Two steps forward one step back
Coming back here to post as I received some very supportive comments from a couple of users here to a recent post, which really helped my state of mind. I wanted to share a bit about my tinnitus journey and what has helped (and not helped) so far.
I developed tinnitus following a slap to the face about 10 weeks ago. It was also accompanied by neck stiffness and pain, though I already had neck stiffness and pain, and jaw pain prior to this occurring.
I initially saw an ENT, and subsequently an audiologist, who ruled out any hearing loss. I then saw a Physical Therapist, who gave me some vestibular exercises (walking while looking at a dot) and some postural strength exercises (using a resistance band). The latter made my neck pain and tinnitus considerably worse so I stopped seeing that PT. Around the same time I also had a follow up with my ENT, who essentially told me there was nothing anybody could do, and that PT would not help. The only intervention they suggested was CBT to help manage it and learn to live with it.
That was about 4 weeks ago and was a low point in my journey for sure.
Following advice here I sought out a different PT with more experience in TMJ issues, and was lucky enough to find an excellent person. For the last three weeks or so I have been doing a very different set of PT exercises - intra-oral massage and jaw massage, and very small and controlled neck exercises.
About a week after starting this PT I randomly experienced one afternoon / evening of much lower volume. This was the first downward variation in the volume since the onset of my tinnitus (I had been able to vary it upwards but not down). The next day I was back to full volume!
But then a week later I started experiencing lower volumes in the mornings, ramping up by the end of the day.
Now, three weeks into this PT regimen, I am in a very variable state. My overall volume is lower (more of a static white noise than the high-pitched whine I started with), and I have some longer periods where I do not notice it at all. Then occasionally (like yesterday) I will have another loud day. I have noticed that after my PT sessions (where we do a lot of manual work), the volume increases, but is then lower the following days.
I've been spending a lot of time tracking my progress and trying different interventions, but wanted to tell you what (for me) has worked and not worked. I would guess most of this is fairly specific to somatic tinnitus linked to muscle guarding in the face and neck.
Things that worked
- PT involving manual therapy of the jaw and neck and intra-oral massage / release, and small (not strength-based) postural exercises. I have about 30 mins worth of PT exercises that I am doing about twice a day at the moment.
- Using LLMs to log progress, assess interventions and try to feel better about set-backs, and for general motivation (if I moaned to my partner about this as much as I moan to Gemini we would have broken up by now)
- Flexeril (muscle relaxant) does help me when things are bad, but it also makes me sleepy and I usually experience a 'bounce-back' after I stop taking it so I'm trying to use it less
- Clonazapam (benzo, dials down nervous system) also helps with both intensity and related anxiety... less help than the Flexeril but also less side effects
- Cervical neck pillow: the type with the divot in the middle. About 50 bucks from Amazon, and really made a difference to how I felt in the mornings
- Sleep: one of the biggest things is how well rested I am. The more I sleep, the better it is.
- Upgrading my desk chair and workspace: more lumbar support and avoiding pushing my neck forward at my desk has helped
- Hydration: waking up dehydrated makes it worse
- Breathing exercises: Just a few simple deep breathing exercises when things are bad have really helped
Things that have not worked or made things worse
- Booze: I enjoy a drink, but have noticed that this makes a real difference. Up to about two glasses of wine is fine, but any more than that makes things worse the next day. Liquor always makes things worse the next day, and a hangover = a raging tinnitus day
- Stress: any stressful situation spikes the tinnitus
- Exercise: this is tricky because I want to exercise, but the more active I am the worse the tinnitus is immediately afterwards. Obviously I'll have to work through this eventually!
- Massage: I booked a couple of myofascial release type massages. These were fine and dandy and I enjoyed them, but they didn't move the needle on the tinnitus
- Generic PT: This was the worst thing I did I think. Being given generic postural strengthening exercises just sent everything back into spasm and locked me up and set me back weeks I think. I wish I'd found my current PT first.
- ENT: I'm glad my ENT was able to rule out hearing loss - that was an important step - but the fact that she attempted to discourage me from other interventions at my follow up is hard to forgive. I was in constant discomfort and distress at the time - if I had listened to her and not bothered with my current PT I might still be there now.
- Neck heating pad from Amazon: Meh... it feels nice but it doesn't really do anything
- Noise filtering earbuds: just tried this for a concert but they made everything sound really muffled. I don't think loud noises are really triggering me but I'd like to start looking after my hearing long term
- Eating hoagies: Big sandwiches, italian hoagies etc... anything putting a lot of strain on my jaw muscles spikes things for me.
I think that's it. I'm hoping the improvements I've made continue, and trying not to feel demoralised on days where it feels like I've taken a backwards step. I have a new found respect for sufferers of this condition (and really for anyone dealing with chronic pain or similar health issues).
Love to all.