Efficacy of Manual Therapy in the Treatment of Somatic Tinnitus

Gaziler Physical Medicine and Rehabilitation Education and Research Hospital31 enrolled

Overview

Somatic tinnitus is an unpleasant perception of sound that occurs in the absence of any external acoustic stimulus. Despite the correct diagnosis of somatic tinnitus, there is currently no specific treatment. The hypothesis of this study is that the application of manual therapy to the cervical region will help to treat tinnitus in patients. This study aims to investigate the effectiveness of manual therapy in the treatment of somatic tinnitus of cervicogenic origin.

Somatic tinnitus is an unpleasant perception of sound that occurs in the absence of any external acoustic stimulus. It results from complex interactions between the somatosensory and auditory systems, which involve the musculoskeletal system rather than the ear. The temporomandibular joint, craniocervical junction, cervical vertebrae and neck and shoulder muscles, in particular the sternocleidomastoid (SCM) muscle, upper trapezius and levator scapula, are anatomical regions that can cause somatic tinnitus. Despite the correct diagnosis of somatic tinnitus, there is currently no specific treatment. The hypothesis of this study is that the application of manual therapy to the cervical region will help to treat tinnitus in patients. This study aims to investigate the effectiveness of manual therapy in the treatment of somatic tinnitus of cervicogenic origin.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Tinnitus, Subjective

Interventions

Manual TherapyOTHER

Manual Therapy

ExerciseOTHER

Isometric and strengthening exercises for the cervical region, which are provided to patients with cervical pain and limitation

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: Patients aged ≥ 18 and ≤ 65 years Patients fulfilling the clinical criteria4 defined for sevichogenic somatic tinnitus 1. Neck pain 2. Cervical joint range of motion limitation (especially rotation) 3. Modulation of tinnitus in relation to head and neck movements and posture 4. Tenderness in the cervico-occipital muscles Patients reporting cervical pain between \>2 and \<7 on a visual analogue scale (VAS) on most days of the last month Patients with stable medical and psychological status Patients willing to participate in the study Exclusion Criteria: Objective tinnitus Subjective tinnitus with hearing loss Meniere's disease History of vertigo Middle ear pathologies History of intracranial pathology History of whiplash injury History of cervical spinal surgery History of active infection, malignancy, inflammatory rheumatic disease or fibromyalgia Pregnancy Patients who have undergone any exercise or physiotherapy programme for the cervical region in the last 3 months

Locations (1)

Gaziler Physical Medicine and Rehabilitation Educiation and Research Hospital

Ankara, Turkey (Türkiye)

Outcomes

Primary Outcomes

Visual Analogue Scale for Tinnitus (VAS-tinnitus)

The severity of tinnitus will be graded using a 10 cm visual analogue scale (VAS, 0-10 cm; 0 means no tinnitus, 10 means extremely severe tinnitus).

Time frame: baseline- week 3 - week 6

Secondary Outcomes

Visual Analogue Scale for cervical pain (VAS-Cervical)

Pain intensity will be assessed with the visual analogue scale (0-10mm), which has proven validity and reliability for measuring musculoskeletal pain.

Time frame: baseline- week 3 - week 6

Tinnitus Handicap Index (THI)

The THI contains a total of 25 items with functional (11 items), emotional (9 items) and catastrophic (5 items) subscales. Each item is rated 0 (not affected), 2 (sometimes affected) or 4 (always affected). The total score ranges from 0 to 100, with higher scores indicating higher levels of disability of perceived tinnitus.

Time frame: baseline- week 3 - week 6

Neck disability index (NDI)

The NDI is designed to assess self-reported neck functional status. The questionnaire consists of 10 items related to pain, activities of daily living, weight lifting, reading, headache, concentration, working status, driving, sleep and recreation and is rated on a 6-point Likert scale ranging from 0 (no disability) to 50 (major disability). Higher scores represent greater disability. The NDI has been found to be reliable and valid for cervical disorders.

Time frame: baseline- week 3 - week 6

Cervical range of motion (ROM)

Time frame: baseline -week 3- week 6

Manual muscle testing (MMT)

MMT for assessing strength of cervical flexors, extensors, lateral flexors, and rotators

Data from ClinicalTrials.gov

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