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

[donotringatme]

This is interesting.

Heat causes vasodilation. Cold causes vasoconstriction. If I apply heat on the c1 and 2, or higher, tinnitus increases. So, heat is bad, cold is good. However, that would mean drinking coffee should help. However, internet states that coffee acts as a vasodilator in the brain and vasoconstriction in the peripheral vessels(?) so I don't know.

The issue is that TECAR laser stimulates the nerve directly. So this can be a vessel or nerve issue.

TECAR laser at 4 watt only, selecting "tinnitus" as an option on the screen (which doesn't give further instructions probably because tinnitus can be from anything), and applying it on the SCM and jaw gave me positive results.

Another funny one: increasing the outer ear pressure kills the tinnitus, probably because of the increased middle ear pressure. So if you have ETD, equalizing the pressure will take tinnitus away for a brief moment. Similarly, lying in bed on the side, the ear on the pillow gets the same effect and tinnitus goes away. A physiotherapist can try to put a suction cup to your ear and very very slightly increase pressure and tinnitus again flies out the window.

Moreover, the little bones responsible for amplifying sounds working too much causes H. Some more stuff to it but definitely not psychological lmao, I wish I wrote down everything from talks I had today.

Cortisone fights inflammation so since my ET were not inflamed at least at the base entrance, it could be muscles. SCM and a bunch of other muscles, masseters etc, they all play a role in tinnitus and ETD. So one must definitely address them.

IMO, restoring proper function to your ETD kills tinnitus. Now if it is a tiny vessel pumping close to a nerve and such and such, taking MRI and MRA is a must but the people doing it should be informed and actually search for a dozen stuff. Truly, the jaw may not be the issue at all as @Greg Sacramento mentioned. It's something else, either a vessel, a nerve or ETD.

So far, Cortisone took down whatever inflammation I've had that was causing this massive ear pressure and pressure on my zygomatic bone, temples and jaw. Physiotherapy consists of TENS on the entire neck, TECAR laser (which is around 20 or 40 watt can't remember, on the neck, c1+c2 increases tinnitus pitch/loudness) and manual therapy (muscle knots, massage etc). Neck will be fixed. Facial/jaw muscles will be improved. If these fix ETD completely, something tells me tinnitus will completely go away. If, however, it's a tiny vessel next to a tiny nerve branch passing through bones that does such and such and ear acts up, then yeah, good luck. I do believe though that somatic tinnitus sufferers without hearing loss, eardrum issues or fluid should definitely act on these. At this point, my tinnitus has decreased from a relatively loud static + eeeeeee and a spike of a loud af eeeeee tone with a few fleeting incidents, to a static only detectable if I close my ears or if I'm in a quiet place, with the worst being a static I can hear in a somehow quiet place if I look for it (and frankly, it's more of a sensation of pressure rather than "sound"). Lying down definitely brings the worst out of it so either it's ETD (which is indeed worsening when lying down) or something's being jammed (I can feel pressure building up from my zygomatic bone close to the ear, linearly down to my jaw, as if the muscles are being squashed, while having a relaxed mouth (no clenching, no bite). Head position influences it, pillow height and such. The higher the pillow, the worse the neck curve/strain, the worse the pressure near the ear.

I don't know if anyone is finding similarities to all those or benefits from but there you go.

@Greg Sacramento thank you for investing time to help me even though you have to deal with your tinnitus too.

@KWC The hunt for a cause continues

 

[KWC]

@KWC The hunt for a cause continues

Sounds like progress in the right direction. I am at a continuous sound in between somewhat static and a higher pitch sound. My TMJ is still sore and pain right under along jaw line. (Could be from jaw realignment with splints).

Basically doing my own physical therapy for neck/back posture. I did about 4 sessions with doctor with cold laser but not sure I had any benefit. I have to pay for each session. Whole side around my TMJ just feels sore... may just have to give it time and cope. Not really sure who else to see or what else to test.

 

[donotringatme]

Sounds like progress in the right direction. I am at a continuous sound in between somewhat static and a higher pitch sound. My TMJ is still sore and pain right under along jaw line. (Could be from jaw realignment with splints).

Basically doing my own physical therapy for neck/back posture. I did about 4 sessions with doctor with cold laser but not sure I had any benefit. I have to pay for each session. Whole side around my TMJ just feels sore... may just have to give it time and cope. Not really sure who else to see or what else to test.

I saw a neurosurgeon. He saw my MRI. Neck is something I have to fix, I guess yours too, we have to for precaution not that we have life threatening issues. I ask him about the nerves, he said absolutely not. They are too deep. The trigeminal? No way. I'd have sharp pains and other stuff. The other ones? No. Jugular foramen? Normal. Auricular nerve, meh, too deep, not a chance.

