- A 58 year-old dentist fell while waterskiing, landing heavily on the right side of his head.
- He subsequently developed bilateral tinnitus, L>R, described as a high pitched shrill
- CAT scans, cerebral angiogram and X-rays performed at Massachusetts General Hospital’s ENT department were all found to be normal.
- He had trouble sleeping because the ringing seemed louder at night.
- He was put on anxiety medication after three sleep studies came back normal.
- A course of multi-factorial therapies was prescribed, including pharmacology, P-Stim, Chiropractic and Acupuncture.
- He came to Myopain Solutions to address soft-tissue contributions to his tinnitus.
Evaluation, clinical reasoning & treatment strategizing
- He described his symptoms as a pulsatile high-pitched, shrill noise that at worst was 8/10 and at best 5/10.
- He had no hearing loss.
- Active movement of the head, and especially resisted neck movements changed the symptoms
- As a dentist he sat on the patient’s left, therefore he was habitually rotating his upper body and head to the right. We suspected that this might be a perpetuating factor.
- NMT treated trapezius, infraspinatus, splenius capitis, semispinalis capitis, sternocleidomastoid, middle scalene, masseter (especially the deep head) and temporalis.
- I co-treated with tinnitus expert the Otolaryngologist Dr. William Teachey of Virginia Beach VA, who administered trigger point injections, and Frank Carderelli a local acupuncturist, who also administered P-stim
- I treated all of the aforementioned muscles.
Results and follow-up
- During some treatments, we were able to reduce the patient’s symptoms to a 2/10. He described anything under a 6/10 “livable.”
- Results were best when combined with trigger point injections from his Otolaryngic physician in VA
- He experienced the most relief when performing isometric contractions of his neck muscles. This indicates a soft-tissue component still driving the tinnitus.
- He received dozens of these treatments to maintain results. His symptoms abated to bearable and he stopped treatments. I kept in touch every time I had my teeth cleaned
- He has since retired from dentistry to my chagrin