Help - One sided pulsatile tinnitus and neck pain same side

I have the same neck and tinnitus issues. 62 years ago I was in an automobile accident, pre-seatbelt days, and as a front seat passenger my head hit and cracked the windshield. 3 discs in my neck were tilted 3, 4 and 5.
I was told by age 50 I would be getting traumatic arthritis which would include headaches. By 50 I had a neck that didn't have full rotation, but no headache or other symptoms, but by age 73 changes were noticed. Big negative for me is I kept hearing water running. Lying in bed at night I'd get up and roam around the house trying to figure out the source. Finally figured out it wasn't a water leak, the sound was coming from my left ear and the running water noise would skip with the beat of my pulse. I'd heard my pulse in my left ear for years especially if my blood pressure was high.
Had a MRI to check out my brain for blood clots, all clear. But before reading your post I never found any collaboration from other bloggers about tilted neck discs being the cause of my tinnitus. My neck must be supported in a perfect position when I lay down and thank goodness for back up cameras on cars these days. Rarely do I need an NAISD like Aleve for the pain, I don't get headaches just neck pain. This is progressive and hope the arthritis doesn't deteriorate to the point I need a fusion, which no doctor has mentioned. Thanks for sharing.

I will add that as a child I would get severe ear aches. I remember screaming in pain and my father taking me to the ER at night to have my eardrum lanced to release the fluid.

@gardeningjunkie You are the first person who has suggested that pulsative tinnitus could be related to the neck ! Thank you. I was in a very traumatic crash, many years ago, head crashed into the windshield. Have had neck pain since and now have lost hearing in my ear with PT making me nuts. Don't know what kind of doctor to see. So far, ENT is not helping. Maybe go to a neurologist for MRI? thank you so much !

@phxbarb Two years ago for the first time since my accident at age 16 I went to a orthopedist to have my neck checked out since my expected traumatic arthritis discomfort was becoming constant. My tilted discs were identified with x-ray and I was told I should do neck exercises. I did a few and I felt worse, Never went back because I was managing my pain well enough.
Then last year the tinnitus which I realize now I've had for years became louder and very noticeable without the background sounds during the day. If I wasn't married I think I would try soothing background music at a low volume because as you know when the tinnitus gets loud it makes falling asleep difficult. I was told to go to a neurologist who then wanted to rule out of a brain tumor which is a common cause of pulsative tinnitus. By the way I'm sure you've read that pulsative tinnitus is not a common form. For the MRI I refused the contrast solution injection because of my abundant allergies. The contrast improves the quality of the MRI. That said I was told my scan clearly showed no tumors and they found a very tiny small bleed, an non related issue to pulsative tinnitus in my brain which is typical of aging. I never got any clear answer about my tilted neck discs causing this issue. Also I have been telling doctors for years that I can hear my pulse in my left ear so I know when my blood pressure is high because it gets really loud, I simply get a blank look.
You should get the MRI, but I'm betting with our similar histories you don't have a brain tumor causing you tinnitus, it's the pressure on our nerves from our neck disc trauma caused by our worsening traumatic arthritis. Keep me posting. I'm just in a holding pattern right now.

@gardeningjunkie Hey, we are so similar. I want to get the MRI but should I ask for neck, brain, ear, or what? I totally think you are right because my neck is always a pain and I have severe arthritis there too. Here I have been blaming the ENT because of the sinus surgery when maybe it's not related. Or maybe the ET is blocked . These docs know nothing. I really should go to Mayo. Insurance won't cover.
Another question: Do you get out of breath at times? Barb

Why are we, the patients, having to try to discover the diagnosis when doctors have several years of medical school that I do not. I was a nurse at one time but years ago. I expect medical personnel to know what they are doing since I am paying them big bucks for help. Is that too much to ask? Recent encounters with medical people have been very discouraging.