There have been people with psychosomatic tinnitus that did retraining therapy and eventually tinnitus went away, I do believe him, he's seen actual patients who did that. But he said mine isn't. It's organic, meaning something is wrong with the ear. He asked me about it, I told him such and such and then I told him about ETD / middle ear pressure being double. He said there you go...

Now I will do MRA for the ears although I'll ask for more stuff to check. The issue is ET and why it's dysfunctional. It isn't entirely dysfunctional because I'm not having fluid, which is good. But whatever it is, it's on the other side, the inner side of ET. Either it's muscle inflammation (which I think it is because cortisone helped) or something anatomically around the ET changed and the palatini muscle has a hard time working fully (also a possibility from what literature says) OR my ET shrank in size (which means I'm fucked) or anatomically (tongue in upper palate, changes in bite, whatever) they are messed up (angle or thickness). I was told that the angle can't just change. I've no idea about the rest, I do know that muscles involved in jaw can get inflammation and mess the ET up. So the MRI/MRA will show and hopefully, with the right treatment, they'll go away. The neck I think can worsen this, by worsening the ET as muscles are connected or maybe back in c1/c2, for someone who already HAS tinnitus, using TECAR laser (which goes deep into the nerve) can irritate the nerve and naturally change the pitch of tinnitus. But not that the nerve itself is the cause.

In your case @KWC I would suggest you to check your ET and have someone measure your middle pressure (I linked tests in another thread) and perhaps turn to a neurosurgeon with an MRI / MRA of the inner ear so that they can eliminate some stuff. Working on the jaw muscles isn't easy, you gotta find someone who knows what they do (the YouTube stuff is ridiculous). That's as far as I know, seeing a TMJ specialist / orthodontist and having some xrays / MRI done will shed some more light.

I think you said your tinnitus is in only one ear so I really don't know if it's the same. As long as the ENT rules out a bunch of stuff, I guess...

 

[just1morething]

@just1morething any change, for the better I hope? I am sure you like others trying to rule out one by one. This is definitely a marathon. Mine stays pretty constant. I may pursue an extended hearing test just to rule it out. I also might seek a consult with a Oral/Facial surgeon. TMJ joint and jaw line still sore/inflamed under ear. Follow up with TMJ doctor on 10/13 and that will be 16 weeks. Pain better but not sure what's next. Steroid shots in TMJ? Not sure. Still working on neck/back posture exercises...

@Greg Sacramento what are your thoughts on TMJ arthrocentesis?

I was good yesterday but woke up to static today. Actually I woke up with static yesterday but it went away so I was happy.

Caring Medical looked at my imaging reports and said this:

We reviewed your case and it sounds like you would probably need your upper cervical (C1-C2) and TMJ treated. Tinnitus is sometimes a difficult symptom to alleviate when treating cervical instability but if you would like to come in for a Digital Motion X-ray and thorough exam we can move forward with scheduling. Please let me know if you have any questions.

 

[donotringatme]

LOL, I made a search online and it gave me this:

https://www.tinnitustalk.com/thread...t-neck-and-eustachian-tube-dysfunction.20528/

This site seriously has everything thought, said and done years ago.

 

[KWC]

I was good yesterday but woke up to static today. Actually I woke up with static yesterday but it went away so I was happy.

@just1morething, sounds positive. What type of doctor did the prolotherapy shots? I still think mine is jaw/TMJ related to some extent. Kinda of lost of what to do next except continue splint therapy.

 

[KWC]

In your case @KWC I would suggest you to check your ET and have someone measure your middle pressure (I linked tests in another thread) and perhaps turn to a neurosurgeon with an MRI / MRA of the inner ear so that they can eliminate some stuff. Working on the jaw muscles isn't easy, you gotta find someone who knows what they do (the YouTube stuff is ridiculous). That's as far as I know, seeing a TMJ specialist / orthodontist and having some xrays / MRI done will shed some more light.

I think you said your tinnitus is in only one ear so I really don't know if it's the same. As long as the ENT rules out a bunch of stuff, I guess...

