Tight neck muscles may cause pulsatile tinnitus in some cases. However, the most common causes are vascular, meaning they relate to problems with the blood vessels.

Pulsatile tinnitus is a relatively rare condition that results in a rhythmic buzzing or whooshing sound in the ears that resembles a pulse.

The most common cause is unmanaged high blood pressure. However, muscular and skeletal problems such as an uneven bite, temporomandibular (TMJ) disorder, and muscle tension are also potential causes.

This article explores how tight neck muscles might cause pulsatile tinnitus, signs that muscle tightness could be causing the condition, and what might help.

Rear view of a woman using a massage gun for tight neck muscles.Share on Pinterest
Photographer, Basak Gurbuz Derman/Getty Images

Yes, tight neck muscles can potentially cause pulsatile tinnitus. However, neck tension is not among the most common causes of the condition.

Tinnitus refers to a constant buzzing or ringing in the ears. While nonpulsatile tinnitus is fairly common, pulsatile tinnitus, which is intermittent, is rare. One of the most prevalent causes of pulsatile tinnitus is high blood pressure.

When a person has high blood pressure, their blood travels with force through their blood vessels, which may lead them to be able to hear their pulse.

Because pulsatile tinnitus can have vascular causes that require treatment, it is important that people seek a diagnosis from a doctor.

What is somatosensory pulsatile tinnitus?

Somatosensory pulsatile tinnitus is when a person only experiences rhythmic ear ringing or whooshing in response to certain stimuli, such as when they:

  • track something with their eyes
  • move their head or neck a certain way
  • touch certain points on their face

There is no way people can be certain that tight muscles are causing their pulsatile tinnitus without a diagnosis from a doctor.

However, tight muscles could be responsible if:

  • a person only notices tinnitus when they are tense
  • straining their neck makes it worse
  • muscle relaxation or neck massage makes it better

Doctors group the potential causes of pulsatile tinnitus into vascular and nonvascular categories.

“Vascular” means the symptoms occur due to a problem with the veins or arteries, with arterial causes being the most common.

“Nonvascular” includes all other explanations.


The vascular causes of pulsatile tinnitus include:


Nonvascular causes of pulsatile tinnitus include:

  • damage to the ears
  • conditions that affect the structure of the ears
  • TMJ disorder
  • a misaligned bite
  • certain medications, such as aspirin, chemotherapy drugs, or certain antibiotics
  • involuntary twitching in the mouth or ear
  • cervical spine misalignment
  • neurological conditions, such as multiple sclerosis

Diagnosing pulsatile tinnitus and its underlying cause is essential.

Around 70% of cases of pulsatile tinnitus have an identifiable cause, some of which can be serious without treatment. However, unlike some other types of tinnitus, doctors can usually treat pulsatile tinnitus.

First, the doctor will take a person’s medical history. They may ask about:

  • symptom onset or frequency
  • what makes the symptoms worse or better
  • whether the tinnitus affects one or both ears
  • what medications a person takes, if any
  • whether they or their family members have had previous ear or hearing problems

Physical examinations of the head and neck may help identify any signs of muscle tension, TMJ disorder, or structural problems with the neck.

The doctor will also examine the ear using a magnifying device known as an otoscope. They may carry out a tuning fork test, an audiogram, or both. These tests can detect hearing loss.

If these examinations do not reveal a cause, the doctor may run cardiac tests to determine if the tinnitus is in time with the heart and whether there is any underlying cardiovascular condition.

The cause of pulsatile tinnitus will inform which treatments and strategies work best to ease the symptoms. If the cause is neck tension, the following may help:

Muscle relaxation

Relaxing tense muscles may help ease pulsatile tinnitus in some cases. A 2017 review on somatosensory tinnitus notes several studies that found benefits in using muscle relaxation techniques, such as:

However, the research to date has been inconsistent and primarily focused on small groups of participants.

Electrical stimulation

Transcutaneous electrical nerve stimulation (TENS) involves using a device to deliver small electrical pulses through electrodes that sit on the skin. In tinnitus treatment, the electrodes sit around or behind the ears and neck.

The tiny electrical pulses may influence the nerves connected to the auditory system, allowing the brain to respond differently. This may lead to the suppression of symptoms.

The 2017 review highlights previous studies where larger groups of people with tinnitus found benefits in TENS therapy. However, the research has had mixed results. In some studies, most participants reported improvements, but only a few found their symptoms completely resolved.

The response people have to TENS therapy may depend on what is causing their tinnitus.

Somatic modulation therapy

Somatic modulation is a type of physical therapy that focuses on improving tinnitus intensity through movement.

Repetitive training maneuvers involving head and neck muscle contractions may have a positive effect. However, the 2017 review suggests there is currently very little scientific evidence to support this idea.

Tight neck muscles may cause pulsatile tinnitus, but neck tension is not the most common cause of the condition. Vascular issues, such as high blood pressure, can also cause pulsatile tinnitus. As a result, it is important to consult a doctor about tinnitus symptoms.

If tight neck muscles are the reason a person has tinnitus, a doctor may suggest muscle relaxation, physical therapy, or electrical stimulation to reduce the symptoms. However, research into tinnitus treatment is still ongoing. A person may need to try several approaches to find what works for them.