Cervicogenic somatosensory tinnitus: An indication for manual therapy plus education? Part 2: A pilot study

• Published in: Manual therapy 2016-06, Vol.23, p.106-113
• Main Authors: Oostendorp, Rob A.B, Bakker, Iem, Elvers, Hans, Mikolajewska, Emilia, Michiels, Sarah, De Hertogh, Willem, Samwel, Han
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cervical spine; Cervical Vertebrae - physiopathology; Education; Female; Humans; Male; Manual therapy; Middle Aged; Musculoskeletal Manipulations - education; Netherlands; Outcome; Patient Education as Topic; Physical Medicine and Rehabilitation; Pilot Projects; Somatosensory tinnitus; Surveys and Questionnaires; Tinnitus - diagnosis; Tinnitus - therapy; Tinnitus sensitization; Treatment Outcome
• ISSN: 1356-689X; 1532-2769
• DOI: 10.1016/j.math.2016.02.006

Abstract Objectives The aim of this study was to evaluate the efficacy of Manual Therapy Utrecht (MTU) plus education in patients with cervicogenic somatosensory tinnitus (CeT). Study design Pretest–posttest design. Method Five hundred and six patients were referred or referred themselves. A subgroup of patients was identified with CeT, and within this a subgroup with tinnitus sensitization (TS). Two CeT groups were created based on the presence or absence of TS. Both groups underwent manual therapy combined with tinnitus education. Tinnitus intensity (VAS-tin 0–100 mm) was the primary outcome measure. Number of treatments and adverse effects were the secondary outcome measures. Results A total of 122 patients with CeT (24.1%) were included (average age 53.3 years [±9.8], female 38.5% and duration of tinnitus 7.3 years [±8.9]). Patients were divided into two groups: 55 patients (45.1%) with TS (CeT + TS group) and 67 patients (54.9%) without TS (CeT − TS group). Pretest to posttest differences on the VAS-tin were statistically significant within both groups (CeT − TS group: difference VAS-tin 5.9 [ p  = 0.01]; CeT + TS group: difference VAS-tin 18.2 [ p  = 0.00]), and between the groups in favor of the CeT + TS group (difference VAS-tin 12.3 [ p  = 0.01]). Pretest to posttest differences were clinically significant for the CeT + TS group (difference VAS-tin 18.2 [MCIC = ≥10 mm VAS-tin]) and between the groups (difference VAS-tin 12.3 in favor of the CeT + TS group). The average number of treatment sessions was 9.6 (±2.6) for the CeT − TS group and 10.3 (±2.5) for the CeT + TS group, a non-significant difference. There were no adverse effects in either group. Conclusions Despite its limitations, this study provides valuable information on both the characteristics of patients with CeT and TS in a Dutch primary care manual therapy practice and on the potential effectiveness of MTU combined with tinnitus education for the subgroup of CeT + TS patients.