I close my mouth and how I tense my tongue to the roof of my mouth most of the time, especially when it's bedtime. I've taken to trying to relax my tongue when in bed, but I keep pushing my tongue up. That can't be good.

I've never been able to take a back massage, since it's directly painful no matter how light people touch me. My "friends" like to massage me in order to get a reaction out of me - and the reaction is usually to get away. Sure, they're guys and they like using their muscles to massage extra hard, but I can't take even light massages. It feels just like the dentist's prodding: really hard, when in reality it's really light.

So... back to the origin of the tinnitus. At this point, I figure that the headphone listening, even at low volume or at higher volume that one evening 6 months ago, is not the culprit. It's not even my visits to the outdoor gun range, since I use thick earmuffs and we shoot 22s. It can't be noise since I've been careful with my ears to the point that I think that city traffic is loud (which it probably is to a person from the countryside). I've not yet read that hearing damage tinnitus causes pain like what I've experienced while cycling or even lying in bed. Just pain out of the blue, which then gradually subsides; headaches that make me hold on to a nearby object and crouch down until the pain becomes milder. From what I understand, noise damage tinnitus is a one off thing. Perhaps some hyperacusis accompanying it a while, but not sudden bouts of pain.

No, it's more the 25 years of:

• Having super tense jaw and shoulder muscles
  
• Having a slumped posture at the PC
• Not really ever stretching after my 5-6 workouts a week
• Not really relaxing in bed - I catch myself being tense very often before finally falling asleep
  
• Cycling long distances, slumped over the handlebars

Last year was when I discovered the joys of cycling long distances, on a normal city bike instead of a fancy sports bike. 50-100 km every other day used to be the norm for quite a few months. The other days I'd lift weights. On Sunday I might rest, or do something else to work out.

My neck and shoulder muscles are really tense, my jaw clicks, my back hurts. The thing is, I've probably had all sorts of body pain a long time without noticing it, thinking it's normal.

So, yeah... noise damage doesn't make as much sense as muscle tension. And that makes the accepting tinnitus so much more easy. Instead of blaming myself for that one night of good music (and it was good), I have 25 years of slowly-building body trouble. Even as I write this, making a point of sitting upright instead of half-lying down with my feet up, my back hurts. Turning my head hurts. And since the tension has been building up for 25 years, the massive amounts of cycling last year surely not doing me any favors, I don't expect it to go away overnight. I can wait.

The noise is a nice whitish noise that is relatively easy to ignore, and be masked relatively quickly by my friends the computers, so it's not as bad as other people have it, and for that I'm thankful.

I'm glad you've read this far and would like to conclude with some tips to new sufferers:

• Get more than one opinion on why your ears are ringing.
• If an ENT tells you to just get used to it, go somewhere else. For me, it was more important to find the cause of the problem than it was to solve the problem.
  
• Get a pair of active shooting earmuffs (the ones that have microphones). Use those outside. Instead of walking around tense as hell in fear of loud noises, you can relax knowing that the earmuffs, while allowing you to listen to city noise, also will automatically block out sudden, loud noises.
  
• My Peltor Shooter active earmuffs have two great things about them: they have an AUX connection that is also limited to 80 dB (in case you want to listen to your music player and know you're at a safe volume) and they generate white noise by themselves. The white noise is great at masking. You might look like an idiot walking around with them, since they're rather large. Keep them at home, then.
• Speaking of white noise, don't try to be macho and try to habituate without any maskers. Use them, take your time, allow your psyche to accept the ringing.
• If the ringing goes away, then you've won. If you get used to the ringing, you've also won. If you don't notice the ringing anymore, does it matter whether it's because the ringing is gone or because you've gotten used to it?

That's about it. I think I've been as thorough as I can. Hopefully all this data will help someone else. Now it's time to massage my jaw, neck and shoulders, do some jaw exercises and then go to bed.

