Greetings
@KWC -
Your tinnitus onset and the set of accompanying symptoms and issues pretty much mirrors mine exactly but I was only 29 when I went thru all of this between summer and fall 2019. For the sake of brevity, I will not recount the development of my own tinnitus as it covered in several forum posts I have authored or contributed to which I encourage you to read at some point in the future. Instead, I will outline some of the more successful treatments I have pursued. I have mostly recovered from the poor posture and musculoskeletal components of my issues but the tinnitus remains but it is around a 1-2 >95% of the time. However, with continued treatment and self-care I am hoping for full resolution at some point in the future. Please remember any suggestions I offer should be discussed with your docs before pursuing them yourself
Over the last 13 months, I have diagnosed with several different conditions including Tietze Syndrome, Costochronditis, Mild Sleep Apnea, Gaisbock's Syndrome, Chronic Sinusitis, TMJ, SI Joint Dysfunction, and Tinnitus. I firmly believe that all of these are related somehow as all can be traced back to some musculoskeletal alignment and/or neuromuscular imbalances. Years of poor diet, poor sleep hygiene, sedentary lifestyle, and other poor habits predisposed me to all of these of conditions as well. Given the similarities in our presenting symptoms, I would wager your tinnitus, TMJ, and muscle/joint pain is conservatively caused by sort of misalignment and imbalances as well. The key to your treatment will be to map your misalignment and clearly establish what muscular imbalances you have which can then be cohesively treated. The human body is a single kinetic chain so misalignment and imbalances in one area will cause it to develop in others. You should endeavor to treat as many problem areas as possible. A good place to start would be to stabilize the feet, sacrum/pelvis, and atlas/jaw which should slow or halt further progression of your musculoskeletal and/or neuromuscular issues. Keys to this approach are remember to walk before you can run and release and stretch muscles before strengthening them.
First some comments about your post -
My journey started as a headache and right ear ache that I went to urgent care for and got Augmentin. About 5-7 days later started having ringing in my right ear and jaw pain and extreme ear fullness.
Two months prior to my tinnitus onset I had a series of really bad migraine headaches with paint mostly located in the forehead and between the eyes. I believe this a result of my poor posture and was caused by some misalignment in the cranial bones (sphenoid and temporal bones). I continue to have facial asymmetries. Look at your face in the mirror and look at the bones above the eye socket and below the eye brow. Each side should slope down at about the same angle, but now my right side slopes down at a steeper angle. Before I started treatment, my neck was torqued to the right and bent sloping down to the left which helped keep both eyes straight and level on the horizon. This is one of the things I have not been able to permanently correct yet. I would check this on your end as well. A good video describing the issue below.
Ended up at a neuromuscular dentist (TMJ dentist), who did a bunch of tests and said I have TMJ and that that my right condyle was pushed to far backwards and my jaw is misaligned. (I am a teeth grinder). Also said that not good posture and one shoulder is lower than the other. I ended up pursing dual splint therapy (almost at week 4) and have pain in TMJ area, pain around eyes, neck tightness, and ear soreness.
You probably have a higher hip and shorter leg on the side of the body with the lower shoulder. This means whatever you postural issues you have, offset with or without rotation is one of them. I went thru dual-splint therapy as well, but I no longer use either anymore. For pain around the eyes, this helps me a lot -
https://www.amazon.com/Fronnor-Eye-...on-Pressure-Eyestrain-Headaches/dp/B07Z7P7FJX. I use it every night before going to bed which also helps alleviate eye pain associated with looking a PC screen all day. Pain around the eyes again may indicate cranial misalignment. If TMJ/jaw pain continues after you complete dual splint therapy, then seek a PT knowledgeable in this area for some stretches and exercises. Neck tightness with misaligned shoulders usually indicates weakness and dysfunction in shoulder and back muscles since both support the neck.
My tinnitus is a high pitch constant 24/7 sound that for a few days went to a hissing static sound but then back to high pitch. Initially when I would lay down to sleep no matter which way I would put my head it would increase. (that finally subsided).
My tinnitus is high-pitch and 24/7 as well. For information on sleeping with this type of tinnitus, please read this post I authored last year -
https://www.tinnitustalk.com/threads/tinnitus-from-musculoskeletal-misalignment-imbalances-—-achieving-better-sleep.39047/. I rotate between sleeping on my back and side. If you are a side sleeper, then be sure to do it properly (see video below).
