Tinnitus from Chiropractic Neck Adjustment 3 Weeks Ago

[Wheella]

Dear friends,

This is my first post after loads of research on the forum. I'm still trying to gather my thoughts and formulate a game plan, but the past 3 weeks have been rough, given that I just came out of a panic attack. I do not have a scientific background, and hence am doing my best to try and understand what is happening to me. My story is as follows.

- Due to a traumatic event leading to a panic attack sometime in December of last year, I read that a Chiropractic adjustment might just get me out of "fight, flight, freeze" mode. This turned out to be a very bad decision, as immediately after a single high velocity neck adjustment, whilst driving home, I started to notice a high pitched hissing sound when I turn to the extreme right and left. This led to be being hyper focused on the hissing, and in no time, my regular "tonal" tinnitus which I had no problem cancelling out 100% came back.

- The "hissing" is only provoked when I turn my neck to the extreme left (lesser when I turn to the right), and rotate / incline my head forward in certain directions. All evidence points to some sort of "disturbance" to the left side of my neck (muscle, vessel, nerve, who knows ...). I think that because the "hissing" is so intermittent, my brain cannot cancel this out and hence, my regular "tonal" tinnitus is coming back out with a vengeance. The "hissing" turns pulsatile sometimes.

- I have seen 2 ENT doctors, who seem to rule out ear and sinus problems. An audio test shows slight hearing loss to my left year at the higher frequencies, which might explain my regular "tonal" tinnitus which I have always managed to cancel out without difficulty, but the ENT tells me that my hearing range is normal. I think the audio test might be flawed, as I will obviously not be able to hear the higher ranges in my left ear due to the high pitch of my regular "tonal" tinnitus. I do not seem to have other ear / nose problems (e.g. Eustachian Tube Dysfunction), but since the onset of Tinnitus, I sometimes experienced ear pressure / pain (which may be psychological in my view).

- I saw an orthopedic surgeon, who ordered an MRI and tells that that I have a "very slight" bulge at my C4/5 and C5/6 cervical vertebrae, and that there shouldn't be any pinched nerved given that my cervica vertebrae are not really herniated. I do however have slight loss of "lordosis" in my neck.

- In reviewing the comments by the many experts on the forum, I have gathered that there could be many possible reasons for my somatic cervicogenic Tinnitus:

(i) Muscle Spasm (however I don't seem to have any real neck pain - any muscle soreness was likely due to the fact that I was moving and experimenting with my neck so much)
(ii) Irritated / pinched nerve
(iii) Conflict of vessels and the auditory nerve (?)
(iv) Disinhibition / cross-talking at the level of the Dorsal Cochlear Nucleus (?)
(v) Aneurysm / fistula / ruptured aorta or vein, which might the sometimes pulsatile nature of my tinnitus (?)

(iii), (iv) and (v) sounds scary and I am hoping that it wouldn't come to that. A neurologist tells me that (iii) is unlikely given the distance between the vessels and the auditory nerve.

I have been advised by @tiniturtle to do an MRA to rule out (v) and will be proceeding to get this done soon.

I have to date tried acupuncture, physio, dry needling, but I think these are early days yet. I had a bit plate made and will be collecting it on Friday, to address any TMJ problems I may have...

However I seem to have gone through the exact same symptoms during my high school years and lived through this an even recovered. These sensations do not seem new to me. This is the only thing that is giving me hope. My mother tells me that she too suffered from neck movement induced tinnitus, but she this only lasted a few days for her. If indeed I had survived the same when I was younger (I vaguely recall but cannot be sure), this might be because I was oblivious to the severity of tinnitus when I was younger, and somehow managed to overcome / recover naturally because I was able to shrug it of? Could also be because I was younger and my body stronger. I am very much more anxious this time round, and find myself in a very dark place as I type this -- this could be related to my state of mind and recent panic attack / anxiety. I was on my way to recovery and sleeping better, before the chiropractic adjustment threw me now into despair. I have been unable to sleep over the past 3 weeks, which isn't helping.

