Chiropractic Care Techniques Uncovered to Reduce Tinnitus from TBI

Discover effective approaches in chiropractic care for TBI to enhance your quality of life and reduce tinnitus symptoms.

Traumatic Brain Injury and Hearing Problems: Understanding Tinnitus, Hearing Loss, Vestibular Disorders, and More

Traumatic brain injury, or TBI, occurs when the brain is damaged by a violent blow to the head. This may result from falls, auto accidents, sports mishaps, or other incidents. Many individuals with TBI experience hearing problems, including sensitivity to noise, ringing in the ears, or difficulty hearing sounds clearly. These issues may significantly impact day-to-day functioning, making it challenging to concentrate or appreciate peaceful moments. Vestibular abnormalities, or balance issues and lightheadedness, may also result from traumatic brain injury. This article covers the definition of TBI, its specific mechanisms of action, the hearing and balance problems it causes, and management strategies. We also examine the effects on the body of tinnitus, a frequent ringing sound associated with TBI. This handbook gives a comprehensive explanation of these difficulties in simple words, drawing on medical research and professional perspectives.

What Is Traumatic Brain Injury (TBI)?

Traumatic brain damage happens when the brain is injured by an external force. A bump, blow, or head jolt may all constitute this force. Additionally, a skull piercing may cause it. TBI may be moderate, like a concussion, or severe, such as a long-term loss of consciousness or permanent damage. Inside the skull, the brain is protected by cerebrospinal fluid. On the other hand, the brain may bounce against the inner walls of the skull after a severe collision. The brain tissues may rip, bleed, or bruise as a result. In moderate instances, headaches, disorientation, or lightheadedness may be symptoms. Coma, memory loss, and personality changes are all possible outcomes of severe TBI. TBI occurs often. Millions of individuals worldwide encounter it every year (NeuroTucson, n.d.). It is a major contributor to disability in the United States. Falling among the elderly, injuries sustained in sports by youth, and auto accidents that impact individuals of all ages are among the causes. Combat or explosions often cause TBI in military personnel.

A TBI Symptom Questionnaire Example:

Mechanisms of TBI: Primary and Secondary Injuries

It’s useful to dissect how the damage occurs in order to better comprehend TBI. Primary and secondary mechanisms of damage are the two basic categories.

The first injury happens at the point of impact. The force’s direct harm is this. This may happen in several ways. In a contact injury, the head is struck by an object, such as a baseball bat or the ground during a fall. This may result in bleeding under the skull, brain cuts, or fractures of the skull. Another is harm from acceleration and deceleration. In this case, the head jerks rapidly, similar to whiplash sustained in an automobile accident. As the brain moves inside the skull, nerve fibers are torn and stretched. Diffuse axonal injury is the term used to describe damage to the brain’s wiring (Chendrasekhar, 2024; Wikipedia, 2024). Delicate structures are harmed by pressure waves that surge through the skull and ear canals during bursts, such as those from explosions. This may cause immediate rupture of inner ear components or eardrums (NeuroTucson, n.d.; Armstrong et al., 2023).

After the initial injury, the secondary one may worsen over the course of several hours or days. Because inflammation decreases blood flow and results in ischemia—a condition in which cells do not get enough oxygen—the brain expands. When brain chemicals overflow, excitotoxicity occurs, which causes cells to become overexcited and eventually die. Cells may sustain additional harm from oxidative stress caused by free radicals. Cell mortality increases when energy failure occurs because cells are unable to generate power (Chodobski et al., 2019; Physiopedia, n.d.; Prins et al., 2019). These processes help explain why symptoms may worsen after the initial impact. For instance, swelling puts pressure on parts of the brain that regulate balance or hearing. Physicians can anticipate and treat issues more successfully when they have a better understanding of primary and secondary injuries.

When TBI occurs, it affects more than just thinking and mobility. Sensations, including hearing and balance, may be affected. Together, the brain and ear process sounds and maintain stability. Issues like dizziness, chronic ringing in the ears, or hearing loss may result from damage to either. Even if the damage seems minor, research indicates that individuals with TBI often report these problems (Harris et al., 2024). Damage may occur to the brain’s vestibular and auditory circuits, which transmit signals related to balance and hearing. Symptoms of this may last for weeks, months, or even years. It is easier to understand TBI and the reasons for hearing and balance abnormalities. We next examine the direct relationship between TBI and hearing problems.

