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

[Mathew Gould]

@just1morething

I really don't think that an auriculotemporal nerve block will help you.

Can you tell me if your c spine has straighten and if your atlas is off center from X Ray?

Your CT may not show other problems in neck, but would with jaw.
When your tinnitus eases up at times and screams at other times, then the problem is neck.
Your C spine may be placing pressure on neck muscles most of the time causing tinnitus, but your TMJ would had been caused from your atlas placing pressure on your jaw.

Tell me if ever you hear squealing on a night here and there when moving head around a while after getting into bed?
If so, then your problem is your atlas causing pressure to occipital nerves and jaw.
You most likely had an neck injury from forward motion strain.

@Greg Sacramento is this good for TMJ, reverse curve in neck, forward head posture, etc?

Amazon.com: Neck and Shoulder Relaxer, Cervical Traction Device for TMJ Pain Relief and Cervical Spine Alignment, Chiropractic Pillow Neck Stretcher: Health & Personal Care

 

[Greg Sacramento]

@Mathew Gould

There can be good or bad results with device that you point out in post above to place a curve back from a straightened C spine from forward neck injury.

Constant pressure on neck muscles may end up straightening C spine more.
If one's atlas is tilted to one side, device can do more harm with applied central pressure that could cause more TMJ and also increased tinnitus.

With use for a straighten C spine, a pillow should also be used under head for brain stem support with tinnitus.

Don't advise using with carotid artery disease - pulsatile tinnitus or vertebral artery trauma from whiplash.

 

[just1morething]

Thanks @Greg Sacramento.

The local pain management clinic will do the auriculotemporal nerve block. I had nerve blocks in my neck to see if they helped my tinnitus. I have the grade 5 internal derangement in my left TMJ.

An oral facial pain management specialist brought up that injection to me. She thinks I should see Piper TMJ clinic in Florida. I think it could be neck and TMD related possibly. I'm sure frustrated with head noise.

I had a neck injury when I was a teenager. Not sure if that would affect me anymore. I wish there was an easy solution. Anything to do with your body seems complicated.

Noise seems to make me very tired.

Merry Christmas.

 

[just1morething]

@KWC

Merry Christmas. I hope you are doing better. I was working a bit on inside patching around cement blocks to keep mice out of basement. Just getting distracted and getting my blood pumping seems to help my noise quite a bit.

 

[Greg Sacramento]

@just1morething - very rare and mostly all female. In this study 87 percent female, but other studies it's 99 percent. Headaches from this is only 0.04 percent and there's often redness on the cheek in front of ear - Frey's.

Auriculotemporal Neuralgia: Eight New Cases Report | Pain Medicine | Oxford Academic (oup.com)

Auriculotemporal Nerve - an overview | ScienceDirect Topics

I had a neck injury when I was a teenager. Not sure if that would affect me anymore.

Effect from this can show up anytime for life and arthritis can set in.

I was working a bit on inside patching around cement blocks to keep mice out of basement. Just getting distracted and getting my blood pumping seems to help my noise quite a bit.

Yes, stay active.

 

[just1morething]

My noise went berserk again after falling asleep so my ideas are probably no good.

 

[KWC]

@just1morething @Greg Sacramento

Merry belated Christmas to you too.

I had a major setback this past week.

Something burned in the microwave and set off 3 smoke detectors. It happened so quickly that I did not grab my earmuffs beforehand. I had to reach up and reset them so I was exposed to loud sound for a few seconds. I tried to cover my ears but not sure what damage was done. Really kicking myself for not moving the detectors or getting my earmuffs. It all seemed to happen so fast.

No ear pain or fullness, just the ringing went to a whole new level.

Hope your holidays have been nice.

 

[just1morething]

@just1morething @Greg Sacramento

Merry belated Christmas to you too.

I had a major setback this past week.

Something burned in the microwave and set off 3 smoke detectors. It happened so quickly that I did not grab my earmuffs beforehand. I had to reach up and reset them so I was exposed to loud sound for a few seconds. I tried to cover my ears but not sure what damage was done. Really kicking myself for not moving the detectors or getting my earmuffs. It all seemed to happen so fast.

No ear pain or fullness, just the ringing went to a whole new level.

Hope your holidays have been nice.

Sorry to hear that. My noise is probably talking level. I'm still going to try injections and probably see Piper Clinic and/or Mayo Rochester.