I have gathered quite alot of information, but the real question for me is, what next? There are so many possible outcomes, and I cling onto every success story I could find which appears similar to mine. I know I have to be patient, and not let this finish me of. I also need to find the motivation to keep my job, and stay strong for my wife and daughter, but I have been completely defeated over the past 3 weeks. Although I am certain my tinnitus isn't particular bad (it only bothers me in a quiet room, before I sleep and when I wake up), I somehow have sunk into despair perhaps because of my recent panic attack / anxiety -- I have somehow convinced myself that my life is over, which is silly ...

I hope to find support from the many kind souls on this forum, and to learn from you all. I am keeping my fingers crossed that this nightmare will soon be over for me.

 

[Wheella]

So it would seems that my kind of somatic tinnitus isn't very common? Any thoughts and advice will be much appreciated...

 

[Wheella]

Dear @Michael Leigh, I have been researching on this forum and have particularly benefited from your advise and kind natured positivity to certain other members of the forum, in particular the fact that too much aggravation might lead to more damage to my neck and make my tinnitus permanent. I am currently seeking help from so many health professionals and doctors, and am very confused and suffering from info overload. I am sure that I can benefit greatly from you wisdom -- and let my neck calm down. Thank you!

 

[Wheella]

May I seek the advise of the veterans on the forum? I have not been sleeping over the past 3 weeks since I developed somatic tinnitus as a result of a chiropractic neck adjustment.

1. Should I play masking music for 30 minutes only to fall asleep, or play the music until in wake up? I put on earphones but these drop out during the night and I find myself waking up very early, feeling stressed, and unable to fall back to sleep. Some advise on then best approach will be much appreciated.

2. I will be commencing physiotherapy to try and stretch some muscles in my neck. Any idea if the physiotherapist should be stretching to provoke the tinnitus? If the stretching produces the tinnitus, is this a good thing and will this irritate : damage my nerves eventually leading to permanent tinnitus?

 

[oceanofsound26]

Hi @Wheella -

Welcome to the forum and sorry to hear about your recent tinnitus from a chiropractic adjustment. There are several threads on the forum about the efficacy and effectiveness of chiropractic treatments. I, myself, have found relief with a technique known as Atlas Orthogonal that was paired with physical therapy, TMJ treatments, light cardio, and several lifestyle changes. My life is in flux right with moving and starting a new job so I am not very active on the forum right now. I would be interested to know what type of adjustment gave your tinnitus. @Michael Leigh indeed has some good info on the forum about various things. I would also encourage you to seek out threads authored by or added to by @Greg Sacramento, @linearb, and @Lane as well as @Kaelon (who is not so active anymore). You may find some helpful info there. There are several threads of sleeping strategies as well. A simple search should yield some of those for you. I authored some very long posts about things including how I handle sleep that may be of use to you. Directing you to those threads would be easier than recounting all the info here. See below.

https://www.tinnitustalk.com/thread...s-—-achieving-better-sleep.39047/#post-502890

https://www.tinnitustalk.com/threads/how-do-you-know-if-tinnitus-is-from-tmj.36685/#post-501454

https://www.tinnitustalk.com/thread...ractic-adjustments-for-tmj.36535/#post-472997

https://www.tinnitustalk.com/threads/hi-guys-new-here-tinnitus-in-left-ear.36914/#post-472476

I suspect I have some type of craniocervical tinnitus due to musculoskeletal misalignment and neuromuscular imbalances. Whatever you decide to do, take it slow and do not overdo it.

Some other comments based on your intro -

This turned out to be a very bad decision, as immediately after a single high velocity neck adjustment, whilst driving home, I started to notice a high pitched hissing sound when I turn to the extreme right and left.

Generally speaking you should avoid this for at least 2-3 hours after a chiropractic adjustment. In this case, rotate at the hips to turn your entire upper body rather than turning the neck.

I started to notice a high pitched hissing sound when I turn to the extreme right and left. This led to be being hyper focused on the hissing, and in no time, my regular "tonal" tinnitus which I had no problem cancelling out 100% came back.

