Patients with head or neck injury may have particularly loud and disturbing tinnitus (Folmer and Griest, 2003). Tinnitus due to neck injury is the most common type of "somatic tinnitus". Somatic tinnitus means that the tinnitus is coming from something other than the inner ear. Tinnitus from a clear cut inner ear disorder frequently changes loudness or pitch when one simply touches the area around the ear. This is thought to be due to somatic modulation of tinnitus. We have encountered patients who have excellent responses to cervical epidural steroids, and in persons who have both severe tinnitus and significant cervical nerve root compression, we think this is worth trying as treatment.
The majority of cases of tinnitus are subjective. Objective tinnitus is far less common. However, a diagnosis of objective tinnitus is tied to how hard and well the objective (outside) listener tries to hear the sound in question. Because of this problem, some clinicians now simply refer to tinnitus as either rhythmic or non-rhythmic. Generally, rhythmic tinnitus correlates with objective tinnitus and non-rhythmic tinnitus correlates with subjective tinnitus. Specific forms of tinnitus such as pulsatile tinnitus and muscular tinnitus, which are forms of rhythmic tinnitus, are relatively rare. Pulsatile tinnitus may also be known as pulse-synchronous tinnitus. Properly identifying and distinguishing these less common forms of tinnitus is important because the underlying cause of pulsatile or muscular tinnitus can often be identified and treated.

Tinnitus is characterized by ringing or buzzing in the ears. Exposure to loud noises, earwax blockages, heart or blood vessel issues, prescription medications, and thyroid disorders can all cause tinnitus. See your doctor for an accurate diagnosis, and work with them to develop a treatment plan. In many cases, tinnitus is irreversible, but there are several ways to reduce its severity. For instance, sound generators, hearing aids, and medication can help mask ringing or buzzing. Tinnitus research is a constantly evolving field, and you might be able to try experimental therapies as well.


^ McCombe A, Baguley D, Coles R, McKenna L, McKinney C, Windle-Taylor P (2001). "Guidelines for the grading of tinnitus severity: the results of a working group commissioned by the British Association of Otolaryngologists, Head and Neck Surgeons, 1999". Clinical Otolaryngology and Allied Sciences. 26 (5): 388–93. doi:10.1046/j.1365-2273.2001.00490.x. PMID 11678946. Archived (PDF) from the original on 2017-09-24.
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Approximately 50 million Americans have some form of tinnitus. For most people, the sensation usually lasts only a few minutes at a time. About 12 million people have constant or recurring tinnitus that interferes with their daily life so much that they seek professional treatment. For these individuals, tinnitus may result in a loss of sleep, interfere with concentration, and create negative emotional reactions such as despair, frustration, and depression.

Tinnitus habituation therapies, such as tinnitus retraining therapy (TRT), involve using low level sounds in a graduated fashion to decrease the perception of tinnitus. This differs from use of masking devices such as described earlier. TRT involves a wearable device that an affected individual can adjust so that the level of sound emitting from the device is about equal to or matches the tinnitus sound. This may be called the “mixing point” because the sound from the device and the tinnitus sound begin to mix together. An affected individual must repeatedly adjust the device so that the sound is at or just below the mixing point. TRT is supported by counseling with a trained professional who can teach the individual the proper techniques to maximize the effectiveness of TRT. Eventually, by following this method, affected individuals no longer need the external sound generating device. Affected individuals will become accustomed to the tinnitus sound (habituation), except when they choose to focus on it. Even then the sound will not be bothersome or troubling. The theory is akin to a person’s ability to ignore sounds such as the hum of air conditioner, the refrigerator motor turning on, or raindrops falling on the roof when driving a car in the rain.
Some persons with severe TMJ (temporomandibular joint) arthritis have severe tinnitus. Generally these persons say that there is a "screeching" sound. This is another somatic tinnitus. TMJ is extremely common -- about 25% of the population. The exact prevalence of TMJ associated tinnitus is not established, but presumably it is rather high too. Having TMJ increases the odds that you have tinnitus too, by about a factor of 1.6-3.22 (Park and Moon, 2014; Lee et al, 2016). This is the a large risk factor for tinnitus, similar to the risk from hearing loss (see table above).
Objective tinnitus is very rare. It can be heard by a doctor either using a stethoscope or by listening very closely to your ear. It occurs rarely and may due to involuntary muscle contractions or vascular deformities. The sound is often described as pulsating and may be heard in time with your heartbeat. Objective tinnitus usually has a determinable cause and disappears when treated by surgery or other medical intervention.

This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
Ocean waves are designed to create a soothing environment, like that of the serene ocean waves.  Miracle-Ear hearing aids offer four different ocean wave signals to choose from so that you can find the one that you find to be the most relaxing.  Ocean waves are an alternative to static noise and can be found to be a stress-free type of tinnitus treatment.  Your hearing care specialist will work with you to find the signal that offers the most relief.
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).
To keep the brain activated and aware, Kilgard’s therapy involves stimulating the vagus nerve, which is actually a pair of nerves that runs inside the neck and into the brain. “All the stuff you brains learns about your body — it all comes in through the vagus nerve,” he says. “We trick the brain into thinking it’s learning something important by stimulating this nerve in the neck.”
About six percent of the general population has what they consider to be "severe" tinnitus. That is a gigantic number of people ! Tinnitus is more common with advancing age. In a large study of more than 2000 adults aged 50 and above, 30.3% reported having experienced tinnitus, with 48% reporting symptoms in both ears. Tinnitus had been present for at least 6 years in 50% of cases, and most (55%) reported a gradual onset. Tinnitus was described as mildly to extremely annoying by 67%.(Sindhusake et al. 2003)

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