Some instances of tinnitus are caused by infections or blockages in the ear, and the tinnitus can disappear once the underlying cause is treated. Frequently, however, tinnitus continues after the underlying condition is treated. In such a case, other therapies -- both conventional and alternative -- may bring significant relief by either decreasing or covering up the unwanted sound.
Tinnitus Retraining Therapy. Tinnitus Retraining Therapy (TRT) combines a wearable device that is individually programmed to mask the specific tonal frequency of that person’s tinnitus, with psychological therapy that teaches a patient to ignore the sounds his tinnitus is creating. I consider it the best of all of the above noise suppression techniques, as it is individually tailored for each person and involves support from a trained psychological therapist. It is also the most expensive and time consuming, but in my medical opinion, the most beneficial of all the noise suppression techniques listed above.
^ Jump up to: a b c Han BI, Lee HW, Kim TY, Lim JS, Shin KS (March 2009). "Tinnitus: characteristics, causes, mechanisms, and treatments". Journal of Clinical Neurology. 5 (1): 11–19. doi:10.3988/jcn.2009.5.1.11. PMC 2686891. PMID 19513328. About 75% of new cases are related to emotional stress as the trigger factor rather than to precipitants involving cochlear lesions.
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If your doctor cannot find any medical condition responsible for your tinnitus, you may be referred to an otolaryngologist (commonly called an ear, nose, and throat doctor, or an ENT). The ENT will physically examine your head, neck, and ears and test your hearing to determine whether you have any hearing loss along with the tinnitus. You might also be referred to an audiologist who can also measure your hearing and evaluate your tinnitus.
There's no known cure for tinnitus. Current treatments generally involve masking the sound or learning to ignore it. A research team led by Dr. Michael Kilgard at the University of Texas at Dallas and Dr. Navzer Engineer at MicroTransponder, Inc. set out to see if they could develop a way to reverse tinnitus by essentially resetting the brain's auditory system. Their work was funded in part by NIH’s National Institute on Deafness and Other Communication Disorders (NIDCD).
An assessment of hyperacusis, a frequent accompaniment of tinnitus,[56] may also be made.[57] The measured parameter is Loudness Discomfort Level (LDL) in dB, the subjective level of acute discomfort at specified frequencies over the frequency range of hearing. This defines a dynamic range between the hearing threshold at that frequency and the loudnes discomfort level. A compressed dynamic range over a particular frequency range is associated with subjectve hyperacusis. Normal hearing threshold is generally defined as 0–20 decibels (dB). Normal loudness discomfort levels are 85–90+ dB, with some authorities citing 100 dB. A dynamic range of 55 dB or less is indicative of hyperacusis.[58][59]
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.
The noise heard by people with tinnitus may be a buzzing, ringing, roaring, whistling, or hissing sound and is often associated with hearing loss. Some people hear more complex sounds that may be different at different times. These sounds are more noticeable in a quiet environment and when people are not concentrating on something else. Thus, tinnitus tends to be most disturbing to people when they are trying to sleep. However, the experience of tinnitus is highly individual. Some people are very disturbed by their symptoms, whereas others find them quite bearable.
Tinnitus can be extremely frustrating and can leave you feeling overwhelmed and unsure about your next steps. Remember that you are not alone - tinnitus, while not well-understood, is common. Make an appointment with a hearing care professional near you, preferably one who specializes in tinnitus treatment. Be prepared to discuss your symptoms in detail so you can get relief and regain your quality of 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 treatment group (245 patients) received some elements of standard care (such as a masking device and hearing aid if needed), but also received CBT. The CBT included an extensive educational session, sessions with a clinical psychologist and group treatments involving “psychological education” explaining their condition, cognitive restructuring, exposure techniques, stress relief, applied relaxation and movement therapy.
Wearable sound generators are small electronic devices that fit in the ear and use a soft, pleasant sound to help mask the tinnitus. Some people want the masking sound to totally cover up their tinnitus, but most prefer a masking level that is just a bit louder than their tinnitus. The masking sound can be a soft “shhhhhhhhhhh,” random tones, or music.
If your tinnitus is a symptom of an underlying medical condition, the first step is to treat that condition. But if the tinnitus remains after treatment, or if it results from exposure to loud noise, health professionals recommend various non-medical options that may help reduce or mask the unwanted noise (See Masking Devices below). Sometimes, tinnitus goes away spontaneously, without any intervention at all. It should be understood, however, that not all tinnitus can be eliminated or reduced, no matter the cause.
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 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.
Acoustic neuroma: This is a rare subjective cause of tinnitus, and includes a certain type of brain tumor known as an acoustic neuroma. The tumors grow on the nerve that supplies hearing and can cause tinnitus. This type of the condition usually are only noticed in one ear, unlike the more common sort caused by hearing loss usually seen in both ears. Causes of objective tinnitus are usually easier to find.
Tinnitus varies dramatically from person to person, so it is important that you visit an audiologist to learn more about your specific circumstances. Some of the causes result in permanent tinnitus and require treatment, while others induce temporary tinnitus that disappears on its own. To find out what causes tinnitus in your specific situation, contact Sound Relief Hearing Center today.
We occasionally recommend neuropsychological testing using a simple screening questionnaire -- depression, anxiety, and OCD (obsessive compulsive disorder) are common in persons with tinnitus. This is not surprising considering how disturbing tinnitus may be to ones life (Holmes and Padgham, 2009). Persons with OCD tend to "obsess" about tinnitus. Treatment of these psychological conditions may be extremely helpful.
Being exposed to loud noise on a regular basis from heavy equipment, chain saws or firearms are common causes of hearing loss and tinnitus. Noise-induced hearing loss and tinnitus can also be caused by listening to loud music through headphones or attending loud concerts frequently. It is possible to experience short-term tinnitus after seeing a concert, but long-term exposure will cause permanent damage.
Another example of somatic tinnitus is that caused by temperomandibular joint disorder. The temporomandibular joint (TMJ) is where the lower jaw connects to the skull, and is located in front of the ears. Damage to the muscles, ligaments, or cartilage in the TMJ can lead to tinnitus symptoms. The TMJ is adjacent to the auditory system and shares some ligaments and nerve connections with structures in the middle ear.