If you had tinnitus before this you were able to habituate to, this might just be a spike.

The "hissing" turns pulsatile sometimes.

Hallmark of a possible blood circulation problem. My tinnitus has never turned pulsatile as of yet.

I do not seem to have other ear / nose problems (e.g. Eustachian Tube Dysfunction), but since the onset of Tinnitus, I sometimes experienced ear pressure / pain (which may be psychological in my view).

I do not either, but I still take steps to open and clear my Eustachian Tubes several times a day to minimize occurrence of ETD. May be a good idea for you as well.

- I saw an orthopedic surgeon, who ordered an MRI and tells that that I have a "very slight" bulge at my C4/5 and C5/6 cervical vertebrae, and that there shouldn't be any pinched nerved given that my cervica vertebrae are not really herniated. I do however have slight loss of "lordosis" in my neck.

Sounds like you may have forward head posture. I do as well. There are plenty of stretches that can help this. Some neck traction exercises with a resistance band and/or restoring natural curvature of your neck using a Denneroll may also be of further benefit. Consult with someone like your orthopedic surgeon or a chiropractor to learn proper techniques for these. Youtube has some videos on this as well.

(i) Muscle Spasm (however I don't seem to have any real neck pain - any muscle soreness was likely due to the fact that I was moving and experimenting with my neck so much)
(ii) Irritated / pinched nerve
(iii) Conflict of vessels and the auditory nerve (?)
(iv) Disinhibition / cross-talking at the level of the Dorsal Cochlear Nucleus (?)
(v) Aneurysm / fistula / ruptured aorta or vein, which might the sometimes pulsatile nature of my tinnitus (?)

Do not discount some degree of musculoskeletal misalignment or neuromuscular imbalance. Also get an MRI/MRV/MRA of the head as well to make sure you do not suffer from a transiently compressed blood vessel, artery, or vein around your neck, brainstem, or around your ears (or anywhere in brain for that matter). Also these can help you check whether your cranial nerves are compressed or not possibly due to the neck adjustment. Several cranial nerves can play a part in the development of tinnitus. If blood is too thick or viscous, circulation problems can also rise. Some blood work like a Complete Blood Count and Glucose/A1C test may be of further consideration if pulsatile tinnitus becomes more frequent. Tinnitus is not a conditions that proceeds linearly or is usually restricted to a single cause.

I have to date tried acupuncture, physio, dry needling, but I think these are early days yet. I had a bit plate made and will be collecting it on Friday, to address any TMJ problems I may have...

Acupuncture has helped me, but target and refine your treatments as you move forward to concentrate on areas that bring you some relief. Right QL and SCM muscles give me the most relief.

I have been unable to sleep over the past 3 weeks, which isn't helping.

Prioritize sleep for the next 2-3 months if you can. Develop good sleep hygiene and practice it daily. Hopefully things will improve for you. They have for me after doing this.

I somehow have sunk into despair perhaps because of my recent panic attack / anxiety -- I have somehow convinced myself that my life is over, which is silly ...

Your life is not over. Stress and anxiety are only going to make your tinnitus worse. Take steps to de-stress like deep breathing or meditation. I use this to chill out before going to sleep most nights - BrainTap (https://braintap.com/) with Sleep RX bundle. My chiropractor was test driving it in his office while I saw him. Used it once in mid-morning and fell asleep in <10 minutes while practicing static back. I bought it afterwards (its expensive though, >$500 USD).

I hope to find support from the many kind souls on this forum, and to learn from you all. I am keeping my fingers crossed that this nightmare will soon be over for me.

There are many here. I hope you are able to find some relief as well, but it will take time. Many of us do several things a day to help deal with it and minimize pitch and volume. I have found some relief with my approaches. It will be up to you and your docs to manage it and find what works for you.