 

[PortalNaut]

Sorry for your situation, but I can appreciate your efforts at logging and reporting. If only our efforts directly resulted in preferred outcomes - sadly we usually wind up finding out how little control we have. Your approach of acceptance and responsibility for life I think will bode you well.

While i don't have direct tmj related issues, sometimes I can do some exercises near the jaw hinge or behind the Mastoid process and get some relief, so it's something I may play with. You may well have to experiment for the right kind of body adjustments, but it sounds like you already know of some areas, postures and jaw, that could help you. I recently saw a video that showed pressure on the forearm and near the wrist and little finger for adjusting T and jaw problems. That idea about active headphones makes some good sense for those wearing headphone; thanks for sharing.

 

[PrimeCyclist]

It's now been a year and I thought it would be a good time to update y'all. The short version is that it's definitely jaw-related and I have good weeks where I only hear it during bedtime and during the day if I force myself to look for it, and "bad" weeks, when the ringing is louder or more noticable during the whole day. Since I know what it is (jaw, neck, mouth muscles), I'm pretty calm about the situation.

The long version

According to my diary, which I've been keeping more or less every day, is that the ringing fluctuates from week to week. Sometimes day to day. Eating is definitely a major culprit, resulting in attacks of fleeting T, fullness and occasional ear pain. I know this because I only eat once a day, in the evening, and I might not even notice the ringing all day until after dinner.

Has the ringing gone down since I got it? Difficult to say. Either I'm noticing it less, or it has gone down periodically. Again, some days / weeks are far more noticable than others. I can still easily hear it when going to bed. In the morning it's usually much milder.

Weird things I've noticed:

• Neck exercises don't seem to help
• Jaw exercises don't seem to help.
  
• Don't seem to help = the effect is random. After some neck and jaw exercises before bedtime I can be sitting up in bed, back straight and everything relaxed, and my left ear might get some fleeting for no reason what so ever.
• I can sometimes make the ringing louder, softer and add new tones by exercising my jaw and neck. This ability varies week by week.
  
• The fleeting T and fullness appears mostly after dinnertime.
• Sometimes I take a drink of water during the day and I get fullness and fleeting.
  
• On a nice, mild day I might nap for an hour or so and wake up to the T being louder. Was I sleeping on my stomach again? There were no deafening noises in the room, that's for sure.
  
• My tongue is very tired. I keep catching myself tensing my tongue against my teeth / roof of the mouth. Consciously relaxing my tongue gives me a feeling of pain / tiredness.
• While the tooth guard helps me remind myself to relax my tongue, I notice myself clenching down on it during the night. Trying to relax my mouth is a full-time job.
  
• My H is still there, although much milder. My ears, currently with a focus on my left, don't like sudden, loud noises. Nearing a loud noise and having the volume constant isn't really much of a problem.
• When cycling outside, especially near fast traffic, I use 20 dB active Peltor earpro. That helps me remain calm when exposed to noisy cars and trucks passing by. I find highway noise semi-painful, especially if I have to cycle 1-2 yards next to the highway lane due to the bicycle lane being there. And it's even worse when the road is wet.
  
• Rain completely drowns out the ringing. Standing on the porch listening to the rain is great.
  
• I can still hear mosquitos - which is kinda shitty since I can never see them...

I still drink alcohol and eat candy whenever I feel like it. T has taught me that there is no point in taking 100% care of your body (no drinking and candy only once a week) when you could wake up a paraplegic the next day.

I still enjoy going to the outdoor shooting range, but I stick to 22's with my thick 26dB Peltors. Whenever there's somebody nearby with a .357 I double up to the point that I can't hear anything at all except ringing. In other words, there's no way in hell that the ringing is due to noise damage - not solely at least.

How am I doing mentally? Fine. Much, much better than I thought possible a year ago. No thoughts of suicide, no depression, enjoying each day as much as I want. Working out as much as I feel like (which is a fair amount) and taking care of the new house. I've found out that I enjoy building things with my hands.

Life could be much, much worse.