 

How TBI Causes Symptoms Like Ringing in the Ears, Hearing Loss, and Noise Disturbances

TBI may harm hearing-related brain or ear regions. The middle, inner, and outer ears are the three primary components of the ear. Sound is detected by the outer ear. They are amplified by the middle ear’s small bones. Sound waves are converted into brain messages via the inner ear. A head injury may damage the delicate hairs in the inner ear, rip the eardrum, or shatter these bones. These hairs are sensitive to vibration. They cannot transmit clear signals if they are damaged, which can result in hearing loss. Sounds that are muted or have a lower loudness are indicative of hearing loss. Both ears may be impacted. TBI is often followed by tinnitus, or ringing in the ears. When the hearing centers of the brain get confused, this occurs. In the absence of appropriate ear signals, the brain produces its own noises, such as buzzing or ringing (Cleveland Clinic, n.d.). According to studies, tinnitus is more common among individuals with TBI, particularly among veterans (Coco et al., 2024).

Brain alterations can cause noise disturbances or increased sensitivity to noise. Everyday noises may become overpowering because the brain may have trouble filtering them out. Hyperacusis is the term for this. The auditory nerve or parts of the brain that process sound may be damaged by TBI (Theodoroff et al., 2022). According to one study (Vernon et al., 1994), tinnitus was louder in individuals who had experienced head trauma than in those who had not. According to another study, TBI exacerbates tinnitus and increases the frequency of headaches and lightheadedness (Folmer & Griest, 2003). Usually, these symptoms start just after the accident, but they may sometimes appear later. In military contexts, blast injuries are prevalent and exacerbate this. The pressure waves they produce harm both the brain and the ears (Clifford et al., 2022). According to Le et al. (2024), tinnitus is often caused by non-blast TBIs, such as those resulting from falls. Additionally, TBIs may result in brain edema or bleeding, which can obstruct hearing pathways. Signals are interfered with, resulting in distorted or continuous noise. The brain may adjust over time, but symptoms may persist for many people. These problems are not only bothersome. They impact relationships, employment, and sleep. Early detection facilitates therapy. Let’s now investigate the effects of TBI on general hearing and cognitive function.

How TBI Can Impact a Person’s Auditory and Cognitive Function

The ability to hear and process sounds effectively is known as an individual’s auditory function. Because TBI damages the brain or ear, it may impair this function. For instance, injury to the inner ear nerves results in sensorineural hearing loss. Similar to TBI, this form is difficult to treat (NeuroTucson, n.d.). People may struggle in loud environments, such as restaurants. Background noise and speech are indistinguishable by the brain. This is a dysfunction of central auditory processing. Even if their hearing tests appear normal, research indicates that individuals with TBI have difficulty processing language (Harris et al., 2024). Cognitive function includes the ability to think, remember, and pay attention. Often, TBI damages them. The situation becomes even more challenging when hearing problems are added to the mix. Concentration might be difficult due to tinnitus. Fatigue results from noise sensitivity, which increases stress.

Veterans’ TBI from explosions or noise is linked to tinnitus and hearing loss. Daily chores, such as following conversations, are impacted by this (Clifford et al., 2022). The brain has to work harder to hear, which leaves less energy for remembering, resulting in memory issues. This may lead to anxiety and depression. People may find constant ringing annoying and depressing. Tinnitus patients with TBI had greater rates of depression, according to one study (Folmer & Griest, 2003). Cognitive testing reveals that loud settings cause slower reasoning. Adults and children are different. Age is a major factor in the likelihood of hearing loss in adults. TBI, however, accelerates this. Cognitive function and hearing may both be enhanced by early intervention, such as the use of hearing aids. In general, cognitive and auditory problems are commonly associated with TBI. One benefit of fixing the other. Treatments help the brain adjust. Recovery is facilitated by understanding this connection.

 

Vestibular Disorders Caused by TBI

Vestibular diseases, often caused by TBI, are issues with the inner ear’s balance mechanism. Our sense of balance and spatial orientation is maintained by the vestibular system. Both the eyes and the bodily sensations are affected. TBI affects this system, resulting in imbalance, lightheadedness, and other problems.

Causes of Vestibular Disorders in TBI

Both direct and indirect damage to the vestibular system may result from TBI. One of the main processes is inner ear damage, such as the dislodging of small crystals known as otoconia. Benign paroxysmal positional vertigo (BPPV), the most prevalent vestibular problem after traumatic brain injury (TBI), results from this (Wallace & Lifshitz, 2022; Vestibular Disorders Association, n.d.; Akin et al., 2021). Fistulas, which are tiny holes in the ear that allow fluid to escape, may be caused by blasts or strikes. Secondary reasons include injury to core circuits in the brainstem or cerebellum, or swelling of the brain. These regions are responsible for processing impulses related to balance. Shearing pressures cause nerves to rupture, which interferes with communication (Alhilali et al., 2019; Ernst et al., 2021). Vestibular indications of acute TBI arise rapidly. About 50% of those who have traumatic brain injury say they feel lightheaded (NeuroTucson, n.d.). Over time, chronic cases—such as those resulting from repeated concussions—accumulate damage.