All the best,

-Oceanofsound26

 

[Wheella]

Hi @oceanofsound26

Your responses are very helpful to me, especially during these troubling times. If I may say so, I think that my inability to get over my somatic tinnitus and relax lies in the fact that I have been unable to forgive myself (and the chiropractor) for the neck adjustment. But then again, I was seeking treatment to help myself overcome my anxiety and never expected this to happen.

As of yesterday, I have been doing the weird neck motions and rotations, and contracting the muscles in my neck (when I tense up the left side of the muscle behind the ear at the base of my skull, apply force on my right molar, etc.) that produce the high shrill, and pressing down on the various possible muscle groups (masseter, SCM, back of neck) to see if this helps to reduce the shrill . I find that it does to a certain extent, especially when I press on a group of muscles directly below the ear. Then again, this could this simply be the result of restricting the blood flow? When I relax my muscles and stay in a neutral position (without tucking my chin in), my tinnitus goes back into a hissing tone. As I type this, I seem to be experiencing a spike in my regular tinnitus with all this "experimentation" I've been doing. @Michael Leigh if of the view that such "experimentation" might do harm and lead to permanent tinnitus -- taking his advise I've been trying to not manipulate my neck so much, but sometimes cannot help myself

I am curious what the physiotherapists will be doing. I saw 2 different physios this week and the last week, one does deep tissue massage and another dry needling. They don't seem to have particular experience in helping tinnitus victims though. I will be seeing 3 other physiotherapists today and tomorrow - thereafter I'll see if I can identify one that can help me better than then rest. It is difficult to find someone with the necessary skills in my part of the world (Singapore). I'm still wondering if it is a good idea to do the exercises and stretches that produce the shrill. If the objective is to be relaxing the muscles, then logically I should be stretching the muscles that produce the shrill. But if this equally compresses upon the nerves, then I can see how could do more damage than good.

If there was a NUCCA chiropractor in Singapore, I'd jump at the opportunity. However there isn't one, and my concern at this point is that any generalized chiropractic adjustments might do more harm than good. The neck adjustment I had might have been the straw which broke the camel's back ... I'm thinking that even if harm was done, this cannot be that serious? Optimistically, this provoked: (i) muscle spasms which changed the blood flow; (ii) slight muscle tears; or (iii) irritated certain nerves (though I do not have neck pain). WHAT COULD HAVE HAPPENED IN MY NECK THAT IS SO BAD THAT COULD BE GIVING RISE TO ALL MY SYMPTOMS? I'm a hoping that an MRA (of the neck and brain?) as advised by @tiniturtle will shed more light than the MRI carried out that only showed a very slight left bulge of of my C3/4 and C4/5 -- ortho says that it is unlikely that any nerves are pinching.

In the worst case scenario that there are some "sensory pathways" opened at the level of the DCN leading to muscle signals and auditory signals cross talking (which I think I've always had because the Pulsatile Tinnitus is not new to me and I've definitely had the same experience before but didn't realize this), I just found out that a certain Dr. Susan Shore from the University of Michigan is inventing a devise that can "close" this "sensory pathway".

A good thing about living in Asia is the fact that I think I can find very good acupuncture and TCM experts. I will tell them to apply the needles so as to calm my nerves down. I am thinking that what I am experiencing might also be due to overacting and overstimulated nerves and tense muscles (given my recent anxiety disorder developed since December last year).

I will be seeing an ENT tomorrow (although I've already seen 2) just to check that I don't have an Eustachian Tube Dysfunction -- my left ear feels full sometimes but I can always pop it. Wondering also if this could be due to muscles pulling at my year. In any event, I'll ask for Nasal Spray.

Collecting my bite plate on Friday to deal with any TMJ issues (I've been told that I grind my teeth).

As you can tell, I'm going a bit mad here... consulting with one doctor after another and unwilling to accept my fate haha. I suspect that I'll be running out of options by next week...

 

[Michael Leigh]

Dear @Michael Leigh, I have been researching on this forum and have particularly benefited from your advise and kind natured positivity to certain other members of the forum, in particular the fact that too much aggravation might lead to more damage to my neck and make my tinnitus permanent. I am currently seeking help from so many health professionals and doctors, and am very confused and suffering from info overload. I am sure that I can benefit greatly from you wisdom -- and let my neck calm down. Thank you!

