While tinnitus is the general name for a condition that creates a ringing or pulsing sensation in the inner ear, there are various types of tinnitus and hearing loss that affect people in different ways. It is a difficult condition to treat with a one-size-fits-all approach because there are so many factors to address, from the root cause to the type of tinnitus the individual is experiencing. For some, tinnitus is closely associated with sleep patterns (for example it becomes worse at night or after waking from a nap) and for others, it is closely associated to specific movements (the tinnitus increases when the head or neck are moved in a certain direction). This movement and muscle-related tinnitus are often referred to as somatic tinnitus or somatosensory tinnitus.
What is somatic tinnitus?
Somatic, a word with Greek origins, essentially by means of the body. The body’s sensory signals are somatic signals, generated in the head, neck, tongue, and temporomandibular joint (or “TMJ”), as well as in the trunk and the arms.
Muscle spasms can actually be the cause of chronic tinnitus in some cases. The sternocleidomastoid muscle, which is found under the ear and allows us to rotate our heads, can spasm when the neck is moved a certain way or even by sleeping in a particular position (think of the experience we often refer to as a crick in the neck, usually arising after sleeping with the head in an awkward position or angle). Sometimes, it can be difficult to discern that the neck crick and ringing in the ears are actually related because the tinnitus may not surface immediately. It could happen hours after the initial spasm occurred.
TMJ dysfunction is also a contributing factor to somatosensory tinnitus. This condition occurs when the lower jaw is not aligned properly with the skull. Additionally, dental issues such as impacted wisdom teeth or tooth abscesses have even been found to cause somatic tinnitus.
One of the first indicators that someone is experiencing somatic tinnitus, versus the other types, like pulsatile tinnitus, is the presence of tinnitus in one ear only. This type of tinnitus will typically have fluctuations in noise level and an intermittent presence. A constant, unrelenting ringing in the ears may be a sign that it is not somatic tinnitus, rather another type of tinnitus stemming from other causes such as circulatory issues or even exposure to loud noise at a concert.
How is somatic tinnitus treated?
After an examination to assess somatic tinnitus (which will include an evaluation of the jaw and neck muscles), a physician may recommend various treatments aimed at reducing muscle tension in order to relieve tinnitus. The dental occlusion may be adjusted by light grinding and a bite splint may be used with some patients to counter the effects of jaw clenching. Special stretching exercises may be recommended for further relief. Treatment of the muscle tension can provide ongoing relief from somatic tinnitus.
Myofascial therapy may be used, which involves the application of digital pressure in conjunction with stretching exercises. Dry needling is another technique that has been used, but there are still no conclusive reports on its effectiveness. Other treatment possibilities include massage, auriculotherapy, transcutaneous electrostimulation, and atlas therapy.
There is no pharmaceutical cure for chronic tinnitus, somatic or pulsatile tinnitus otherwise and it is important to bear in mind that some medications can actually worsen the effects of your tinnitus. Evaluating all medications taken for other health concerns will be important to discuss with your physician, as you could be exacerbating your tinnitus simply by treating other unrelated health issues.
In many cases, tinnitus can lead to depression and anxiety and seeking psychiatric treatment can be advised as well. While there is no evidence that depression causes tinnitus, the two conditions often become co-dependent. Cognitive behavioral therapy can help some sufferers who are battling both depression and tinnitus. Your primary physician may be able to recommend a specialist in cognitive behavioral therapy. Acknowledging depression can be difficult for many, but it is critical that you are honest and open with your physician about all the ways tinnitus is affecting you. This can only help in terms of finding the right combination of therapies and treatments to bring your relief.
If not somatic tinnitus…what type do I have?
In addition to somatic tinnitus, there are three other types: subjective, objective, and neurological. Subjective tinnitus is caused by exposure to a loud noise or noises; objective tinnitus is the rare form where the noise can be heard by others (and is actually the easiest to fix, once the root cause is identified); and neurological tinnitus is typically associated with disorders such as Meniere’s disease.
Clearly, someone who is exposed to extremely loud noise may deduce that the tinnitus is subjective and veterans often fall into this category, as well as others who may work around loud noise without proper ear protection. Objective tinnitus can happen in conjunction with a heart murmur and, in these cases, a physician, using a stethoscope, can also hear a whooshing sound described by the patient. Neurological tinnitus is most closely associated with Meniere’s disease and can occur along with vertigo.
In any case of tinnitus, you should consult your physician and undergo a full evaluation to determine not only what type you are experiencing but the best plan of action for treatment.
Summary and moving forward
Somatic tinnitus is a disruptive condition that affects quality of life and, in particular, when it is caused by some type of strain to the temporomandibular joint it can be years before the injury heals to the point that tinnitus is reduced. Therefore, seeking treatment to provide relief is strongly encouraged and you may need to go through a process of trial and error to find the approach that works best for you.