Somatic Tinnitus Causes (TMJ, Neck, etc.): Is There a Way to Tell?

Thanks @Greg Sacramento.

I’m supposed to be getting a lower back injection today. I will see if he can inject my left TMJ once again. I woke up with discomfort in my left TMJ today along with loud noise. I’ll show him your article and maybe he will prioritize my jaw. Laying on my back doesn’t increase my tinnitus I don’t think but increases my TMJ pain it seems.

Maybe TMJ threw my neck off. Dr. Injected my right C7 area with steroid last visit.

 

I tried to talk pain management Dr. into injecting my Left TMJ today but he said wait till next week. Noise in left ear sounds like a power line. Someone told me TMD can affect ear canal producing noise somehow. I don’t think my HF hearing loss is causing my loud noise.

 

I am slated for physical therapy next week for posture, traps, back, etc. am going to be very careful with neck for now. Will see what the physical therapist knows about digastric massage. (have not done really anything with that yet as everything is tender) I also wonder if pursuing prednisone for the swelling serves benefit or just riding out the splint process and PT and hope it gets better. Been leery to pursue any Chiro work. Monday will be 7 weeks for me on the splint out of 12-16 weeks. I think some pain has subsided, good days and bad. The ringing like everyone else is my challenge. Went from using earbuds for masking to having background/sound enrichment noise playing in the background for past week.

Thanks,
ken

 

@Greg Sacramento greetings and I hope this post finds you as well can be. Reread your quote. Two questions if I may.

You note about the nerves coming into play with what I have got going on. My tinnitus almost feels/sounds like something (swelling, etc.) is pressing on the nerves, guessing that is TMJ. As noted my tinnitus is on side with my TMJ and the ear fullness I got initially. (Also have really bad allergies, was on shots but stopped in December right before all this started with me second week in January). My sound is basically like a constant tapered down smoke alarm sound that I can modulate with jaw movements and I feel pressure at the TMJ area and pain to go with random hand tingling. Are there other treatment options for the swelling, inflammation assuming I have that beyond splints? Not sure prednisone would help at this point. TMJ doctor said only would do TMJ steroid shots if pain was really bad... he is taking conservative approach.

My second question is you noted I need to address digastric muscle to lower tinnitus. Can you elaborate on that?

Thanks,
Ken

 

@KWC

TMJ disorders typically start with some type of trauma, such as head and neck whiplash, overstretching of the lower jaw, or trauma around the lower jaw or chin. The resulting injury to the ligaments within the TMJ results in slippage of the disk.

Any of this can cause somatic tinnitus. Whiplash may happen from lifting head off a dental headrest when pressure is being applied to lower jaw. Tinnitus from his is usually caused from muscle spasms in neck that press on C spine, causing nerves and sometimes arteries to become inflame. The jaw should be rested for a few minutes during dental treatment.

https://www.tmjsurgery.com/AboutYou/Overview

The temporomandibular joint (TMJ) acts like a sliding hinge, connecting your jawbone to your skull. This can cause pain in your jaw joint and in the muscles that control jaw movement and when severe, swelling will happen.

Treatment for the sliding hinge is needed later and not by exercises.

Trial and error: Either warm or cold to see what helps.
Done by ringing out a washcloth. Apply for a couple of minutes and if some relief, use for two minutes or longer - 6 times a hour. Continue as needed to bring down the swelling.

I would focus on this for now. You have an jaw injury and I would not mess with other treatments for now, unless you have a toothache.

Besides muscles interaction and nerves, you may have some infection, from injury. Infection from shifting of teeth with having an injury. Clinching of teeth, pressing teeth together or by a splint could cause a shifting of teeth infection.

TMJ steroid injection may be needed with inflammation - swelling and pain. Should be done by an oral maxillofacial surgeon.

