Function And Anatomy Of The Ear
To understand why the neck and jaw may influence our hearing, we first need to look at how sound signals are generated and sent to the brain for interpretation, as well as get acquainted with the relevant anatomy.
The ear is a very complex network of structures which contribute both to our sense of hearing as well as balance, i.e the vestibular system. There are three main segments of the ear, namely the external, middle and inner portions. Lets have a closer look.
Fig. x
The external ear, also called the pinna or auricle, is designed mainly to capture the sound waves. The design of the ears lobes make it perfect to collect waves and funnel them to the eardrum, which is also known as the tympanic membrane, via the external auditory canal. The external auditory canal is an approximately one inch long tubular structure that the sound waves travel through, ultimately hitting the eardrum and causing its vibration. It has a natural secretion of cerumen that protects the canal and prevents unwanted entities or particles to enter it, thus protecting the eardrum and middle & inner ear segments.
Fig. x
The inner ear consists of the cochlea, the vestibular labyrinth, and the vestibulocochlear nerve.
Fig. x
Fig. x
The vestibular portion of the inner ear, also known as the labyrinth, consists of two otolith organs: The utricle and sacculus, which register linear movements , and three semicircular canals which register rotational movements .
Fig. x
Fig. x
Tinnitus From Neck Injury
If you dig deep enough you will find there are several pieces of research literature that indicate neck injury can cause clonus of two muscles in the inner ear that may be related to chronic tinnitus. When someone suffers a whiplash-type trauma the muscles, ligaments, and soft tissue of the upper cervical spine become injured.
This injury results in biomechanical aberrations at the joint level which can have wide-reaching effects on the central nervous system including the clonus of the inner ear muscles. Injury to the neck causes tight cervical spine muscles, which then results in decreased joint motion, leading to aberrations in neurological function.
This mechanism must be at the root of why a percentage of patients that undergo Upper Cervical Chiropractic care like Dr. Pat Allen, find relief and recovery from their tinnitus problems.
Vagal Somatosensory Evoked Potential Test
In order to biomonitor the electrical stimulation of ABVN, we measured the VSEP response . We used EGI GTEN 100 EEG system with 8 kHz collection rate and with different stimulation parameters. We used uni- or bipolar pulses, pulse width 100560 microseconds, frequencies 1, 2, 4, 8, 15, 20, 25, 30 Hz, amplitude at or just below the pain threshold, and delivered 200500 epochs at each setting.
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Blair Upper Cervical Care And Tinnitus:
While Upper Cervical Care does not correct Tinnitus in 100 percent of the patients, approximately 30 percent of those that come to us have 90 percent improvement. Another 40 percent improve about 50-70 percent while the other 20 percent seem to be unchanged. We wish there was a 100 percent success rate, but with that said, the patients who are relieved of their constant noise are grateful.
Dr. Dan Murphy explains how the stapedius and tensor tympani muscle can be affected by upper cervical injury. Many tinnituses suffer notice that their onset of tinnitus happens following a neck injury. The onset can be explained by muscle, ligament and soft tissue injury to the neck. When someone experiences whiplash they lose normal joint biomechanics. This loss of motion sends aberrant neurological input into the CNS which can underlie chronic hypertonicity of the stapedius and tensor tympani muscles. Remove the interference and health returns!
Stress And Tinnitus Transcutaneous Auricular Vagal Nerve Stimulation Attenuates Tinnitus
- 1Helsinki Ear Institute, Helsinki, Finland
- 2Salustim Group Inc., Kempele, Finland
- 3Department of Otolaryngology-Head & Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- 4Department of Anatomy, University of Helsinki, Helsinki, Finland
- 5Molecular and Integrative Biosciences Research Program, University of Helsinki, Helsinki, Finland
- 6Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
Methods: Diagnostic tinnitus and hearing profiles were defined. To detect possible cardiac adverse effects, test-taVNS with heart rate monitoring as well as pre- and post-stimulation HRV tests were performed. Daily taVNS home therapy was prescribed thereafter. To assess therapeutic usefulness of taVNS, 1-year follow-up outcome was studied. Results of HRV tests were retrospectively analyzed and correlated to diagnostic data.
Results: The large majority of patients with TRMS suffer from associated symptoms such as sleep disturbances and anxiety. Baseline HRV data showed that more than three quarters of the 171 patients had increased sympathetic activity before test-taVNS. Test-taVNS shifted mean values of different HRV parameters toward increased parasympathetic activity in about 80% of patients. Test-taVNS did not cause any cardiac or other side effects. No significant adverse effects were reported in follow-up questionnaires.
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Doctors Find Something Is Missing In A Tinnitus Examination It Is A Look At The Neck
In December 2018, Israeli doctors summed up a big problem in tinnitus examinations in one simple sentence. In their study published in The Journal of International Advanced Otology, this is what they said:
- Physicians routinely perform an otoscopic examination, whereas other relevant possible physical findings, such as temporomandibular joint disorders or neck trauma, are less frequently examined.
