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

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

Man Ther. 2016 Aug 26;26:125-131

Authors: Michiels S, Van de Heyning P, Truijen S, Hallemans A, De Hertogh W

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.

PMID: 27592038 [PubMed - as supplied by publisher]

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