Tinnitus

Tinnitus - Causes and Treatment Options

In the course of a case study during my Master's degree in Osteopathy at the University of Health in Fribourg, I focused on the topic of Tinnitus. During my first internship, one case particularly impressed me. It was a patient who complained about somatic tinnitus. The patient described a unilateral tone in the ear which was partially triggered by certain head positions or by stress. After just one osteopathic treatment, the patient was completely symptom-free.

Do you also know the feeling of a disturbing tone in the ear? Then read on here!

First, a definition: What is somatic tinnitus?

Tinnitus describes a subjective perception of a non-externally generated tone or noise in the ear, which is mostly described as ringing or humming. Worldwide, 15-20% of the population is affected by this phenomenon. It is known that the constant tone in the ear leads to a significant reduction in quality of life in 1-3% of affected individuals.

Causes of somatic tinnitus and its symptoms

There are different causes of tinnitus. The somatic tinnitus described here originates from dysfunctions of the musculoskeletal system. Therefore, during an ENT examination by the doctor, no disease or injury of the auditory tract can be detected.

Through neurological, myogenic, vascular, and anatomical connections of the temporomandibular joint (specifically the M. temporalis, M. masseter, M. pterygoideus lateralis, and the sphenomandibular ligament), the cranio-cervical junction and the shoulder girdle muscles with the ear or the auditory pathway, dysfunctions of these regions can lead to somatic tinnitus. Often somatic tinnitus is accompanied by pain in the aforementioned regions or modulated by certain movements.

Henry Vandyke Carter creator QS:P170,Q955620 Henry Gray creator QS:P170,Q40319, Gray907, marked as public domain, details on Wikimedia Commons

A typical symptom of somatic tinnitus looks like this:
Perception of unilateral tinnitus without ENT findings and without a specific trigger. Usually, additional pain occurs in the temporomandibular joint or in the neck-shoulder area. Somatic tinnitus may be modulated by certain head positions and/or stress.

Henry Vandyke Carter creator QS:P170,Q955620 Henry Gray creator QS:P170,Q40319, Gray915, marked as public domain, details on Wikimedia Commons

The Role of Osteopathy and Physiotherapy in the Treatment of Somatic Tinnitus

Through a precise examination and subsequent treatment of the affected regions, we can assist patients with somatic tinnitus here at Bodylab Osteopathy and Physiotherapy.
Through myofascial techniques, mobilizations, and thrusts (mobilization with impulse), the affected structures regain their physiological function. As a result, this leads to the disappearance of the tinnitus.

Henry Vandyke Carter creator QS:P170,Q955620 Henry Gray creator QS:P170,Q40319, Gray906, marked as public domain, details on Wikimedia Commons

An important part of the treatment also involves education and instruction about the mechanism behind the symptoms and triggers of the present tinnitus. With extensive knowledge of the processes and interactions of the human body, the therapists at BodyLab Zurich can carry out significant educational work and help raise awareness of the triggering problem and counteract it.

Research

According to current studies, clinical examinations and treatments should focus mainly on the head, neck, jaw, and shoulder areas, as well as the adjacent muscles, structures and fasciae, with particular attention to the cervicocranial junction, masticatory muscles, and sphenomandibular ligament (SML).
The prevalence of dysfunctions of the Temporomandibular Joint in somatic tinnitus patients is around 30%.

When somatic tinnitus and its associated dysfunction is correctly diagnosed, an osteopathic or physiotherapy treatment can lead to a successful outcome.
However, the classification, examination, and treatment of tinnitus remain controversial topics. Therefore, NICE (National Institute for Health and Care Excellence) is currently working on developing guidelines for "Tinnitus assessment and management," which are expected to be published in 2020.

This blog was written by our intern Anita Jost (MSc Ost in training). The complete study by Anita Jost, including the bibliography, can be found at this link if you are interested.

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Title Image Credit

Henry Vandyke Carter creator QS:P170,Q955620 Henry Gray creator QS:P170,Q40319, Gray907, marked as public domain, details on Wikimedia Commons