Hi all,
You likely know me if you frequent the form. If not, I am a member who suffers with both ES and hyoid bone syndrome.
For those unfamiliar with hyoid bone syndrome, it is similar to ES, but instead of your bony styloids causing problems (i.e., nerve irritation, vascular compression, etc), it’s (typically) the bony greater horns of the hyoid causing symptoms.
When helping members with their imaging (I’m not a radiologist just passionate) I’m seeing many members with “deep seated” hyoid bones. Or in other words, hyoid bones where the tips of the greater horns are in contact or nearly touching the cervical vertebrae, or in contact with deep vascular structures they should not be in contact with. Here is a couple pictures of my imaging to show you my deep seated hyoid:
We know that hyoid bone syndrome can commonly present with ES. I hypothesize that this is because the stylohyoid ligament (a typically fibrous/malleable ligament connecting the styloids to the lesser horns of the hyoid) in ES becomes calcified, potentially pulling the hyoid deeper into the neck.
For those with hyoid bone syndrome, and maybe those with just ES, you may experience spasms in your suprahyoid muscles (the muscles under your chin):
These muscles are attached to the lower jaw and the top of the hyoid bone, and their role is to assist in swallowing and also hold the hyoid bone in a superior-anterior (upwards and forwards) position.
Although research doesn’t talk about the association between hyoid/styloid problems and spasms of the suprahyoid muscles, it is commonly talked about amongst those with ES. I hypothesize that these muscles become weakened and stretched in those with ES, since these muscles (which function to pull the hyoid bone forward) are being counteracted by too much posterior force (by the stylohyoid ligaments or muscles connected to the hyoid posteriorly such as posterior digastric), which pulls the hyoid bone deeper into the neck.
IF my hypothesis is correct, surgery (i.e., styloidectomy) would be the sure fix to relieve pressure off the suprahyoids. However, there is relatively recent literature demonstrating effective exercises that strengthen the suprahyoids. And so if your suprahyoids are weakened and stretched, maybe it’s possible to strengthen and shorten them by consciously and actively using them. This won’t treat ES, but maybe it could alleviate SOME hyoid bone symptoms in those with ES, at least until surgery.
Here is the paper that summarizes the suprahyoid exercises:
https://www.nature.com/articles/s41598-021-86502-w
The most effective exercise seems to be the Submandibular Push Exercise, which involves pushing your tongue forcefully against the roof of your mouth to engage the muscles under your chin. When pushing the tongue against the roof of your mouth you’ll feel your hyoid bone rise. There is also the Shaker exercise which involves laying on your back and lifting your head and looking down at your toes. I’m not a physiotherapist so don’t take practice these as I describe them as I’m not providing you with the appropriate amount of sets and frequency.
I just wanted to share this in hopes that it could be helpful for some members.