Tinnitus is the perception of sound in the ears or head when no external sound is present. This phantom sound can manifest as ringing, buzzing, clicking, humming, or hissing, and can vary in intensity and frequency. While various factors can contribute to tinnitus, cervical tinnitus is directly linked to issues within the neck or cervical spine. This connection highlights how problems in the musculoskeletal system can influence auditory perception.
What is Cervical Tinnitus?
Cervical tinnitus, also referred to as somatosensory or somatic tinnitus, is a form of tinnitus characterized by sounds originating from biomechanical or musculoskeletal problems in the cervical spine. A distinguishing feature is that the sound often changes in pitch or intensity with specific neck movements, head positions, or when pressure is applied to certain areas of the neck. This direct correlation with neck activity helps differentiate it from other forms of tinnitus.
Unlike sensorineural tinnitus, which typically arises from auditory system issues like hearing loss, cervical tinnitus has a mechanical or somatic origin. It is influenced by sensory signals from the nerves and muscles of the neck. The term “cervical” refers to the seven vertebrae that make up the neck region of the spine, emphasizing its root cause.
Root Causes
Cervical tinnitus stems from underlying conditions within the neck and cervical spine. Neck injuries, such as whiplash, can damage nerves, cartilage, and ligaments, leading to tinnitus. Degenerative changes like osteoarthritis or disc herniation can also contribute by compressing or irritating nerves that connect to the neck and ears.
Muscle tension and spasms in neck muscles, including the sternocleidomastoid or trapezius, are common causes. This tension can affect cranial nerves and blood flow, leading to perceived sounds. Poor posture, particularly forward head posture, creates chronic strain in the upper neck, which can disrupt blood circulation and nerve function. Cervical spine instability, where neck ligaments are damaged, can also cause tinnitus by disrupting Eustachian tube function or compressing blood vessels like the carotid artery.
These issues can impact auditory processing by influencing nerve pathways and blood supply to the ear and brain. Altered sensory input from the cervical spine can affect brain regions involved in auditory processing, leading to enhanced excitability and tinnitus perception. Muscle tension can also constrict blood vessels, leading to pulsatile tinnitus—a rhythmic pulsing sound synchronized with the heartbeat.
Identifying Cervical Tinnitus
Diagnosing cervical tinnitus involves a comprehensive evaluation to distinguish it from other forms. The process begins with a detailed medical history, where a healthcare professional inquires about the onset, characteristics, and any changes in the tinnitus sound related to neck movement or posture. A physical examination focuses on the neck, spine, and surrounding muscles to identify tension, restricted movement, or signs of cervical spine disorders.
Specific tests, such as neck movement tests, are performed to see if they provoke, worsen, or alleviate the tinnitus sound. Imaging techniques, including X-rays or MRI scans of the cervical spine, can identify structural issues like cervical spondylosis or disc degeneration that could be contributing to the condition.
Cervical tinnitus often presents with other accompanying symptoms. These include neck pain, stiffness, and headaches, particularly cervicogenic headaches. Dizziness or vertigo, and shoulder pain are also commonly reported alongside cervical tinnitus.
Treatment and Management Strategies
Treatment for cervical tinnitus primarily focuses on addressing the underlying neck issues. Physical therapy is a common approach, incorporating exercises to improve posture, strengthen neck muscles, and increase range of motion. Manual therapy techniques, such as massage and mobilization, can help alleviate muscle tension and improve cervical spine alignment.
Medications may be prescribed to manage symptoms, including muscle relaxants, anti-inflammatories, and nerve pain medications. Dry needling, a technique involving thin needles inserted into trigger points, can help release tight muscle knots in the neck. Ergonomic adjustments to workspaces and daily habits are also important to prevent further strain on the cervical spine.
Stress management techniques can be beneficial, as chronic stress often exacerbates muscle tension in the head, neck, and shoulders, which can influence tinnitus. A multidisciplinary approach, involving physical therapists, neurologists, and audiologists, is often recommended for comprehensive care. In some cases, surgical correction of severe cervical spine instability has been shown to alleviate tinnitus symptoms.