Cervical Tinnitus: Can Neck Injuries Lead To Ringing Ears?

If you’ve recently suffered a neck injury and are experiencing persistent ringing in your ear, it’s possible you’re dealing with tinnitus, especially if the sound is inaudible to others and has no external cause.

Recovery from a neck injury can be lengthy and accompanied by a range of discomforting symptoms, from stiffness to severe headaches. Although these symptoms typically subside over time, tinnitus can continue to worsen and become overwhelming.

To better understand and manage your condition, it’s crucial to explore the connection between head or neck injuries and tinnitus. There are effective ways to alleviate tinnitus symptoms and improve your quality of life during the recovery process.

Can Neck Injuries Cause Tinnitus?

Besides ringing, tinnitus can present itself as buzzing, humming, whistling, clicking and even roaring in one or both ears. This can happen for several reasons, but the takeaway is that generally, others can’t hear these sounds. 

Based on current medical research, the most common and well-respected theory of tinnitus suggests that this results from inner ear damage. This damage affects how nerves translate sound to the brain, leading the brain to perceive sound that isn’t actually present – there is no real sound, your brain just thinks there is. Another theory links tinnitus to pre-existing abnormalities between the auditory cortex and other neural circuits.

However, we do know for sure that head or neck trauma can cause tinnitus. From a pool of 2,400 patients, 279 respondents cited some form of neck trauma as a precursor for their chronic tinnitus. 

From this, we learned a few things:

• The number of men who suffer from tinnitus as a result of a neck or head injuries is significantly higher than women
• Tinnitus associated with neck or head trauma is more likely to affect younger people
• Tinnitus causes difficulties with concentration, focus, and memory. It may also make it harder to detect soft sounds and other noises.
• Phantom sounds may be louder and more severe in tinnitus caused by head and neck injuries.

How Head And Neck Injuries Cause Tinnitus

Tinnitus, a condition characterized by persistent ringing in the ears, can manifest in either one or both ears; however, many individuals who have sustained head and neck injuries experience it in just one ear. The intensity and presence of the sound vary— it can be a constant companion or an intermittent annoyance. The condition is deemed chronic when symptoms persist beyond six months. Pulsatile tinnitus, a rarer form, syncs its phantom noises with the patient’s heartbeat and is sometimes observed in those who have suffered head or neck trauma, possibly stemming from specific incidents like motor vehicle accidents. In its more severe form, tinnitus has the potential to overpower thoughts and mask external sounds, with its severity often directly correlated to the extent of the head and neck trauma endured. This type of trauma, frequently resulting from slips and falls, vehicular accidents, vigorous physical activities, sports injuries, or physical assaults, can lead to alterations in blood flow, damage to sensitive auditory structures and blood vessels, as well as injuries to the auditory nerve.

A common head trauma, a concussion, can cause neck pain and result in tinnitus symptoms. However, thankfully, concussions are less likely to cause these symptoms beyond a month so the tinnitus symptoms experienced are not classified as chronic tinnitus. Chronic tinnitus sticks around for longer, even if the effects of the head or neck trauma don’t affect hearing itself.

Are All Kinds Of Tinnitus The Same?

There are four types of tinnitus:

• Subjective tinnitus: the type of tinnitus that can’t be heard by others, no matter how loud it is to you. This is often related to excessive exposure to noise and noise-induced hearing loss.
• Objective tinnitus: the only type of tinnitus that a doctor can hear during an examination. This is a result of abnormalities in the muscles or blood vessels around one ear.
• Neurological tinnitus: the type of tinnitus experiences by those that suffer from certain types of brain disorders.
• Somatic tinnitus: the type of tinnitus that occurs as a result of issues with a patient’s sensory system.

Tinnitus can therefore have several origins outside of head or neck injuries. These include:

• Ear canal obstruction or infections
• Hearing loss
• Head or neck tumors
• Chronic conditions such as diabetes, lupus and migraines
• Certain medications
• Drug and alcohol abuse
• High blood pressure
• Exposure to loud noises

Certain auditory conditions or disorders have also been cited as possible causes of tinnitus. Though common symptoms are shared between them, it was noted that tinnitus caused by head and neck injuries is louder and more frequent than tinnitus of unknown or mixed origins. Tinnitus sufferers who had head injuries were also more prone to dizziness.

There are, however, no real distinctions between pitch, the number of sounds, hearing level, and masking level.

What Causes Cervical Tinnitus?

The neck is one of the most vulnerable areas of the body. We instinctively protect it, but sometimes head and neck injury is unavoidable. Besides neck pain and discomfort, traumatic injury to the spinal cord can affect the way the nerves in your neck function and cause cervical tinnitus. 

Even seemingly minor incidents, such as falling onto your back, have the potential to result in cervical tinnitus. More severe incidents, like motor vehicle accidents, can induce upper cervical instability (UCIS), with cervical tinnitus being one of the various symptoms that might manifest subsequently.

