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Tinnitus, TMJ, Neck Pain and Headaches

Posted in TMJ Disorder on Sep 21, 2020

 

What type of Tinnitus do you have?

Did you know that tinnitus may actually be connected with headaches, your jaw, and a mechanical problem with your upper neck?

If you’ve recently started to experience tinnitus - or even if you’ve been experiencing it for a long time - I’m sure that you can appreciate that it can be more than a mild annoyance. It can be completely life disruptive like a goblin buzzing around inside your brain.

It can affect your ability to think. It can affect your ability to sleep. It can affect your mood.

The thing about it is that not all tinnitus is created the same way.

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Sensorineural Tinnitus and Hearing Loss

Certainly, one of the first and most important people to see if you experience tinnitus is your GP and an audiologist, who will likely order a CT scan and do hearings tests to determine if you are experiencing sensorineural tinnitus, which is caused by damage to the cochlear nerve or by something sinister like a brain tumour.

Usually, it isn’t the latter.

Sensorineural tinnitus is sometimes also associated with “industrial deafness” from having worked a lifetime around noisy machinery (but is increasingly common among fans of rock, metal, and loud music concerts) or prolonged headphone use.

If the nerve is damaged, then your GP or audiologist may refer you to a neurologist for tinnitus treatment.

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However, if your tests come back as “normal” (except for maybe a little bit of hearing loss, and not enough to account for your tinnitus), then it means that there must be something else going on.

 

Pulsile Tinnitus

Another possibility is known as “pulsile tinnitus” which is tinnitus that follows the rhythm of your heartbeat. This type of tinnitus is commonly associated with a blood flow issue within your brain: either blood going into your brain through arteries, or blood draining from your brain through veins. 

One of the most valuable tests that a tinnitus specialist or neurologist may recommend is called an MRA or MRV scan. These are specialised types of MRI scans that show blood flow in your brain, and if there is some construction point that would explain the “whooshing” tinnitus sound that you experience. 

Again, it is important to rule out pulsile tinnitus caused by something sinister like a brain tumour of infection. Usually, it is not the case.

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But then you are left with the question, “Well, if my scans are saying that ‘Everything is normal’ WHY am I experiencing this sound in my head.”

 

Somatosensory Tinnitus

The answer may be because you don’t have nerve damage, and you don’t even have a pathological condition, but that you are experiencing a functional neurological symptom as the result of something else.

Consider the example of a computer with a cracked screen and a spam infection. The cracked screen is like a pathological condition (e.g., infection, tumour, etc) that you can clearly see.

A spam or malware problem on your computer, however, is not visible per se, but certainly affects the way your computer works.

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That is what a functional neurological symptom is.

And tinnitus may well be an example.

It is known as “somatosensory tinnitus,” where something is affecting the normal sensory transmission of nerve signals to your brain, but that a “signal distortion” is producing an abnormal noise like static on the radio that your brain perceives as a ringing or buzzing noise.

If so, you may now be wondering what type of problem could cause somatosensory tinnitus.

 

What does Tinnitus have to do with my TMJ and my Neck?

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There are two major sources of neurological input that are commonly associated with somatosensory tinnitus, and they are your temporomandibular joints (TMJ, or jaw) and your upper cervical spine (C1 and C2 vertebrae) at the base of your skull.

Your TMJ, your C1, and your C2 vertebrae contain and extremely dense volume of nerve receptors, specifically the type that is involved with pressure (mechanoreceptors) and movement/balance (proprioceptors). 

In brief, your brain requires a huge volume of input to know where your skull is in open space, and it is sitting upright relative to the horizon. It is one of the reasons that the C1 vertebra is also known as the “atlas” because it supports the weight of your skull.

So will all this neurological information going to your brain, let me posse the possibility that a percent of it may experience a “transmission error.”

If the joints of either the TMJ, the C1, or the C2 and injured causing a shift in their position and abnormal movement by even a millimetre, the nerve receptors may bombard your brain will a swell or abnormal neurological information.

Think of it like a car accident on a busy freeway on a Friday afternoon. The normal volume of traffic gets compounded, leading to delays and gridlock.

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When this happens, it may be possible for the information to “spill” over into adjacent areas of the brain and therefore produce strange symptoms. It is called the “Dysafferentation hypothesis.”

Because the nerves that transmit information from the TMJ, the C1, and C2 vertebrae are closely associated with the nerve centres involved with balance, hearing, and coordination, it may be possible that the “spillover” occurs in those areas.

If so, it may be possible that you go on to experience tinnitus, dizziness, vertigo, or even hearing problems (such as Meniere’s disease) as the result of a physical or mechanical problem in your jaw or your upper neck. 

 

What does Tinnitus have to do with my TMJ Pain, Neck Pain, and Headaches?

It is important to add that there are also pain receptors (nociceptors) in your jaw and upper neck. However, it is possible that you can still have or experience problems with your TMJ, C1, or C2 and not experience any pain.

