Tinnitus for 2 Months. Not Sure if Muscle\TMJ\Other-Related.

[Ofir]

Hi all,
(I know this is long so I include a TL;DR version at the beginning)
After discovering this wonderful community and getting frustrated from doctors, I want to hear your experienced opinion.

About me: 23 year-old male, healty in almost all aspects, not drinking or smoking.

"TL;DR" version: I had a bad emotional period (seeing a psychologist now), which caused me several physical issues, directly and indirectly, including tense neck and headaches. Nothing of those bothered me till T.

The T in my left ear is the newest symptom. It started after a specific night, in which I had a very bad sleep (had a nightmare), from which I woke with several symptoms: locked jaw, strong pain in the head (mostly left side) and in the ears (mostly left), burning sensation in the throat. About 12 hours later, T has started in my left ear.

The T has become worse in the last month, and I've discovered I'm more sensitive to noise. When my ear hurts, it can even project to my neck and face muscles. The ear pain has a pulse. Last night I went to a concert and my ears really hurt now - hope it's temporary.

When my T started, the doctor told me just not to think of it, and I followed his advise, but now it's got worse and I worry it might get even worser.

What steps should I follow now? How do I treat those ear pains and make the tinnitus stop getting worse? The doctors don't see anything wrong. I speculate my problem is related to tense muscles in the neck and\or to (mild) TMJ, but have no idea what to do about it (or how to prove it). Any suggestions\tips?

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I'll give the longer version now. I'll appreciate if you'll read it, because it gives much more context.

1. I had an anxiety over some personal issue. I didn't have panic attacks, but I did think about this issue very often. This all started about 2 years ago.

This anxiety caused me some physical issues, which only very recently included the T (indirectly, it seems), and then I understood I have to solve this anxiety and I am seeing a psychologist for several weeks now - and I can say wholeheartedly that I am much less anxious now, I feel good emotionally.

2. The anxiety affected my health in several ways (and still affects, even though the anxiety is better now). I'll list 3 major ones, because they might be relevant to my T:

1. Mild headaches (pains in specific muscles in the scalp. sometimes some facial pain), tense neck muscles. The pain is usually in specific points, very often only in the left side of the head.
2. Jaw issues - Some mornings I woke with locked jaw, probably from being tense and anxious in my sleep.
3. Throat issues - Some mornings I woke with sore throat. My self-diagnosis is "silent" reflux (LPR), BUT I might be very wrong abou this, so be skeptive.

All those pains were very mild and didn't affect my functionality at all. Doctors didn't find anything wrong with my head\throat, and was diagnosed with very mild TMJ, which doesn't affect my jaw's functionality.

3. Because I thought the throat pain is related to stomach issues, I was tested for H. Pylori, found positive, and started antibiotic treatment for 10 days. During it, I felt much worse (physically and emotionally; it was before I went to a psychologist).

One specific terrible night, I woke up from a bad nightmare with a locked jaw, severe headache (left side mostly), ear pain (again, mostly left ear), and "burning" throat. Later on that day, I got a T in my left ear.

4. Doctors didn't see anything wrong with my ear. The antibiotics I took aren't the kind that causes T. My hearing test was good. So I was told: Don't think about it.

5. 2 months has passed. I did a BERA test + another hearing test and it turns out my left ear doesn't hear 10 dB now, while it used to a month ago and my right ear still does.
Last night I went to a rock concert. I didn't think about bringing ear plugs, and I suffered. I have ear pain, and my T is worse. I know it is probably a temporary thing, but the ear pain (which has a pulse) is extremely annoying. Not used to being sensitive to noise in that way. Didn't now it comes with the T.

6. I have several speculations about my T.
My first speculation was: I have LPR and somehow my acid reflux has went inside my ears. This doesn't sound very plausible, but it was my first hypothesis. I'll be tested for LPR in a few days.
My second speculation is that a combination of tense muscles (from anxiety) and the locked jaw at night caused the T. I have no idea how to "prove" it, and what to do about it...

So, what the hell is going on? What should I do?

 

[Mark Beehre]

Hi @Ofir,

I'm not a doctor, but I am aware of friends who grind their teeth or tense their muscles in response to stress and anxiety. It often happens during sleep, but can also happen during the day. It is not done intentionally but is a response of your subconscious to stress.

I am not a proponent of anti-anxiety medications, but I have been taking Escitalopram for about 5 weeks now and notice I am less bothered by tinnitus and not so stressed. Mind you, I didn't have the whole muscle tensing jaw thing going on that you might have.

Muscle strain or teeth grinding can definitely cause tinnitus. If this is the cause of your tinnitus then you need to address the cause of the straining or grinding, which would be your anxiety. Medication might help, but it takes around 4-8 weeks for anti-anxiety drugs to become effective, and possibly another couple of months (speculation) for the tinnitus to go away, assuming the cause is muscle strain or grinding.

That being said you may have already done damage to your Temporomandibular Joint (TMJ), to get this checked out you can go and see a maxillofacial consultant and let them to a cat scan of your head. Cat scans make no significant noise beyond that a hum of any computer system and the consultant should be able to look at the tissue around your joint or spot any issues with alignment.

You may wish to also get an MRI of your head done to rule out anything obstructing your auditory nerve like a tumor. You have more chance of being struck by lightening or hit by a car than having a tumor but it's worth checking out. That being said, MRI's are very loud so make sure you use hearing protection.

While your ear has increased sensitivity I suggest you avoid noisy environments like concerts. I know you want to live your life, but taking it easy now may be the best decision for the rest of your life, especially once you recover.

Remember, not all tinnitus is permanent!

 

[Ofir]

Hi @Mark Beehre ,

Thanks for your reply!

You're right in suggesting treating the anxiety first of all, as it causes the tension. I'm seeing a therapist and she's saying that I really don't need medications at the moment, and I trust her opinion. SSRI's seem like a convenient "way out", but maybe when the psychological change comes from within it is better. I have good days, I just need to distract myself.

I'm not sure I can get an appointment for a CAT scan (at least not one covered by insurance), because a jaw doctor + physiotherapist said my condition isn't bad at all (and as I said, I don't know if the jaw caused the T or the neck muscles or whatever... because all those stuff occurred together). I was given exercises to ease the pain in jaw and neck, they help.

I did an MRI a few months ago because of headaches - nothing wrong found there. It was before T, but I don't expect it to change.

I really hope it's all temporary (but don't delude myself).
So far I have 2 directions - in the emotional path I will keep seeing the therapist, continue doing enjoyable activities and just relax. In the physical path I will keep doing physical activity and physiotherapy exercises. Might get a mouthguard.
I just have to be persistent.

Thanks for the support.