It is typical for pulsatile tinnitus to change with a person’s head position. Lying down, turning the head, or sitting in a different posture may all change the sound.

Pulsatile tinnitus is a relatively rare condition where individuals hear a rhythmic whooshing sound that often beats in time with their pulse.

Many people with pulsatile tinnitus find that changes in head position and posture can affect their symptoms. The sound may also change when a person puts pressure on the jugular vein.

This article explores how pulsatile tinnitus changes with head position and what treatments are available to ease symptoms.

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Yes, pulsatile tinnitus symptoms can change with head position. Many individuals report that their symptoms improve or worsen when they move their head, bend over, or change their posture in some way.

Why can pulsatile tinnitus change with movement?

The changes in the intensity or presence of pulsatile tinnitus with movement may occur due to alterations in blood flow or pressure within the head and neck.

Movement can influence the blood inside the vessels near the ear, especially if these vessels are compressed or have an irregular shape. Head movements may affect how blood moves past the structures of the inner ear, which can alter the sounds a person hears.

Activities and conditions that increase blood circulation and pressure, such as exercise or pregnancy, may have a similar effect. This accelerated flow can cause more noise, which may become noticeable.

Posture does not cause pulsatile tinnitus, but it could theoretically exacerbate the symptoms.

An imbalanced posture may lead to muscle tension and changes in blood flow. This may then influence blood flow in veins close to the auditory system, affecting the sounds a person can hear.

However, no research has been done on this. Most of the known causes of the condition are vascular.

Some people anecdotally report that tight muscles, especially in the neck and jaw area, worsen their pulsatile tinnitus. It is possible that, for some, muscle tension could alter blood pressure or flow near the ears.

As with posture, though, there is not much scientific research on muscle tension as a primary cause.

Pulsatile tinnitus typically occurs due to blood flow disturbances. The cause may be vascular, meaning it occurs due to problems with the blood vessels, or nonvascular. The vascular causes include:

  • High blood pressure: One of the most common causes of pulsatile tinnitus is high blood pressure, or hypertension. Elevated blood pressure forces blood through the blood vessels with greater force. This heightened flow can make the pulse more pronounced as the increased pressure pushes blood through sensitive areas in and around the ear.
  • Turbulent blood flow: Turbulent blood flow means there are disruptions in the speed and pressure of the blood. It may speed up or slow down abruptly. When this happens near the ears, a person may hear it. Turbulent blood flow can be the result of cardiovascular disease (CVD).
  • Narrowed veins or arteries: Atherosclerosis is when plaque builds up inside blood vessels, making them narrower. This can lead to turbulent blood flow or high blood pressure. If atherosclerosis affects the carotid artery, the pulse may become audible in the ears.
  • Arteriovenous malformations (AVMs): An AVM is a tangle of arteries and veins that connect to one another, causing blood to flow at high speed around them. When AVMs occur near the ear, a person may be able to hear them. This can cause very loud pulsatile tinnitus.
  • Natural variations: Sometimes, people naturally have basilar arteries in a location closer to the ears. Even without any disease, this may cause pulsatile tinnitus.
  • Head or neck tumors: Tumors in the head or neck can exert pressure on surrounding blood vessels, compressing or displacing them.
  • Idiopathic intracranial hypertension (IIH): This condition causes elevated pressure in the brain, which can lead to headaches and vision changes. It may also cause pulsatile tinnitus in both ears.

Nonvascular causes of pulsatile tinnitus are less common. They include:

  • Anemia: Anemia is when blood cells do not have enough oxygen to carry to cells. When this happens, the heart begins working harder to pump more blood around the body to deliver oxygen. Pulsatile tinnitus can be one of the symptoms.
  • Pregnancy: During pregnancy, blood volume naturally increases, which may lead to pulsatile tinnitus.
  • Hyperthyroidism: In hyperthyroidism, excessive thyroid hormone production accelerates the body’s metabolism, leading to increased heart rate and blood circulation. When thyroid hormone levels are very high, people can develop thyrotoxicosis, which is serious. Sometimes, this contributes to pulsatile tinnitus.

Treatment of pulsatile tinnitus focuses on addressing the underlying cause. The options may vary significantly depending on what that is. For example, the treatment plan may include:

  • dietary changes to improve cardiovascular health or to address other problems, such as nutritional deficiency anemia
  • lifestyle changes, such as exercise or reducing stress
  • medications to lower blood pressure or treat hyperthyroidism
  • surgery to address AVMs, remove tumors, or treat IIH

Treatments for nonpulsatile tinnitus, such as sound therapy, may potentially help with the symptoms. However, scientists have not tested these treatments in those with pulsatile tinnitus.

Anyone with pulsatile tinnitus should contact a doctor for a diagnosis.

This is important, as some of the most common causes of pulsatile tinnitus are medical conditions that require treatment. Without treatment, some causes, such as hypertension, could get worse or cause complications.

Up to 70% of people with pulsatile tinnitus have an identifiable cause for their symptoms. Treating the underlying cause may also improve the tinnitus or make it go away entirely.

Pulsatile tinnitus can change with head position, posture, or muscle tension around the face or neck. However, these factors do not cause the condition.

Pulsatile tinnitus stems from altered blood flow near the ears. This can occur due to natural variations in blood vessels or benign conditions, but some of the most common causes, such as high blood pressure, are not benign.

For this reason, it is important that people with pulsatile tinnitus speak with a doctor. Many of the causes of pulsatile tinnitus are treatable, and treating them may make the tinnitus stop. It may also help to avoid complications.