Loosening Up: Can Muscle Tension Cause Tinnitus?

Easing muscle tension isn’t just a good excuse to get a massage – it can help quiet the ringing in your ears, too. True, there aren’t a lot of strong muscles inside your ears. However, strain on the muscles, especially the neck muscles, jaw muscles, nerves, joints, and other tissues in your head, neck, and shoulders has been reported to trigger tinnitus. It is possible that alleviating muscle tension in these areas may also provide tinnitus relief as well?

What Are Tinnitus Symptoms?

Tinnitus is the perception of sound when there is no external source. Everyone’s experience is different – some people hear tinnitus sounds for only a few seconds, but for others it is a persistent nuisance that can interfere with their ability to keep up with daily activities. Some tinnitus symptoms include:

• A ringing, buzzing, hissing, roaring, clicking, or whooshing sound in one or both ears
• Worsened mental health conditions like anxiety, depression, or insomnia
• Difficulty paying attention, socializing, or ignoring background noises
• Many tinnitus patients may also have hearing loss

There are many possible causes of tinnitus, just like there are many causes for neck pain and stiffness. However, the actual mechanism behind most tinnitus is thought to be the misinterpretation by the central auditory areas of the information coming from the periphery as they are processed by the auditory system. Scientists believe that in some tinnitus patients, tinnitus can be triggered by activity in the somatosensory system as well as somatomotor and visual-motor systems.

Tinnitus symptoms will also vary based on the type of tinnitus. For example, cervical tinnitus and somatic tinnitus (or somatosensory tinnitus) may cause tinnitus that resembles high pitched ringing, buzzing or hissing. Whereas, pulsatile tinnitus may result in a whooshing sound that is often in sync with the heartbeat and is often related to circulatory system problems. Somatic tinnitus and somatosensory tinnitus intensity may change in response to specific body motions such as opening or closing the jaw or moving the head or neck in certain positions. Cervical tinnitus is often related to neck injury which results in neck tension and damage to the nerves within the cervical spine. Movements of the cervical spine can trigger tinnitus symptoms to flare up with those who suffer from cervical tinnitus.

Somatosensory And Somatomotor Tinnitus

Somatosensory pathways are neural pathways that allow us to perceive various sensations, such as touch, temperature, pain and body position in space. Somatomotor system (or sensori-motor) is a body’s neural network that connects the brain, spinal cord, peripheral nerves and musculoskeletal structures. Somatosensory tinnitus is thought to arise from somatosensory stimulation, triggered by, among other things, muscle contractions or tense muscles.

Somatosensory tinnitus can be found in patients with tinnitus who have a history of head and neck trauma or pain, teeth grinding, or bad posture and many other muscle or skeletal related issues.

Understanding Muscle Tension And Strain

Nearly everyone has experienced the tightness of muscle tension – an uncomfortable condition in which muscle contractions are held for a long period of time. This tension leaves your muscles feeling tender, cramped, or dotted with small lumps (knots) that you can feel through the skin. Muscle tension usually goes away with rest and proper care, but in some cases, the muscle contractions can lead to longer-term stiffness that impacts your ability to be active. 

Causes of Muscular Tension

Unexpected or excessive physical activity is one of the most common causes of muscle pain and strain. Other causes include:

• Stress. Nervousness, anxiety, and other types of stress can make you tense up. This is a normal reaction, but chronic stress can put unnecessary pressure on your muscles. Stress restricts blood vessels, so your muscles receive less oxygen and waste products build up. Over time, this process contributes to excess tension, muscle spasms, and back pain.
• Changes in physical activity. It’s good to get plenty of healthy exercise, but if you overdo it, you can put excess strain on your muscles. On the other hand, a sedentary lifestyle can weaken your muscles and make them vulnerable to injury. Similarly, repetitive movement or positions can cause wear and tear on muscle groups without giving your body time to repair itself. 
• Consistent poor posture. If you’re not keeping your body in alignment, your muscles will compensate to support your weight. Some muscles weaken over time while others work too hard to maintain an awkward position. People who sit at desks or use their phones a lot often experience this kind of cervical pain. Even sleeping wrong can put pressure and strain on your muscles – especially your neck and shoulders. 
• Whiplash. If you’ve been in an accident or have an injury to your neck, you may notice stiffness, neck pain, and headaches. Your neck muscles may be weakened due to the trauma.
• Low magnesium or potassium. Electrolytes like magnesium and potassium help prevent cramps and tension by helping your body absorb calcium. Eat a balanced diet and maintain good nutrition to help keep your body in working order. 
• Dehydration. Hydration is essential to almost every bodily function, and without enough fluid, your muscles can contract or spasm. Waste can build up in the muscles, inflame the joints, and lead to pain.
• Poor blood circulation. Lack of oxygen from reduced blood flow reduces your muscles’ ability to rest and heal themselves, so if you have blood flow problems, you may feel cramping and soreness, especially in your extremities. 
• Certain medications. Some medications are known to cause jaw muscle contractions, including a class of antidepressants called SSRIs. This tension is especially noticeable if you clench or grind your teeth. 
• Certain health conditions. There are some medical conditions that can cause muscle pain, like those that trigger random involuntary movements, tremors, or extended muscle contraction. 

Which Strained Muscles Can Contribute to Tinnitus?

Any muscle in your body can become stiff, tense, or cramped, but the neck muscles, shoulders, back, and legs are most likely to be affected. Ongoing muscular tension in your neck can lead to chronic neck pain, which can in turn lead to tinnitus. Those who are experiencing tinnitus are often looking for tinnitus relief and thankfully, tinnitus treatment is available and effective for those who need it. People who experience neck pain sometimes experience vertigo (dizziness), tingling hands, headaches, ear popping, and tinnitus. Tension can lead to headaches and migraine if your pain is in your shoulders, neck, head, or scalp. 

