Shelly-Anne Li is the VP of clinical research and operations at Sound Options Tinnitus Treatments Inc. As a research methodology consultant for various projects, she brings expertise in health research methods, as well as experience from conducting multi-site randomized controlled trials, mixed methods studies and qualitative research. Shelly-Anne Li is currently a PhD candidate at University of Toronto, and obtained her MSc (health sciences) from McMaster University.

There is a growing body of evidence suggesting that some tinnitus is a consequence of neuroplastic alterations in the central auditory pathway. These alterations are assumed to result from a disturbed sensory input, caused by hearing loss.[28] Hearing loss could indeed cause a homeostatic response of neurons in the central auditory system, and therefore cause tinnitus.[29]
As with the first exercise, make sure you’re comfortable and unlikely to be disturbed. Now imagine yourself leaving this room. You walk out of the door and follow a path… at the end of the path is another door. You open that door and inside you see a beautiful garden – you can hear birds singing, children playing somewhere in the distance. You feel a cool breeze on your skin and hear the rustle of leaves through the trees. The colours of the leaves, green, gold, red, all dance across a beautiful pond in the middle… as you walk over to the pond, you feel the soft grass under your bare feet… you dip your toes into the calm, clear pond and stop for a moment – just experiencing the beauty of everything around you…
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While there may be a wide range of causes, an important underlying factor for the development of tinnitus is brain plasticity.5,7 This property allows the brain to change and adapt, and it is essential to how we learn. Unfortunately, in some cases, such as with hearing loss, the auditory part of the brain may be altered as brain plasticity tries to compensate for the abnormal auditory inputs. This response leads to changes in brain activity in the auditory system (e.g., the auditory cortex) that can create a phantom percept: tinnitus. As such, while tinnitus may begin a problem at the auditory periphery, it persists because of changes throughout the auditory system. Treating tinnitus may require addressing both the initiator (e.g., hearing loss) and the driver (changes in the auditory brain).
Acoustic Neural Stimulation. This relatively new treatment has shown to be effective in reducing, and in some cases eliminating, symptoms in patients whose tinnitus just won’t go away or is very loud. The treatment utilizes a device small enough to fit into the palm of your hand that delivers a broadband acoustical signal embedded in special music you can listen to via headphones. The treatment eventually desensitizes you to the ringing in your ears by stimulating changes in the neural circuits in your brain.
Prolonged exposure to loud sounds is the most common cause of tinnitus. Up to 90% of people with tinnitus have some level of noise-induced hearing loss. The noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear. Carpenters, pilots, rock musicians, street-repair workers, and landscapers are among those whose jobs put them at risk, as are people who work with chain saws, guns, or other loud devices or who repeatedly listen to loud music. A single exposure to a sudden extremely loud noise can also cause tinnitus.
According to the American Tinnitus Association, most cases of tinnitus are caused by hearing loss. Occasionally though, tinnitus is caused by an irritation to the auditory system. Tinnitus can sometimes be a symptom of a problem with the temporomandibular joint (TMJ). If your tinnitus is caused by TMJ, then a dental procedure or realignment of your bite may alleviate the problem.
Don't give up on things unless you are sure they are having some effect, especially if it's something you enjoy; or you could end up feeling miserable and deprived for no reason. Do not give up several things at once, or you will not know which one was affecting your tinnitus. If you decide to limit these things and fancy the occasional treat, maybe try using the other strategies (such as relaxation) for those times when your tinnitus is a bit louder. For more details, see our information on Food, drink and tinnitus.

Vertigo is the sensation of spinning or rocking, even when someone is at rest. Vertigo may be caused by a problem in the brain or spinal cord or a problem within in the inner ear. Head injuries, certain medications, and female gender are associated with a higher risk of vertigo. Medical history, a physical exam, and sometimes an MRI or CT scan are required to diagnose vertigo. The treatment of vertigo may include:


Tinnitus remains a symptom that affects the lives of millions of people. Research is directed not only at its treatment, but also at understanding why it occurs. Research by doctors at the University at Buffalo, The State University of New York, Dalhousie University (Canada), and Southeast China University have published research using electrophysiology and functional MRI to better understand what parts of the brain are involved in hearing and the production of tinnitus. Their research has found that much larger areas of the brain are involved with the process of hearing than previously believed, which may help direct future diagnostic and therapeutic options.