Fast forward to present. If I push my tongue on my back molar on my tinnitus side the tinnitus gets louder. If I jut my jaw forward my tinnitus gets louder. If I push my head forward pretty far my tinnitus gets louder (not sure if tied to TMJ). Right under my right ear lobe if I rub my neck in front of my SCM (digastric muscle?) feels very tight. Also have what feels like a gland in front of my ear on my jaw near the trages. My traps feel very tight as well. Dentist said gland is normal and was not worried about neck muscle.
You are on the right path with the tight digastric and SCM muscles. Both of these muscles were tighter on the side of my dropped shoulder. Try this jaw stretch - Assume a chin tuck position and then push the lower jaw forward. Then raise the lower lip like you are snarling with bringing neck forward and elevating your head. Do 3 sets of 20 of these a few times a day for a week or two. This should stretch those muscles and provide some separation to free up the jaw and neck. It continues to work for me. Be weary of your dentist not worrying about your neck muscles. If you have long-standing dysfunction in your neck, your splints while possibly repositioning the discs on the condyles to fix your TMJ may also not actually fix the position the position of the condyles and the TM joints in the joint space. I am convinced my treatment further torqued my neck to the right and made my neck muscles even tighter, which I have mostly reversed now and brought everything back to center without reigniting my TMJ issues. Other things like doing the wrong exercises early on and side-sleeping on a worn out mattress probably contributed to this, but remain aware of this nonetheless. If your traps are tight, you might have forward head posture and also check your sleeping posture as well (again please see the info/thread included earlier in the post about this).
Second, some treatment approaches to consider (remember to weigh potential benefits against the coast of treatment though before pursuing any of these).
1) Referrals to consider - Physical Therapy, Chiropractic, Podiatrist, Orthopedic Surgeon, Neurology, Acupuncture, and Massage (depending on what country you reside in and what insurance you have)
2) Supplements to consider - Calcium, Vitamin D3, Turmeric/Curcumin, Protein, Phosphatidyl Choline, Magnesium, and Collagen Peptides (to help ligaments recover but some folks may have ethical reservations about this one). I advocate being as conservative as possible with supplements for tinnitus though as it is a very slippery slope.
3) Check your feet for bunions on your big toe and pinky toe, plantar fascilitis, fallen arches, and hammer toe. Also keep your toenails clipped and do not let them grow too long. The way your walk and how feet contact the ground determine how the forces distribute and travel up the legs to the hips while you move affecting gait, posture, and musculoskeletal alignment. Check the patterns of wear on the bottom of your shoes to see if favor a heel or mid-foot strike or under-/over-pronate while walking. Seek out a podiatrist if problems are suspected after discussing things with your primary care doctor to discuss treatment option. I also tossed all of my shoes with a narrow toe box and only mostly use zero-drop shoes with a wide toe box now. Vibrams V-Trek and Topi Fli-Lyte 3 are my new favorites.
4) Realign your feet, ankles, knees, and hips. The feet and ankle bones connect to the hip bones which stabilize the sacrum. An unstable sacrums may cause misalignment up the rest of the spine to the atlas and depending the scope of the misalignment cause you develop laxity in the spine if it becomes overstretched. I use something called the Egoscue Tower to perform a series of stretches known as the Supine Groin Progressive to do this and do it 2x per day every day in the morning and evenings. More information -
http://www.oregonexercisetherapy.com/blog/egoscue-supine-groin-stretch. This also helps reset the scapulas to their correct position as well so useful for shoulder dysfunction as well. This runs about ~$100-$150, so it is not cheap. There are places you can try it out before purchasing it, so I would recommend this approach once COVID19 restrictions start to lift more widely.
5) Restore bilateral balance. If your dropped shoulder is on your dominant side, then it may be that way due in part to overuse. Start doing more activities with your non-dominant hand and arm instead and stop reaching across your body to get something (i.e., do not reach across your body with right hand to pick something up on your left side; use your left hand). With the exception of writing, I do most everything else with my left hand now and can shoot decently left-handed when playing basketball now.
