Persistent Tinnitus: Causes and Connections to Neck Issues

Q: Persistent Tinnitus: Causes and Connections to Neck Issues

Hello： If the hearing test shows no significant abnormalities, common tinnitus is often related to anxiety, insomnia, and high stress levels. <br>It is advisable to avoid excessive focus on the tinnitus phenomenon or to gradually adapt by using music or external sounds to mask it

Tinnitus in the right ear for an extended period?

Hello Doctor: I have been experiencing tinnitus for 4 weeks now, but my hearing test is still pending.
I would like to ask about my situation.
During this time, I have frequently cleaned my ears (using a bamboo ear scoop and cotton swabs that I have used for years).
I confirmed a fungal infection in my left ear, but initially, my right ear was fine.
One night, I remember cleaning my right ear vigorously, and when I woke up, I started to experience tinnitus.
However, the tinnitus does not feel like my ear is blocked; I can still hear the external environment clearly, but I have a continuous, persistent sound resembling cicadas that lasts 24 hours (though it does not significantly affect my daily life, and I cannot hear it while sleeping, which I fall asleep easily).
If the external noise is loud, I do not particularly notice the cicada sound, but it is more pronounced when wearing a safety helmet.

Initially, the cicada sound was a continuous tone, but after researching online, I came across the term pulsatile tinnitus, and I feel that I experience both the continuous cicada sound and a pulsating sound that coincides with my heartbeat, creating a composite sensation of both sounds.
One day, while lying on my stomach to retrieve something from under the bed, I felt blood rush to my head, and my right ear felt blocked as if I were at a high altitude, accompanied by a different pulsating sound that was not the cicada sound.
When I lifted my head, it returned to normal.
Currently, I perceive the following: 1.
I do not feel dizzy, but the more I think about it, the more I feel like I might be dizzy, although I am not.
2.
My hearing feels equally clear in both ears.
3.
An ENT clinic used an endoscope to examine my nasopharynx, and everything appeared normal; they also removed earwax from my right ear.
I felt some discomfort in my ear canal from cleaning, but both the clinic and a teaching hospital said my right ear looked fine.
4.
During this period of tinnitus, both ears occasionally feel itchy, prompting me to use my fingers to scratch.
5.
The tinnitus remains as described above.
6.
I have had an X-ray and am currently awaiting the hearing test results.
Initially, the clinic noted that there was a piece of earwax too close to my eardrum, so they prescribed ear drops for a while, but they have not been effective.
Could this possibly be unrelated to ear issues and instead be related to my neck and shoulders? I previously experienced tension in my neck and shoulders due to stress, which led to fascial issues in my neck, causing some dizziness and facial numbness at that time (which has since resolved).
I have also noticed that my neck and shoulders feel slightly sore, and sometimes I experience a sensation of tightness in my gastrointestinal tract (I have a history of irritable bowel syndrome but underwent a colonoscopy last year to rule out colorectal cancer).
If I move my jaw or apply pressure to my right shoulder and neck, it seems to amplify the tinnitus sound, but it does not go away.
Thank you, Doctor.

Niu, 30~39 year old female. Ask Date: 2018/01/16

Dr. Zheng Jueyi reply Otolaryngology

Hello: If the hearing test shows no significant abnormalities, common tinnitus is often related to anxiety, insomnia, and high stress levels.
It is advisable to avoid excessive focus on the tinnitus phenomenon or to gradually adapt by using music or external sounds to mask it.
Most cases will improve over time.
It is recommended to return for a follow-up examination and discuss further with your physician.
Wishing you peace and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2018/01/16

More Info

Understanding persistent tinnitus can be quite complex, especially when it is associated with other symptoms such as neck issues, muscle tension, and even gastrointestinal discomfort. Your experience of a continuous ringing or buzzing sound in your ear, which you describe as a "cicada sound," is a common form of tinnitus. Tinnitus can manifest in various ways, including constant sounds, pulsatile tinnitus (which is rhythmic and often in sync with the heartbeat), and can be influenced by a variety of factors.

From your description, it seems that your tinnitus began after a period of excessive ear cleaning, which may have led to irritation or injury in the ear canal. The fact that you have a confirmed fungal infection in your left ear suggests that there may be an underlying issue that needs to be addressed. However, it is also important to consider the possibility that your tinnitus could be related to other factors, such as muscle tension in the neck and shoulders, which you have previously experienced.

Muscle tension in the neck can lead to a condition known as cervicogenic tinnitus, where the tinnitus is thought to be a result of nerve irritation or compression due to tight muscles or misalignment in the cervical spine. This is particularly relevant in your case, as you mentioned experiencing shoulder and neck discomfort, which could be contributing to your symptoms. Stress and anxiety can exacerbate muscle tension, leading to a cycle of discomfort that may affect your auditory system.

Additionally, the connection between the ear and neck is significant. The auditory nerve, which transmits sound information from the inner ear to the brain, can be influenced by surrounding structures, including muscles and nerves in the neck. If there is tension or irritation in these areas, it could potentially lead to changes in how sound is perceived, resulting in tinnitus.

Your mention of gastrointestinal symptoms, such as a feeling of tightness, could also be related to stress and anxiety. The gut-brain connection is well-documented, and stress can lead to gastrointestinal issues, which may further complicate your overall health picture. It is not uncommon for individuals experiencing chronic stress to have a combination of symptoms affecting multiple systems in the body, including the auditory system.

Given the complexity of your symptoms, it is advisable to continue working with healthcare professionals who can provide a comprehensive evaluation. A multidisciplinary approach may be beneficial, involving an ear, nose, and throat (ENT) specialist for your tinnitus and ear concerns, as well as a neurologist or physical therapist who can address potential musculoskeletal issues in your neck and shoulders. Additionally, a mental health professional could help you manage stress and anxiety, which may be contributing to your symptoms.

In summary, while your tinnitus may initially appear to be an isolated ear issue, it is essential to consider the broader context of your health, including neck tension, stress, and gastrointestinal symptoms. A thorough evaluation and a holistic treatment approach may help alleviate your tinnitus and improve your overall well-being.

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