If you develop tinnitus, it's important to see your clinician. She or he will take a medical history, give you a physical examination, and do a series of tests to try to find the source of the problem. She or he will also ask you to describe the noise you're hearing (including its pitch and sound quality, and whether it's constant or periodic, steady or pulsatile) and the times and places in which you hear it. Your clinician will review your medical history, your current and past exposure to noise, and any medications or supplements you're taking. Tinnitus can be a side effect of many medications, especially when taken at higher doses (see "Some drugs that can cause or worsen tinnitus").


Tinnitus affects every layer of society, and there has been increasing support for awareness. Recently, musicians who are affected by tinnitus have come together to create awareness for the disorder. Artists including Chris Martin of Coldplay and Black Eyed Peas have created a compilation album to help raise funds towards finding a cure for tinnitus. In the United States, the Department of Defense has invested millions of dollars into investigations of tinnitus sound therapies. In addition, the American Tinnitus Association makes efforts to lobby the US government to provide support for tinnitus sufferers.
An ultrasound is another test that may be used to aid in the diagnosis of tinnitus. An ultrasound uses reflected high-frequency sound waves and their echoes to create images of structures within the body. An ultrasound can reveal how blood flows within vessels, but is only useful for accessible vessels. It is not helpful for blood vessels within the skull.
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Vascular issues. Some people have blood vessels near their ears that are capable of causing tinnitus. I have found that if the blood pressure is elevated, this increased pressure can cause that dreaded ringing in your ears or even a whooshing sound. Because pregnant women often have elevated blood pressure, they are easily susceptible to tinnitus. Tinnitus caused by pregnancy should go away with an over the counter tinnitus treatment and once the baby is born. An overactive thyroid has also been shown to causes vascular issues that bring on tinnitus.
Oticon Tinnitus SoundSupport works by adding sound to the buzzing, hissing, or roaring you already hear. This may seem peculiar, but in fact, the relief sounds (which are dynamic and soothing) can mix with and distract you from those bothersome noises, giving you control over your condition. The flexible program includes a variety of relief sounds that can ease the effects of tinnitus. Your audiologist can personalize the sounds to your needs and preferences, and they can be used alongside Tinnitus Retraining Therapy for instruction and support.
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.

Counseling helps you learn how to live with your tinnitus. Most counseling programs have an educational component to help you understand what goes on in the brain to cause tinnitus. Some counseling programs also will help you change the way you think about and react to your tinnitus. You might learn some things to do on your own to make the noise less noticeable, to help you relax during the day, or to fall asleep at night.
When a medication is ototoxic, it has a toxic effect on the ear or its nerve supply. In damaging the ear, these drugs can cause side effects like tinnitus, hearing loss, or a balance disorder. Depending on the medication and dosage, the effects of ototoxic medications can be temporary or permanent. More than 200 prescription and over-the-counter medicines are known to be ototoxic, including the following:
We provide here a list of known ototoxic drugs and herbs that have been known to cause or exacerbate tinnitus. This list is for educational purposes only and is available as a resource to you to use in your discussions with your health care professional. We thank doctor Neil Bauman, Ph.D., for his expertise in this area and for compiling this list for us.
White Noise Machines. These devices do a great job of simulating the sound of everything from ocean waves, to rain, to a thunder storm, to a crackling fire to an oscillating fan to just plain old static. The result is that your brain focuses on the sounds around you instead of the ringing in your head. You can even download apps on your iPhone that do the same thing so that you can always have a noise machine with you wherever you go. The constant background noise can not only bring back nostalgic feelings of joy, if you used to site around a crackling fire on holidays with your family, but also allow you to forget about your tinnitus.
Muscle spasms: Tinnitus that is described as clicking may be due to abnormalities that cause the muscle in the roof of the mouth (palate) to go into spasm. This causes the Eustachian tube, which helps equalize pressure in the ears, to repeatedly open and close. Multiple sclerosis and other neurologic diseases that are associated with muscle spasms may also be a cause of tinnitus, as they may lead to spasms of certain muscles in the middle ear that can cause the repetitive clicking.

