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Bluegrass Doctors of

Physical Therapy, PLLC



Ringing in the Ears

Posted on August 13, 2015 at 8:45 AM

Do you Suffer with Ringing in the ears? (AKA Tinnitus). Have you had a myriad of tests only to find no cause for your symptoms? That feeling in your ear may be coming from a muscle. Believe it or not!

Lets dive a little deeper. 

The muscles of the head and neck were neglected as a cause of medical problems until Dr. Janet Travell described myofascial dysfunction (MFD). The tenets of MFD are described in the classic Travell-Simons text- book, Myofascial Pain and Dysfunction: The Trigger Point Manual (1). MFD is a primary muscle disorder which is characterized by: a) taut bands (tight bands of contracted muscle fibers), trigger points (TrPs, exquisitely tender, discrete nodule within the taut bands), muscle shortening and muscle stiffening, with attendant limitation of range of motion, motor abnormalities, and disturbed motor function; b) sensory abnormalities, such as tenderness and referred symptoms; c) autonomic changes which are occasionally present, especially in longstanding cases.


MFD develops as a result of muscle abuse in in- dividuals who have a poorly understood predisposition to this disorder. The muscle abuse takes the form of: a) overuse (e.g. sitting for many hours with poor posture, and other poor work ergonomics); b) misuse (e.g. para- functional chewing due to a dental problem); c) under- use; d) trauma (e.g. whiplash). Chronic tightening of the upper shoulder muscles from mental stress also plays a role. Other factors which promote myofascial dysfunction are metabolic, endocrine, and nutritional abnormalities. (These factors along with the muscle abuse factors are known as precipitating and perpetuating factors. The muscle abuse types of precipitating and perpetuating factors may not be readily apparent). There is a female: male incidence of MFD on the order of 3:1 to 9:18. Muscles involved with MFD can cause local or referred symptoms, or can incite secondary trigger points (termed satellite trigger points) which can in turn themselves cause local or referred symptoms. Although pain is the best known symptom of this muscle disorder, MFD is responsible for a large number and a wide variety of symptoms, especially in the head and neck. These symptoms often masquerade as primary disorders of the ear, nose, and throat. One of these symptoms is tinnitus. The influence of the musculoskeletal system upon certain types of tinnitus is well recognized.


Tinnitus of myofascial origin may be unilateral or bilateral. There are no predictive audiometric patterns for MFD tinnitus. Patients with severe hearing loss may completely clear their tinnitus with MFD treatment, and tinnitus sufferers with a normal audiogram may have no improvement with MFD treatment, and vice versa. Although there is no strong predictor of which patients will benefit from MFD treatment, the following factors are somewhat more predictive of a favorable outcome:


1. Tinnitus which has been present for a shorter period — e.g. under 2 years vs. 10-20 years.

2. Tinnitus which accompanies other myofascial ENT/head & neck symptoms.

3. Tinnitus which fluctuates in intensity synchronously with other myofascial ENT/head and neck symptoms.

4. Tinnitus which is more pronounced on the side ipsilateral (or on the same side) to the more prominent accompanying myofascial symptoms.

Sound like any of your symptoms? If you have these symptoms and all other patholgoy has been ruled out, don't give up! We can help!!! Give us a call at 1-502-771-1774. Your symptoms may be muscular in origin and can oftem be alleviated in 2-4 treatments!

Categories: Trigger Point, Manual Therapy, Dry Needling