Effects of complex neck therapy – kinesiotherapy and interspinal muscles massage – on tinnitus

Abstract

Introduction: Past studies have shown connections between the somatosensory system (the neck and temporomandibular joint region) and the auditory system. It is therefore likely that tinnitus patients might benefit from neck therapy. The aim of this study was to investigate the effects of physiotherapy of the neck, comprising cervical spine kinesiotherapy and interspinal muscles massage, on subjective tinnitus. We also investigated the effects of the therapy on the range of cervical spine motion and cervical muscles tension.

Material and methods: This was a non-randomised controlled trial. Adult patients with chronic subjective tinnitus (n = 118) were enrolled in an intervention group and received 10 sessions, over 2 weeks, of neck therapy comprising active exercises, massage of the cervical interspinal muscles, and post-isometric relaxation exercises. There was also a control group (waiting list). The effects of the therapy on tinnitus were assessed at baseline, immediate post-treatment, and follow-up (2 weeks after the end of therapy) using the Polish Tinnitus Functional Index (TFI-Pl, primary outcome measure), a visual analogue scale (VAS) of tinnitus loudness, and the Polish Tinnitus Handicap Inventory (THIPl). Effects of therapy on neck were assessed using two measures: the range of cervical spine movement (cervical flexion, cervical rotation, and cervical side bending measured in cm using a tape measure); and muscle tension – assessed by palpation and graded using a scale of either 0 (normal) or 1 (increased).

Results: In the intervention group, the mean TFI score was reduced significantly from baseline (mean = 52.6, SD = 20.4) to post treatment (mean = 40.9, SD = 19.0, p < 0.001) and at follow-up (mean = 40.4, SD = 21.1, linear mixed model). In the control group, mean TFI score did not change significantly from baseline (mean = 46.8, SD = 20.1) to post treatment (mean = 45.8, SD = 40.9) and follow-up (mean = 45.2, SD = 26.2, linear mixed model). Improvement in tinnitus in the intervention group was accompanied by a reduction in cervical muscles tension and improvement in the range of cervical spine motion.

Conclusions: Complex neck therapy of the neck appears to be a promising intervention for tinnitus treatment. Further randomised studies are needed to confirm the positive effects of the therapy on tinnitus and explore the mechanisms leading to improvement.