Myofascial trigger points: another way of modulating tinnitus.

Tinnitus is a multifaceted symptom that may have many causes (otologic, neurological, metabolic, pharmacological, vascular, musculoskeletal and psychological) several of which often occur in the same patient. Tinnitus can often be modulated by different kinds of stimuli. In this chapter we describe the results of a study of modulation of tinnitus from stimulation of myofascial trigger points (MTPs). MTPs are small hypersensitive areas in palpable taut bands of skeletal muscles found in patients with the myofascial pain syndrome where stimulation of MTPs causes local and referred pain. We found a strong correlation between tinnitus and the presence of MTPs in head, neck and shoulder girdle (p<0.001). In 56% of patients with tinnitus and MTPs, the tinnitus could be modulated by applying digital compression of such points, mainly those of the masseter muscle. The worst tinnitus was referred to the side that had the most MTPs (p<0.001); Compression of the trigger point on the same side as the tinnitus was significantly more effective than the opposite side in six out of nine of the studied muscles. Compression of MTPs was most effective in patients who have had chronic pain earlier in the examined areas.