Tinnitus retraining therapy (TRT). This technique is based on the assumption that tinnitus results from abnormal neuronal activity (see "What's going on?"). The aim is to habituate the auditory system to the tinnitus signals, making them less noticeable or less bothersome. The main components of TRT are individual counseling (to explain the auditory system, how tinnitus develops, and how TRT can help) and sound therapy. A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient's tinnitus. Depending on the severity of the symptoms, treatment may last one to two years.


Addressing Any TMJ Disorders. A small percentage of people will experience tinnitus if they are having problems with their temporomandibular joint. This joint is located in front of the ears, on each side of the head, where the lower jawbone meets the skull. In these rare cases, a dental treatment or bite realignment may relieve you of the ringing you hear in your ears.
The results were calculated using a measure called “effect size”, which is a way of quantifying the size of the difference between the two groups. For the difference in quality of life scores between groups, the effect size was calculated to be 0.24. This can be interpreted as a “small” effect. In other words, treatment including CBT gave a small improvement in quality of life compared with usual care.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. The National Institutes of Health recommend about 7-9 hours of sleep each night for older, school-aged children, teens, and most average adults; 10-12 for preschool-aged children; and 16-18 hours for newborns. There are two stages of sleep; 1) REM sleep (rapid-eye movement), and 2) NREM sleep (non-rapid-eye movement). The side effects of lack of sleep or insomnia include:

^ Jump up to: a b Schecklmann, Martin; Vielsmeier, Veronika; Steffens, Thomas; Landgrebe, Michael; Langguth, Berthold; Kleinjung, Tobias; Andersson, Gerhard (18 April 2012). "Relationship between Audiometric Slope and Tinnitus Pitch in Tinnitus Patients: Insights into the Mechanisms of Tinnitus Generation". PLOS One. 7 (4): e34878. Bibcode:2012PLoSO...734878S. doi:10.1371/journal.pone.0034878. PMC 3329543. PMID 22529949.
Take medication for a thyroid disorder, if necessary. Tinnitus can be related to both hyperthyroidism, or an overactive thyroid, and hypothyroidism, or an underactive thyroid. Your doctor can check for swelling or lumps in your thyroid gland, which is in your throat, and order blood screens to test its function. If they find an issue, they’ll prescribe medication to regulate your thyroid hormone levels.[17]
When we hear, sound waves travel through the ear into the cochlea, our hearing organ in the inner ear. The cochlea is lined with thousands of tiny sound-sensing cells called hair cells. These hair cells change the sound waves into electrical signals. The hearing nerve then sends these electrical signals to the hearing part of the brain, which analyses them and recognises them as sound.

Tinnitus that's continuous, steady, and high-pitched (the most common type) generally indicates a problem in the auditory system and requires hearing tests conducted by an audiologist. Pulsatile tinnitus calls for a medical evaluation, especially if the noise is frequent or constant. MRI or CT imaging may be needed to check for a tumor or blood vessel abnormality.

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