Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?
Faculty of Sciences. Biology
Faculty of Medicine and Health Sciences
Translational Neurosciences (TNW)
Rehabilitation Sciences and Physiotherapy (REVAKI)
Manual therapy / Manipulation Association of Chartered Physiotherapists. - Edinburgh
26(2016), p. 125-131
University of Antwerp
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): 2590 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.