For many people with tinnitus, a simple look in the ear for ear wax buildup or infection can be an effective way to handle problems of tinnitus by handling the problems of ear wax and ear infection. But what about persistent tinnitus? How many times can we look inside a patients ear looking for an answer that may not be in the ear?
Doctors do look at the neck, but what they may be looking for is a neck mass or a neck tumor, an obvious anatomical deformity that may lead them towards neurological disorders. But what if there is an anatomical deformity that is not so obvious? Cervical neck ligament damage causes hypermobility in the cervical spine and pressure on the nerves that run through the vertebrae and the nearby circulatory system into the neck and head?
Research On Cervical Instability And Prolotherapy A Mechanical Approach To Tinnitus
In the research above, a case is laid out for the treatment of cervical spine instability in patients with tinnitus. As pointed out, not every case of tinnitus can be attributed to tinnitus but it may be likely that more cases than are reported of tinnitus induced cervical spine instability exist. Certainly, at our center, we see many people with this connection because this is what we treat.
Above you read about cervical manipulation, physical therapy, and exercise programs for the treatment of tinnitus. In this section, I will explain our Prolotherapy program.
Medical research validating the use of Comprehensive Prolotherapy, from simple dextrose injections to stem cell prolotherapy injections is not new. There are decades years of research supporting the use of Prolotherapy for problems of the neck and head.
Caring Medical has published dozens of papers on Prolotherapy injections as a treatment in difficult-to-treat musculoskeletal disorders. Prolotherapy is an injection technique utilizing simple sugar or dextrose. We are going to refer to two of these studies as they relate to cervical instability and a myriad of related symptoms including the problem of tinnitus. It should be pointed out that we suggest in our research that Additional randomized clinical trials and more research into its use will be needed to verify its potential to reverse ligament laxity and correct the attendant cervical instability. Our research documents our experience with our patients.
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Tinnitus And The Trigeminal Nerve
A paper in the May 2020 issue of the Journal of Headache and Pain suggested, as we have seen in many patients, that trigeminal neuralgia patients have a significantly increased risk of tinnitus within 1 year of trigeminal neuralgia diagnosis compared to those without the diagnosis. Trigeminal neuralgia centers on what is happening to the trigeminal nerve which carries pain, feeling, and sensation from the brain to the skin of the face. In the case of trigeminal neuralgia, most medical professionals cannot find the cause of why this pain started. This is borne out by the definition of trigeminal neuralgia. Trigeminal neuralgia means that there is nerve pain in the nerve distribution of the trigeminal nerve. It actually does not tell a person what is causing the condition.
As we stated above, tinnitus can be caused by many physical challenges. We will not suggest that every incidence of tinnitus can be treated by addressing chronic neck pain and chronic neck instability. The purpose of this article was to offer a missing diagnosis for people who have had extended medical care and seemingly no answers. We are trying to help people who are on medications and other cope management techniques by looking at something they may not have had explored, an examination of the stability of their cervical spine.
What Causes Pulsatile Tinnitus
Some cases of pulsatile tinnitus are caused by a narrowing of one of the large veins in the brain . The narrowing, or stenosis, disrupts the flow of blood and can lead to the whooshing sound or other noises of pulsatile tinnitus.
Pulsatile tinnitus can be caused by problems in the arteries or veins of the head, neck, or both. A 2013 review of the current literature indicated that about 28 percent of pulsatile tinnitus cases were due to venous causes, 23 percent were arterial, 18 percent were arteriovenous, and 31 percent were due to other or unknown causes. More than half of the venous cases of pulsatile tinnitus were due to idiopathic intracranial hypertension , which has recently been associated with venous stenosis.
Many cases of pulsatile tinnitus can be traced to stenosis in one of the large veins in the brain, most commonly the traverse and sigmoid sinuses. The narrowing of the veins causes a disturbance in the blood flow, contributing to the whooshing sounds of pulsatile tinnitus. A new clinical trial for pulsatile tinnitus shows great promise that inserting a stent to widen the veins will restore healthy blood flow and eliminate the symptoms .
Other conditions that can lead to changes in blood flow and result in pulsatile tinnitus include:
It is critically important to identify the underlying condition causing the pulsatile tinnitus treating and resolving that condition is the key to ending the noise.
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Chiropractic Care For Tinnitus
Constant noise in your head is distracting, exhausting, and can trigger both anxiety and depression. Thats what people with tinnitus live with every day. About 50 million Americans deal with some degree of tinnitus, 20 million Americans suffer from chronic tinnitus, and 2 million experience extreme symptoms.
Tinnitus is frequently referred to as ringing in the ears but can also include sounds like hissing, whistling, chirping, buzzing, etc. Tinnitus is common, and for many people, its an annoying thing they tolerate. However, the constant drone can interfere with hearing, ruin concentration, affect memory, and interfere with sleep. Living with pronounced tinnitus can take a toll on a persons mental health, triggering depression and anxiety.
Feeling That Your Foot Or Hand Has Fallen Asleep
You can temporarily compress your nerves with a poor posture. This usually happens if you sit on your leg or awkwardly rest on your arm. It often goes away when the pressure from your weight is removed.