@donotringatme my ENT did a brain scan MRI and they checked all of the inner ear nerves, etc. and it all came back clear. I did a CT soft tissue of neck and nothing jumps out. Yes my tinnitus is just in my right ear where I have the TMJ issues and I can feel the TMJ pain within the inner ear, sore sometimes. I have allergies but nothing that jumps out as EUD. The TMJ guy I am seeing has been in biz for 40 years... not sure but they were thorough in their testing. I went first to my local University teaching medical hospital and the doc there just checked muscles and did a basic panoramic. I read CBCT/MRI is better but as Greg Sacramento noted pluses and minuses. I also read jaw issues take a while to fix. Going to get some second opinions... but my TMJ pain has improved... just slow... I do not have use ice everyday. Seems like every time I move my jaw the sound goes up. Weird thing for me is I can take my tongue and press on my back molar and basically flex the jaw muscles and the sound goes up. This thing is a beast.

 

[donotringatme]

@donotringatme my ENT did a brain scan MRI and they checked all of the inner ear nerves, etc. and it all came back clear. I did a CT soft tissue of neck and nothing jumps out. Yes my tinnitus is just in my right ear where I have the TMJ issues and I can feel the TMJ pain within the inner ear, sore sometimes. I have allergies but nothing that jumps out as EUD. The TMJ guy I am seeing has been in biz for 40 years... not sure but they were thorough in their testing. I went first to my local University teaching medical hospital and the doc there just checked muscles and did a basic panoramic. I read CBCT/MRI is better but as Greg Sacramento noted pluses and minuses. I also read jaw issues take a while to fix. Going to get some second opinions... but my TMJ pain has improved... just slow... I do not have use ice everyday. Seems like every time I move my jaw the sound goes up. Weird thing for me is I can take my tongue and press on my back molar and basically flex the jaw muscles and the sound goes up. This thing is a beast.

You'll figure it out I'm sure. I'd say get second third fourth and fifth opinions. Don't invest in them but take them. I'm pretty sure you'll treat it, and as @Greg Sacramento said it takes time. Best of luck with it!

 

[donotringatme]

@Greg Sacramento I wonder, is there a link to a website or thread here that has a list of all the possible outer, middle and inner ear diseases/disorders? I mean, one starts searching and bumps into tumors and Meniere's, then finds out about jugular foramen, then an elongated condyl, hydrops and temporal bone holes then fluid leak. It's insane how much stuff there is. It would be great if such a list existed with mentioning of how to detect and rule them out (MRI, CT etc.).

 

[KWC]

@Greg Sacramento not sure if I posted my CBCT results, could you give me your take?

Calcified arethoma is a non issue. #30 had a root canal and crown before CBCT.

Thanks,
Ken

 

[KWC]

There is nothing in these two scans that I can see that would show concern and I used enlargement of small sections to full page view. An overbite would not be seen from these views. Your teeth are straight, even for a mouth breather, which is same with me. I had a cone beam with over 300 scan pictures that was sent to me, so I was able to view interior problems. I also have two scans like yours and all sorts of unbalanced problems can be easily seen. I also have soft and hard palate issues, nerve issues, salvia gland issues, lip issues and had tongue issues as well. My cause was dental whiplash that messed up my neck, caused TMJ and dental problems. Dental errors were also made.

From your scans of neck, there are noted problems. So many possibilities that need radiological exam, but I think that your neck is primary - as to where things began. One of many possibilities:

https://www.epainassist.com/back-pain/upper-back-pain/can-a-herniated-disc-in-neck-cause-jaw-pain

What's the best doctor to see for cervical neck... an orthopaedist?

 

[Greg Sacramento]

@KWC Once again, I would not get cervical neck treatment before seeing an intervention radiologist from issues that you posted. Now, even more so with your CBCT results above. Ready need a long face to face discussion, but I will give some thoughts. You don't have to answer, but I wonder if you are a smoker?

Tinnitus may be from soft tissue of jaw and muscles. The Radiologist that noted your CBCT - is recommending soft tissue - MRI assessment. Your CBCT has shown to be more accurate than your CT.

Ruling out root fracture symptoms from #30 is suggested by radiologist. Any clenching as cause of this and with pressure to your lateral pterygoid muscle - soft tissue could be a cause of tinnitus. Any bacteria getting into gum pockets will also infame roots that can move teeth and cause or increase TMJ.

_______________________________________________________________

Read what is said under OTHER - first line. within notes that is highlighted. A big reason not to mess with neck before seeing an intervention radiologist. With this, your tinnitus could also be part pulsatile. Read the second line under OTHER that is also highlighted: The circle of Willis / internal carotid - atheroma. Don't sleep in a chair, as your neck could bend forward.

The radiologist mentioned cardiac follow ups and these are the tests that I had.

Blood test - Cardiac enzymes (including troponin and creatine kinase), C-reactive protein (CRP), fibrinogen, homocysteine, lipoproteins, triglycerides, brain natriuretic peptide (BNP) and prothrombin.

Hypertension blood pressure testing.

