Effects of complex neck therapy – kinesiotherapy and interspinal muscles massage – on tinnitus
Shikha Spencer 1, A-C,E-F
Magdalena Sereda 2,3, D-F
Jurek Olszewski 1, A,D,G
Jan Bulla 5,6, C
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Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Medical University of Lodz, Poland
Nottingham Biomedical Research Centre, National Institute for Health and Care Research (NIHR), Nottingham, United Kingdom
Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, United Kingdom
Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Teaching Hospital of the Medical University of Lodz – Central Veterans’ Hospital, Lodz, Poland
Department of Mathematics, University of Bergen, Norway
Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
Submission date: 2023-05-21
Acceptance date: 2023-06-30
Online publication date: 2023-09-21
Publication date: 2023-09-21
Corresponding author
Marzena Mielczarek   

Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Medical University of Lodz, Zeromskiego 113, 90-549, Lodz, Poland
J Hear Sci 2023;13(3):19-30
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).

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.

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.

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