Vestibular Physiotherapy for Tinnitus Relief

Finding Relief from Tinnitus Through Vestibular Physiotherapy

Tinnitus, commonly described as a persistent ringing, buzzing, or hissing sound in the ears, affects approximately 15–20% of the population, often leading to discomfort and distress, especially when linked with dizziness or balance problems (Baguley et al., 2013). This condition is thought to arise from abnormal neural activity in the auditory system, which can stem from a variety of causes, including exposure to loud noise, age-related hearing loss, and vestibular disorders (Henry et al., 2005). Vestibular physiotherapy, while primarily known for treating balance and dizziness issues, has shown potential to help alleviate tinnitus symptoms, especially in cases where tinnitus coexists with vestibular dysfunction. At Advanced Vestibular Clinics (AVC), we work closely with patients to address both vestibular and tinnitus symptoms, enhancing quality of life through a comprehensive approach.

The Link Between Tinnitus and Vestibular Disorders

The vestibular system, housed in the inner ear, works alongside the auditory system to support balance, hearing, and spatial awareness. Because of their shared pathways, any disruption in the vestibular system can potentially influence hearing and vice versa, often leading to overlapping symptoms like tinnitus, dizziness, and vertigo (Møller, 2011). Disorders like Meniere’s disease, vestibular migraines, and vestibular neuritis frequently show coexisting tinnitus and balance issues, underscoring the importance of an integrated treatment approach.

How Vestibular Physiotherapy Can Help with Tinnitus

Vestibular physiotherapy, or vestibular rehabilitation therapy (VRT), aims to address sensory and balance disruptions in the vestibular system, which in turn can lessen the severity and impact of tinnitus. Here are some ways vestibular physiotherapy may benefit individuals experiencing tinnitus:

1. Reducing Dizziness and Improving Balance
   For many people, tinnitus coexists with dizziness and balance issues. VRT focuses on retraining the brain to process vestibular signals more accurately, which can lessen dizziness and, consequently, reduce the intensity of tinnitus (Shepard & Telian, 1995). Studies indicate that reducing vestibular symptoms can indirectly help diminish tinnitus-related distress (Zenner & Reinecke, 1999).
2. Addressing Sensory-Motor Discrepancies
   Individuals with vestibular disorders often struggle with sensory-motor disruptions, such as instability and poor eye-head coordination. VRT’s focus on improving proprioception (awareness of body position) and gaze stability helps reduce the brain’s sensitivity to abnormal sensory input, potentially decreasing tinnitus perception (Horak & Shumway-Cook, 1991).
3. Reducing Anxiety and Stress
   Anxiety and stress often exacerbate tinnitus, creating a cycle of discomfort. VRT includes exercises for relaxation and stress management, which help calm the nervous system and reduce the intensity of tinnitus (Jastreboff & Hazell, 1998). Many patients report a decrease in tinnitus severity when they adopt consistent relaxation practices alongside VRT.
4. Supporting Neuroplasticity and Adaptation
   VRT is based on the concept of neuroplasticity, where the brain can adapt and reprocess abnormal signals from the vestibular system. By following a structured exercise program, individuals can retrain their brains to better handle vestibular signals, which can lessen tinnitus and improve stability (Furman et al., 2010).

Common Vestibular Physiotherapy Exercises for Tinnitus Relief

At AVC, we personalize exercises to meet each patient’s needs. Here are some exercises that may be beneficial for those with both tinnitus and vestibular issues:

1. Gaze Stabilization Exercises
   These involve focusing on a stationary object while moving the head side-to-side, which helps improve visual fixation and lessen dizziness and tinnitus. Studies support that gaze stabilization reduces vestibular and tinnitus discomfort when practiced daily (Horak & Shumway-Cook, 1991).
2. Balance Training on Various Surfaces
   Training balance on unstable surfaces (e.g., foam) can enhance proprioception and stability, both of which reduce fall risk and ease tinnitus perception in some patients (Yardley & Luxon, 1994).
3. Breathing and Relaxation Techniques
   Breathing exercises and progressive relaxation help reduce stress and tinnitus symptoms. Research suggests that calming exercises have a direct effect on reducing tinnitus severity, making the symptoms more tolerable (Jastreboff & Hazell, 1998).

Is Vestibular Physiotherapy Right for You?

If you experience tinnitus alongside dizziness, imbalance, or vertigo, vestibular physiotherapy may be a valuable treatment option. At Advanced Vestibular Clinics, our approach is tailored to address both vestibular dysfunction and tinnitus symptoms, providing relief and enhancing day-to-day comfort. Contact us today to explore a personalized vestibular rehabilitation plan designed to support both your vestibular health and tinnitus management.

References

• Baguley, D., McFerran, D., & Hall, D. (2013). Tinnitus. The Lancet, 382(9904), 1600-1607.
• Henry, J. A., Dennis, K. C., & Schechter, M. A. (2005). General review of tinnitus: Prevalence, mechanisms, effects, and management. Journal of Speech, Language, and Hearing Research, 48(5), 1204-1235.
• Horak, F. B., & Shumway-Cook, A. (1991). Vestibular function: A basis for therapy. Physical Therapy, 71(10), 698-705.
• Jastreboff, P. J., & Hazell, J. W. (1998). Tinnitus retraining therapy: Implementing the neurophysiological model. Cambridge University Press.
• Møller, A. R. (2011). Tinnitus and vestibular dysfunction. Neuroscience Letters, 497(1), 134-137.
• Shepard, N. T., & Telian, S. A. (1995). Practical management of the balance disorder patient. ENT Journal, 74(4), 228-244.
• Yardley, L., & Luxon, L. M. (1994). The assessment and management of balance disorders in the elderly. Clinical Otolaryngology, 19(3), 226-233.
• Zenner, H. P., & Reinecke, M. (1999). Therapy of chronic tinnitus by retraining: Implementation of the Jastreboff model. HNO, 47(10), 929-944.
• Furman, J. M., Cass, S. P., & Whitney, S. L. (2010). Vestibular disorders: A case-study approach to diagnosis and treatment. Oxford University Press.