 

I got a pain management Dr. to do my first steroid injection. TMJ Dr. wouldn’t do it. I get another one done next week. Right now I have a very high pitched noise in left ear. Really debilitating noise. I took 2 meloxicam 7.5 mg to see if that helps.

 

@Greg Sacramento thanks for your feedback. I cannot help but believe my tinnitus is related or enhanced by TMJ but really do not know. (since you throw in stress, ear infection, allergies, antibiotic, jaw pain, and that 2 ENTs said my hearing was fine).

I Just know I have pain in that area, ringing, and can modulate the sound with jaw movements and according to the TMJ doctor the posterior condyle and superior condyle locations, i.e. TMD.

Will be focusing on heat/ice treatment for swelling and usage of splints. Also thinking I will do a 2 week stint of 800mg ibuprofen 3x a day to hit it as well and get physical therapy evaluation. Just really impatient. Part of me is "broken" and like others I have this drive to "fix" it. Trying to also be patient (know not going to be fixed in 7 weeks of splint usage) and evolve habituation as well. First ENT gave me prednisone for my inner ear fluid which was a 10mg pack/48 count so what I think I understand is that is a low dose and not was what would help TMJ inflammation. Still trying to figure out if I should purse MRI.

I also welcome any coping tips from you and all forum members. I applaud you for managing/surviving since 2011. I am trying to survive 1 year.

@just1morething will be interested to see if you get any benefit. Did you get benefit from your first shot? I do not know what range the ENT's testing my hearing to... I believe most go to 8 kHz.

My pain varies. Mornings are better and my joint gets more sore during the day. Yesterday morning for about 2 seconds I swear I heard silence but could not be sure. Have not done a true Oral/Facial practice yet as medical not covered by my insurance. Went to Oral pain management at local university teaching hospital and they only did a panoramic. So not a lot faith with them. That is why I ended up at TMJ doctor. Ringing is constant in TMJ ear. I was masking fully until a week ago and I went to sound enrichment... basically playing a outdoor fire sound on my phone in the background... coping as best as I can. Have paid out of pocket for splints/tests and almost 7 weeks in... so have to pursue that and going for physical therapy evaluation next week.

 

@just1morething
When did you have your first TMJ steroid injection?
This can cause a temporary spike in tinnitus, usually no longer than a few days to a week.

 

It was several weeks ago. I posted it on this forum. I wish something would calm down my current spike. High pitched in ears/head. It is hard to bear. I just took a couple GABA Calm. Nothing works for relief consistently. I might try some generic Lyrica.

 

I did get benefit but it didn’t last. It seemed to open up my Eustachian tubes when I awakened. I will try only left TMJ this coming week as it hurts quite a lot. Another thought is to have several prolotherapy injections. If your noise is anything like mine it can be brutal. I’m taking 2 Zolpidem tonight to see if it relaxes my body more. I also have a tele-consult with a Mayo Rochester TMJ Dr. later this month. He has already looked at my MRI report.

I also talked to someone on Facebook TMJ group. He is a dentist that has dealt with TMJ disorder. I just sent him an email yesterday. He claims the ear canal can be affected by a worn TMJ producing noise. I have to do some more follow up emails regarding his questions.

Pic of my TMJ appliance:

 

@just1morething I have 2 splints. Daytime/nighttime... the nighttime fits over my upper teeth and has a depression in the front that the lower teeth close over and push forward. The daytime splint is fitted over my lower teeth and when I close my mouth it aligns my lower jaw into per the TMJ doctor the correct alignment... open and forward...

The sound for me is constant 24x7 in my right ear only... not sure how to put it on a 1-10 scale but I have to have either close almost in ear or background noise... my right TMJ pain is more dull pain and soreness than sharp... that coupled with sleep issues... got about 3.5 hours with meds... makes it rough.

Not sure where to turn or wait it out and see what splints do (7 weeks in)
maybe chiro, physical therapy.

ENTs, GP, neurologist, now TMJ doctor... been through all that.

