Tinnitus is the perception of sound when no actual external noise is present. While it is commonly referred to as “ringing in the ears,” tinnitus can manifest many different perceptions of sound, including buzzing, hissing, whistling, swooshing, and clicking. In some rare cases, tinnitus patients report hearing music. Tinnitus can be both an acute (temporary) condition or a chronic (ongoing) health malady.
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
CBT could potentially help people with tinnitus deal with fears that their tinnitus might be caused by brain damage or might lead to deafness. During CBT, they might learn that the condition is common and that it is not associated with brain damage or deafness. They might also be exposed to the sound in a safe environment, so that it has less of an impact on their daily life. CBT also involves techniques such as applied relaxation and mindfulness training.
The latest news about tinnitus treatment comes from a UK study showing that Mindfulness Based Cognitive Therapy (MBCT) significantly helps reduce the severity of the disorder. The researchers reported that, among the 75 patients being studied, both relaxation therapy and MBCT worked to alleviate symptoms as well as reducing psychological distress, anxiety and depression related to the disorder. MBCT led to greater reductions in tinnitus severity and the improvements lasted longer.
Pulsatile tinnitus: This problem usually is related to blood flow, either through normal or abnormal blood vessels near the ear. Causes of pulsatile tinnitus include pregnancy, anemia (lack of blood cells), overactive thyroid, or tumors involving blood vessels near the ear. Pulsatile tinnitus also can be caused by a condition known as benign intracranial hypertension (an increase in the pressure of the fluid surrounding the brain).
It can often be very helpful to talk to someone who understands how you are feeling, who can reassure you about any anxieties you may have, and answer your questions. We can provide details of self-help groups and contacts in the UK, and we also run a helpline on 0800 018 0527. Most of the people who run groups or are contacts have tinnitus themselves and have been helping people with the condition for a long time. Even if you don't want to take part in group activities, it can be a comfort to know there is someone you can contact.
Since most persons with tinnitus also have hearing loss, a pure tone hearing test resulting in an audiogram may help diagnose a cause, though some persons with tinnitus do not have hearing loss. An audiogram may also facilitate fitting of a hearing aid in those cases where hearing loss is significant. The pitch of tinnitus is often in the range of the hearing loss.
Many people find that tinnitus causes frustration, stress, and even anger. And unfortunately, your exasperation and anxiety can seem to amplify the issue. Learning how to thoroughly relax can help you manage your tinnitus. Deep breathing, meditation, yoga, or music therapy may help in combination with sound therapy. You could also explore relaxing hobbies like gardening, painting, swimming, photography, knitting, reading, cooking, or other physical activities (walking, biking, etc.).
The researchers next tested whether tinnitus could be reversed in noise-exposed rats. The animals received VNS paired with various tones other than the tinnitus frequency 300 times a day for about 3 weeks. Rats that received the treatment showed behavioral changes indicating that the ringing had stopped. Neural responses in the brain's auditory cortex returned to their normal levels as well, indicating that the tinnitus had disappeared.
Health care professionals who incline to offer patients an option or strategy to deal with tinnitus are confronted with the variability inherent to this disorder.5 The cause of tinnitus can vary, although people who experience tinnitus have usually first developed hearing loss due to ageing or from exposure to loud noise that caused peripheral auditory damage. In fact, the number of tinnitus sufferers that develop the constant ringing due to hearing loss may be even higher than thought, as some tinnitus sufferers only appear to have normal hearing when thresholds at frequencies below 8 kHz are measured. Less frequently, tinnitus may also occur after a head or neck injury, or due to the presence of an acoustic neuroma. Certain medications may also contribute to the development of tinnitus through effects on hair cells in the inner ear or via mechanisms that are not yet well understood.6 This variety in cause has been the first part of the challenge in developing a “cure” or effective treatment for tinnitus. However, even for the largest group of tinnitus sufferers (those who may develop tinnitus due to hearing damage), effective treatments have been hard to come by.
Individuals were recruited from within and around Hamilton, Ontario via online announcements and audiology clinics. Applicants were initially interviewed via telephone to screen for all inclusion and exclusion criteria for the study in order to determine whether they qualified for on-site screening. The on-site screening, and characterization of participants’ hearing thresholds and tinnitus profiles were conducted in a lab at McMaster University using a computer-based tinnitus assessment tool. Participants were randomly allocated to the treatment or placebo-control group. The assignment of the treatment or placebo music package was completed by a distributor site independent of the research study site. Participants and research personnel were blinded to which music package the participants received.
A wealth of research has gone into understanding the mechanisms of tinnitus due to the increased concern in our ageing and noise exposed society through the support of organizations such as the Tinnitus Research Institute, the American Tinnitus Association and even the US Department of Defense. This research has helped us to understand not only why and how this phantom percept can develop, but also sheds light on why it may sound like a hiss for one person and a high pitched tone for another.7 In addition, neuroscientists have shown connections between the limbic system (where emotions are processed) and the auditory system; it is not uncommon for tinnitus to increase during times of stress or negative emotions.5 As such, the effective tinnitus treatment strategies should be enjoyable and positive, and should account for the variability in what tinnitus sounds like for each patient.
In addition, a healthy lifestyle can reduce the impact of tinnitus. Avoid physical and emotional stress, as these can cause or intensify tinnitus. You may be able to reduce your stress levels through exercise, meditation, deep breathing, or massage therapy. If you suffer from high blood pressure, consult your doctor for help controlling it, as this can also impact tinnitus. Finally, get plenty of rest to avoid fatigue and exercise regularly to improve your circulation. Although this won’t eliminate the ringing in your ears, it may prevent it from worsening.
Vitamin Supplements. Vitamin supplements, like Lipo-Flavonoid Plus, contain the vitamins that some studies have shown to be beneficial to inner ear health. These include Vitamin C, B-1, B-2, B-6, B-12, zinc, niacin and calcium. And while I am a proponent of vitamins, I advise my patients to take a regular OTC multivitamin that costs $15, versus Lipo-Flavonoid Plus, which has the same ingredients, but costs up to $90 for the same number of pills, just because it’s packaged and marketed to people that suffer from tinnitus.
Biofeedback and stress management. Tinnitus is stressful, and stress can worsen tinnitus. Biofeedback is a relaxation technique that helps control stress by changing bodily responses. Electrodes attached to the skin feed information about physiological processes such as pulse, skin temperature, and muscle tension into a computer, which displays the output on a monitor. Patients learn how to alter these processes and reduce the body's stress response by changing their thoughts and feelings. Mindfulness-based stress reduction techniques may also help.
Meniere’s disease isn’t directly connected to tinnitus, but people with Meniere’s often experience it, at least temporarily. Meniere's disease is an inner ear disease that typically only affects one ear. This disease can cause pressure or pain in the ear, severe cases of dizziness or vertigo and a ringing or roaring tinnitus. While Meniere’s isn’t fully understood, it appears that several relief options for tinnitus can also help with this disease. Patients are often advised to reduce stress and lower their consumption of caffeine and sodium.