Tinnitus is typically blamed on listening to loud music or working in a noisy environment (such as construction) without adequate ear protection but for some people tinnitus is a result of neck problems. Now, a group of physicians investigating cervicogenic somatic tinnitus are looking to find out if physical therapy could offer patients with neck-related tinnitus some relief.
In the medical literature, cases of tinnitus, vertigo and hearing disturbances have all been attributed to pathology in the cervical spine and the temporomaxillary joint. Such cases of tinnitus are referred to as somatosensory tinnitus and research has uncovered neural connections protruding into the cochlear nucleus from the cervical spine.
Those found to have such neuronal projections upon examination have begun to be treated with physical therapy, including a focus on muscular trigger points, the use of self-massage, and anesthetics, and treatment through a physiotherapist or osteopath. Cervical tinnitus is typified by hearing loss at low frequencies and infrequent tinnitus and in some cases symptoms of hearing loss have been reported after neck surgery or other form of neck treatment.
Research Into Cervicogenic Somatic Tinnitus
This latest trial (NCT02016313) will look specifically at the effects on tinnitus of a standardized physical therapy treatment directed at the cervical spine. A secondary aim is to identify those likely to experience the most significant benefit from such an intervention.
Those with neck complaints (over 14 on the Neck Bournemouth Questionnaire) and severe subjective tinnitus (between 25 and 90 points on the Tinnitus Functional Index) are eligible for this trial. Anyone suffering from tinnitus with a clear cause in the ear, severe depression, traumatic cervical spine injury, tumors, cervical spine surgery, or conditions in which physical therapy is contra-indicated, is not eligible for the study.
During the study one group of patients will be randomized to receive immediate therapy and the other group will have therapy delayed by 6 weeks. A maximum of 12 sessions of 30 minutes over a 6 week program will occur and measurements taken for the TFI and NBQ at week 0 (or week 6 for the delayed therapy group), and then at the end of therapy, six weeks after therapy and three months after therapy.
Biesinger E, Reisshauer A, Mazurek B. The role of the cervical spine and the craniomandibular system in the pathogenesis of tinnitus. Somatosensory tinnitus. HNO. 2008 Jul;56(7):673-7.
Brügel FJ, Schorn K. Cervical tinnitus after cervical vertebrae treatment. Laryngorhinootologie. 1991 Jun;70(6):321-5.
Michiels S, De Hertogh W, Truijen S, Van de Heyning P. Physical therapy treatment in patients suffering from cervicogenic somatic tinnitus: study protocol for a randomized controlled trial. Trials. 2014 Jul 22;15(1):297. [Epub ahead of print]