Symptoms
Dizziness & tinnitus (cervical origin)
Non-vestibular dizziness and ringing in the ears can be associated with trigger points in the SCM and masseter.
Overview
Cervical-origin dizziness and somatic tinnitus are diagnoses of exclusion. After ruling out vestibular, neurological and otologic causes, palpation of the SCM, deep masseter and cervical extensors may reproduce dizziness or change tinnitus character, supporting a myofascial contributor.
Clinical notes
Coordinate with ENT and vestibular assessment first. Treat the muscular contributor when objective tests are negative and palpation is reproducible.
Red flags — when to refer
Sudden hearing loss, pulsatile tinnitus, focal neurological signs, severe vertigo with nystagmus — refer urgently.
Muscles often involved
References
- • Travell & Simons, Vol. 1