Elsevier

Manual Therapy

Volume 26, December 2016, Pages 125-131
Manual Therapy

Original article
Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?

Highlights

Tinnitus and neck complaints decreased after physical therapy treatment.

53% of the study population experienced substantial improvement of tinnitus.

Improved patients report TFI decrease of 11.9 points.

Abstract

Background

Tinnitus can be related to many different aetiologies such as hearing loss or a noise trauma, but it can also be related to the somatosensory system of the cervical spine, called cervicogenic somatic tinnitus (CST). Case studies suggest a positive effect of cervical spine treatment on tinnitus complaints in patients with CST, but no experimental studies are available.

Objective

To investigate the effect of a multimodal cervical physical therapy treatment on tinnitus complaints in patients with CST.

Design

Randomized controlled trial.

Patients

Patients with a combination of severe subjective tinnitus (Tinnitus Functional Index (TFI): 25–90 points) and neck complaints (Neck Bournemouth Questionnaire (NBQ) > 14 points).

Intervention

All patients received cervical physical therapy for 6 weeks (12 sessions). Patients were randomized in an immediate-start therapy group (n = 19) and a 6-week delayed-start therapy group (n = 19).

Measurements

TFI and NBQ-scores were documented at baseline, after the wait-and-see period in the delayed-start group, after treatment and after 6 weeks follow-up. The Global Perceived Effect (GPE) was documented at all measuring moments, except at baseline.

Results

In all patients (n = 38) TFI and NBQ-scores decreased significantly after treatment (p = 0.04 and p < 0.001). NBQ-scores remained significantly lower after follow-up (p = 0.001). Immediately after treatment, 53% (n = 38) experienced substantial improvement of tinnitus. This effect was maintained in 24% of patients after follow-up at six weeks.

Conclusion

Cervical physical therapy can have a positive effect on subjective tinnitus complaints in patients with a combination of tinnitus and neck complaints. Larger studies, using more responsive outcome measures, are however necessary to prove this effect.

Trial registration

NCT02016313.

Keywords

Somatic tinnitus
Cervical spine
Physical therapy
Treatment
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