Carotid and abdominal aortic vessel ultrasound.

Echocardiogram

 

[KWC]

Tinnitus may be from soft tissue of jaw and muscles. The Radiologist that noted your CBCT - is recommending soft tissue - MRI assessment. Your CBCT has shown to be more accurate than your CT.

Ruling out root fracture symptoms from #30 is suggested by radiologist. Any clenching as cause of this and with pressure to your lateral pterygoid muscle - soft tissue could be a cause of tinnitus. Any bacteria getting into gum pockets will also infame roots that can move teeth and cause or increase TMJ.

@Greg Sacramento I see my TMJ doctor in about 2 weeks for a follow up. Possible next step is MRI or he will want to keep going with splints longer. He told me an estimation of 12-16 weeks.

I had a root canal for tooth #30 and had a crown done prior to CBCT. Regarding the lateral pterygoid when I go for follow ups as I understand he inserts a finger alongside my teeth line interior and palpates the muscle but I do not feel any pain.

Thanks,
Ken

 

[KWC]

@just1morething, how are you progressing?

 

[donotringatme]

@KWC this is worth a read, plus the related articles linked in it, @Greg Sacramento linked it in the past: https://mskneurology.com/association-tinnitus-neck-tmj/

I think you should show this to your TMJ specialist and motivate him to read it, it's complicated content but surely it will help.

 

[Greg Sacramento]

@donotringatme Yes, I have linked this article and others including (headaches, jaw, TMD, injury and posture) from their web site. I have wrote to management here and gave a link list of them and said how valuable they are with having physical tinnitus. There are other web based research that I and others have posted on physical tinnitus that is also important. We get questions on why my neck and jaw hurts or anything else above the waist. It's difficult in understanding each individual concerns. Knowing their life style and injury information may help to give some summary thoughts. Radiological testing is often needed and some types of testing is a concern for some - either noise from a MRA or radiation from from a CT. With physical and pulsatile tinnitus, it's important to have testing done before letting a therapist mess with your neck.

With neck and jaw trauma, injury from neck hypertension, whiplash, trapped nerves, muscle concerns, having mouth open too wide or teeth pressure - clenching, often has physical injury association and hypertension and posture can play into this.

 

[donotringatme]

@donotringatme Yes, I have linked this article and others including (headaches, jaw, TMD, injury and posture) from their web site. I have wrote to management here and gave a link list of them and said how valuable they are with having physical tinnitus. There are other web based research that I and others have posted on physical tinnitus that is also important. We get questions on why my neck and jaw hurts or anything else above the waist. It's difficult in understanding each individual concerns. Knowing their life style and injury information may help to give some summary thoughts. Radiological testing is often needed and some types of testing is a concern for some - either noise from from a MRA or radiation from from a CT. With physical and pulsatile tinnitus, it's important to have testing done before letting a therapist mess with your neck.

With neck and jaw trauma, injury from neck hypertension, whiplash, trapped nerves, muscle concerns, having mouth open too wide or teeth pressure - clenching, often has physical injury association and hypertension and posture can play into this.

I showed that link to my physiotherapist whose dad has had tinnitus for years due to dental procedure gone wrong (I think he drilled to the nerve or something like that). He offered to not take money for today's treatment. I think discussing closely with the guy who's in charge of treating you is a must.

Regarding TMD/TMJ, did ten minutes of laser (it's some sort of very expensive TECAR laser, haven't written down the model but I will for all of them next time). Around 7,5Watt, tool addresses both time, watt and the rest automatically. It's working slowly (instead of going all out in the nerve to provide instant but temporary relief) and to the muscle too. One must address both the muscles and the nerves at the same time because one influences the other. Anyway, drove home after treatment and my tinnitus was completely gone for a few minutes. Closed ears, silent room, nothing. Except a very faint "sound" of pressure (more like sensation) which is due to ETD probably.

So there's definitely ways of working towards improvement and also figuring out some things. I haven't printed the articles yet to read in detail but it mentions ETD, the eardrum and the three little bones function that can get a slight "hit" which influences the cochlea and can lead to all this shit. Also, the connection of a muscle to one of these bones if memory serves me right, which means that other muscles tension can influence that one and again lead to issues. It mentions jaw muscles messing - partially - with muscles responsible for ET function (which honestly is what happens to me too). So it's a big labyrinth and finding a cause is impossible. I think treating the areas one by one is more or less the only way to go and then again it may never go fully.

I only have a phone and not a PC but if I find time, I'll catalogue all the links you've posted and scattered information because much of it talks about pulsatile tinnitus and noise-induced tinnitus, tests that should be done and things to monitor because not doing that many times can and will worsen the tinnitus.