 

@KWC, My left TMJ is the problem. My right is normal according to the MRI I had done in March. Left side clicks and is crunchy, more so when I don't use elastic mandibular advancer at night. I have a loud solid high pitched in left ear atm. Did have airplane barotrauma in that ear in 2008. ENTs just say HF hearing loss but then why is noise loud in left and not in right? Frustrating. TMJ must be pressing on a nerve or affecting small muscles in ear.

https://www.caringmedical.com/prolotherapy-news/temporomandibular-joint-syndrome/

 

This is the only TMJ steroid injection data base study that also includes statistics for those with tinnitus - increasing tinnitus. Hidden within other articles without statistics, authors don't think that a spike is permanent, but those are industry articles, not professional studies. I had talked to a researcher about this article and he expressed that this article is also an industry article. He felt that increased tinnitus is higher and gave reasons why. US government reporting agencies see a need for more investigation. I have no opinion as to risk percentages, but I also examined if this could happen with certain TMJ and cochlear pathway properties.

http://www.tinnitusjournal.com/arti...patients-with-tinnitus-only-on-indication.pdf

 

@KWC

Have you researched this as to increasing tinnitus.

 

I have some of the same issues you have. Sleep is only break. I recently overslept and tinnitus was gone for a day but not repeatable. Maybe TMJ relaxed with extended sleep?

 

@Greg Sacramento yes I have with ibuprofen. Grasping at straws. Started working on gentle posterior digastric but believe it will be a process with that splints, physical therapy etc.

@just1morething could be. I would be content with a good night sleep.

 

That’s difficult for me without Zolpidem.

 

@KWC did you read the link in post #35 as to the causes of TMJ. You are now having swelling.

This as well needs to be considered.

Digastric touch is recommended and also when using splints to relax the jaw hinge.

Many methods of TMJ physical exercise. With swelling, more trauma is very possible by exercise therapy. Your doctor is correct. One needs to understand industry BS. Promotion by web sites is also big business.

 

@Greg Sacramento thanks.

Yes I read and I agree on swelling. I was thinking about maybe prednisone but not sure. Concerned running out of time at 7 months after tinnitus onset to resolve. Not very logical I am sure.

Not sure about infection. I cannot rule it out.

Following digastric release on video. I will start doing daily.

Proceeding carefully with physical therapy. I will be focusing on posture but staying away from neck exercises

 

Do you take regular or extended release? Dosage, quantity?

 

(1)10mg. I didn’t know there was an extended release.

 

@KWC I was referring to staying away from jaw exercises with swelling.

 

@Greg Sacramento

To clarify, shouldn't do any jaw exercises but can do gentle digastric release, right?

 

Yes there is.

 

I have a static sound atm. Maybe it is all caused by high frequency hearing loss? Tough to listen too.

 

You could try GABA Calm. Probably less addicting than Zolpidem. I tried that last night. I used CPAP part of the night with mandibular advancer. I don’t seem to have static today, some high pitched noise though.

 

@Greg Sacramento seeking some additional feedback if I may.

One thing I have noticed with me is about 1/2 inch below my ear lobe on my neck at the back of my jawline I can feel a very tight hard lump. When I press on it pain reverberates up into my ear and around my eyes. I think that is a strong possibility that it is also related to my tinnitus. I included a picture of the location.

Not sure if this is the digastric muscle or what it is. What type of doctor would you see for this?

Thanks,

Ken

 

I had a left TMJ steroid injection today. We’ll see if it helps TMD. I was doing better noise wise today anyway but the Dr. let my try another injection. I’m just doing trial and error. I guess that’s better than complaining all the time.

 

@just1morething did it help your tinnitus?

 

I am having a really bad day. So loud. Trying to mask high pitch sound. Not sure if spike or what. Losing hope of medical resolution at 7 months in and not even close to getting used to the sound. I have to figure out steps on how to habituate. Very hard.