TINNITUS

Tinnitus that changes with body movements: somatosensory tinnitus

Francis L'Africain
Written by Francis L’Africain,
Audiologist

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Maybe you have already read that there is no cure for tinnitus (1). It is true in most cases. 
There are a lot of different causes for tinnitus: side effect of medication, earwax blockage, sensorineural hearing loss, noise exposition, etc. Tinnitus can also be caused by head, neck, jaw or shoulder pain. If so, it is called somatosensory tinnitus (or somatic tinnitus). And in this case, a treatment is possible! 
Diagnostic 
In order to diagnose somatosensory tinnitus, three main steps need to be followed:  
1. Case history
Generally, an event causes the onset of the somatosensory tinnitus. Therefore, the audiologist asks the person about his history of: 
  • Head or neck trauma 
  • Teeth, jaw or neck problem 
  • Bruxism (teeth grinding at daytime or nighttime) 
  • Pain 
2. Hearing test 
It is important to do a complete audiological evaluation (2) to be sure the tinnitus is not caused by a hearing loss. The audiologist will check inside your auditory canal and test different parts of your ears. 
If a hearing loss is assessed, the choice of intervention will not be the same as if the person has a normal and symmetrical (same in both ears) hearing. 
3. Somatosensory modulation screening
The main difference between a hearing loss induced tinnitus and a somatosensory tinnitus is the presence of somatosensory modulation. This means the intensity (loud), frequency (high or low pitch) and localization (mostly in the right ear or the left ear) of the somatosensory tinnitus may change when the audiologist performs screening maneuvers.  
The audiologist can also palpate your neck (carotid artery) to determine if the problem could be vascular. If tinnitus beats in rhythm with the heart rate, it is called pulsatile tinnitus. 
Treatment 
 
Physiotherapy and dental procedures can help with somatosensory tinnitus.  
After the physical therapist has done his evaluation and eliminate any contraindication, he may begin manual therapy. This therapy includes a set of exercises for cervical stabilization, temporomandibular joint reinforcement, stretching and pain management. Usually, therapy implies 2 sessions of one hour each per week (for 6 weeks) plus an at-home training program the patient needs to do 3-4 times a week.  
In some cases, dental procedures can help reduce the intensity of the tinnitus depending on where it originates. 
A tinnitus that would be in rhythm with the heart rate is called a pulsatile tinnitus. This may be a hint of a vascular problem. In this case, it is important to see a physician. 
You think you have a somatosensory tinnitus? Feel free to contact ODYO’s team! 
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