 

[just1morething]

10 Symptoms of TMJ


Symptom #5: Tinnitus
Our ears are finely tuned instruments that help us understand what is going on around us. They may not be as sensitive as the ears of many other animals, but they can pick up slight sounds in a range of frequencies. Such sensitive equipment can go wrong, though, and when it does it can be quite uncomfortable.

Tinnitus is a condition that manifests itself as a ringing in the ears, and it is occasionally experienced as a symptom in people with TMJ disorder. In addition to a ringing sound, it can also be experienced as roaring, clicking. or hissing sounds. Depending on the duration and severity, tinnitus can range from being mildly uncomfortable to outright unbearable.

 

[Plat87]

Yes I am in treatment for my TMJ. I have been on dual splint therapy for 17 weeks.

How's the therapy going? Notice any changes?

 

[just1morething]

@Greg Sacramento

Where in the US would they treat this?

The auriculotemporal nerve can be blocked by injecting local anesthetic solution above the posterior portion of the zygoma, anterior to the ear and behind the superficial temporal artery. The needle (27 gauge) is inserted anterior and superior to the tragus.​

I see pain management Dr. can do this injection.

 

[linearb]

@Greg Sacramento I know from confirmed imaging that my C1 is rotated somewhat, and also that this can be connected to tinnitus. No one really seems to have any idea what to do, though: no surgical options I'm aware of, and it seems like the soft tissue etc is all pretty "used" to the bone being in this spot.

Any advice?

 

[just1morething]

Found this:

Hello Mishal. I hope you are going ok. I have been thinking of you. You might also look into nerve blocks. These are administered by pain specialists. Reasoning is that the movement of the tensor tympani and stapedius is innervated (caused) by the 7th cranial nerve. Therefore deaden that section of the 7th cranial nerve temporarily to see if it is the culprit. If so, then there are more long term treatments such as radio frequency burning / steroids / boxtox. Try look up nerve blocks under pain management specialists in your area. This is less invasive than cutting the nerve. Best wishes.

 

[Greg Sacramento]

@linearb Do you have noted asymmetry with temporomandibular joint (TMJ) movements?

Here are other possible neck tinnitus concerns:

How cervical spine instability disrupts blood flow into the brain and causes many neurological problems (caringmedical.com)

Cervical Orthopaedic Tests | Musculoskeletal Key

Dental work can cause a C1 rotation tinnitus if neck was arched.
Some researchers believe that muscle spasm in head or neck is the most common cause of somatic tinnitus, accounting for as many as 80% of patients. The sternocleidomastoid muscle appears to be the culprit in most cases.

----------------------------------

Where in the US would they treat this?

The auriculotemporal nerve can be blocked by injecting local anesthetic solution above the posterior portion of the zygoma, anterior to the ear and behind the superficial temporal artery. The needle (27 gauge) is inserted anterior and superior to the tragus.
I see pain management Dr. can do this injection.

Most all pain doctors are not qualified for this.

 

[just1morething]

Most all pain doctors are not qualified for this.

The auriculotemporal nerve block would be much simpler than injecting Botox into the ear muscles.

 

[Aquaticon]

@Greg Sacramento

I noticed you mentioning the digastric muscle numerous times, and I was wondering if you might be able to offer your opinion on my case since I believe it's the primary malefactor in my new tinnitus tone.

A couple months ago, I could feel my wisdom teeth pushing in again. Moderate pain for a couple days, but nothing really severe. They've never caused more problems than I felt the surgery might have, so I've never had them extracted (currently 25 in age). The pain was more prominent in the right side of my mouth, and not too long after this incident, I've developed a somatic tinnitus buzzing in my right ear (which was previously devoid of tinnitus). If I apply pressure just beneath my ear lobe or under the corner of my mandible, the buzzing dissipates almost entirely.

Do you believe this buzzing could be remedied with extracting the problematic wisdom teeth? Is it possible that impacted wisdom teeth might have some correlation with the ability to modulate tinnitus via digastric pressure, or is this just a convenient coincidence I'm latching onto? Given your circumstances, I imagine you're more informed on this subject than most of the dental 'specialists' I've spoken to, many of whom were surprised to hear that chronic tinnitus was even possible.