6) Address and correct any muscle weaknesses and imbalances before postural issues get worse. When I started out, I had swayback posture with rotation/offset. Correct the offset first before correcting the swayback. Swayback correction requires strengthening the core, obliques, and glute muscles. I do a battery of exercises 7 days a week to address this and then recently added in upper body exercises 3 days a week since my lower body strength is getting better. Seek out a PT or personal trainer to get gait and posture evaluated and your issues diagnosed, so you can get the correct exercises to fix these issues. Big problem muscles for me have the piriformis, subscapularis, SCM. and QL muscles. I would wager this some pattern of misalignment involving these muscles on the side with your dropped shoulder. Remember to release and stretch muscles before strengthening.
7) Upper cervical chiropractic work. This is totally up to you on whether to pursue this or not. Various folks on the forum have their own opinions on it. I finally had success with a Chiro certified in Chiropractic Biophysics, Atlas Orthogonal, and NUCCA and finally maintained adjustments after 2 visits which held since. If you have cranial misalignment, a technique called the Koren Specific Technique (KST) which is one of the few chiropractic approaches for fixing cranial misalignment. I have found a well-reviewed KST chiro near me I will start seeing once the tourist season/summer ends where I live.
8) Achieve a healthy BMI. I have lost 45 pounds in the last year after developing tinnitus through proper diet, exercise, and good sleep hygiene. Part of my issue was probably that I simply overloaded the system without compensating for the extra weight I put on over the years and musculoskeletal system could eventually could no longer support all of this weight. I have gone from a BMI of 30.2 (obese) to 24.4 (healthy) in the last year. Develop your own plan to address this if you feel you need to. On a similar note, lots of folks have found that light exercise tends to help relieve tinnitus temporarily or at least helps them deal with it better, so start exercising too if you do not already.
9) Practice good posture. Easier said then done, but this one is pretty self-explanatory.
10) Promote proper lymphatic system function especially during sleep since sleep is the thing that can often make or break folks who suffer from tinnitus. More info -
https://recoverwellbeing.com.au/10-tips-boosting-lymphatics/. As dumb as it may sound, dry skin brushing has helped me a lot.
11) Since you are a teeth grinder like me, consider exploring conservative ways to control your cortisol and stress hormone levels. People grind their teeth at night often to release excess cortisol. I achieve this thru meditation in the evenings, deep breathing exercises, and drinking teas with adaptogenic herbs. Some treatments designed to control your cortisol levels can be very dangerous if performed incorrectly and pursued unilaterally without consulting proper medical personnel.
12) Develop strategies for pain management. My make or break issue was dealing with tinnitus and constant pain; the latter of which has mostly disappeared for me thankfully. I use a Thermotex Platinum Far Infrared Heating Pad to control pain when I do get it. These things can range from $100-$250 USD each depending on the model you choose, so consider the cost of purchasing one against the potential benefit.
13) Identify and stop bad habits that have contributed to postural problems. The big ones for me were keeping my wallet in a back pocket while sitting down for long periods, wearing a hat backwards while driving (forced my neck forward), lying on my back on the couch with head against an armrest, and not setting my seat far enough back from the steering wheel which adaptively shortened my quadriceps muscles over time and contributed to my posterior pelvic tilt associated with swayback.
14) The vagus nerve innervates around the area of the neck where the SCM and digastric muscles meet that you indicated is tight for you. If you get a spike, try stimulating and calming the vagus nerve to see if it causes the spike to subside (very useful for someone with full body misalignment like me). This calms spikes ~80% of the time for me. There are various approaches to this, and a quick search on Youtube should provide what you need.
It is possible to recover from all of your issues (I am still on the road to recovery). If your TMJ treatment does not fix the problem entirely, you will need to develop a proper treatment plan and stick to it for months and possibly years. Most of the literature I have investigated since developing tinnitus has mentioned tinnitus suffers achieve the best results when combining several different types of treatment but it will be up to you to find the combination that works for you. In the interim, I would also encourage you to look at content on the forum by
@Greg Sacramento,
@Lane,
@linearb,
@Michael Leigh, and
@Bill Bauer for more information on tinnitus in general and tinnitus possibly due to jaw, neck, and other musculoskeletal/neuromuscular issues. Their content held a lot of utility for me when I first developed tinnitus last summer. Good luck with the TMJ splint therapy and I hope your condition improves.
All the best,
-Oceanofsound26
Member