It’s crucial to clarify that neck injuries themselves do not directly produce the sounds associated with cervical tinnitus. Instead, they disrupt the normal signaling process to the brainstem’s sound-detecting structures, resulting in the perception of phantom noises. Here, we delve into the intricacies of how neck injuries can culminate in cervical tinnitus, aiming to provide a clearer understanding of this complex condition.

Cervical Spondylosis

Cervical spondylosis, or the ‘arthritis of the neck’, happens when the cushioning between cervical vertebrae wears away. This can result in severe neck pain which then can cause cervicogenic somatic tinnitus.

In one study on the link between cervical disorders and tinnitus, 64% of patients with tinnitus as their main symptom also have cervical pain. 44% of the patients who complain about cervical pain as their main symptom also have cervical tinnitus. 

Eustachian Tube Dysfunction (ETD)

The Eustachian tube serves as a vital connection between the middle ear and the rear of the throat, remaining closed most of the time and only opening during actions such as yawning, chewing, or swallowing. Its primary functions are to protect the middle ear from pathogens and to regulate air pressure within the middle ear, aiding in the hearing process.

Eustachian Tube Dysfunction occurs when the Eustachian tube does not open or close as it should, leading to a sensation of fullness in the ear. This irregularity in ear pressure can result in a range of symptoms, including tinnitus (ringing in the ears), difficulties in hearing, and challenges with balance. By understanding the critical roles of the Eustachian tube, we can better comprehend how its malfunction can contribute to these auditory and equilibrium issues.

Carotid Artery Compression

Tinnitus caused by carotid artery compression happens when the ligaments in the neck get injured, and the carotid arteries compress or get narrowed. The changes in blood flow can cause pulsatile tinnitus (objective tinnitus which can be heard by others during a medical exam), ear pain, and in severe cases, hearing loss. Hearing loss can also be caused by vagus nerve impairment.  

Internal Jugular Vein Compression

Humming tinnitus can come from changes in blood flow patterns of the jugular vein on either side of the neck. The greater the degree of compression, the more severe the tinnitus, and the easier it is to detect during examination. The compression as well as the tinnitus can cause hearing loss. 

Increased Intracranial Pressure

Increased intracranial pressure occurs when head and neck injuries or illness cause pressure to build up in the skull. This pressure can also lead to internal jugular vein compression and is considered a serious condition. Besides ringing in the ears, many patients describe hearing whooshing sounds, as well as whistling and marching in one or both ears. 

Blocked Cerebrospinal Fluid

Cerebral spinal fluid, or CSF, is a clear, nutrient-rich liquid that surrounds the brain and spinal cord. When trauma occurs, a tear in brain tissues allows this fluid to seep into other parts of the body, and can block all cranial nerves. This drop in CSF in the head may cause a pressure drop which may trigger tinnitus. 

Vestibular Neuritis

Also called Labyrinthitis, vestibular neuritis is characterized by severe balance issues and vertigo. This is caused by inflammation of the vestibulocochlear nerve, and can also happen when the vestibulocochlear nerve is blocked by cerebrospinal fluid. This results in tinnitus, and other balance and concentration-related issues. 

Meniere’s Disease

Meniere’s disease is a rare inner ear disorder. This condition triggers spontaneous bouts of vertigo and hearing loss, ear fullness, and tinnitus. People with this condition would describe it as ‘attacks’ that can last anywhere from a few hours to a few days.

Though the exact cause of Meniere’s disease is unknown, we do know that upper cervical spine disorders and their symptoms are more common in patients with the disease. When compared to the general population, 75% of those with Meniere’s disease agree that “head and neck movements in the atlanto-occipital and atlanto-axial joints and triggered attacks of vertigo”.

So, Can Neck Problems Cause Tinnitus?

Even if you don’t have a neck injury per se, neck pain and problems can still cause tinnitus. Neck pain and problems are fairly common, and are often a result of poor posture. This can happen during exercise, when sitting at a computer desk, or even when sleeping. These problems can also arise when the muscles in the neck are overused and become injured. 

These ailments typically go away with a little rest, de-stressing, diet, and paying attention to posture. But, when left untreated, persistent tension in the neck can cause chronic neck pain. This tension can lead to vagus nerve compression, which can block signals to the veli palatini muscle. When this happens, pulsatile tinnitus may follow. 

Eustachian Tube Dysfunction may also arise when tension in the neck affects the tensor veli palatini muscle. This is connected to the trigeminal nerve and can cause a painful condition called trigeminal neuralgia. This may also lead to pulsatile tinnitus. 

In some cases, the cranial nerve itself becomes overstimulated and can overstimulate the brain. This produces non-pulsatile tinnitus. Other tinnitus sufferers with temporomandibular joint disorders, or TMJ, experience tinnitus because of teeth clenching and grinding.

Signs And Symptoms

• Neck tightness, tenderness, and cramping in muscles
• Difficulty smiling
• Twitching 
• Phantom sounds in one ear (unilateral tinnitus)
• Feeling of fullness in one ear
• Facial numbness on one side (tinnitus ear)
• Jaw movements affect tinnitus volume

Treatments

The best way to treat tinnitus caused by neck tension is to release the tension that is at the root of the issue. The first line of treatment includes special neck exercises and massages, proper diet, and rest. This is usually accompanied by basic heat and water therapy.

