Tinnitus 2: The Car Accident


  • A 68 y-o man was driving alone and was T-boned on his left front side, spinning the car 180˚ to the right
  • Dashboard and knee airbags deployed
  • Although he was discharged the night of the accident, his later pain led to a CAT scan and an MRI, which were unremarkable
  • He was very bruised, had sore left shoulder and neck, and developed headaches
  • Other symptoms included extreme fatigue, brain fog, cognition problems, breakdowns, tremors, apathy, light sensitivity, low sex drive, episodic incontinence and poor sleep
  • Five of his teeth had been chipped in the accident
  • He saw me 6-weeks after the accident c/o tinnitus and headaches

Evaluation, clinical reasoning & treatment strategizing

  • His main complaint was shoulder, neck and jaw pain, along with frontal headache
  • He had been told he had left-sided allodynia, especially in the shoulder and torso
  • The  right-sided tinnitus only rose to prominence once other symptoms abated
  • He described it as high pitched, that when bad was pulsating
  • His cervical ROM was poor in flexion, lateral flexion and rotation
  • He had a droopy right eyelid


  • At certain times he had PT, DC, psychotherapy and NMT all on the same day
  • My focus was to reduce sympathetic overload and provide pain mechanism education
  • Initial treatment began with SCM, scaleni, deep head of masseter, trapezius and all the shoulder muscles
  • Next, was added the extra-oral routine and palatine muscles
  • Once his stress levels allowed he permitted intra-oral jaw muscle work and supra and infrahyoids. Always SCM
  • I worked the mimetic muscles as part of his headache treatment
  • Later, I worked on RCL, the cranial bones and the mastoid bone routine
  • A year after the accident he saw the esteemed neurologist, Dr. Bob Gerwin MD in Bethesda MD for a two-hour consultation. The conclusion was all symptoms corresponded to  Barré Liéou syndrome (cervicogenic headache from WAD). He confirmed the importance of SCM as a main contributor to symptoms

 and follow-up

  • Once his headaches, shoulder, neck and jaw pain abated, tinnitus was his main reason for visiting
  • He could have weeks where it was half what it used to be
  • He was very stressed while going through the litigation process, and through his work as a landlord and this exacerbated the tinnitus symptoms
  • Control of his stress was paramount
  • He saw me weekly, then monthly for 4 years.
  • I have not seen him professionally since the pandemic began in early 2020, but he told that he is doing well after meeting him by chance in a car repair shop that he had recommended