How Might Central Pulsatile Modulation Occur Is Somatic Modulation Of The Auditory Pathway Accounting For These Cases
Because the dorsal cochlear nucleus is implicated in playing a role in tinnitus from cochlear insults based on animal studies and a combination of human studies and animal studies implicates the DCN in tinnitus from a somatosensory insult, consideration of pulsatile modulation of DCN activity as a cause for pulsatile tinnitus is reasonable and may serve as a model for pulsatile modulation of neural activity at other sites along the auditory pathway . Besides receiving deep layer inputs from type I myelinated auditory nerve fibers to the smooth dendrites of DCN fusiform and giant cells, as well as tuberculoventral neurons, the DCN granular cell layer receives inputs from multiple other CNS loci, including the somatosensory system of the head and upper neck, vestibular system, pontine nuclei, type II unmyelinated auditory nerve fibers, the octopus cell area of the ventral cochlear nucleus, the inferior colliculus, and the auditory cortex . Any one of these inputs to the DCN could be responsible for the pulsatile quality of these patients’ tinnitus, if their neural activity had a pattern synchronous with the cardiac cycle. At present, there is no compelling reason to choose one of these inputs as the most likely candidate.
Schematic depiction of cardiac modulation of the somatosensory system leading to pulsatile tinnitus.
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.
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.
The inner ear consists of the cochlea, the vestibular labyrinth, and the vestibulocochlear nerve.
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 .
Treating Neck Problems And Tinnitus
As said, tinnitus is not a disease itself but a result of other conditions so addressing these can help to alleviate symptoms. Tumors of the neck can be removed with surgery or treated with radiation therapy, as per a doctors advice. Often damage to the TMJ can be addressed with rest or medication.
Other neck injuries may also require rest so that the auditory nerves that have been damaged can also heal. There are treatment options available when tinnitus is the result of neck injury but understanding these causes of the condition is the first step.
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.
Ringing In Ears And Stiff Neck
- Medical Author: Dan Brennan, MD
Reviewed on 6/15/2020
You may be fighting off an infection if you are experiencing these symptoms. Other possibilities include medication side effects and/or injury. If your neck stiffness is prominent, then you may need to talk to your doctor right away about the possibility of meningitis.
While the list below can be considered as a guide to educate yourself about these conditions, this is not a substitute for a diagnosis from a health care provider. There are many other medical conditions that also can be associated with your symptoms and signs. Here are a number of those from MedicineNet:
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Relaxing Muscle Tension In The Jaw And Neck
Because patients with temporomandibular disorder often present with muscular tension in both the jaw and neck as well as tinnitus, vertigo/dizziness and aural fullness the first aim of treatment for somatosensory tinnitus is the reduction of such muscular tension.
Many patients with such problems also benefit from performing regular stretching exercises of their suboccipital muscles at home, as well as rotation movements in the atlanto-occipital joint especially to the restricted side and relaxing exercises involving breathing with the diaphragm.
Such treatment of muscle tension in the jaw and neck can reduce tension-related symptoms such as tinnitus, vertigo, aural fullness and pain in the jaw, neck or headache. Indeed, the intensity of all such symptoms was significantly reduced after a 3-year follow-up examination for patients who used this type of treatment.
Focal administration of lidocaine into jaw muscles or into neck muscles may temporarily reduce tension and, consequently, the tinnitus, while the local anesthetic is active.
The Answers To Tinnitus May Lie In Something Hidden
In this article, we are going to make a case for something hidden, the non-treatment, or lack of treatment, of cervical neck instability as a cause of tinnitus in some people. We will present the evidence for Prolotherapy injections as a treatment for cervical neck instability and treatment for a symptom of cervical neck instability, tinnitus.
- The focus of this article is that for many sufferers, tinnitus is a mechanical disorder of the cervical spine as borne out by TMJ-TMD involvement and new research below on a migraine trigger called Clocking Tinnitus.
Throughout our website, we have demonstrated that problems of the head and neck, including sensory issues of sight and sound, are more than an isolated problem of a single diagnosis. TMJ needs to be treated with a focus on cervical neck instability. Cervical neck instability needs to be treated as a problem of itself and the cause of a vast myriad of symptoms including TMJ and Tinnitus, among others.
The patients that we see in our clinics, maybe just like yourself, have been on long journeys looking for help for their problems. They often spend a lot of time on trial and error medications and treatments looking for that correct combination that will provide relief.
The United States National Library of Medicine has a web page dedicated to Tinnitus.
The common causes of tinnitus:
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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.
Upper Cervical Chiropractor And Tinnitus
Tinnitus refers to a ringing, buzzing, whistling, or rushing sound in the ear. Do you hear that ringing sound, or is it just me? If you find yourself asking this question , the problem could be tinnitus.
- Why does tinnitus occur?
- How could it be connected to the upper neck?
- Is there a natural way to find relief?
We will address the answers to these questions and more in our article.
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How Massage Can Relieve Tinnitus Pain
Massage may help relieve tinnitus symptoms in multiple ways. Massage reduces stress, which can exacerbate both the tinnitus and any underlying conditions. Massage can also resolve postural problems that may contribute to tinnitus.
Muscle tension can make tinnitus worse. Massage reduces tense muscles and corrects neck, head, and jaw misalignment which can place stress on the inner ear.
In one case study, a patient showed a reversal of tinnitus symptoms after 2.5 months of soft tissue massage, repetitive movements, and joint mobilization.
