Issue link: https://www.massageandbodyworkdigital.com/i/1501042
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 75 PATHOLOGY PERSPECTIVES because the origins of these phantom noises are still not fully understood. One study made the case that tinnitus can be connected to both somatosensory factors (this refers to general sensory distortions like temperature, texture, and proprioception) and to somatomotor issues, which is to say musculoskeletal and fascial inf luences. 2 This finding proposes that tinnitus is a situation where manual therapies could have a positive impact. Another research team looked at incorporating manual therapies along with exercise and education for people who have tinnitus associated with temporomandibular joint (TMJ) disorders. This study includes some detailed descriptions of the work: "an oscillatory TMJ inferior glide accessory mobilization of mandible distraction intervention for 90 seconds. In addition, different manual therapies were applied, including pressure release, soft-tissue mobilization, or longitudinal strokes of the following cranio-cervical musculature: masseter, temporalis, sternocleidomastoid, and upper trapezius. These muscles were chosen because their pain referral is perceived around the TMJ, the ear, or the orofacial area and can contribute to tinnitus." This team found that adding massage of the neck and jaw muscles led to better outcomes compared to standard care. 3 A small-scale and completely unscientific poll of convenience-sampled massage therapists (i.e., people who responded to my Facebook post) yielded an interesting variety of responses about their work in the context of tinnitus. A general theme was that when tinnitus was related to muscle tension, TMJ dysfunction, or sinus congestion, various types of massage therapy were useful, at least in the short term. People described using myofascial release, cupping, lymphatic drainage, and craniosacral work with some success, although the duration of effect was not clear. But when the tinnitus arose from an acoustic injury or other type of trauma, bodywork appeared to be less helpful. And one person reported the onset of new tinnitus symptoms after receiving forceful bodywork to the neck: a truly adverse event! Tinnitus is common, annoying, and sometimes debilitating. Millions of people report that it negatively impacts their lives. No treatment is universally effective; it seems to be something many of us simply have to learn to live with. So that becomes the challenge: if massage therapy can lessen symptoms, that's wonderful. But another way to think about our work is to help people live with this condition and still have a good quality of life—and that seems like an achievable goal. (For more on this, please see the video that accompanies this article, "Tinnitus.") We don't know if Edgar Allan Poe had tinnitus, but "The Bells" could hint at it. From the introductory stanza about lovely sleigh bells, the poem intensifies into VIDEO: "TINNITUS" 1. Open your camera 2. Scan the code 3. Tap on notification 4. Listen! descriptions of discordant clanging, finally reaching the peak where the King of Ghouls relentlessly rings his iron bells (oh, the melancholy menace of their tone!) . . . And he dances, and he yells, Keeping time, time, time, As he knells, knells, knells, In a happy Runic rhyme, To the rolling of the bells— Of the bells, bells, bells— To the tolling of the bells, Of the bells, bells, bells, bells— Bells, bells, bells— To the moaning and the groaning of the bells. Notes 1. A. Henton and T. Tzounopoulos, "What's the Buzz? The Neuroscience and the Treatment of Tinnitus," Physiological Reviews 101, no. 4 (2021): 1,609–32, https://doi.org/10.1152/physrev.00029.2020. 2. Rob A. B. Oostendorp et al., "Cervicogenic Somatosensory Tinnitus: An Indication for Manual Therapy? Part 1: Theoretical Concept," Manual Therapy 23 (2016): 120–3, https://doi.org/10.1016/j.math.2015.11.008. 3. Pablo Delgado de la Serna et al., "Effects of Cervico-Mandibular Manual Therapy in Patients with Temporomandibular Pain Disorders and Associated Somatic Tinnitus: A Randomized Clinical Trial," Pain Medicine 21, no. 3 (2020): 613–24, https://doi.org/10.1093/pm/pnz278. Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology (available at booksofdiscovery.com), now in its seventh edition, which is used in massage schools worldwide. Werner is available at ruthwerner.com.