HI @Wheella

Thank you for your kind comments.

I am sorry to know about the difficulties that you are going through with tinnitus and your neck and hope you are able to get some help soon. I mostly give advice about Noise induced tinnitus, which I have acquired over many years from personal experience, corresponding and counselling people with this particular form of tinnitus. I have written a lot of posts in this forum but if memory serves me correctly, I do not remember writing one about the effects of tinnitus caused by problems with the Neck. I might be mistaken but do not believe so.

Therefore, in this instance I am unable to give you any advice or help on the issues that you have raised, since I have no experience with them. I hope you are able to get some help soon so the quality of your life will be improved.

Wishing you all the best
Michael

 

[oceanofsound26]

Hi @Wheella -

I went thru all this myself during the fall of 2019. The best advice I can give you is to adopt a holistic and systematic approach to the diagnosis and treatment of your tinnitus moving forward. This approach has worked for me. Given what you have been trying with your jaw and neck, seek out stretches and releases for your SCM, traps, levator scapulae, pterygoids, and digastric muscles. Be sure to be gentle with the last two. Videos are sprinkled thruout past posts I pointed you to as some of those stretches and releases are included in them. If you get any relief from these stretches and releases for any neck muscles then instruct your acupuncturist to needle treat those muscles (SCM does it for me). Also, there definitely could be a problem with a cranial nerve that transits the cervical spine. Your MRA and additional imaging you undertake should help figure this out. I am also not a doctor but I have a science and fitness background so any advice I give will not replace that of your docs and medical team. However developing a study to examine acidification and inorganic carbon cycling in an estuary uses the same skills and approaches that go into developing a plan to treat tinnitus that leverages both conventional and alternative medical treatments. Good luck with everything and I will follow-up again when I have some more free time in the next couple weeks.

All the best,

-Oceanofsound26

 

[oceanofsound26]

Also treatment for muscle tears and strains versus treatment of muscles that are chronically contracted, weakened, inhibited, underused, overused, and/or that need to be activated are completely different from one another. I am the latter. If you suspect you have a torn or strained muscle in your neck, then DO NOT try any unnecessary stretches or releases because you could only be worsening your situation. Seek the advice of medical specialists who can diagnose and discuss treatment regiments with you for these issues.

 

[Wheella]

If you suspect you have a torn or strained muscle in your neck, then DO NOT try any unnecessary stretches or releases because you could only be worsening your situation.

Thank you @oceanofsound26 ans @Michael Leigh.

@oceanofsound26 May I know if in your view, given that I do not have any neck pain, that I could be be in the category of needing treatment for "chronically contracted, weakened, inhibited, underused, overused, and/or that need to be activated" rather than for "muscle tear and strain"? I just saw a physio, she didn't come across as very knowledgeable of my condition, ans was just making educated guesses, and told me that the muscles in the right side of my neck are tight (very strange because my ringing is to my left ear). However she did say something which made sense, which is that if the problem was due to a compression of the "fascia joint" where the nerves are exiting from the cervical spine, then any repeated movement will likely hinder my recovery because I am always aggravating the nerve. She thinks I should not be moving my neck so much ans looking for the tinnitus and let my neck rest... hopefully this way any irritated nerve will be able to repair itself and calm down eventually. I did tell her that my tinnitus is only provoked when I contract certain muscles, but not when someone turns my head without muscle contraction on my part, and she says that one theory is that the contraction of muscles can exert pressure on the "fascia" joints and hence the nerves. She didn't really give me any homework for when I am at home. I told her that I'll proceed to buy an inflatable collar (looking at Dr Disc C300 as it is on sale at a rehab shop in Singapore).

Another day of seeking for answers. Hoping that I can find a really good physio soon who better knowledge of the auditory nerves and neck muscles...