Cervical Spine Disorders and Conditions

The bones in the head and neck are called the cervical spine, so tinnitus that results from pain in the neck may also be called cervical tinnitus. Similar to somatic tinnitus, cervical tinnitus can be a result of how certain muscles are working or moving. In these cases, you may experience pulsatile tinnitus (tinnitus synchronized to your heartbeat) or non-pulsatile as a result of cervical pain. Cervical pain may radiate down your spine, leaving you with a stiff neck. Those who suffer with pain or damage to the cervical spine and are suffering from cervical tinnitus may find relief from these symptoms with the help of physical therapy. With the help of physical therapy and a tinnitus specialist cervical tinnitus symptoms do not have to control your life.

How Does Muscle Tension Cause Tinnitus?

If you’re suffering from chronic neck pain, it is sometimes accompanied by tinnitus symptoms. The many muscles, nerves, and tissues in your neck, shoulders, and head are interconnected. Impacting one may lead to issues with another – and occasionally, you may notice tinnitus.

One of the most common ways neck tension causes a ringing in the ears is due to a disruption in your Eustachian tube function. The Eustachian tube is the opening that connects your middle ear to your nasal sinus cavity. It helps drain fluids from and equalize pressure in the middle ear, so when these are disrupted, by tight neck muscles disrupting the ability for these tubes to open and close as they normally would with body functions such as swallowing and yawning, your ears might feel stuffed and you might experience ringing in the ears. Eustachian Tube dysfunction can also occur in those who suffer from TMJ disorder for similar reasons, inflammation of surrounding tissues caused by the temporomandibular disorder can disrupt normal function of the Eustachian tubes function.

Pressure On Your Neck Muscles and Nerves

Excess neck muscular tension can compress the vagus nerve – one of the cranial nerves that links the brain to the rest of the body. You may also experience blocked signals to the veli palatini muscle (the elevator muscle in your soft palate). When this muscle doesn’t elevate properly, it can lead to Eustachian tube dysfunction and tinnitus symptoms. 

Another soft palate muscle, the tensor deli palatini, is linked to the trigeminal nerve – a network that picks up signals in many parts of your face, sinuses, neck, and ears. This nerve can run all the way down to the top of your spine and helps you turn and bend your neck. Tension in this part of the body can manifest as trigeminal neuralgia, leading to Eustachian tube dysfunction and tinnitus. 

Non-pulsatile tinnitus can also occur if the tension in the cervical spine affects the function of the cranial nerves. Cervical spine disorders, like slipped or herniated discs, degenerative disc disease, and other spinal problems can easily lead to neck pain and muscle contractions. When the cervical spine muscles are tense, the cochlear nucleus (the nerve group responsible for hearing) is typically overstimulated. Your brain reacts to this over-stimulation by signaling tinnitus. 

Temporomandibular Joint Disorders (TMJ) and Jaw Pain

The chewing joint at the corner of your jaw — called the temporomandibular joint — can easily become inflamed if you are habitually clenching or grinding your teeth. People with temporomandibular disorders often develop chronic tinnitus due to the damage to the joint. For some people with TMJ disorder, this can lead to a stiff neck, ear pain, or problems with the jaw muscles. In many cases, a dentist can provide pain relief and help you develop effective management strategies for somatic tinnitus caused by the tight muscles in the jaw. Tinnitus perception will vary among this patient population based on the severity of TMJ symptoms.

Pulsatile Tinnitus and Neck Pain

Pulsatile tinnitus can occur due to constriction of large blood vessels, such as the carotid artery, when neck muscles are too tense. This kind of tinnitus is usually described as a whooshing, throbbing or thumping sound, and is generally synchronized to your heartbeat.

Because this type of tinnitus is typically related to blood flow, or circulatory system problems, it is considered objective tinnitus (as opposed to the most common “subjective tinnitus”), meaning it can sometimes be heard by others, with the use of a medical device like a stethoscope. Pulsatile tinnitus patients should see a physician to rule out more serious underlying health conditions.

Symptoms Related to Tinnitus and Neck Pain

• Chronic tinnitus is only heard in one ear (unilateral tinnitus)
• A sensation of ear fullness on one side
• Facial numbness on the same side as the tinnitus
• Touching the face can trigger twitching that worsens the tinnitus symptoms
• Some tinnitus patients experience post-stroke like symptoms which make a full smile difficult 
• Jaw movement changes the volume of tinnitus in your ear
• If you are experiencing somatic tinnitus, opening and closing your mouth or adjusting jaw positioning may lower tinnitus intensity

Treating Tinnitus Caused by Muscle Tension

In order to relax tense muscles and ease the ringing in your ears, first see your audiologist and physician. This way, you can understand your auditory system as it relates to your head and neck pain, and your doctor can plan the best tinnitus treatment strategy for you. 

You can often treat this kind of muscle-related tinnitus with proper exercise, water therapy, heat therapy to reduce chronic pain and neck tightness. Gentle stretching and massage on the back and neck can help reduce stress and buildup of tension by relaxing your muscles and reducing pressure on your nerves in the cervical spine, easing somatic tinnitus.

You might also wish to try biofeedback – a relaxation technique that teaches you how to control certain autonomic body functions like pulse, muscle function, and skin temperature. Biofeedback can help manage stress and anxiety by changing your body’s reaction.

After addressing muscle and nerve issues, you may find tinnitus relief through sound therapy, hearing aids, cognitive behavioral therapy (CBT), and lifestyle changes. Talk to the audiologists at Treble Health to establish the tinnitus management plan that works for you.