Ringing in the ear

Ringing in the ear is very annoying. For severe sufferer, it is devastating. One patient was sent in by his wife because he had “missed lots of conversation” according to his wife. He knew he had ringing problem but was not aware the hearing issue.

The incident of ringing increases with age. Older people frequently have it. In TCM, it is customary to distinguish ringing problem to the pitches of the noise. Older patients tend to have low pitch noise while younger patients would have high pitch. My experience is that regardless of the age, the noise sensation is mostly caused by the excessive muscle tension around the ears, particularly, the TMJ muscle. Therefore, most of the time, people with ringing in the ear would have tender and tight muscle groups surrounding the ear. The acupoint below the ear lobe, SJ 17, would be tender to pressure for them.

As the result, any treatment that would help relax the tension of these associated muscles and get the Qi moving would also be beneficial to reduce the noise.

Therefore, the starting point (no pun intended) is to relax the neck and shoulder tension using the above protocol, followed by needling of SJ 17. Because the GB meridians  also go through the ears, it is helpful to needle the GB meridian at some distal points such as GB 39. Additional benefit would result by warming the area around the affected ear(s) using a heat lamp.  Apply Moxa stick indirectly on the tense area surround the ear is extremely helpful.  Because LI 4 is very effective in regulating the Qi, It should be included as well.

With these points in place, patient will literally feel the noise level decreases. For most patients, such problems have been with them for a long while. Their neck and shoulder muscles tend be always tense. It is expected to have more than a couple treatments to change such situation. The result can be further enhanced during treatment by having the patient taking a few very deep breathe during treatment.

 The treatment would be more difficult if the patient had been treated surgically that aimed to” correct the inner ear defect”. I have a male patient who had this problem for a long while; he also had many procedures done to the inner ear, including surgical drainage, to no avail.  These procedures created additional problems like scar tissues, deceases the flexibility of the ear musculature (similar to situation with elderly patients.). The treatment then has to rely heavily on moxibustion as well as electro acupuncture. It was effective as well. Moxibustion is not very easy to undertake here but is essential in this situation.

Another interesting case happened to me in school’s clinic. A female student in her early 30’s had chronic “wave noise” issue in her left ear. She was trim, tall, big eyes of Indian decent. Unfortunate for her, such issue had been with her since her childhood. Initially I used the above protocol to treat her ringing, believing it should be sufficient. To my surprise, the ringing only subsided partially.  Then I started palpating her temporal area surrounding her ear. I discovered that she had a tender spot directly above her left ear. She never complained about that.  Turned out that as a child she had an accident and sustained an injury of head above the ear.  I applied indirect moxa over the tender area a few minutes, once each week for three weeks. The tenderness disappeared. The noise also disappeared as well. It was a strange feeling for her not having ringing in the ear.     

Dizziness

There are mainly two types of dizziness based on the mechanism of the problem. One is the lack of blood/oxygen to the brain. In the severe case, a person can pass out.  There are myriad of causes that lead to such blood deficiency, such as clotting of certain artery to the brain, blood vessel spasm, insufficient of blood circulation to the head. One common phenomenon that causes under such category is orthostatic hypotension. Whenever we change our posture like standing up from lying down, our body has to raise the blood pressure quickly to maintain proper blood pressure in the head to avoid transitory low blood supply in the head. Such reflex mechanism tends to weaken with age and for some elderly, it becomes a troubling issue. It can leads to a bad fall. For the same reason, many people fell light headed after acupuncture because the body becomes so relaxed that orthostatic low blood pressure kicks in.

The other type of dizziness comes from disorder in the inner ear. Our inner ear has sensors that give the information to our brain about our body’s balance. These sensors can be disturbed and we would lose sense of balance. It can also make us feel like the world around us is spinning.  This could also easily cause the reflex reaction in the stomach and induces nausea. Doctors commonly blame it on the excess fluid in the inner ear and call the symptom Meniere’s disease. So the medical approach is to reduce the amount of fluid by draining fluid from the body trough medication, or try to surgically drain the fluid. Surgery has the potential of causing harm to the hearing organ.

In Chinese herbal medicine, there is a formula called True Warrior decoction (Zhen Wu Tang) that is very effective to drain excess fluid in the body. This formula can be effective in treating such problem. Better result can be achieved by combination of acupuncture and moxibustion. The theory behind it is that provided the inner ear structure is not damaged, the fluid excess is merely a Qi stagnation phenomenon.  Such stagnation stops normal drainage of the fluid and leads to fluid accumulation. As the result, sensory function of the inner ear becomes disorderly. Once the Qi is restored, the fluid draining function in the inner ear return normal and dizziness goes away.

There are a few meridians surround the ear- the gall Bladder, the San Jiao and the small intestine. All of these meridians can be involved. The situation is very much like the issue with tinnitus.  The treatment for this disorder is the same as ringing in the ear. This is called treating different disease with same method. For Qi perspective, both diseases have similar disorder- Qi stagnation in the inner ear.

If the inner ear is damaged from prior infection or traumatic encounter such as injury or surgery.  It would be more difficult to treat as the situation involves more than just Qi stagnation.  Simple Qi restoration through AcuMoxa a few times would not be sufficient .