While there is currently no cure for tinnitus, treatment options like Tinnitus Control at least provide patients with the ability to successfully manage the ringing they hear by suppressing the cause of it. This is achieved through their proprietary blend of the following active ingredients: arnica, chininum sulphuricum, ferrum metallicum, kali phosphoricum, natrum sulphuricum, pulsatilla, silicea, thiosinaminum, garlic and gingko biloba.
These tests are usually performed instead of a traditional catheter angiography, which is more invasive and, while generally very safe, carries greater risk of complications. Angiography is an imaging technique that involves injecting dye into a small tube called a catheter that has been inserted into a blood vessel. An x-ray is then performed to assess the health of the vessels as well as the rate of blood flow.
Antibiotics, including erythromycin, neomycin, polymysxin B and vancomycin, as well as cancer medications, including mechlorethamine and vincristine, and water pills, including bumetanide, furosemide or ethacrynic acid all have the ability to cause or worsen tinnitus. Some patients will experience tinnitus after using antidepressants or quinine medications.

Acoustic qualification of tinnitus will include measurement of several acoustic parameters like frequency in cases of monotone tinnitus or frequency range and bandwidth in cases of narrow band noise tinnitus, loudness in dB above hearing threshold at the indicated frequency, mixing-point, and minimum masking level.[51] In most cases, tinnitus pitch or frequency range is between 5 kHz and 10 kHz,[52] and loudness between 5 and 15 dB above the hearing threshold.[53]
Overdosing on certain prescription drugs, recreational drugs or alcohol. This can sometimes cause permanent damage to nerves that affect hearing. In some cases when a pregnant women uses drugs during pregnancy, this can cause tinnitus to develop in her child. Common drugs that might contribute to tinnitus include ototoxics, psychotropic drugs, aminoglycosides, certain antibiotics and vancomycin.
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).

The best supported treatment for tinnitus is a type of counseling called cognitive behavioral therapy (CBT) which can be delivered via the internet or in person.[5][77] It decreases the amount of stress those with tinnitus feel.[78] These benefits appear to be independent of any effect on depression or anxiety in an individual.[77] Acceptance and commitment therapy (ACT) also shows promise in the treatment of tinnitus.[79] Relaxation techniques may also be useful.[3] A clinical protocol called Progressive Tinnitus Management for treatment of tinnitus has been developed by the United States Department of Veterans Affairs.[80]
Oticon Tinnitus SoundSupport works by adding sound to the buzzing, hissing, or roaring you already hear. This may seem peculiar, but in fact, the relief sounds (which are dynamic and soothing) can mix with and distract you from those bothersome noises, giving you control over your condition. The flexible program includes a variety of relief sounds that can ease the effects of tinnitus. Your audiologist can personalize the sounds to your needs and preferences, and they can be used alongside Tinnitus Retraining Therapy for instruction and support.
^ 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.
Patulous Eustachian tubes can be associated with tinnitus. The Eustachian tube is a small canal that connects the middle ear to the back of the nose and upper throat. The Eustachian tube normally remains closed. In individuals with a patulous Eustachian tube, the tube is abnormally open. Consequently, talking, chewing, swallowing and other similar actions can cause vibrations directly onto the ear drum. For example, affected individuals may hear blowing sounds that are synchronized with breathing.
If you have tinnitus you also may suffer from anxiety, depression, or insomnia. Discuss treatments with your doctor. While tinnitus cannot always be cured, there are many treatments available for you to make it easier to live with tinnitus. See your doctor if tinnitus is accompanied by dizziness, fever, or headache; as this may signal a more serious condition.
Loud noise exposure: Being exposed to occupational loud noise on a regular basis from heavy equipment, chain saws or firearms is a common cause of tinnitus. However, even if you don’t work in a noisy environment, you can still suffer the effects of noise exposure by listening to loud music through headphones, attending live music performances frequently and engaging in noisy hobbies.
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