The Valsalva Maneuver Substantially Lowers My Tinnitus

[Poseidon65]

The title of this thread says it all. I'm not sure why, but it's definitely the case that the Valsalva maneuver, performed gently, brings me substantial relief from my tinnitus. Basically, after performing the maneuver, the intensity of my tinnitus is much lower (as much as 80% lower), and this persists for a good while.

I think this is interesting because I've seen others say that Valsalva has no impact on their tinnitus. In addition, some folks advise against Valsalva due to potential ear damage (it can rupture an eardrum if done too forcefully).

A few other things I'll mention:

- I have a history of ear infections. Growing up, I had tubes put in my ears because of this. Even as an adult, I'll get an ear infection every few years or so, which I think is much more often than for the general population.
- Like the poster in this thread, I also notice that the Valsalva maneuver improves my hearing at high frequencies. Arguably this means that the Valsalva makes it easier to mask my tinnitus (because high frequency noise has an easier time being heard over the tinnitus). However, I'm quite sure that the improvement I notice isn't just from masking. I know this because the improvement is apparent even in a completely silent room.


Does anyone have thoughts on why Valsalva might provide me such substantial relief, given that it doesn't seem to work for many other folks? Could my history of ear infections indicate that my middle ear pressure is "generally not right," and that's perhaps why it helps me specifically? Any general thoughts?

I'll add that if you plan to try the Valsalva maneuver, PLEASE do so very carefully. I don't want this thread to be responsible for any folks' damaging their ears further.

 

[Samantha R]

@Poseidon65 if your ears are clogged, the pressure in your middle ear changes and it's likely your tinnitus is amplified.
You could have a tympanogram at an audiologist to test the pressure in your middle ear.
Valsalva would provide relief for me when I've had blocked ears.

 

[Poseidon65]

@Samantha R thanks for this. I have had a tympanogram and the audiologist did not point out anything as being abnormal. I will have another hearing test in a few weeks (and likely another tympanogram), and so I'll ask about my ear pressure then.

 

[Lane]

Does anyone have thoughts on why Valsalva might provide me such substantial relief, given that it doesn't seem to work for many other folks?

@Poseidon65 -- There seems to be a different combination of causes and contributing factors in most people's tinnitus, so a therapy that works for one kind of tinnitus will not necessarily work for another. Interesting story: My brother told me a good friend of his talked with his doctor about his tinnitus. The doctor suggested he do the Valsalva technique up to 40 times a day, throughout the day. -- It helped improve his tinnitus.

 

[wocaonima]

Same for me and for other people on this forum, such as @Marton and @JayM. I suspect this is an indication for ETD related tinnitus.

I just started a poll for this, please see:

Poll: Does Valsalva Maneuver Make Your Tinnitus Disappear Temporarily?

 

[Poseidon65]

@wocaonima I'll note that my tinnitus is actually noise-induced, though that doesn't rule out other ear issues (as I mentioned, I get ear infections much more often than most people).

I'll also mention that if I do the Valsalva too often, my hearing becomes very sensitive, enough so that I fear another acoustic trauma. For example, if I've Valsalva'd too many times, a sound that's only moderately loud to others can sound very loud to me, potentially damaging my ears. As a result, I will use Valsalva very sparingly (only if I'm having a really tough time, or if I feel negative pressure in my ear).

 

[wocaonima]

@Poseidon65 Also, I noticed that several people on this forum can make their tinnitus disappear temporarily when having their tinnitus ear/s full of liquid/oil so that their ear drums are submerged (again, myself included). Does this also work for you? Has this got something to do with pressure changes in ears also, I wonder.

 

[Poseidon65]

@wocaonima I think my T is mild enough that if I submerge my head in water (say in a bathtub), the T would simply be masked by other noise. As a result, I wouldn't be able to say if the T actually went away. I realize I'm lucky in this regard.

 

[Bill Bauer]

Don't do it too hard - it can make tinnitus worse.

 

[Lurius]

This is an interesting post to me, because doing the valsalva maneuver is what caused my tinnitus in the first place.

 

[wocaonima]

@Lurius I am sorry but I can't help think about it..what would performing Valsalva manoeuvre (a gentle one) do to your T now, I wonder?

 

[Lurius]

@Lurius I am sorry but I can't help think about it..what would performing Valsalva manoeuvre (a gentle one) do to your T now, I wonder?

I don't know and I'm also not brave enough to find out. Sorry, but it's just too risky. I only have T in my left ear. I don't want to risk getting it in the right ear as well.

 

[Kriszti]

I don't know and I'm also not brave enough to find out. Sorry, but it's just too risky. I only have T in my left ear. I don't want to risk getting it in the right ear as well.

Did you get it from only performing the Valsalva once? Do you know how did it hurt your ear?

