Trigger Points as a Cause of Tinnitus
Evaluation Video and Transcript
(except the Pterygiod muscles)
Frequently Asked Questions
The first 5 minutes of the video will answer MANY questions about what a trigger point is, how they came to treated in recent history , and who typically does this work.
Abbreviations and definitions:TP = trigger point – an area in muscle or tendon that has waste products built up, is usually tender to the touch, and when pressed, refers pain, an achy feeling, tingling, etc. to another part of the body through nervous system connections that are not activated by this pathway under normal circumstances TPT = trigger point therapy – Removal of waste products and resetting of nerve receptors and nerve pathway interaction through various means. – Press and hold – Press and hold the trigger point for several seconds. Release quickly. This method was the preferred method of Janet Travell, who popularized TPT many years ago. – Press and move – Press and manipulate the muscle or tendon tissue in order to flush out he waste products and reset nerve ending receptor activity. – Injections – This is the preferred method of the medical profession. Inject an anesthetic (and perhaps an anti-inflammatory or stimulating irritant) to reduce the nerve over-activity or to stimulate further activity to bring further inflammatory reaction and healing to the tissue. – Dry needling – Placing acupuncture needles into the affected muscle and related muscles in order to reactivate normal muscle function patterns.
We have long known that the toxins that build up in muscles can irritate the nerves of that muscle, sending irritating signals into the nervous system.
Janet Travell, MD did much of the pioneering research in this field during and after her success in treating John F. Kennedy for his chronic lower back pain. In 1942 she explained how these trigger points (toxins built up in muscles) could cause widespread nerve irritation (known as myofascial pain syndrome).
But pain is not the only form of nerve irritation these trigger points can cause.
In 2012, researcher William Teachey is quoted in the International Tinnitus Journal saying:
“Although pain is the best known symptom of this muscle disorder, [trigger points are] responsible for a large number and a wide variety of symptoms, especially in the head and neck(1). These symptoms often masquerade as primary disorders of the ear, nose, and throat(2). One of these symptoms is tinnitus(1,9,10). “ — http://www.tinnitusjournal.com/imagebank/pdf/v17n1a13.pdf
Also, in 2012 Rocha, another researcher, got serious about determining exactly what muscles could cause tinnitus and how we could tell if someone would be helped by appropriate therapy. (http://www.ncbi.nlm.nih.gov/pubmed/23306563)
Before the treatment: In people who had tinnitus, he evaluated, by hand, all the muscles that could be causing the tinnitus nerve irritation and asked the people how his evaluation affected their tinnitus. Did it make it temporarily louder, quieter, fewer or more tones?
Treatment: One one group of people (G1), he did 10 weekly sessions of specific, manual muscle work (TPT + MFR) and gave home exercises and habit changes (such as applying heat locally, stretching and postural instructions).
After treatment: The people were asked how their tinnitus had changed.
Results were best in the subgroup in which the tinnitus got quieter during Before-Tx evaluation:
- 5th Tx: Improvement was seen in Pain, Tinnitus Intensity, # of sounds, and total THI scores
- 10th Tx: some tinnitus frequency moved from constant to intermittent others moved from intermittent to absent
- 2-month f-u: 76% showed stable scores
If you have tinnitus, myofascial trigger points may be all or part of the cause.
Since only a few people are able to see me personally, I developed a self-evaluation technique. Follow this technique carefully to find out if myofascial trigger points are causing your tinnitus.
The eight muscles to be evaluated are described below for the RIGHT side. This should be repeated on the left also. You may find looking into a mirror to be VERY helpful in following these directions. If you choose, having a professional trained in muscle therapy follow these directions on you would be even better, but the following technique is designed to be done without the help of a professional.
Dr. Teachey, in the International Tinnitus Journal in 2012, said of muscle trigger point treatment, that “The only certain way to determine whether [trigger point] treatment will be of benefit for tinnitus is to carry out a therapeutic trial.”
***Here is the real important part.**************************
Before finding the critical muscles and trigger point within a muscle, you need to know how to use your hands in a way that brings the problem to the surface. Without the proper technique, it is entirely possible to go to the exact spot, “ground zero” of your tinnitus cause, and miss it. Let’s go over the 2 simple techniques you will use to locate and draw out the toxins from the trigger point.
Trigger Point Palpation techniques:
- [2-Finger] Press method – most common method. With the pad of your fingertip, press moderately deep into the muscle. I encourage you to move your finger around, feeling the muscle striations. Pressing for 5 seconds is enough. Use the pressure it would take to press well into the muscle tissue. This is the amount of pressure it would take to make a depression in molding clay. I prefer to use my index finger with my longest finger resting behind half of the index fingernail for support.
- Common modifications of this method include using the thumb as we do under the zygomatic arch for the jaw muscles and using the longest finger as the primary finger whenever it feels more natural.
- Pincher Method – Used for muscles you can reach around. Using your thumb and finger, reach around and squeeze the muscle, moving slowly across and along the muscle band looking for the hypersensitive area. Use the pressure it would take to gradually flatten a ball of molding clay.
- You will use these same techniques to correct the trigger point later. If you are very toxic, it may be too painful to apply the full pressure for a few sessions.
Now let’s move on to the self-evaluation and find out if you have trigger points causing your tinnitus.
Please understand, I cannot and have not given you medical advice. This is merely for educational purposes. You must make your decision based on your own understanding and your doctor’s advice.