The protocol I'll follow (mentioning it in case more are interested in) is electrotherapy on my entire neck and back, followed by laser (which has enough watt and goes deep) WHILE I'm doing decompression table (DTR? don't know name yet), because you're lightly stressing the muscles and at the same time you're working deep in the other stuff so it's a win-win. The slightly narrow "gaps" on the cervical spine where nerves and stuff go through (normal gap around 17-18mm) can widen with decompression table while the treatment is addressing the herniated disc itself.

There is definitely hope. I do fear that my tongue technique (mewing) changed the angle of the cartilaginous portion of my ET, slowly leading to dysfunction and increased pressure (sort of like what happens to kids) but I hope it isn't the case because I have neither fluid nor infections so I lean towards muscle (and dental) dysfunction which can be addressed.

It is also interesting that it mentions that pressure may be alleviated by a part of the ear that is behind the canal (sort of that body part connecting to the SCM) when the eardrum is tired and the ET functions poorly.

Lots of stuff in those links, one can read for days. @Greg Sacramento I am hooked haha.

 

[KWC]

Thx @donotringatme and @Greg Sacramento good info.

Feeling dejected. Not sure where to go or what to do next.

 

[ajc]

Feeling dejected. Not sure where to go or what to do next.

You've had more tests and doctors than most people.

Next step: learn to live with your tinnitus and continue your life. That's what most of us have to do.

 

[KWC]

@ajc I do not disagree on living life. Good advice.

The TMJ pain doesn't help.

 

[Greg Sacramento]

@KWC Does your TMJ pain come and go?

 

[KWC]

@Greg Sacramento sometimes.

I woke up with pain today and Voltaren gel and Tylenol helped.

 

[Greg Sacramento]

I woke up with pain today and Voltaren gel

I have used it - it helps a little. It does build into a surface on my teeth and is not easy to remove with my soft palate problems.
I found that CloSYS sensitive - a very small amount works better. I like the taste.

 

[KWC]

@just1morething, how are you progressing?

@just1morething hope you are well.

 

[KWC]

@donotringatme I saw in another post your progress... really glad to hear.

@Greg Sacramento how are you?

I took steps backward. Not sure what I did but the the last couple of days my jaw joint pain has increased exponentially and tinnitus went up too.

I was on Klonopin for the anxiety but phased that out... but that does not explain the jaw pain.

This is rough.

 

[donotringatme]

@KWC thank you!

If you have pain, from what I've read so far it's either a nerve, infection or both. You can't have scans done saying they're all good. I don't know if tinnitus is directly related to the jaw situation because there are a lot of ear conditions affecting just one ear. I haven't seen anyone about TMJ/TMD myself so I don't know much but it's obvious that something is up. Could be swollen parotid glands, infected ones, god knows. You have to do tests and insist more on a diagnosis.

 

[KWC]

@donotringatme I agree. Thank you. My dilemma is I have had CT scan of sinuses done, brain scan MRI, CT soft tissue scan of neck, and CBCT of jaw and 3 audiograms. All feedback from all scans except CBCT on TMJ came back clear. That's why I went with splints.

Getting second opinions on jaw but have to wait on appointments.

Not sure what other tests to have.

 

[Greg Sacramento]

@KWC Bring your splint to your appointment. Splint evaluation is needed. Bring all your test notes.

What is the specialization of the dentist that you are seeing?

Last night, I was pressing my teeth together - clenching with splint. From that jaw/tooth pain, face pain, cheekbone pain and a bad headache started. I had to get out of bed. I held warm - not hot water on the bad side for ten seconds and repeated a few more times.

Sorry Ken, hug

 

[KWC]

@Greg Sacramento I appreciate it. I know you and others have a lot to deal with as well. What I have been doing is seeing him every 3-4 weeks for splint adjustments as needed. Mainly to ensure back teeth are not touching. The splints are meant to bring my lower jaw forward to realign position on condyle as noted was posterior

I am very sorry about your clenching episode and hope you are doing better. Well wishes to you too.

Specialization is oral/crainofacial pain/sleep specialist.

The joint pain is clear where it is at. The area previously mentioned 1/2 inch below ear back of jawline still perplexes me. Read if digastric will have referred pain areas. They are telling me it is the stylomandibular ligament.

 

[just1morething]

@just1morething hope you are well.

@KWC - Thanks, I hope you are doing better as well! I am not well, static in ears/head. I have a laminectomy/fusion to my lower cervical coming up in November. I'm hoping that may help if some nerves are being pinched. If not I will probably look into upper cervical prolotherapy, preferably under x-ray guidance.