Hi I'm the OP of the thread. My one-sided (unilateral) pulsatile tinnitus started at the same time as the neck pain on the same side (last summer) and continues along with the one-sided pulsatile tinnitus to this day. I've have two CT A scans (with contrast dye) of brain and neck and the other of temporal/mastoid. Nothing obvious for my uniltaeral pulsatile tinnitus was indicated (they said). I also had two doppler blood flow tests, apparently normal outcomes (a kind of ultrasound that looks through 'windows' in your face and skull to see the main arteries and measure blood flows). I do however have quite severe atherosclerosis (calcified, narrowing arteries in my body). The CTAs saw some of that, but the doctors/radiologists said there wasn't any significant stenosis (blockages). I'm beginning neck traction therapy next week as C4 and C5 in my neck (cervical spine) are compacting and that could be the reason for the coinciding of the neck pain and tinnitus if a nerve is pinched. Running out of ideas fast and normal sleep is a fading memory. Anyone have any other ideas or similar treatments @floridaneurotologist or others?

@phxbarb I had x-ray for the tilted neck discs. The MRI checked the brain for tumors which can cause Pulsative Tinnitus. Your neurologist should be ordering this test. On the internet information is available . If you have a tumor then brain surgery is needed for removal as the tumor can be dangerous. The neurologist didn't find any tumors and had no explanation for my PT.
I always have pain in my neck and any brain pain.
On the internet I read PT can be caused by eardrum damage, which may have been caused from lancing ear drum to drain fluids from severe ear infections as a child. Another cause which may be relevant to both of us is neck trauma, the arteries or veins in the head or neck are narrowed, blocked or damaged. Clearly my 3 tilted neck discs caused by head on damage from cracking a windshield from an auto accident 61 years ago, At that time I was told to expect headache and pain from traumatic arthritis as a senior, if tinnitus was mentioned I probably didn't know what it was. I still haven't' gotten the headaches, neck aches yes.
Like aldo2 , I suspect nerve issues from the disc compression aggravated at this age by traumatic arthritis. Also at my age now 77 I probably have narrowing of blood vessels near these tilted discs causing my tinnitus sound in my left ear only timed to my heartbeat. Also it could be a combination of several causes.
I think I just have to live with it.
phxbarb- so far Medicare plus my supplement Plan F ( the Cadillac of supplements) have paid all my medical expenses checking out my PT and neck pain. Of course as we seniors learn, Medicare and supplements aren't free, the cost of these plans are deducted directly from our Social Security. In my case that is $410.00 a month.

Dr. Breen at Mayo Clinic Jacksonville, is indeed an otologist/neurotologist, but his focus is primarily on ear surgery and tumors (like acoustic neuroma, chronic ear infections, and hearing loss), not on pulsatile tinnitus from vascular or cervical causes. The best hospital on the east coast is Johns Hopkins for cervical neck issues and tinnitus. However, Mayo Clinic Florida (Jacksonville) has one of the more complete neuro-otology and neuroradiology programs on the East Coast for pulsatile tinnitus.
Key Points to Raise at Mayo Clinic Florida. Describe the timing clearly:
Emphasize that your pulsatile tinnitus and neck pain began together on the same side — that pattern supports a possible cervicogenic or somatosensory component. Does Mayo’s team include somatosensory tinnitus specialists ? I see you are starting neck traction. So for your condition :
• Cervical traction or myofascial therapy (to reduce neck compression)
• Postural retraining or neuromuscular therapy.
Mayo Florida can also forward cases internally for remote review by the Johns Hopkins teams — they sometimes do inter-institutional image consultations. You can simply say:
“If Mayo’s evaluation remains inconclusive, could you facilitate an external imaging review by Johns Hopkins.
• Johns Hopkins Pulsatile Tinnitus Center (Baltimore, MD) – Dr. David Eisenman / Dr. Gregory Christoforidis
Dr Eisenman's dept reviews prior CTAs and MRAs that were read as “normal.” but cases remain unresolved. He routinely reviews imaging for subtle vascular or bone-related findings missed elsewhere by other doctors and works closely with neurologists and neuroradiologists to identify vascular, venous, or cervicogenic mechanisms — exactly the type of overlap described in OP's case. If the neck traction therapy doesn't work get a second opinion.