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Michiels S1,2, van der Wal A1,3, Van de Heyning P2, De Hertogh W1
1University of Antwerp, Rehabilitation Sciences and Fysiotherapy, Antwerp, Belgium, 2Antwerp University Hospital, ENT and Communication Disorders, Edegem, Belgium, 3Hogeschool Utrecht, Utrecht, Netherlands
Background: Tinnitus or 'ringing in the ears' is the perception of sound in the absence of overt acoustic stimulation. It appears in 10 to 15% of the adult population and is typically caused by hearing loss or a noise trauma. In about 35% of tinnitus patients however, tinnitus is caused or worsened by changes in the somatosensory system of the cervical spine or temporomandibular area, then called somatosensory or somatic tinnitus (ST). Physiologically ST is explained by the existence of connections between the somatosensory system of the cervical spine and temporomandibular area and the dorsal cochlear nucleus, an important auditory area. Case studies suggest a positive effect of cervical spine treatment on tinnitus complaints in patients with ST, but no experimental studies are available.
Purpose: The aim of this study was to investigate the effect of a multimodal cervical physical therapy treatment on tinnitus complaints in patients with cervical spine related ST.
Methods: Forty patients with chronic tinnitus, in combination with substantial neck complaints (Neck Bournemouth Questionnaire(NBQ) > 14 points) received 12 sessions of 30 minutes cervical physical therapy treatment in a period of six weeks. Patients were randomized in an immediate-start therapy group and a group with a delayed start of therapy by 6 weeks to create a control group.
Tinnitus severity (measured using the Tinnitus Functional Index (TFI)) and global perceived effect (GPE) were collected at baseline, after six weeks wait-and-see in the delayed-start group, immediately after the last treatment session and 6 weeks after the last treatment session.
Results: Immediately after treatment, the average TFI-score decreased significantly (p=0.04) but increased again six weeks after the last treatment session. The NBQ-score decreased significantly directly after treatment (p 0.001) and maintained after 6 weeks follow-up (p=0.001). In week 6 of the study, a substantial improvement of the tinnitus was present in 58% of the immediate-start group compared to no improvement in the delayed-start group.
Further analysis of the data showed that patients whose tinnitus increases and decreases simultaneously with their neck pain are most likely to benefit from cervical physical treatment.
Conclusion(s): Cervical physical therapy can have a positive effect on tinnitus complaints in patients with a combination of tinnitus and neck complaints even in patients with long lasting tinnitus. Larger studies are however necessary to confirm this effect.
Implications: These results are of high clinical importance, since many patients with tinnitus are desperately seeking treatment to alleviate the burden of their tinnitus on daily life. Especially in patients whose tinnitus and neck pain are increasing and decreasing simultaneously, positive effects can be expected.
Keywords: Cervical spine, Tinnitus, Musculoskeletal
Funding acknowledgements: The first and second author are supported by a research grant from the 'Fonds voor wetenschappelijk onderzoek Vlaanderen' (FWO) (T001916N).
Purpose: The aim of this study was to investigate the effect of a multimodal cervical physical therapy treatment on tinnitus complaints in patients with cervical spine related ST.
Methods: Forty patients with chronic tinnitus, in combination with substantial neck complaints (Neck Bournemouth Questionnaire(NBQ) > 14 points) received 12 sessions of 30 minutes cervical physical therapy treatment in a period of six weeks. Patients were randomized in an immediate-start therapy group and a group with a delayed start of therapy by 6 weeks to create a control group.
Tinnitus severity (measured using the Tinnitus Functional Index (TFI)) and global perceived effect (GPE) were collected at baseline, after six weeks wait-and-see in the delayed-start group, immediately after the last treatment session and 6 weeks after the last treatment session.
Results: Immediately after treatment, the average TFI-score decreased significantly (p=0.04) but increased again six weeks after the last treatment session. The NBQ-score decreased significantly directly after treatment (p 0.001) and maintained after 6 weeks follow-up (p=0.001). In week 6 of the study, a substantial improvement of the tinnitus was present in 58% of the immediate-start group compared to no improvement in the delayed-start group.
Further analysis of the data showed that patients whose tinnitus increases and decreases simultaneously with their neck pain are most likely to benefit from cervical physical treatment.
Conclusion(s): Cervical physical therapy can have a positive effect on tinnitus complaints in patients with a combination of tinnitus and neck complaints even in patients with long lasting tinnitus. Larger studies are however necessary to confirm this effect.
Implications: These results are of high clinical importance, since many patients with tinnitus are desperately seeking treatment to alleviate the burden of their tinnitus on daily life. Especially in patients whose tinnitus and neck pain are increasing and decreasing simultaneously, positive effects can be expected.
Keywords: Cervical spine, Tinnitus, Musculoskeletal
Funding acknowledgements: The first and second author are supported by a research grant from the 'Fonds voor wetenschappelijk onderzoek Vlaanderen' (FWO) (T001916N).
Topic: Musculoskeletal: spine; Disability & rehabilitation
Ethics approval required: Yes
Institution: Universitair Ziekenhuis Antwerpen
Ethics committee: Ethics committee of the Universitair Ziekenhuis Antwerpen
Ethics number: B300201421113
All authors, affiliations and abstracts have been published as submitted.