If, however, your hands and legs fall asleep without any known cause, you will need the help of a doctor to identify the cause of the compression.
It is important to note that most of the symptoms of a pinched nerve can also be experienced if you have other medical conditions like multiple sclerosis, stroke, seizures, and heart attack.
So you should visit your doctor when you feel any of these symptoms out of the blues, especially if the symptoms are associated with other problems like difficulty in breathing and trouble with coordination.
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How Is Ringing In The Ear Related To Jaw And Neck Pain
Studies show that theres a close relationship between temporomandibular joint and tinnitus . People with TMJ problems are likely to suffer from tinnitus, and people with neck injuries may also suffer from tinnitus. Some people with either TMJ problems or neck problems can alter the intensity of their tinnitus by moving their mouth, jaw, face and neck. Successful treatment of the neck and jaw can improve tinnitus symptoms.
What is the temporomandibular joint ?
The TMJ is a complex joint which allows chewing. Theres a tremendous amount of force that is applied through the TMJ because the muscles that make the jaw clench are some of the most powerful in the body. As a result, the joint is at risk of damage just as much as any other weight-bearing joint in the body. TMJ problems can be due to trauma, dislocation to the fibrous disc in the joint, or due to arthritis.
What are the symptoms of TMJ problems?
Most common symptoms include:
- Tinnitus
How does the TMJ affect tinnitus?
There are three main reason why problems with the TMJ may cause tinnitus, or make it worse.
What can be done about TMJ disorders?
How can neck problems be related to tinnitus?
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Ringing In The Ears Could Have Roots In The Cervical Spine
Tinnitus is, arguably, one of the most frustrating and uncomfortable medical conditions imaginable. This ailment, characterized by a non-stop ringing sound coming from inside a patients ears, is not an illness in and of itself its usually indicative of some kind of traumatic injury to the neck, spinal column or blood vessels.
Because there are a number of disorders that could potentially cause tinnitus, its important to seek help from a qualified medical professional anytime you are experiencing consistent symptoms. Often, the best place to start is with a holistic medical practitioner, like a chiropractor, to address your potential tinnitus. At Graybar Chiropractic, were ready to help North Carolina patients understand their tinnitus and look for ways to help effectively treat it.
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Can Treating The Neck Change Tinnitus
The answer is its definitely possible, maybe even likely in you. This has been shown in some research and can be seen clinically in practice often with those professions using physical treatments.
*This complex answer is an attempt to explain a complex problem as simply as possible.
If you live in the Texarkana area and would like to have Dr. Hagebusch evaluate you to find out if he can help you, contact our office and set up an appointment.
All articles and posts on this blog are meant to provide general information about health, chiropractic, movement, diet, supplements, etc No specific advice about your health or lifestyle is given.
About Dr. Marc Hagebusch
Dr. Hagebusch has practiced in Texarkana as a Chiropractor since 1999. He has successfully treated thousands of Texarkana area residents suffering with a variety of health problems and injuries.
He is the only local doctor in the Texarkana area that has completed well over 400 post-doctorate hours in Functional Neurology from the Carrick Institute in order to better serve Texarkana residents that have neuro-musculoskeletal problems.
Have a question or need to set up a visit? Contact us at 903-793-1084.
We’re here to help!
The Association Between Tinnitus The Neck And Tmj
Tinnitus is a common hearing disorder that affects up to 80% of the population at one time in their life, whilst approximately 5-20% of the younger population are experiencing it in a prolonged manner. It is more common in senior population. Although, in general, only about 2,5% of the affected people are experiencing severe, continuous tinnitus symptoms
It is known that the cause of tinnitus and similar disorders may have many causes, such as being exposed to excessive sounds, otitis, otosclerosis, MS, atherosclerosis, tumors, aneurysms and so on. Less known, is the notion that temporomandibular joint, and neck disorders also may cause tinnitus. This article will be addressing the lesser known causes of tinnitus, relating to jaw and neck disorders, how to identify them, and how to treat them. The principles in this article are also applicable when treating vestibular and other otic disorders who have MSK components.
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Something At C2 The Dorsal Root Ganglion
That researchers and clinicians are making a connection between what is happening in the cervical spine in tinnitus patients is expressed by a study concerning Pulsed Radiofrequency Treatment. This is a treatment that we do not use. We have been offering cervical spine therapies for almost three decades and based on our experiences and that of our patients, we have not found these treatments to be more effective than our current treatments of regenerative medicine injections. So lets look at this research, it is not so much about the treatment but an observation of the C2 vertebrae.
Many of you may have already tried or are at least familiar with Pulsed Radiofrequency Treatment. An electrode is applied to the impacted nerves and electrical stimulation is offered. The hope is that the treatment will provide pain relief by altering the nerves currents and transmissions.
In this September 2019 study in The International Tinnitus Journal researchers wrote:
The second cervical nerve ganglion bar appears to be beneficial in patients with treatment safe tinnitus The point of this investigation was to decide the adequacy of beat radiofrequency of C2 dorsal root ganglion for treating patients with tinnitus, and all the more explicitly, to survey the parameters related to a long haul advantage so as to improve understanding determination.