 

[Greg Sacramento]

@Wheella @oceanofsound26

I've have not posted in a while due to health, but saw something within this excellent discussion thread that may appear to show reason for Wheella issues.

- I saw an orthopedic surgeon, who ordered an MRI and tells that that I have a "very slight" bulge at my C4/5 and C5/6 cervical vertebrae, and that there shouldn't be any pinched nerved given that my cervica vertebrae are not really herniated. I do however have slight loss of "lordosis" in my neck.

- In reviewing the comments by the many experts on the forum, I have gathered that there could be many possible reasons for my somatic cervicogenic Tinnitus:

(i) Muscle Spasm (however I don't seem to have any real neck pain - any muscle soreness was likely due to the fact that I was moving and experimenting with my neck so much)
(ii) Irritated / pinched nerve
(iii) Conflict of vessels and the auditory nerve (?)
(iv) Disinhibition / cross-talking at the level of the Dorsal Cochlear Nucleus (?)
(v) Aneurysm / fistula / ruptured aorta or vein, which might the sometimes pulsatile nature of my tinnitus (?)

Lets try to find cause:
I doubt that you have an enlarged abdominal aortic/aneurysm as you don't appear to have hypertensive blood pressure. Being over 60 would be needed. I don't see mention of eye problems. However any of this could cause pulsatile tinnitus in an instant if one has a habit of twisting neck under emotional stress (quick, brief moments of rising blood pressure).

I don't think that carotid arteries have involvement or a pitched nerve at C4/5 or at C5/6.

Other involvement that sometimes could cause some pulsatile tinnitus without having any serious neck pain or none at all:
Somatic tinnitus - Silent neck muscles spasms appeared to have caused some loss of lordosis - C spine. Lifting head and turning (twisting) neck from a lean back sitting or laying position could be very possible or hitting head - minor whiplash or injury.

The vertebral artery runs thru the C spine and injury is often not noted on a MRI/MRA. When having regular tinnitus or maybe just unrealized weakness (noise exposures) within the Dorsal Cochlear Nucleus - the hearing nerve - VII cranial nerve and sometimes even the facial nerve and jaw will contribute with (cause) somatic tinnitus with a new added neck injury (lordosis) and then it will later cause some pulsatile tinnitus when under stress with twisting neck. Everything that you mention, appears pattern (events) to your tinnitus concerns. This can happen easily (vertebral artery trauma) and is often noted in case studies. I have posted about this with links where all your concerns are discussed. Place - vertebral artery - into site search and look for my postings. Correct posture and use of warmth should help.

 

[Jazzer]

I've have not posted in a while due to health, but saw something within this excellent discussion thread that may appear to show reason for Wheella issues.

Obviously I cannot comment on the info given above - I am not a medical boffin - however I am sure it's the genuine article.
I am just delighted that @Greg Sacramento
my old mate, is back in circulation again, dispensing his words of wisdom.
xx

 

[Wheella]

Hi @Greg Sacramento @tiniturtle @oceanofsound26 @Jazzer
@Michael Leigh @Kaelon

I consulted with a neurosurgeon today, who asked me whether my tinnitus was pulsatile, which made me realize that my bothersome tinnitus had always been the pulsatile kind. This was why my research always felt wrong and didn't add up (I don't have neck pain, tense muscles, nerve irritation, etc.).

The neurosurgeon tells me that with pulsatile tinnitus, there is a 50% chance that this would be due to a Dural AV Fistula. However, I had a MRI and MRA carried out in January (this was before my chiropractic neck adjustment 3 weeks ago which exacerbated my pulsatile tinnitus) which came back normal. The neurosurgeon says that very mild and small fistulas cannot be detected by an MRI or MRA, and one would need a good neuro radiologist to carry out a DSA (Digital Subtraction Angiogram). I will be seeing the neuro radiologist tomorrow on his referral to see what he thinks.

