In this exercise you are going to imagine yourself in another place – as if you’re actually there. What it looks like, the smells, the sounds… You can make this exercise as long as you want to and you can take your time to visualise a number of different places, such as a forest, a garden or a beach. Here is a short example of how you can do this (remember not to rush through it).
Changing Prescriptions, OTC Medications and Food Additives. Sometimes the cause of tinnitus is a prescription (such as an antibiotic), an over the counter medication or a food additive. As an example, two very common prescriptions that have been shown to cause tinnitus are quinine and chloroquine, which are both used to prevent malaria. Certain diuretics and cancer medications can also cause tinnitus. Even something as simple as OTC aspirin can generate tinnitus in some people. The food additives NutraSweet, Splenda and Aspartame have all been linked to tinnitus, and a whole host of other side effects, in clinical studies. These man-made food additives should be eliminated from your diet completely. If any of your medications are causing your tinnitus, your doctor may recommend stopping, reducing or switching them out for other medicines to see if that helps cure your tinnitus.
If you’re struggling with tinnitus and experience anxiety or depression relating to your condition, cognitive behavioural therapy is a form of counselling that helps you to cope and readjust your negative feelings. Tinnitus retraining therapy (TRT) can also be used in conjunction with CBT, harnessing the body's natural ability to tune out sounds and make it part of your subconscious mind rather than at the forefront.
However, the multidisciplinary approach based on CBT is not a “cure for tinnitus”, as implied in some papers, but rather a system for managing its symptoms and effects on people’s lives. The differences in outcomes between the treatment and usual care groups were quite small, with the multidisciplinary approach giving a small improvement in quality of life compared with usual care, and moderate improvements in tinnitus severity and impairment. Also, less than 70% of participants completed the trial to 12 months, and this could have affected the reliability of the study’s overall results. Furthermore, as the patients in the study were only followed for 12 months, it is uncertain whether this approach can help in the longer term.
Some patients question the value of treatments that fall short of an absolute cure. ATA believes patients should do everything possible to lessen the burden of tinnitus until a definitive cure is found. An appropriate analogy may be the use of ibuprofen for a headache. Ibuprofen itself does not cure the underlying cause of most headaches, but it does reduce the pain that makes headaches feel so awful. Likewise, the most effective tinnitus treatment tools address the aspects of tinnitus that so often make the condition feel burdensome: anxiety, stress, social isolation, sound sensitivity, hearing difficulties, and perceived volume.
This well-designed study found that using CBT alongside elements of standard therapy can help patients with tinnitus of varying severity. However, the differences in outcomes between the two groups were quite small, and this technique can only help manage tinnitus rather than curing it, as some papers implied. Also, the patients in the study were followed for only 12 months, so it is unclear whether this approach can help in the longer term.
Tinnitus can be caused by a variety of less common underlying conditions or injuries. If you have tinnitus, start your treatment path by seeking out a hearing healthcare professional who specializes in tinnitus diagnostics so they can help identify the underlying cause. If the common causes for tinnitus are ruled out, the practitioner will refer you to another specialist for further evaluation. Listed below are related medical specialties who might be able to help you determine the cause of your tinnitus.
If the cause of your tinnitus is excessive earwax, your doctor will clean out your ears by suction with a small curved instrument called a curette, or gently flush it out with warm water. If you have an ear infection, you may be given prescription ear drops containing hydrocortisone to help relieve the itching and an antibiotic to fight the infection.
It is possible that the most common cause of pulsatile tinnitus is sigmoid sinus diverticulum and dehiscence, which can be collectively referred to as sinus wall abnormalities or SSWA. The sigmoid sinus is a blood carrying channel on the side of the brain that receives blood from veins within the brain. The blood eventually exits through the internal jugular vein. Sigmoid sinus diverticulum refers to the formation of small sac-like pouches (diverticula) that protrude through the wall of the sigmoid sinus into the mastoid bone behind the ear. Dehiscence refers to absence of part of the bone that surrounds the sigmoid sinus in the mastoid. It is unknown whether these conditions represent different parts of one disease process or spectrum, or whether they are two distinct conditions. These abnormalities cause pressure, blood flow, and noise changes within the sigmoid sinus, which ultimately results in pulsatile tinnitus. Narrowing of the blood vessel that leads into the sigmoid sinus, known as the transverse sinus, has also been associated with pulsatile tinnitus.
The multidisciplinary approach required input from many different professionals including audiologists, psychologists, speech therapists and physical therapists. Which particular care elements of the intervention had the greatest effect is unknown. A multidisciplinary approach such as the intervention trialled here may have resource implications if it were introduced into standard clinical practice.
Tinnitus (pronounced tin-NY-tus or TIN-u-tus) is not a disease. It is a symptom that something is wrong in the auditory system, which includes the ear, the auditory nerve that connects the inner ear to the brain, and the parts of the brain that process sound. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus. But it can also be the result of a number of health conditions, such as:
Every person living with tinnitus hears a unique sound. The sound can be a low or high frequency, and its volume and pitch may change over time, with the severity varying from person to person. Those with acute tinnitus may struggle to sleep, focus at work, or communicate with others. In such cases, treatment plays a crucial role in helping an individual regain control of his or her life.