 

[Lurius]

Did you get it from only performing the Valsalva once? Do you know how did it hurt your ear?

I had been sick for a week. Just a common cold, even though it was nasty, it passed. On the "last" day of the sickness I felt well again, but my ears felt very clogged. This was bothering me quite a lot so I decided to do the valsalva maneuver. I pinched my nose and blew really hard - way too much. IMMEDIATLY after I could hear the tinnitus. The day after I started suffering from vertigo. I was stuck in bed for many days, and I needed support from my mom to eat and to walk around. I was extremely dizzy all the time. Fortunately, the vertigo passe in about 6-7 days. The tinnitus did not. Here I am, almost 2 years later and I still have that bloody noise in my ear. Only in the left ear though.

I'm hoping that it's just a matter of time and that my ruptured eardrum will finally heal 100% sometime in the next 1-3 years. I know for a fact that I did not get this from noise trauma, so I'm not worried about "the little hairs" being knocked down. I did this to myself.

 

[Kriszti]

I tried the Valsalva gently. It made both of my ears really clogged for some minutes. I freaked out, but I think, now it's normalized. Weird thing is that it made my tinnitus lower in volume, but shriller in nature.

 

[Lane]

I'm hoping that it's just a matter of time and that my ruptured eardrum will finally heal 100% sometime in the next 1-3 years.

Hi @Lurius -- I'm sorry to hear how that Valsalva technique caused your tinnitus. One thought I had was whether it could have pushed some of the infection from your cold into your ear drum and/or inner ear. If you think that's a possibility, you may want to check out THIS POST. The following is the finish of that fairly long post.

As soon as I realized that my Tinnitus could have an inflammatory aspect, I looked for medicines with an anti-inflammatory effect (on my Tinnitus) and tried a few different things including Mullein Garlic Oil.
As soon as I tried this ear oil I noticed a huge change in my Tinnitus - literally the volume was cut in half. This simple ear oil brought my Tinnitus completely under control. I only need to use it now and then and it will stay subdued and under control for weeks.

I know that this is a bit of a long story but I wanted to make a bigger point (like other threads that I read) that some of this is psychosomatic and that part of it is paying enough attention to what your body is trying to tell you. Do you get enough sleep? Do you try to avoid stress and be honest about it with yourself?

Discovering that my type of Tinnitus is treatable has improved my quality of life a lot. I hope this story helps others to find their best approach to deal with and treat Tinnitus successfully.

Yours truly, Roger

https://www.amazon.com/Herb-Pharm-Mullein-Garlic-Herbal/dp/B001E8DBU8/​

 

[Mister Muso]

Ah yes, I remember when I just had tinnitus in one ear. Happy days.

 

[Tanni]

@Poseidon65 Interesting story: My brother told me a good friend of his talked with his doctor about his tinnitus. The doctor suggested he do the Valsalva technique up to 40 times a day, throughout the day. -- It helped improve his tinnitus.

Funny, my last doctor told me to do the exact same thing -- he said he could see bubbles of air behind my eardrum. But I was too afraid to try it in case it made my Tinnitus worse.

 

[Poseidon65]

I tried the Valsalva gently. It made both of my ears really clogged for some minutes. I freaked out, but I think, now it's normalized. Weird thing is that it made my tinnitus lower in volume, but shriller in nature.

@Kriszti is the shriller nature of your tinnitus now back to normal?

I'll mention that I've found the same on two different occasions (too much Valsalva has made my tinnitus more shrill). Today is one of those occasions. As a result I'll likely discontinue the Valsalva for tinnitus relief, unless I feel an actual pressure problem in my ear.

 

[Kriszti]

@Kriszti is the shriller nature of your tinnitus now back to normal?

I'll mention that I've found the same on two different occasions (too much Valsalva has made my tinnitus more shrill). Today is one of those occasions. As a result I'll likely discontinue the Valsalva for tinnitus relief, unless I feel an actual pressure problem in my ear.

Yes, fortunatly. But my tinnitus is normally very prone to fluctuation of volume and shrillness.

And another side effect which I guess was due to the Valsalva was that for some day my nose felt weird. It was a bit runny, and I felt that phlegm were going down to my throat. I was not having a cold and it presented itself right after the Valsalva.

 

[Poseidon65]

@Kriszti Glad to hear it!

 

[sophia1688]

Hi @Poseidon65,

Does your tinnitus go away when you are upside down?

I can, also, make my tinnitus disappear by doing the valsalva maneuver.

 

[Poseidon65]

My tinnitus doesn't disappear when I'm upside down.

 

[Dirtworks]

Hello,

I have read on this forum that some people's tinnitus temporarily quietens during the Valsalva Maneuver. If that is where you close your mouth, pinch your nose and apply pressure then I am one of those people.

