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Can a chiropractor help with tinnitus? The short answer is yes, we have seen it plenty of times before. However, we must be responsible here that there are a series of complications with tinnitus which means that a chiropractor cannot always help with tinnitus.
Among the people we see in our practice, approximately 50% who experience somatosensory tinnitus (i.e., not industrial damage to the hearing centers of the brain) report experiencing an improvement with tinnitus. However, the other 50% do not even though they may experience other improvements such as vertigo, dizziness, headaches, migraines, chronic pain, and so forth.
In other words, there is not always a direct linear relationship between chiropractic treatment and tinnitus. It instead seems to be one piece of the overall puzzle, and so we should like to be completely forthright about that from the get.
How can a chiropractor help with tinnitus?
To understand how a chiropractor both can and cannot help with tinnitus, it is useful to understand a few basic things about the neurology of the brain and the neck. Your neck contains three general types of sensory nerve receptors (there are more, but this will give you the general idea:
- Pain receptors
- Proprioceptors (for balance and muscle tone)
- Pressure receptors
These pressure receptors send messages about movement (both normal and abnormal) to the parts of your brain that are responsible for sensation, but interesting, also to the parts of the brain that are responsible for hearing. So, not only can it be possible to experience physical pain or discomfort should there be something mechanically wrong with the alignment or motion in your neck, but it can actually produce abnormal auditory sensations, not unlike static on a radio.This appreciation of neurology may well explain why many people who experience tinnitus who have normal MRIs and hearing tests may actually have a problem with their necks.
In terms of what types of problems with the neck can cause tinnitus and that a chiropractor can help with, we are specifically referring to small yet significant injuries, usually 2-3mm in total magnitude that causes an offset in the normal position of the vertebrae in your neck. As small as that might be, a 2mm offset actually represents a 20% derivation from the neutral position. Moreover, your brain is capable of detecting sensations 10x smaller than that!
So these are the types of injuries that can come about through normal daily living - sports injuries, falls, minor car accidents, and so forth - that may not cause immediate pain or problems, but that can accumulate over a long period of time to produce issues such as tinnitus later in life that may not necessarily kill you but can certainly make your life unpleasant. Of particular note, as it relates to tinnitus and other associated symptoms such as a blocked ear feeling (Eustachian tube dysfunction), dizziness, or vertigo, it is important to pay particular attention to the vertebrae at the base of your skull in your upper neck.
The top vertebrae in your spine called ed atlas (C1) and axis (C2) is responsible for around 50% of your total head and neck movement. As a result, they both receive and transmit a huge amount of sensory information to your brain that is necessary for your body to function properly. Therefore, an issue with a misalignment up here may be particularly important as it is related to tinnitus. If so, the way that a chiropractor can help with tinnitus is by addressing and resolving the underlying alignment issues in this area so that the nerves may not need to bombard your brain with abnormal signals, and thus have the opportunity to do what it is designed to do: heal itself.
What if a chiropractor cannot help with tinnitus?
As we said at the beginning of this article, we find that around 50% of people in our practice who experience somatosensory tinnitus experience improvements. Nevertheless, around 50% of the people do not. In this regard, we have nevertheless observed a few patterns in this 50% of people that a chiropractor was not able to help that we can to share here as well?
Why would we do that? Because at the end of the day, what is most important is our ability to help and direct people to find the solutions they are looking for so that they can enjoy the best quality of life possible … and that means even if it is not us who does the treatment.
First, one thing that we typically find different from many general chiropractors to help with tinnitus is the nature of the alignment in the upper neck. The particular approach that we use, called the Blair Technique, is designed to take individual differences in bone and body structure into account. Because all human beings are built differently on both the outside and the inside, it is important to be as accurate as possible that we find the exact location, direction, and degree of misalignment that is producing the problem so that we can have the best chance of success.
So, one of the commonalities that we find with tinnitus is that there is some type of TMJ (jaw) dysfunction. Where did we mention how the joints in your upper neck have all the pressure nerve receptors? Your TMJ does as well. So, the question as it related to tinnitus is, “What is causing your TMJ issue?” One possibility is that your TMJ is compensating for your upper neck because there is an intimate connection between the two. However, it also goes the other way:L a TMJ problem can also cause a spinal issue. If this is the case, yes, you may still need a chiropractor, but you also need a specific type of dentist who is able to address the underlying TMJ issue.
Otherwise, it is like solving a combination lock with the digits in the wrong sequence. We know that as profound and powerful as correcting the alignment of the upper neck is as one piece of a healthcare strategy, it is one piece; and there can be other things going on as well that must be addressed so that people can actually achieve their full potential.
So, the question is which is it? Is it an upper neck problem producing tinnitus, in which case a chiropractor may be able to help? Is it a TMJ problem, in which case a dentist may be able to help? Or might it be a combination of both? This is one of the important questions that need to be considered in the beginning so that you can have the best chance for success. Even then, tinnitus can be a real challenge getting to the underlying issue. To a certain degree, it is like having a ghost in a machine. There are no absolutes, and no one to the best of my knowledge either has it all figured out. We certainly don’t. We do have an approach that is able to help many people, but I’d be lying if I said it worked for everyone.
Nevertheless, the one thing that we can guarantee in the process is that we do our very best with the knowledge and resources we have so that you can get back to enjoying the things in life that matter most to you. And while we may not have any absolute answers in this article, we hope that in our direct approach - both letting you know what we can and cannot do - that you may have learned something valuable so that you are able to take the next step forwards in finding the solution you are looking for.
References
Biesinger E, Reisshauer A, Mazurek B. [The role of the cervical spine and the craniomandibular system in the pathogenesis of tinnitus. Somatosensory tinnitus]. [Article in German] HNO. 2008 Jul;56(7):673-7. doi: 10.1007/s00106-008-1721-2. https://www.ncbi.nlm.nih.gov/pubmed/18560742
Hölzl M, Behrmann R, Biesinger E, et al Selected ENT symptoms in functional disorders of the upper cervical spine and temporomandibular joints. HNO. 2019 Mar;67(Suppl 1):1-9. doi: 10.1007/s00106-019-0610-1. https://www.ncbi.nlm.nih.gov/pubmed/30742234
Michiels S, Van de Heyning P, Truijen S, et al. Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus? Man Ther. 2016 Dec;26:125-131. doi: 10.1016/j.math.2016.08.005. Epub 2016 Aug 26. https://www.ncbi.nlm.nih.gov/pubmed/27592038
Ralli M, Altissimi G, Turchetta R, et al. Somatosensory Tinnitus: Correlation between Cranio-Cervico-Mandibular Disorder History and Somatic Modulation. Audiol Neurootol. 2016;21(6):372-382. doi: 10.1159/000452472. Epub 2017 Jan 19. https://www.ncbi.nlm.nih.gov/pubmed/28099967
Ralli M, Greco A, Turchetta R, et al. Somatosensory tinnitus: Current evidence and future perspectives. J Int Med Res. 2017 Jun;45(3):933-947. doi: 10.1177/0300060517707673. Epub 2017 May 28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536427/
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