Use other relaxation techniques. Tinnitus is understandably anxiety provoking, often a source of frustration and stress throughout the day and night. Reducing anxiety, and finding ways to relax, have benefits for both tinnitus and sleep. Relaxation exercises can reduce the aggravation of tinnitus, and make you more able to fall asleep. A few of the relaxation techniques my patients find most effective and easy to use are:
The similarities between chronic pain and tinnitus have led researchers to develop a mindfulness-based tinnitus stress reduction (MBTSR) program. The results of a pilot study, which were published in The Hearing Journal, found that participants of an eight-week MBTSR program experienced significantly altered perceptions of their tinnitus. This included a reduction in depression and anxiety.
Tinnitus (pronounced "tin-it-tus") is an abnormal noise in the ear (note that it is not an "itis" -- which means inflammation). Tinnitus is common -- nearly 36 million Americans have constant tinnitus and more than half of the normal population has intermittent tinnitus. Another way to summarize this is that about 10-15% of the entire population has some type of constant tinnitus, and about 20% of these people (i.e. about 1% of the population) seek medical attention (Adjamian et al, 2009). Similar statistics are found in England (Dawes et al, 2014) and Korea (Park and Moon, 2014).
It is very well accepted that tinnitus often is "centralized" -- while it is usually initiated with an inner ear event, persistent tinnitus is associated with changes in central auditory processing (Adjamian et al, 2009). Sometimes this idea is used to put forth a "therapeutic nihilism" -- suggesting that fixing the "cause" -- i.e. inner ear disorder -- will not make the tinnitus go away. This to us seems overly simplistic -- while it is clear that the central nervous system participates in perception of sounds, and thus must be a participant in the "tinnitus" process, we think that it is implausible that in most cases that there is not an underlying "driver" for persistent tinnitus.
Cochlear implants are sometimes used in people who have tinnitus along with severe hearing loss. A cochlear implant bypasses the damaged portion of the inner ear and sends electrical signals that directly stimulate the auditory nerve. The device brings in outside sounds that help mask tinnitus and stimulate change in the neural circuits. Read the NIDCD fact sheet Cochlear Implants for more information.
The important thing to remember about tinnitus is that the brain’s response to these random electrical signals determines whether or not a person is annoyed by their tinnitus or not. Magnetoencephalography (MEG, for short) studies have been used to study tinnitus and the brain. MEG takes advantage of the fact that every time neurons send each other signals, their electric current creates a tiny magnetic field. MEG allows scientists to detect such changing patterns of activity in the brain 100 times per second. These studies indicated tinnitus affects the entire brain and helps with understanding why certain therapies are more effective than others.
Hyperacusis is a different, but related condition to tinnitus. People with hyperacusis have a high sensitivity to common, everyday environmental noise. In particular, sharp and high-pitched sounds are very difficult for people with hyperacusis to tolerate—sounds like the screeching of brakes, a baby crying or a dog barking, a sink full of dishes and silverware clanging. Many people with tinnitus also experience hyperacusis—but the two conditions don’t always go together.
Pulsatile tinnitus is generally caused by abnormalities or disorders affecting the blood vessels (vascular disorders), especially the blood vessels near or around the ears. Such abnormalities or disorders can cause a change in the blood flow through the affected blood vessels. The blood vessels could be weakened from damage caused by hardening of the arteries (atherosclerosis). For example, abnormalities affecting the carotid artery, the main artery serving the brain, can be associated with pulsatile tinnitus. A rare cause of pulsatile tinnitus is a disorder known as fibromuscular dysplasia (FMD), a condition characterized by abnormal development of the arterial wall. When the carotid artery is affected by FMD, pulsatile tinnitus can develop.
A loud work environment. A loud work environment that involves the use of power tools, power saws, drills or other noisy equipment may cause temporary bouts of tinnitus. I know of many tinnitus suffers who have attended rock concerts and left with ringing in their ears that may take hours or even days to subside. The longer a person remains in that loud environment, the better their chances will be of developing the condition permanently. These environments can also cause hearing loss. Always wear earplugs when you are in a loud environment, even if it is only going to be for a short time. Mowing the lawn? Wear earplugs.
Somatic tinnitus is caused, worsened, or otherwise related to your body’s own sensory system. Sensory signals coming from various parts of the body are disrupted, causing a spasm that produces tinnitus. Those who have somatic tinnitus usually have it in only one ear. Depending on the root cause your doctor may come up with treatment options to alleviate the symptoms.
If you have tinnitus, you might be feeling frustrated and helpless, but there is hope! The first step is to consult a hearing care professional at one of our consumer-reviewed clinics. There are also audiologists who specialize in managing tinnitus and many non-medical ways to help you regain your quality of life. Learn more through the links here and, when you’re ready, let us help you connect with a professional in your area.