Development and Feasibility of a Novel Comprehensive SPARKS Physiotherapy Protocol for Somatic Tinnitus Associated with Cervical and Temporomandibular Dysfunction: A Randomized Controlled Trial

Abstract Context: Somatic tinnitus is the conscious perception of auditory sensation in the absence of an external stimulus, characterized by buzzing, ringing, hissing, or whistling noises which can affect the quality of life. It may be caused by cervical and temporomandibular joint (TMJ) dysfunction. To date, there is no comprehensive physiotherapy protocol to manage somatic tinnitus with cervical and TMJ dysfunction. However, there is little evidence about individual physiotherapy approaches and no comprehensive integrated protocol exists for managing tinnitus holistically. Aims: This study aimed to develop and assess the feasibility of an integrated SPARKS physiotherapy protocol for individuals suffering from somatic tinnitus. Settings and Design: This feasibility study involved 22 participants clinically diagnosed with somatic tinnitus and were randomly assigned to either a control group or an experimental group. Materials and Methods: The integrated protocol was developed to manage somatic tinnitus using manual therapy, exercises, and virtual reality. The outcomes were assessed on days 1 and 28 using a tinnitus handicap inventory (THI), sleep disorder questionnaire (SDQ), and neck Bournemouth questionnaire (NBQ) to evaluate tinnitus symptoms, sleep quality, pain reduction, and neck disability. Results: Analysis demonstrated significant improvement in all three outcomes in the experimental group ( P < 0.05). Between-group analysis of THI ( P = 0.0001), SDQ ( P = 0.0108), and NBQ ( P = 0.0001) indicates a statistically superior improvement in the experimental group, in comparison to the control group ( P > 0.05). Conclusions: This novel SPARKS physiotherapy protocol for somatic tinnitus has demonstrated superior effectiveness in managing tinnitus compared to traditional medical treatments and it shows a promising and safe multimodal approach.