Many people with tinnitus are told they will just have to live with it. For some, that isn't the whole story. When the neck or jaw is influencing the tinnitus, there is often something we can work with. This is called somatosensory (or somatic) tinnitus. This article explains what it is, the signs that your neck or jaw may be involved, what the research says about treatment, and what realistic goals look like.
What is somatosensory tinnitus?
Somatosensory tinnitus is tinnitus that is influenced by input from the neck or jaw. It happens because the hearing system and the nerves from your head and neck meet in the same place. Sound travels from the inner ear to a relay station in the brainstem called the dorsal cochlear nucleus. That same relay station also receives signals from the jaw, face and upper neck. Signals from these areas can turn its activity up or down (Shore et al. 2016). This helps explain why clenching your jaw, moving your head or pressing on your neck can change the loudness or pitch of your tinnitus. This is called somatic modulation.
Signs your neck or jaw may be involved
Researchers led by Prof. Sarah Michiels at Hasselt University built a four-question screening tool, the RaSST, from survey data on 7,981 people with tinnitus (Michiels et al. 2022). It identified somatosensory tinnitus with 82.2% accuracy. The four questions are:
Do your tinnitus and your neck or jaw pain increase and decrease together? This was the strongest sign.
Do you have tension in the muscles at the base of your skull?
Does your tinnitus change when you move your head, neck or jaw?
Do you clench or grind your teeth?
Answering yes to some of these doesn't confirm a diagnosis. It means a proper assessment of your neck and jaw is worth considering.
What an assessment often finds
A 2026 study from the same research group assessed the neck and jaw of people diagnosed with somatosensory tinnitus (Demoen et al. 2026). The most common findings were:
Reduced coordination or strength of the deep neck muscles
Active trigger points in the neck muscles, found in 95% of people
Active trigger points in the jaw muscles, found in about half
Reduced jaw movement, especially pushing the lower jaw forward
Reduced neck movement and less accurate sense of neck position
No two people had the same mix. The authors concluded that a thorough clinical assessment is essential to guide treatment. That's why every tinnitus assessment at our clinic examines both the neck and the jaw.
What treatment can and can't do
Physiotherapy for somatosensory tinnitus combines education, exercise and hands-on techniques aimed at the neck, the jaw, or both. A 2023 review by Prof. Michiels found this approach reduces tinnitus severity or loudness in most cases, while complete remission is rare (Michiels 2023).
So the realistic goal is usually habituation, not resolution. Habituation means the tinnitus becomes less intrusive, so it bothers you less and takes up less of your attention. Treating the neck and jaw addresses one contributor to your tinnitus. It won't change the parts that come from the hearing system itself.
Your hearing still matters
Even when the neck or jaw is involved, hearing is part of the picture. Age-related loss of very high-frequency hearing starts from around 35, well before most people notice a problem (Škerková et al. 2023). A standard hearing test doesn't measure these frequencies. A review found that people with tinnitus but a normal standard hearing test often had poorer hearing in this very high range than people without tinnitus (Jafari et al. 2022). That's why we work closely with audiologists, and why a hearing assessment is an important part of understanding your tinnitus.
Understanding your tinnitus is part of managing it
The better you understand what is driving your tinnitus, the better placed you are to manage it. Explaining what is happening, why it is happening and how to influence your triggers is part of every session we run.
If your tinnitus changes with neck or jaw movement, or rises and falls with neck or jaw pain, an assessment can help you find out whether these areas are involved. You can book online through Cliniko or call us on 02 8528 2985. We're at 80 Bronte Road, Bondi Junction.
Some tinnitus needs a medical check first. See your GP if your tinnitus is in one ear only, pulses with your heartbeat, or comes with hearing loss in one ear or new neurological symptoms such as weakness or numbness (Tunkel et al. 2014). Sudden hearing loss needs urgent medical attention.
References
Shore SE, Roberts LE, Langguth B. Maladaptive plasticity in tinnitus: triggers, mechanisms and treatment. Nat Rev Neurol. 2016;12(3):150-160. doi:10.1038/nrneurol.2016.12
Michiels S, Cardon E, Gilles A, et al. The Rapid Screening for Somatosensory Tinnitus Tool: a data-driven decision tree based on specific diagnostic criteria. Ear Hear. 2022;43(5):1466-1471. doi:10.1097/AUD.0000000000001224
Demoen S, Timmermans A, Van Rompaey V, et al. Neck and jaw dysfunctions in somatosensory tinnitus: clinical insights and implications. Musculoskelet Sci Pract. 2026;83:103546. doi:10.1016/j.msksp.2026.103546
Michiels S. Somatosensory tinnitus: recent developments in diagnosis and treatment. JARO. 2023. doi:10.1007/s10162-023-00912-3
Škerková M, Kovalová M, Rychlý T, et al. Extended high-frequency audiometry: hearing thresholds in adults. Eur Arch Otorhinolaryngol. 2023;280:565-572. doi:10.1007/s00405-022-07498-1
Jafari Z, Baguley D, Kolb BE, Mohajerani MH. A systematic review and meta-analysis of extended high-frequency hearing thresholds in tinnitus with a normal audiogram. Ear Hear. 2022;43.
Tunkel DE, Bauer CA, Sun GH, et al. Clinical practice guideline: tinnitus. Otolaryngol Head Neck Surg. 2014;151(2 Suppl):S1-S40. doi:10.1177/0194599814545325