Symptoms of Vestibular Disorders

Vertigo, characterized by a spinning sensation, is a common symptom, particularly when shifting positions. Feeling lightheaded makes everything seem shaky. Falls or shaky walking, known as gait ataxia, are caused by balance issues (Alhilali et al., 2019). Vomiting and nausea often coexist, much like motion sickness. The ailment known as oscillopsia causes blurred vision when the head moves. As you move, your headaches and exhaustion become worse. Symptoms may persist in other conditions or last only a few seconds in BPPV (Vestibular Conditions Association, n.d.; Balance and Dizziness Center, n.d.). Individuals may underreport symptoms because they believe they are only related to the head injury. However, testing reveals problems in as many as 80% of TBI sufferers (Marcus et al., 2022).

Impact on Auditory and Sensory Functions

Balance is just one aspect of vestibular diseases; other senses, such as hearing, are also affected. Damage affects both the inner ear, which controls both sound and balance. For instance, dizziness increases stress, which might worsen tinnitus. The inability of the brain to integrate data from the body, eyes, and hearing results in sensory overload (AAPMR, n.d.). It affects day-to-day living. People with weak spatial awareness often struggle to navigate through crowds. Reading or driving may trigger symptoms. The brain adapts by increasing cognitive load, which causes more weariness and focus problems. In more extreme situations, it causes fear of falling. People often become socially isolated when they experience hearing loss. Early vestibular treatment may be beneficial, including activities that help realign crystals in BPPV (Wallace & Lifshitz, 2022). Gaining insight into vestibular issues demonstrates the wide-ranging impacts of TBI. Taking care of them enhances overall recovery.

How TBI Symptoms Like Tinnitus Can Affect a Person’s Sensory Function

Perception of touch, sound, sight, and other senses is all included in sensory function. TBI-related tinnitus interferes with this. It’s not only hearing; it also impairs balance and pain sensitivity. Tinnitus may cause discomfort while hearing noises. This hypersensitivity alters a person’s perception of reality. Noisy locations lead to overload, whereas quiet ones may be beneficial (Cleveland Clinic, n.d.). Related symptoms include the ears, neck, and head. Headaches are a widespread condition often resulting from stress or pressure in the brain. The most common cause of neck discomfort is whiplash injuries. Ears could hurt or feel full. Damage to the inner ear’s balancing system results in vertigo or dizziness. Everything is spinning because of this vestibular problem. Research indicates that dizziness affects 50% of TBI patients (NeuroTucson, n.d.). TMJ problems might cause jaw discomfort as one of the other symptoms. Potential problems with blood flow may be indicated by tinnitus that pulses in time with the heartbeat. Noise-induced sleep deprivation exacerbates sensory impairment.

Severe instances may cause blurred vision or eye fatigue. Increased touch sensitivity causes discomfort from wind or clothing. These impacts accumulate over time. Tinnitus can strain the body, potentially elevating blood pressure. Chronic weariness is the result of time. Tinnitus management aids in reestablishing sensory equilibrium. To this are added vestibular symptoms. Balance and movement senses are impacted by imbalance, which makes coordination challenging. Hearing problems, such as difficulty identifying noises, are exacerbated by this.

What Is Tinnitus? Its Causes and Symptoms Correlating with TBI

Perception of noises without an external source is known as tinnitus. Like phantom sounds, it might be roaring, clicking, buzzing, or ringing. It may be sporadic or ongoing (Cleveland Clinic, n.d.). Among the causes are noise exposure and aging-related hearing loss. TBI, however, is a giant. Brain regions or the ear nerves are harmed by head trauma. Tinnitus is caused by misfiring signals. Symptoms differ. Low hums and high-pitched ringing are experienced by certain individuals. After an injury, it may be in one ear. Loudness fluctuates with stillness or tension. Tinnitus often develops shortly after a TBI. According to Vernon et al. (1994), it is more annoying and louder in situations of head injuries. TBI veterans report significant disability (Coco et al., 2024). Infections, drugs, or earwax can also be other reasons. But what sets TBI apart is its immediate impact. Symptoms include difficulty concentrating, impatience, and insomnia. It becomes worse without therapy. But it may be covered up with methods like sound treatment. Since inner ear injury is a common cause of both vestibular problems and tinnitus in TBI, they may be related.

