“What Is That Ringing In My Ears?” by David Coletta, MPT, CMPT

Although tinnitus, or ringing in the ears, can be a sign of serious brain pathology, tumors, and hearing loss, this condition can also be often diagnosed by your physician as idiopathic tinnitus.  Such a diagnosis indicates no known or verifiable cause to the ringing in your ears.  Ruling out the more concerning problems through brain imaging, neurological testing, and hearing tests is helpful, but often leaves the patient with no real answers about how to decrease or eliminate the annoying sound.  One theory regarding the source of idiopathic tinnitus centers on the musculoskeletal system as a trigger for ear ringing. 

The term somatic tinnitus has been offered by some to describe this condition.  A complex system of nerves in the brain, the brain stem, and the neck/head exist in the human body.  The balance in this system can sometimes be disturbed by injury or strain to the neck or jaw muscles and joints.  Such strain can exist after trauma or be present with poor posture and/or emotional stress.  Muscles in the head and neck often becomeImage result for ears ringing picture very tight and irritable during periods of stress and anxiety.


I have had the opportunity to work with hundreds of head, neck, and jaw pain patients over the last 20 years, which has shown me the high prevalence of idiopathic tinnitus in this population.  These individuals are often referred to me by ENT physicians, who have cleared the patients from any true hearing problems.  The key to helping these patients lies in locating the dysfunction (often stiffness) in the muscles and joints of the head and neck, allowing the therapist to develop a treatment plan.  Joint mobilization/manipulation, massage, dry needling trigger point release, posture re-education, and targeted exercises are necessary to treat the patient in a comprehensive way.


Many of the patients that I evaluate for tinnitus also have complaints of neck and head pain.  Most of these patients have significant improvement in ear ringing and pain complaints with specialized physical therapy.   Almost all of my clients have already been screened by their general physician and an ENT specialty physician.  Somatic tinnitus is not the most common cause of ringing in the ears, but perhaps the least understood and most undertreated.


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About David Coletta, MPT, CMPT:

As the founding owner of Excel Physical Therapy, David strives for our clinics to deliver unprecedented excellence with patient care in the Gallatin Valley. David established Excel in 2001 on the principles of specialization, advanced education and customer service.

David specializes in the treatment of back and neck pain, spinal issues, whiplash, headaches, TMJ/jaw pain, and postural dysfunctions. David received his masters in physical therapy from Mount St. Mary’s College in Los Angeles, California. He enjoys finding long-term solutions for his patients — solutions that involve a fine-tuned combination of manual manipulative therapy and a targeted exercise program that address even the most difficult patient presentations.

A considerable amount of David’s advanced training occurred through the North American Institute of Orthopedic Manual Therapy (NAIOMT). He has completed advanced certification in manual therapy (CMPT) with NAIOMT, and he has received advanced training in dry needling techniques for the spine and extremities. David is a Certified Clinical BikeFit Pro Fitter and treats patients out of our Bozeman, Montana office. You may schedule an appointment with him at 406.556.0562.