[Case Study] Improvement of Hyperacusis, Facial and Ear Pain, and Dizziness in a Woman in Her 60s through Upper Cervical, TMJ, and Myofascial Integration Care

by Son PMR(Physical medicine & Rehabilitation ) & Chiropractic Clinic in Seoul

A woman in her early 60s presented to our clinic with the following symptoms:

  • Hyperacusis (sound sensitivity)

  • Persistent facial pain and inner ear discomfort

  • Dizziness triggered by neck and shoulder muscle tension

  • Tightness and pressure in the temporomandibular (TMJ) region

Despite prior evaluation by ENT and neurology specialists, no structural abnormalities were found on imaging studies. Medication had limited effect. Given the complexity of her symptoms, we performed a functional assessment of the upper cervical spine, TMJ region, and cervical myofascial chains, and applied a multi-modal, non-invasive approach.

Treatment Overview

  1. Upper Cervical Manual Integration (C0–C2)

  • Assessment tools: posture analysis, prone leg check, head rotation test

  • Applied gentle and specific upper cervical correction techniques to reduce craniocervical tension and improve neural input

  1. Myofascial Treatment around the TMJ

  • Focused on releasing tension in the masseter, temporalis, and lateral pterygoid muscles

  • Targeted to relieve facial pressure, ear discomfort, and related autonomic symptoms

  1. Intramuscular Stimulation (IMS) of Cervical and Shoulder Girdle Muscles

  • Triggered relaxation of levator scapulae, sternocleidomastoid, upper trapezius, and deep paraspinals

  • Enhanced proprioceptive input and reduced autonomic overactivation contributing to dizziness

Outcomes After 5 Sessions

  • Hyperacusis: Dramatically reduced sensitivity to ordinary environmental sounds

  • Facial and Ear Pain: 70–80% reduction in discomfort and pressure

  • Dizziness: Significantly diminished, no longer triggered by neck tension

  • TMJ and cervical tightness: Markedly improved, enhancing quality of daily life

Neuroanatomical and Functional Basis

  1. Trigemino-Cervical Convergence

  • The trigeminal spinal nucleus caudalis extends into the upper cervical spinal cord (C1–C3), explaining how cervical dysfunction can refer pain to the face and ears.

  • → Bogduk N. Cervical headache: anatomic basis and pathophysiologic mechanisms. Curr Pain Headache Rep. 2001.

  1. Cervico-Vestibular Interaction

  • Proprioceptive input from deep neck muscles influences balance and spatial orientation via the vestibular and cerebellar pathways.

  • → Brandt T. Vertigo: Its Multisensory Syndromes. Springer, 2003.

  1. TMJ–Cervical Fascial Connection

  • Fascial and muscular tension in the TMJ can alter the biomechanics of the upper cervical spine and cranial base.

  • → Cooper BC, Kleinberg I. Biomechanics of occlusion—implications for the TMJ. Cranio. 2007.

  1. Intramuscular Stimulation (IMS) and Neuroregulation

  • IMS has been shown to decrease nociceptive input, improve muscle function, and normalize autonomic tone through stimulation of deep paraspinal structures.

  • → Gunn CC. The Gunn Approach to the Treatment of Chronic Pain. Churchill Livingstone, 1996.

Disclaimer: This case is anonymized and reconstructed with the patient's consent for educational purposes. The intention is not to advertise specific procedures, but to raise awareness of the interplay between cervical spine function, TMJ tension, and sensory symptoms like hyperacusis or dizziness.

👍Consultation and Appointment Information

Son PMR & Chiropractic Clinic( 2nd floor, 229-1 Gucheonmyun-Ro, Gangdongu, Seoul, South Korea) 

by  Dr Son MD & DC 
Contact: 02-482-8875 in Seoul( +82-2-482-8875)




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