My symptoms are now beginning to add up which is bringing me some comfort, although there is a chance I could be wrong:

(1) I've sometimes experience very high pitched and loud pulsatile tinnitus especially after a stressful event. This never bothered me as the pulsatile tinnitus never lasted long, and I had habituated to it all these years without realizing that this was a problem. I might have always lived with a vascular anomaly perhaps? The chiropractic neck adjustment might have aggravated any vascular anomalies I have, such that certain muscle contractions would direct more blood into the relevant vascular anomaly?

(2) Even when I don't move my head but just tense up my neck muscles, I can hear the whooshing, so my problem is related in a way to muscular contraction.

(3) When I listen intently, the whooshing sound is clearly pulsatile.

(4) I think that the whooshing then provoked and brought out my regular tinnitus, which my brain never had a problem cancelling out in the past, because of my hyperfocusing on any tinnitus these few weeks

(5) In the beginning when I lie down, my pulsatile tinnitus will be louder, perhaps due to greater blood flow? But when I press on my neck, particularly where the aorta is, the pulsatile tinnitus is reduced -- this is simply due to the fact that I was reducing blood flow (which had nothing to do with muscle spasm or tension)

MY ONLY CONCERN AT THIS POINT IS THE RECOMMENDATION TO DO A DIGITAL SUBTRACTION ANGIOGRAM (DSA). I went online and read that this has now been replaced by the CTA? I wonder why my neorosurgeon is still recommending the more invasive DSA.

I ALSO SEEM TO HAVE EAR PRESSURE ON MY LEFT EAR. @tiniturtle Do you know if vascular anomalies can provoke ear pressure?

 

[Wheella]

Hi @Tinniger
I just saw your response in your thread on how chiropractic manipulation might cause some vascular dissection leading to blood flow problems and pulsatile tinnitus. Hoping its some sort of fistula or the like (I think a dissection is much more serious and can lead to a stroke?). See my account above based on discussion with neurosurgeon today.

@FocusRS @tiniturtle My neurosurgeon seems to be telling me exactly the same points you made in your thread. I've read your thread before somehow but never put one and one together until today.

@tiniturtle My regular tinnitus has been spiking. Do you think the "fistula" or any other vascular issues I am having could be provoking or irritating the cranial nerve leading to the spike? In other words, if the vascular issue is fixed (through emolization or surgery), will the regular tinnitus subside and cancel out eventually? What was your experience? Thank you.

 

[Wheella]

Hi @Greg Sacramento - Thank you for your technical response. May I clarify your point on "vertebral artery trauma" as I'm not certain that I fully comprehend. I tried to read up on your posts on the subject but this didn't help my confusion. Are we talking about possible "dissection" (I understand this to mean tear) of the vertebral artery"? Or some sort of fusion / entanglement between this artery and the DCN? Thank you.

 

[Greg Sacramento]

@Wheella It's not possible to conclude without getting the recommended testing.

The neurosurgeon says that very mild and small fistulas cannot be detected by an MRI or MRA, and one would need a good neuro radiologist to carry out a DSA (Digital Subtraction Angiogram).

That is often so, and for the vertebral artery which I mentioned.
As said, chiropractic manipulation might have cause some vascular dissection leading to blood flow problems and pulsatile tinnitus.

The chiropractic neck adjustment might have aggravated any vascular anomalies I have, such that certain muscle contractions would direct more blood into the relevant vascular anomaly?

Most likely so.
A Dural AV Fistula is possible, but this is where it gets complicated with vascular crossovers and input without the recommended testing as the vertebral artery (chiropractic manipulation) may have association - see link below for possible location.
I posted that you have not mentioned vision problems and I would add headaches. So your blood pressure may not get hypertensive. This could support decreased vertebral artery hemodynamics ?
You also have ear pressure and that points to blood flow.


https://en.wikipedia.org/wiki/Dural_arteriovenous_fistula

 

[Wheella]

Thank you @Greg Sacramento.
Would you have an idea why my neurosurgeon would talk about the more invasive DSA, rather than a CTA or MRA to detect any vascular problems? Should I push back or go for the lost aggressive approach?