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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Is This Trigger Point Causing Your Tinnitus
Have you had ringing or buzzing in the ear that hasnt gone away? Have you already seen different doctors, specialists, had different tests done, yet still havent been able to figure out the ringing in the ear?
There are different causes of tinnitus. If you have already had your inner ear and hearing checked, but have not been able to identify the cause of the tinnitus, try examining your neck musculature, more specifically the Sternocleidomastoid and Masseter muscle.
Are There Natural Supplements To Help
- A 2011 study in the International Tinnitus Journal found taking 532 mg of magnesium a day for 3 months significantly decreased severity in those patients who had moderate to high levels of handicap related to their tinnitus. This was a phase 2 study, without placebo, to see if this therapy would help at all. The data was analyzed by the Mayo Clinic and the results suggest magnesium may play a role in treatment.
- A nice study in a , indicated Melatonin has been proposed as a treatment for tinnitus, especially on the basis of its positive effects on sleep and its vasoactive and antioxidant properties. It explores melatonin use, explaining its effect on central nervous system resulting in a type of protective mechanism. Melatonin was able to significantly decrease the intensity of tinnitus, especially in men with a history of exposure to noise and having severe symptoms.
- This was also noted in the 2014 issue of the Southern Medical Journal, where the authors indicated that melatonin may be a good treatment option for those suffering from tinnitus. They indicated melatonin may protect against ototoxic drugs, noting the antioxidant property, enhanced sleep and possible other action not understood yet. They recommend a daily dose of 1 to 3 mg.
- A 2019 study in Biomedical Journal found that 40 mg of elemental zinc per day significantly improved noise induced hearing loss associated tinnitus after 2 months.
B2, B3, Water & Protein
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Connection Between Neck Problems And Tinnitus
Because there are so many causes of tinnitus, its often difficult for doctors to understand why sufferers hear this ringing, buzzing, clicking, or other such noises that are common with the condition. In some cases, damage to the nerves around the ears can cause the brain to hear phantom sounds or cause the nerve endings to be constantly stimulated.
Neck problems can also cause tinnitus as the neck and shoulders along with the lower areas of the skull and jaw are connected to the auditory nerves. The neck serves to support the head and the skull bones, and damage to these areas can cause the sensation of tinnitus. Neck injuries or damage can cause problems with the temperomandibular joint or TMJ, the joint on the side of the head in front of the ears, and this in turn can cause tinnitus. If the neck is not supporting the head properly, this joint can get damaged or worn and in turn, a person can experience tinnitus.
Neck injuries can also result in injuries to the nerves of the ear as these nerves run from the inner ear through the neck and to the motor cortex. If a person suffers a neck injury they may not connect this with resultant ear damage, but these nerves are protected by the muscles of the neck and when they are compromised, tinnitus may result.
Tumors and other illnesses in the neck can also damage or affect these auditory nerves and in turn, result in tinnitus.
How To Relax Your Jaw And Face Muscles
Relaxing your jaw is a learned skill. Most of us go through our days with little awareness of how we are holding our jaws. Unless we experience jaw pain or discomfort, we rarely think about this joint and the muscles that assist us with important tasks such as chewing, drinking, and yawning.
Learning how to relax jaw muscles requires sustained focused effort. Were going to explore some techniques you can use to begin relaxing your jaw today.
- Massage: Open your mouth and softly rub the muscles next to your ear in a circular motion. Do this throughout the day and right before you go to bed.
- Apply a cold or hot compress to your jaw.
- Slack Jaw: Fully relax your mouth and let your jaw hang open. Touch the very back of your mouth with the tip of your tongue. Stay in the position for 5 seconds, then slowly close your mouth. Repeat 10 times.
If you continue to experience jaw pain or stiffness after using these exercises, talk to your doctor or pharmacist. There are over-the-counter anti-inflammatory drugs, pain relievers, and prescription medications that may be useful for chronic cases.
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Misaligned Atlas And The Ringing Ears
For one thing, a misaligned atlas can affect the structures of the ear. The eustachian tubes, in particular, play a vital role. These tubes drain away excess fluid from the ears so they can drain harmlessly. However, if tube function is inhibited, fluid can build up and lead to tinnitus. Therefore, even when ringing in the ears is caused by a blockage, the problem may still be in the neck.
In This Video Ross Hauser Md Discusses General Problems Of Ear Pain Ear Fullness Sound Sensitivity And Hearing Problems
Here is a transcript summary:
- Dr. Hauser makes a connection between cervical spine/neck instability and cause problems related to the ear and hearing
- Many patients we see have ear pain, ear fullness, or sensitivity to sound.
- Some of these people have a long medical history that may include visits to the ENT and other specialists and doctors. Some may get a diagnosis of Menieres disease.
- In many of these patients, their problems of tinnitus, Menieres disease, dizziness, ear fullness, decreased hearing, or sensitivity to sound may be traced to problems of cervical spine/neck instability.
- Eustachian Tube Dysfunction
- The eustachian tube is the canal that connects the inner ear and the upper throat. It regulates the pressure within the inner ear.
- Eustachian Tube Dysfunction can occur when the muscles of the eustachian tube, the tensor veli palatini, the levator veli palatini, the salpingopharyngeus, and the tensor tympani, do not perform their job of opening and closing the tube. This can cause fluid build-up in one ear as opposed to the other. This can cause problems of inner ear fullness, ear pain, and loss of sense of balance. Cervical spine instability can cause muscle disruption.
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