Biofeedback is recommended in some cases to teach patients experiencing tinnitus to isolate and relax certain muscles. This is meant to treat tinnitus by reducing the intensity of these symptoms. Other treatments include sound therapy, hearing aids, tinnitus retraining therapy (TRT), and cognitive behavioral therapy (CBT).

Temporomandibular disorders can be treated with a night guard, but drug therapies and mechanical treatment options also prove effective.

Somatic Tinnitus

Somatic tinnitus is a type of tinnitus that doesn’t occur as a result of hearing loss, but rather as a result of problems within the sensory system. The body can only pick up sounds in two ways: from the dorsal cochlear nucleus (DCN) in the brainstem, and from the inferior colliculus (IC) in the midbrain.

Auditory signals travel from hair cells in the cochlea and certain muscles to the DCN in the brainstem, then go to the IC in the midbrain for processing. When the DCN is impaired, it can become hyperactive and affect the way we interpret sound. 

The DCN can become impaired in several ways – two examples are from whiplash or teeth grinding problems. This may be a reason there are many origins of tinnitus. Doctors can confirm tinnitus using specific somatic maneuvers.

The root cause of this specific disorder lies in the stiffness of the muscles found in the neck, face, and jaw areas. Somatosensory tinnitus manifests through alterations in the volume, pitch, or spatial perception of sounds triggered by stimulation from the neck or head region. To effectively address this auditory condition, a comprehensive treatment plan that encompasses a variety of exercises and therapeutic techniques focusing on the muscles is essential. Typically, the primary issues leading to this auditory condition are associated with the neck, head, or jaw, as opposed to being ear-related. Employing massage techniques can be beneficial in mitigating these illusory sounds, working to lessen muscle tension in the neck, face, and jaw, and ultimately fostering a state of tranquility and relief in the affected tissues.

Improving Tinnitus From The Neck

Identifying the underlying cause of tinnitus is the best way to reduce tinnitus. Unfortunately, there are clear disparities in the way it’s diagnosed and treated. Many doctors still only examine the ear, but studies have shown a closer look at the head or neck is needed before ruling the area out. 

Tinnitus that occurs as a result of neck pain and injury is sometimes treated with physical therapy. Drug therapies and alternative treatment options such as massage, acupuncture, and chiropractic care have been known to treat tinnitus.

Injection Painkillers

There’s no debate whether addressing cervical spine instability is one treatment option for tinnitus symptoms. In a recent study, injection painkillers were proven to minimize the effects of tinnitus in the third and fourth cervical nerves. At least half the patients in the study experienced tinnitus relief at around four months after the initial injection.  

Steroid Therapy 

Using steroid injections, doctors in another recent study were able to lessen the intensity of tinnitus in 18% of their patients. This tinnitus treatment targeted C6 and C7 and was especially beneficial to patients with no hearing loss at 8 kHz and no disc degeneration at C4-C5.

Cervical Spine And Jaw Therapy

Tinnitus due to neck trauma or neck pain can potentially be fully reversed with cervical spine and jaw therapy. Successful treatment methods include soft tissue massages, repetitive movements, and joint manipulation.

Explore Our Hearing Aids

For those who have pre-existing tinnitus that worsened with a head or neck trauma or who are experiencing chronic tinnitus related to a recent head or neck trauma it might be time to visit your local hearing care professional. It is important to have your hearing health evaluated to determine if there has been any underlying damage to your auditory system that needs addressing to help alleviate your tinnitus symptoms.

Hearing aids can be used to help manage tinnitus, especially for individuals with hearing loss. Browse our hearing aid selections, or get a free consultation to find the right fit for you.  

Tinnitus Treatment Alternatives

Your medical doctor will likely find the best treatment management plan for your head and neck trauma and  you can turn to  a hearing care professional for support to alleviate your tinnitus symptoms. A multi-pronged treatment approach is typically the most successful when looking for tinnitus relief.  There are also alternative tinnitus treatment options that you can add to your multi-prong treatment  approach such as:

• Acupuncture
• Sound therapy
• Masking devices
• White noise machines
• Yoga

Treating Cervicogenic Tinnitus With Treble Health

At Treble Health, we recognize the unique challenges posed by cervicogenic tinnitus, where neck issues and auditory symptoms intertwine. Our team of audiologists have worked at top practices around the country, and have decades of experience in helping patients to manage their tinnitus. Our team is here to provide guidance, support, and actionable solutions tailored to your specific condition. We invite you to take the first step towards relief by scheduling a complimentary telehealth consultation.

In this 20-minute Zoom session, our audiologists will delve into your unique situation, answering any questions and offering personalized strategies to manage and alleviate your tinnitus symptoms. We understand that tinnitus is not just a noise; it’s a condition that affects every aspect of your life. Our commitment is to guide you back to a sense of calm and control. Click here to book your free consultation and embark on the journey to a quieter, more peaceful life.