Physio didn't help

[TurboTrace]

Hi all.

Had my first and only physio session just now here in Spain.

Lovely chap, great therapy but it's actually made my T worse.

On the flip side, he said I have no issues with my neck so my T is not coming from there. I'm just a little stiff and hunched over so need to sit up more.

Ho hum. Onwards and upwards

[bridgeit]

Hi Turbo. First, most of us with tinnitus (T) need to learn to habituate because there's no evidence-based fix out there for the vast majority of us.Second, I read in some of your earlier posts that you have left-sided head disturbance and migraine. Based on my experience (not medical training) this suggests to me that you could have either a temporomandibular joint (TMJ) issue that needs addressing and/or a cranial blood flow problem, possibly with outflow on the left side of your head.

Investigating the first possibility needs the attention of a good dentist, who can assess the health and position of your jaw joints. If there's a TMJ problem, it's usually easily fixed.

Investigating the second possibility requires a comprehensive MRI venogram of the head/neck for assessment by an interventional neuro-radiologist. The scan would normally be ordered by a neurosurgeon, so it would be to that specialist that you'd need a referral.

There is a long-shot possibility that the sternocleidomastoid (SCM) muscles, if you have a 'hunched' posture, might also be in spasm which can cause T, but I suspect noise would affect both sides, not just your left side. Neck exercises are always worthwhile to correct muscle spasm and posture in any case, particularly to reduce the risk of permanent kyphosis (hunched back).

Do bear in mind though, that even if a physiological problem is found and fixed your T may be a permanent fixture. Habituation is a sound (no pun intended) approach to ensure that you remain calm and relaxed while you're seeking investigations.

Finally, and this should in my view be a final recourse (not the first), a neurologist is well placed to address idiopathic migraine and headaches and medicate as appropriate. Medication for migraine/headaches treats the symptoms and in many cases manages them well, but medication for the disturbing effects does not even begin to address their root cause.

I hope you're able soon to find out what's happening to your system!

[TurboTrace in reply to bridgeit]

Thank you for your very expansive post ☺ Yes agree with all you've said.

Still awaiting results on bilateral MRI with contrast.

I suffer with TMJ anyway; I wear a bite guard to sleep.

Physio indicated my neck wasn't an issue.

The ENT specialist said he would refer me to neurology if these current tests/interventions prove inconclusive.

[TurboTrace in reply to bridgeit]

Hi. Thank you for your very expansive reply. It is very helpful information. I've now got an opportunity to reply in more detail. Habituation: already do and use mindfulness here. I'm also taking Betahistine which makes my T high pitched and more in the background.

TMJ - I have this and wear a bite guard. Cranial blood flow: hopefully this would be highlighted in my MRI results, which I'm still waiting for🙄

MRI venogram: the next stage if the current MRI is inconclusive, is to be referred to a neurologist. Will mention the venogram.

SCM: will investigate

Migraine: only get 3 or 4 per year usually triggered by tiredness.

[Hidden]

Hi TurboTraceThe advice from Bridgeit is excellent, but I would not write off your neck as a cause.

My view is that in some cases restricted blood flow (the carotid artery is near the ear), in or around the ear can generate a noise. A bit like putting a finger over the end of a hosepipe. The finger restricts the flow of water, increasing the pressure and it also generates a noise, but the overall flow of water remains virtually unchanged.

Restrictions can be due to age, posture, TMJ disorder etc.

Can you alter the volume of your T by clenching your teeth or by changing the posture of your neck/head. If you can, then blood flow may be an issue. It was for me.

I had T in my left ear only for the last 9 months but have now managed to virtually eliminate it altogether by: -

Reducing my blood pressure & pulse.

Getting fitter

Improving my posture

Specific neck exercises daily.

Cheers

Marcus

[TurboTrace]

Just researched SCM. Blimey! That was an eye opener. 3 things stood out:Stress - I try to control this but am always stressed or anxious, which became worse with the menopause. I take Miterzapine which helps.

Poor posture - I read in bed although I have a stand for my book/Kindle - obviously this isn't enough.

In addition, I sit at right angles to the tv so my head is permanently turned to the left. I try and sit with my head straight onbut you can't sit in one position for too long. I'll have to swap with my husband!

I'll see if altering the latter 2 things helps.

Thanks again! 🥰👍