The International Tinnitus Journal

Is Pain Harder to Withstand than Tinnitus?

Author(s): Henk M Koning, Bas C ter Meulen

Objectives: The object of the study was to compare the perception of tinnitus with the perception of pain and to find specific factors that could influence the perception of both pain and tinnitus. Design: A retrospective analysis of 124 patients with tinnitus as main complaint and 300 patients with cervical pain as main complaint who visited our clinic in a two-year period. Results: This study indicates that it is harder to withstand cervical pain than tinnitus with a higher prevalence of fatigue and impaired work performance in cervical pain patients. Our analyses highlight the importance of fatigue as a potential mediator of the deleterious effects of pain and tinnitus on individual functioning. Female gender and the presence of cervical pain makes patients more accessible for fatigue. Tolerance against tinnitus depends on the perceived maximal intensity of tinnitus, but also of the presence of cervical pain. Cervical pain may reinforce the irritating awareness of tinnitus. Conclusions: Tinnitus and chronic pain are related to structural and functional brain changes that show a striking overlap between both conditions. The tolerance, the ability to withstand the “unpleasantness” of the percept, for tinnitus and pain depends on the perceived intensity of the sensation. However, the perceived intensity of pain provoked annoyance earlier compared to the perceived intensity of tinnitus. Cervical pain may reinforce and maintain the negative awareness of tinnitus. For a better withstanding of tinnitus, we advise to reduce the perceived maximal intensity of tinnitus and to treat cervical pain and fatigue

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