title: Cervicogenic somatosensory tinnitus: An indication for manual therapy? Part 1: Theoretical concept.
abstract: Tinnitus can be evoked or modulated by input from the somatosensory and somatomotor systems. This means that the loudness or intensity of tinnitus can be changed by sensory or motor stimuli such as muscle contractions, mechanical pressure on myofascial trigger points, transcutaneous electrical stimulation or joint movements. The neural connections and integration of the auditory and somatosensory systems of the upper cervical region and head have been confirmed by many studies. These connections can give rise to a form of tinnitus known as somatosensory tinnitus. To date only a handful of publications have focussed on (cervicogenic) somatosensory tinnitus and manual therapy. Broadening the current understanding of somatosensory tinnitus would represent a first step towards providing therapeutic approaches relevant to manual therapists. Treatment modalities involving the somatosensory systems, and particularly manual therapy, should now be re-assessed in the subgroup of patients with cervicogenic somatosensory tinnitus. The conceptual phase of this study aims to uncover underlying mechanisms linking the auditory and somatosensory systems in relation to subjective tinnitus through (i) review of the literature (part 1) and (ii) through design of a pilot study that will explore characteristics of the study population and identify relevant components and outcomes of manual therapy in patients with cervicogenic somatosensory tinnitus (part 2). This manuscript focusses the theoretical concept of (cervicogenic) somatosensory tinnitus, either with or without secondary central tinnitus or tinnitus sensitization.
authors.affiliation: Department of Manual Therapy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Pain in Motion International Research Group, Vrije Universiteit Brussel, Brussels, Belgium (1). Electronic address: rob.oostendorp@planet.nl.
authors.forename: Rob A B
authors.initials: RA
authors.lastname: Oostendorp
authors.affiliation: Practice for Manual Therapy, Arnhem, The Netherlands.
authors.forename: Iem
authors.initials: I
authors.lastname: Bakker
authors.affiliation: Department of Public Health and Research, Radboud University Nijmegen Medical, Nijmegen, The Netherlands; Institute for Methodology and Statistics Beuningen, Beuningen, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Elvers
authors.affiliation: Department of Physiotherapy, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland; Rehabilitation Clinic, Military Clinical Hospital No. 10 with Polyclinic in Bydgoszcz, Poland; Neurocognitive Laboratory, Center for Modern Interdisciplinary Technologies, Nicolaus Copernicus University in Toruń, Poland.
authors.forename: Emilia
authors.initials: E
authors.lastname: Mikolajewska
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Otorhinolaryngology, Antwerp University Hospital, Antwerp, Belgium.
authors.forename: Sarah
authors.initials: S
authors.lastname: Michiels
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
authors.forename: Willem
authors.initials: W
authors.lastname: De Hertogh
authors.affiliation: Department Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Han
authors.initials: H
authors.lastname: Samwel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000193:education*; D009426:Netherlands; D010353:Patient Education as Topic; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Auditory–somatosensory interactions; Cervical spine; Manual therapy; Somatosensory stimulation; Somatosensory tinnitus; Tinnitus sensitization