Effectiveness of manual therapy in the treatment of somatic tinnitus: a randomized controlled trial.

BACKGROUND

Somatic tinnitus of cervicogenic and temporomandibular origin remains a therapeutic challenge, with limited evidence supporting manual interventions.

OBJECTIVE

This study aimed to compare the efficacy of manual therapy combined with home-based exercises on tinnitus severity and outcomes in individuals with somatic tinnitus.

METHODS

This single blinded randomized trial included 31 participants, allocated to manual therapy plus home exercises (n = 16) or home exercises alone (n = 15) for six weeks. All participants performed daily home exercises, with the manual therapy group receiving one weekly therapist session, totaling six. The primary outcome was tinnitus severity (visual analog scale, VAS). Secondary outcomes included cervical pain-VAS, Tinnitus Handicap Inventory (THI), Neck Disability Index (NDI), cervical range-of-motion (ROM), manual muscle testing, and Short Form-36 (SF-36) scores, assessed at baseline, week 3, and week 6.

RESULTS

Significant interaction-effects favored the manual therapy group for tinnitus-VAS (p = .031, ηp2 = 0.144), cervical pain-VAS (p = .031, ηp2 = 0.219), THI (p = .038, ηp2 = 0.136), and NDI (p = .020, ηp2 = 0.164). Cervical ROM improved significantly in all directions, with group-effects in left lateral flexion (p = .012, ηp2 = 0.199) and right rotation (p = .042, ηp2 = 0.135). SF-36 improvements were noted in energy/fatigue (p = .005, ηp2 = 0.246), general health (p = .012, ηp2 = 0.198), and health change (p = .006, ηp2 = 0.161).

CONCLUSION

Combining manual therapy with home exercises provided greater improvements in tinnitus severity, cervical symptoms, and quality of life in individuals with somatic tinnitus.Trial registration: ClinicalTrials.gov, NCT06433895.