I have an appointment this week to get all 4 wisdom teeth removed, but I'm having second thoughts after recently being exposed to excessive noise and other potential abuse factors in the past month and a half. Also, correct me if I'm wrong about the digastric muscle being culpable for my symptoms -- I'm fairly sure it's the culprit because I can trace my finger down from just beneath my ear lobe to under my jaw, and it'll alleviate the buzzing at any point. Also, if I press on the impacted bottom right wisdom teeth, the tinnitus lessens as well, although this is harder to test. I've always considered my left ear's tinnitus to be derived from TMJ, but after being more proactive about posture and stretching, I'm beginning to think my issues are minor relative to full-blown TMJ.

My biggest concern is just making it worse, either via action or inaction. It's pretty tolerable right now if I'm careful about spiking it, but I consider the noise being omnipresent at all as a warning. I was going to get light local anesthesia, and already have the amoxicillin they prescribed, but intend to not take any painkillers unless absolutely necessary. My bottom two wisdom teeth are horizontally impacted plus ruptured, so it seems advisable to remove them, but do you think the potential complications might outweigh the benefits?

I know soliciting medical advice from online forums is usually met with disapproval, but every doctor I've talked to has screwed me with tinnitus, so I'd like to just decide for myself after tempering myself with the knowledge of other people who have had it longer/worse than I have.

Thanks for any input you might have, and sorry for all the exposition.

 

[Greg Sacramento]

@Aquaticon, tight digastric muscles can jam the mandible posteriorly in the TMJ, causing compression at the posterior side of that joint. From this, pressure is place on the two tiny nerves that serve both the eardrum and the jaw.

Unilateral tinnitus (jaw or myofascial) may be associated with trigger points in the deep layer of the masseter muscle, but also could be intracapsular - TMJ joints. So your wisdom tooth - possibly upper right side may be the problem inflaming digastric muscle, mandible and masseter.

Your two bottom wisdom teeth that are horizontally impacted plus ruptured should be removed sooner than later. After this is done, get back to me to let me know if tinnitus improvement has been made.

Yes, you probably don't have full-blown TMJ, but if tinnitus doesn't resolve, then we should talk more. Two weeks after wisdom tooth removal, try light touch to the digastric muscles with back of both hands. Start under chin and move back gently to under ears. Then place warm water from a cup to one side of mouth, hold for five seconds and then gently release over sink. Then do the other side. Repeat 6 to 12 times before going to bed.

Don't lift head off the dental head rest and close your mouth a tiny bit when the dentist isn't having his hand or a tool in your mouth.

 

[KWC]

@Greg Sacramento, how are you doing? I hope somehow you can get some relief for the help you give others (karma).

I somewhat have not pursued to much right now due to COVID-19. I have not been to the TMJ doctor since late November, still wearing splints.

I had an acoustic event in December with smoke detectors so not sure I impacted my tinnitus and hearing with that issue (I had to reset 3 smoke detectors so I was within a foot for several seconds).

My tinnitus is more of a static sound now that is very somatic.

I had another audiogram and it showed some loss, not major, between 6-8 kHz but I was not in a good state that day so not sure of accuracy.

I've been working with an audiologist with different frequency hearing aids/maskers to try to help with habituation... work in progress, have not gotten far. Also I have been coming off of Lunesta (Z drug) and Klonopin so my CNS is amped up and I am sure that does not help my tinnitus.

As I noted in the earlier post, the last time I saw my TMJ doctor he took imaging and said my C1 looked off. Still thinking about a certified upper cervical chiropractor and know there are differing opinions on that. Just not sure.

I have been lax on doing posture exercises and doing the digastric exercises. The splints helped my TMJ pain (I have some soreness sometimes) but tinnitus has never changed.

Anyway best wishes and thoughts to you.

KWC

 

[Greg Sacramento]

@KWC, thank you Ken for your kindness and I return best wishes and thoughts to you.

Glad to know that your jaw pain has improved. With that, may I say to avoid a certified upper cervical chiropractor.

I certainly wouldn't have a drop table neck type adjustment with your jaw.
Maybe see a cervical physical therapist after your med tapering to have light gentle treatment to C1.

Hoping that you will see some tinnitus improvement within a year. Please stay in touch my dear friend.

 

[KWC]

@KWC, thank you Ken for your kindness and I return best wishes and thoughts to you.

Glad to know that your jaw pain has improved. With that, may I say to avoid a certified upper cervical chiropractor.

I certainly wouldn't have a drop table neck type adjustment with your jaw.
Maybe see a cervical physical therapist after your med tapering to have light gentle treatment to C1.