Clinical Observations from Dr. Alexander Jimenez

TBI and associated problems are discussed by El Paso, Texas, chiropractor and nurse practitioner Dr. Alexander Jimenez. He treats injuries resulting from jobs, sports, personal mishaps, and auto accidents, and has over 30 years of expertise (Jimenez, n.d.a; Jimenez, n.d.b). Dual-scope diagnosis is used in his practice, integrating medical and chiropractic perspectives. This entails evaluating both general health and bone health. He looks for hidden signs of TBI, such as headaches, balance issues, or dizziness linked to vestibular diseases. Advanced imaging is used to detect neuromusculoskeletal impairments as part of the treatment. This aids in identifying inner ear, brain, or nerve problems. Procedures involve targeted exercises to rebuild strength, flexibility, and balance. A typical symptom of TBI is stress in the head and neck, which massage treatment helps to relieve. Pain is lessened and recovery is encouraged with acupuncture. These integrated approaches don’t just treat symptoms; they also address the causes.

The clinic deals with medical treatment and legal paperwork related to auto accidents. Patients will receive comprehensive assistance from diagnosis to recovery, thanks to this. The focus of Dr. Jimenez is on natural healing. Long-term issues can be avoided by addressing imbalances such as inflammation or poor posture. His method enhances health by promoting physical activity and healthy eating habits. Patients who suffer from vestibular problems or tinnitus as a result of TBI benefit from this. Better balance may result from chiropractic adjustments that reduce ear pressure and realign the neck. Overall, the advantages of integrated treatment are demonstrated in this study.

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Personal Injury Rehabilitation- Video

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Treatment Options for TBI-Related Hearing and Vestibular Issues

The first step in treating TBI-related hearing and balance problems is to identify the specific issues. Audiologists check your hearing and balance. Sound therapy for tinnitus utilizes white noise to distract your mind from it. Hearing aids help people who have difficulty hearing. Cochlear implants can restore sound in severe cases. Vestibular rehabilitation therapy (VRT) teaches individuals with vestibular disorders how to perform exercises to enhance their balance. Canalith repositioning maneuvers move crystals that have come loose in BPPV (Vestibular Disorders Association, n.d.). Dr. Jimenez’s integrative medicine is helpful. Working out makes the body stronger. Massage can help relieve stress, which can exacerbate symptoms. Medications can help with dizziness or nausea, but people often prefer natural options for long-term use. Staying away from things that trigger flare-ups, such as loud noises or sudden movements, helps. Therapy for cognitive problems also helps. Counseling helps with anxiety caused by noise or imbalance. It takes time to get better. Early care leads to better results.

Conclusion

Traumatic brain damage can make normal noises and motions very difficult, resulting in problems such as tinnitus, hearing loss, noise sensitivity, and vestibular disorders like vertigo and dizziness. Understanding the main and secondary processes underlying TBI helps us better understand why these symptoms occur and how they impair auditory, cognitive, and sensory functioning. These mechanisms range from immediate effects, such as nerve ripping, to delayed effects, like swelling. One recurring reminder of the brain’s fragility is tinnitus, which often exacerbates other issues with the head, neck, and ears. However, thorough treatment and early detection hold out hope. Specialists, such as Dr. Alexander Jimenez, demonstrate how integrative methods, including massage, acupuncture, targeted exercises, and chiropractic adjustments, can address underlying issues, stimulate the body’s natural healing process, and reduce the likelihood of long-term problems. Whether from a fall, a vehicle accident, or a sports injury, don’t ignore these symptoms; getting expert assistance as soon as possible will help you regain your balance, reduce pain, and enhance your quality of life. Remember that with the correct help, recovery is achievable, and keep informed and safe.

References

• AAPMR. (n.d.). Vestibular dysfunction (after brain injury). https://now.aapmr.org/vestibular-dysfunction-after-brain-injury/
• Akin, F. W., et al. (2021). Understanding and managing trauma-induced vestibular deficits. Journal of International Advanced Otology, 17(6), 559-565. https://pmc.ncbi.nlm.nih.gov/articles/PMC8975387/
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• Armstrong, M. J., et al. (2023). Traumatic brain injury: Mechanisms, manifestations, and visual sequelae. Frontiers in Neurology, 14, 1290665. https://pmc.ncbi.nlm.nih.gov/articles/PMC9995859/
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• Chendrasekhar, A. (2024). Classification and complications of traumatic brain injury. Medscape. https://emedicine.medscape.com/article/326643-overview
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• Coco, L., et al. (2024). Associations between traumatic brain injury and severity of tinnitus-related functional impairment among US military veterans: A national, population-based study. Journal of Head Trauma Rehabilitation, 39(3), 218-230. https://pubmed.ncbi.nlm.nih.gov/38709830/
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• Jimenez, A. (n.d.a). El Paso, TX, doctor of chiropractic. https://dralexjimenez.com/
• Jimenez, A. (n.d.b). Dr. Alexander Jimenez, DC, APRN, FNP-BC, IFMCP, CFMP, ATN ♛. LinkedIn. https://www.linkedin.com/in/dralexjimenez/
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