 

[oceanofsound26]

Hi @Wheella -

To pick up where I left off -

The progression of your tinnitus has diverged from my own quite a bit at this point and we are well outside of my sphere of knowledge and experience with tinnitus right now. Just a few other notes -

I am curious what the physiotherapists will be doing. I saw 2 different physios this week and the last week, one does deep tissue massage and another dry needling. They don't seem to have particular experience in helping tinnitus victims though. I will be seeing 3 other physiotherapists today and tomorrow - thereafter I'll see if I can identify one that can help me better than then rest. It is difficult to find someone with the necessary skills in my part of the world (Singapore). I'm still wondering if it is a good idea to do the exercises and stretches that produce the shrill. If the objective is to be relaxing the muscles, then logically I should be stretching the muscles that produce the shrill. But if this equally compresses upon the nerves, then I can see how could do more damage than good.

It seems like a mixed bag of results here with the different things you are trying with respect to neck muscles. Since you know what the problem might be and if you can locate where the problem area, then return to your physiotherapist who can offer a more refined regiment of stretches and treatment for you.

Collecting my bite plate on Friday to deal with any TMJ issues (I've been told that I grind my teeth).

Careful with this and make sure you get the right type of orthotic. I developed tinnitus after two nights with a night guard. A TMJ orthotic has been better for me since it transfers the strain of bruxism to my front teeth rather than my molars near my TM joints.

@oceanofsound26 May I know if in your view, given that I do not have any neck pain, that I could be be in the category of needing treatment for "chronically contracted, weakened, inhibited, underused, overused, and/or that need to be activated" rather than for "muscle tear and strain"?

It is hard to say without some diagnostic tests. You will need to distinguish between direct pain and referred pain. Problems with the C-spine are particularly difficult to diagnose and treat since pain from a C-spine issue that be felt in the back, shoulders, neck, jaw, and face. Nerves transiting the C-spine go or come from all over the body as they connect to the brain. Also, problems can take time to develop, so just because you do not have pain in the neck now does not mean you will not develop it in time - in which case some conservative stretching is probably a good idea. Again, difficult to know what to recommend. Consult your physiotherapist for some recommendations.

However she did say something which made sense, which is that if the problem was due to a compression of the "fascia joint" where the nerves are exiting from the cervical spine, then any repeated movement will likely hinder my recovery because I am always aggravating the nerve. She thinks I should not be moving my neck so much ans looking for the tinnitus and let my neck rest... hopefully this way any irritated nerve will be able to repair itself and calm down eventually.

Makes sense. A cervical pillow might help for sleeping as well.

Correct posture and use of warmth should help.

Agree with these recommendations. Practice good posture and utilize a warm compress or heat therapy device at night for a few weeks.

It sounds like you have pinpointed the likely cause of your tinnitus with the help of @Greg Sacramento and others and have found your way forward with all the imaging your doctors have recommended. I wish you the best of outcomes and good luck with the treatments.

All the best,

-Oceanofsound26

 

[Wheella]

I started hearing a hissing sound when I turn my neck to the right and to the left after a chiropractic neck adjustment, and with certain head rotations. My pulsatile hissing is light a punctured tire at certain head positions and with certain muscle contractions. Compression the carotid suppresses it, which convinced my neuro radiologist that my problem is vascular.

Did the full suite of tests, MRI, MRA, MRV, Ultrasound and DSA. The only conclusion was that I have a stenosis of the internal jugular vein, with by pass veins forming around my ears. This is a tricky situation for me, as stenting at the IJV wouldn't work and might dislodge. Ballooning would only work for a short while and there is a chance of restenosis.

To make matters worse, a different radiologist who carried out a CTA and CTV with contrast tells me that she feels that my left internal jugular vein is not stenosed but she things its is simply developmentally smaller, and that the by pass vein formation is a normal variation.

I have been holding on to every glimmer of hope for a cure of my PT, but now am losing hope. I have been coming in and out of aggressive depression, and have been suicidal too. I need a lifeline, someone who can help me and teach me how to carry on living my life. Please help, someone... I am on the verge of a complete breakdown...