Hoping that you will see some tinnitus improvement within a year. Please stay in touch my dear friend.

Thank you. Hope you are doing ok.

Thanks for your feedback. The Chiropractor I was looking at does Orthospinology which is like Atlas Orthogonal with a gentle manipulation with the machine. From what I can tell the adjustment is a gentle adjustment.

 

[just1morething]

I certainly wouldn't have a drop table neck type adjustment with your jaw.

That's what the last chiropractor done to my neck. I agree with you it's too rough and it made me worse.

 

[KWC]

That's what the last chiropractor done to my neck. I agree with you it's too rough and it made me worse.

I'm so far two adjustments in with the chiropractor. Like noted, what he does is similar to Atlas Orthogonal. I have a little bit of soreness in neck. He also did cold laser therapy yesterday to my TMJ area and right below my ear behind the pivot jaw joint that is sore for me.

My tinnitus sounds different today... so not sure if that is good or bad.

 

[Aquaticon]

@Aquaticon, tight digastric muscles can jam the mandible posteriorly in the TMJ, causing compression at the posterior side of that joint. From this, pressure is place on the two tiny nerves that serve both the eardrum and the jaw.

Unilateral tinnitus (jaw or myofascial) may be associated with trigger points in the deep layer of the masseter muscle, but also could be intracapsular - TMJ joints. So your wisdom tooth - possibly upper right side may be the problem inflaming digastric muscle, mandible and masseter.

Your two bottom wisdom teeth that are horizontally impacted plus ruptured should be removed sooner than later. After this is done, get back to me to let me know if tinnitus improvement has been made.

Yes, you probably don't have full-blown TMJ, but if tinnitus doesn't resolve, then we should talk more. Two weeks after wisdom tooth removal, try light touch to the digastric muscles with back of both hands. Start under chin and move back gently to under ears. Then place warm water from a cup to one side of mouth, hold for five seconds and then gently release over sink. Then do the other side. Repeat 6 to 12 times before going to bed.

Don't lift head off the dental head rest and close your mouth a tiny bit when the dentist isn't having his hand or a tool in your mouth.

It's been nearly a week since I had the teeth pulled and I believe I'm roughly the same as before. Maybe a modest increase from the jaw inflammation, but ultimately I don't think wisdom teeth were related to my tinnitus directly. The only thing I've noticed is that my right jaw no longer 'clicks' as if it's slightly dislocating when I stretch my mouth wide, but I'm not too sure what to make of that in regards to tinnitus.

I was going to wait a little longer to see if it died down with the swelling, but I think it's been long enough that it's obvious to me that it won't.

So I'm back to square one again, but one step closer to the actual problem I guess. The buzzing in my right ear remains, but it's mild and fluctuates. My left ear is the one that has the constant high-pitched screeching I've come to associate with my somatic tinnitus, so it's mostly unilateral.

I'm quite certain the issue is with my jaw since even small pressure like chin tucks or stretching my tongue left or right modulates the volume dramatically. It's just strange to believe that I have TMJ when I've never once felt any pain or suffered headaches as a result of it.

Are there any exercises I could do without risking further trauma, or is my only recourse finding a TMJ specialist? I've mentioned this to my dentist before but they didn't seem to be too knowledgeable about the subject. I'll wait a little while before trying anything too intensive to respect the wisdom teeth healing, but I really don't feel comfortable unless I'm at least trying something to remedy it since the volume is usually a 5 or 6 and generally at an unmaskable. Thus far, the only significant form of relief I've found is warm showers, presumably because it relaxes the muscles.

Thanks for any help again.

 

[Greg Sacramento]

@Aquaticon, let's compare the right side of your mouth and body to left side.

Are your gums more red on left side to that of right side?
Do you have any gum recession on left side - lower or upper?
Look into a walk mirror to see if your left shoulder is lower than right shoulder?

 

[Josh59]

When I have dreams during REM sleep, I tend to clench my teeth which accentuates my high frequency tinnitus.

Beyond TMJ, what advice could you give me to reduce the intensity of tinnitus coming from the digastric muscles, sternocleidomastoid muscles, and the neck?

For the vagus nerve and breathing, the amazing thing is that after 5 minutes of deep breathing, my tinnitus also increases.

Any link with the digastric muscles?

This somatic (somatosensory) tinnitus is still very annoying; it continues to modulate, but not decrease in intensity.

Maybe there is a link with these tensions, or with my hyperacusis and the environmental sound?