I'm wondering what conclusions can be drawn from this.

If tinnitus stops during the Valsalva Maneuver, does it suggest a sinus blockage somewhere, i.e. ETD?

 

[Drachen]

If tinnitus stops during the Valsalva Maneuver, does it suggest a sinus blockage somewhere, i.e. ETD?

This appears to be the most likely scenario. The point of the maneuver is to modulate the pressure in those areas, so if relief is found, it could be indicative of a problem like interior blockage.

Of course, there's no way to know for sure. I would perhaps take this up with your preferred medical professional and see what can be done about evaluating that area. I wonder if some nasal spray could be beneficial if to you, particularly if inflammation is a problem.

 

[Poseidon65]

I think I've determined more definitively that the Valsalva isn't good news for my tinnitus.

Specifically, the Valsalva definitely reduces the volume of my lowest frequency (and loudest) tinnitus tone. The reduced volume last for a couple of hours. As a result, it's tempting to perform a Valsalva when my lowest frequency tone is really bothering me.

However, the Valsalva also increases the volume of my highest frequency tinnitus tone. This increase lasts for at least a full day, and possibly longer.

For me the increase in high-frequency tinnitus isn't worth the reduction in low-frequency tinnitus. This is because the high-frequency tone is much harder for me to deal with than the low-frequency tone. The high-frequency tone is also more resistant to masking than the low-frequency. And the low-frequency relief last for much shorter than the high-frequency worsening. So overall it's not a good tradeoff.

Now I only wish I could "forget how to do the Valsalva."

 

[Dirtworks]

@Poseidon65, very interesting, but to me we should be able to draw some conclusions from your observations on the Valsalva.

Can we not conclude that your problem lies within your MIDDLE ear? The part of your ear that is affected by the Valsalva.

I would just like to mention that I had almost unnoticeable tinnitus today. I had to plug my ears and listen very carefully to notice it. Hallelujah what a beautiful day. I am so very determined to figure this out.

ENT basically told me after 10 minute phone chat to just get used to it. LOL, "I advise you to stay off the tinnitus forums". Of course he did also prescribe some anxiety medication. Could that be it ? Hmm, I've been on it for a week now.

I'm also suspicious of the my wood stove and the dry air. Weather just got much warmer and I'm using it much less. Hoping to get to the bottom of this.

 

[Poseidon65]

@Poseidon65, very interesting, but to me we should be able to draw some conclusions from your observations on the Valsalva.

Can we not conclude that your problem lies within your MIDDLE ear? The part of your ear that is affected by the Valsalva.

Believe me, I would love to "figure it all out."

FWIW, @Kriszti also reported that the Valsalva made her tinnitus "lower in volume, but shriller in nature." The "shriller in nature" part sounds a lot like my "Valsalva makes the high frequency part of my tinnitus worse." So that's two people who report something a similar, specific finding.

 

[Tweedleman]

Of course he did also prescribe some anxiety medication.

What did he prescribe, a benzo? If you don't mind me asking that is.

Clonazepam usually blunts my tinnitus' shrillness. Sometimes I really give in and double or triple up my dosage and it puts me in a wonderful headspace where I just don't give a flying fuck about what my ears are doing. It's like drug induced habituation. I suspect the muscle relaxant and anxiolytic effects also are responsible for taming the TTTS muscles from going ape shit to the offending frequencies.

@Poseidon65, the valsalva maneuver affects my right ear differently, I can feel and hear my eardrum stretch out from the air pressure. Then there's a crunchy papery sound when I swallow and the eardrum reverts back to normal position as middle ear pressure equalizes. When my ears are "popped" it also changes the tone of my tinnitus and makes high frequency hearing much sharper and shrill.

 

[Dirtworks]

@Tweedleman, he prescribed Escitalopram 5-10 mg nightly.

Currently 5mg.

I should mention I had been taking it for a year or so previous to the tinnitus spike.
The spike occurred a week or so after I quit smoking, quit coffee (6-7 cups a day), quit Escitalopram, started Rosuvastatin (for cholesterol), and started eating better. All at the same time. Born with bad allergies and asthma, this COVID-19 thing was a wake up call.

I can't say the Valsalva has any noticeable long term effects for me but while I'm doing it my tinnitus gets silent or very close to it.

If my tinnitus was caused by a brain, nerve or inner ear problem, I can't see why the Valsalva would silence it. From what I understand Valsalva pressurizes the middle ear.

Maybe there is something I'm missing or failing to understand?

Yesterday, I went all day with tinnitus I had to carefully listen for to hear. What an amazing feeling. I would put an exclamation after feeling but I don't do that anymore .

This morning it is there but not bad.
2/10. Is it the weather? I went for a 1 km run the last 3 days. The exercise maybe?