Somatic Tinnitus and Manual Therapy: A Systematic Review

Background: In 2016, a systematic review was conducted to examine the effects of physical therapy interventions on individuals with subjective tinnitus. However, the research study investigated subjective tinnitus that may not have had a somatic origin. In addition, only one of the included studies specifically assessed the effectiveness of manual therapy. Objectives: The purpose of this systematic review was to examine the effects of manual therapy techniques on individuals with somatic tinnitus. Methods: A search was performed using the following databases: CINAHL Complete, ProQuest Medical Library, and PubMed. The search terms were “somatic tinnitus” OR “somatosensory tinnitus” AND “manual therapy”. An evaluation of the evidence level for each included article was conducted using the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence, and an evaluation of the methodological rigor for each included article was conducted using criteria adapted by Medlicott and Harris. Results: A qualitative synthesis was ultimately performed on eight articles. The manual therapy techniques included in this systematic review were cervical mobilizations, myofascial techniques, osteopathic manipulations, soft tissue techniques, and manual therapy as developed by the School of Manual Therapy Utrecht. This systematic review also included complementary treatment approaches such as patient education, therapeutic exercise, transcutaneous electrical neurostimulation, and home exercise programs. Conclusion: Manual therapy appears to be an effective intervention for individuals with somatic tinnitus, especially if they have co-varying tinnitus or tinnitus sensitization. In addition, a multimodal intervention approach may be the ideal way in which to positively impact an individual’s activities of daily living.