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Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?
S Michiels1, P Van de Heyning2, S Truijen3
1Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium.
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.