Nevertheless, IF YOU ALSO EXPERIENCE SYMPTOMS SUCH AS TMJ PAIN, NECK PAIN, HEADACHES, MIGRAINES, DIZZINESS, VERTIGO, OR FIBROMYALGIA, then there could well be a connection to your tinnitus!

It is also important to note that problems with the alignment of the C1 or C2 vertebrae have also been shown to affect blood flow to-and-from the brain. Therefore, it is possible that even if you experience pulsile tinnitus that the point of constriction may be coming from your upper neck!

In addition, there is an important reciprocal relationship between the alignment and function of your TMJ and your upper neck. In brief, your upper neck affects the position of your jaw and visa versa

Therefore, a problem with one can cause a problem with the other … and then either one may be responsible for somatosensory tinnitus.

 

Upper Cervical Chiropractic, Tinnitus and TMJ

So how do you know if your tinnitus or other symptoms may be coming from your TMJ or your upper neck?

 Well, as we already said, it is important to rule out the dangerous or pathological things like you have probably already done. This may involve seeing your GP, audiologist, or even neurologist.

If your tests come back as “normal,” then you may well be dealing with a functional condition as we mentioned, that requires different turps of healthcare.

This may involve seeing a head, neck, or jaw physiotherapist, chiropractor, or acupuncturist.

Many people experience great relief with this type of allied health and other tinnitus specialists. 

However, there is still a percentage of people who experience symptoms despite their best efforts. If so, there may be additional tests needed on a higher and more precise level to identify exactly what is going on.

And this type of person is who we are and how we may be able to help you if you are experiencing tinnitus: an upper cervical specific chiropractor

Upper cervical chiropractic is remarkably different from what most people think of as chiropractic. Foremost, there is no neck twisting, cracking, or spinal manipulation. Second, an upper cervical chiropractor focuses on the relationship of your jaw and upper neck (C1 and C2) because of their unique relationship to your nerve system and the function of your entire body.

Misalignment in this area of the spine may only be a few millimetres large, which is why they are not often observed on common x-rays, CTs, and MRIs.

Therefore, what upper cervical chiropractic does BEFORE any treatment is performed a series of physical and neurological tests to determine If you have a problem with your upper neck that could be connected with your tinnitus. And then if so, he/she takes a series of x-rays or advanced images that are customised for your unique bone structure.

Every human being is different on both the outside and the inside. Therefore, when the internal differences are taken into account, we are often able to see joint misalignments that provide evidence of damage and how those problems may be producing the very type of abnormal nerve problems associated with somatosensory tinnitus.

In this way, upper cervical care is not a treatment for the symptoms of tinnitus. It is an approach to restore the function and motion through the joints in the upper neck (and by proxy, the TMJ) in order to restore normal neurological communication so that your brain and body and are to do what they are designed to do: heal themselves naturally.

 

Upper cervical chiropractor Brisbane

Upper cervical care is not new (90+ years), but is unfortunately very uncommon in Australia with fewer than 20 advanced certified practitioners. 

Atlas Heath is the premier upper cervical specific healthcare centre in Brisbane and the leader for Blair upper cervical care in Australia. Our practice located in North Lakes (north Brisbane) accepts clients from across the SE Queensland and Sunshine Coast regions, including many visitors who seek care from across the state and country.

Our mission is to provide hope, healing and long term outcomes for people experiencing chronic conditions such as tinnitus so that they can get back to enjoying the quality of life that they desire most. 

We recognise that there are many facets to tinnitus: some that we may be able to help, and others that we cannot. For this reason, our practice is happy to offer a complementary 15-minute phone consultation without a principal upper cervical chiropractor, Dr. Jeffrey Hannah, to discuss your condition and answer any question you may have so that you can decide if care may be right for you.

Dr. Hannah is an advanced certified Blair upper cervical chiropractic doctor. He is a published author, lecturer, and recognised leader in the field of upper cervical chiropractic care internationally. 

If you would like to schedule a 15-minute complementary phone consultation with Dr. Hannah, you can contact our office at 07 3188 9329. Alternatively, you can click the Contact Us, and one of our staff will reply to your email as soon as possible.

It is our privilege to be trusted with your health, and we will do your best to assist you.

Atlas Health Australia - “Hope, healing, and wellbeing from above-down, inside-out.”

 

References

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Greenbaum T, Dvir Z, Reiter S, Winocur E. Cervical flexion-rotation test and physiological range of motion - A comparative study of patients with myogenic temporomandibular disorder versus healthy subjects. Musculoskelet Sci Pract. 2017 Feb;27:7-13. doi: 10.1016/j.msksp.2016.11.010. Epub 2016 Dec 11. https://www.ncbi.nlm.nih.gov/pubmed/28637604

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Häggman-Henrikson B, Rezvani M, List T. Prevalence of whiplash trauma in TMD patients: a systematic review. J Oral Rehabil. 2014 Jan;41(1):59-68. doi: 10.1111/joor.12123. Epub 2013 Dec 30. https://www.ncbi.nlm.nih.gov/pubmed/24443899

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