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.


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Luckily, many can live with their tinnitus as it may only occur occasionally and/or is relatively quiet, but for some the tinnitus is so bothersome, severe and intense that it negatively influences their daily life to a very large extend. For those people, it is very natural to look for a cure that can make the tinnitus go away - or at least reduce it.

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.
The sound perceived may range from a quiet background noise to one that can be heard even over loud external sounds. The specific type of tinnitus called pulsatile tinnitus is characterized by hearing the sounds of one's own pulse or muscle contractions, which is typically a result of sounds that have been created by the movement of muscles near to one's ear, or the sounds are related to blood flow of the neck or face.[10]
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 associated with a high level of emotional stress. Depression, anxiety, and insomnia are not uncommon in people with tinnitus. Cognitive behavioral therapy (CBT) is a type of talk therapy that helps people with tinnitus learn to live with their condition. Rather than reducing the sound itself, CBT teaches you how to accept it. The goal is to improve your quality of life and prevent tinnitus from driving you crazy.
Tinnitus can be extremely disturbing to people who have it. In many cases it is not a serious health problem, but rather a nuisance that may go away. However, some people with tinnitus may require medical or surgical treatment. Sixteen million Americans seek medical treatment each year for tinnitus, and about one-quarter of those experience it so severely it interferes with their daily activities.

Tinnitus also could be the result of neural circuits thrown out of balance when damage in the inner ear changes signaling activity in the auditory cortex, the part of the brain that processes sound. Or it could be the result of abnormal interactions between neural circuits. The neural circuits involved in hearing aren’t solely dedicated to processing sound. They also communicate with other parts of the brain, such as the limbic region, which regulates mood and emotion.
Age-Related Hearing Loss: Also known as presbycusis, age-related hearing loss results from the cumulative effect of aging on hearing. This permanent, progressive, and sensorineural condition is most pronounced at higher frequencies. It commonly impacts people over the age of 50, as all people begin to lose approximately 0.5% of the inner ear’s hair cells annually starting at age 40.

A large, 2014 study of almost 14,000 people found obstructive sleep apnea was linked to significantly higher rates of hearing impairment and hearing loss. Scientists think one reason for this is changes to blood flow to the ear that result in inflammation. (We know that sleep apnea causes changes to circulation and weakens blood flow to some areas of the body, including the brain.) A related factor? People with sleep apnea are at greater risk for high blood pressure, and high blood pressure can exacerbate hearing loss, according to research.


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.
Technology and portable music devices also contribute to noise pollution, especially in younger people. Keep the volume of your phone, MP3 players or iPod on the lower end when listening to headphones, and don’t play very loud noises for long durations of time. To aid in tinnitus treatment, look out for changes in your ability to hear if you’re frequently exposed to loud noises, limit use of headphones or consider wearing earplugs.
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Notch Therapy can reduce the perception of tinnitus after wearing your hearing aids for weeks or months without hearing an audible signal like static noise or ocean waves.  The goal of Notch Therapy is for your brain to learn to ignore the tinnitus sound.  This type of treatment is most effective for people who have tonal tinnitus – the most common type of tinnitus.  Notch control is set up in the Miracle-Ear programming software by the hearing care specialist and the settings are fine tuned with you to match the pitch of the tinnitus. This feature is available in our GENIUS™ 2.0 solutions.
Experts believe that tinnitus is associated with neural (brain and nerve) injuries that affect the auditory pathway and therefore someone’s ability to hear sounds. (10) Most of the time, tinnitus is a result of a disorder that affects parts of either the outer, inner or middle ear. The good news is that the majority of cases are not linked to any serious illness, although some cases are.

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.
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.

Luckily, many can live with their tinnitus as it may only occur occasionally and/or is relatively quiet, but for some the tinnitus is so bothersome, severe and intense that it negatively influences their daily life to a very large extend. For those people, it is very natural to look for a cure that can make the tinnitus go away - or at least reduce it.
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.
Some patients choose to get involved in “tinnitus retraining,” which involves wearing a device in the ears that provides soothing music or noise, along with undergoing counseling. The goal is to help your body and brain learn to get accustomed to tinnitus noise, which reduces your negative reactions to unwanted sounds. Support and counseling during the process can be helpful for reducing anxiety. Researchers are now learning more about the benefits of coherent cognitive behavioral therapy interventions to help treat distress associated with tinnitus. (3)

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.
Another way of splitting up tinnitus is into objective and subjective. Objective tinnitus can be heard by the examiner. Subjective cannot. Practically, as there is only a tiny proportion of the population with objective tinnitus, this method of categorizing tinnitus is rarely of any help. It seems to us that it should be possible to separate out tinnitus into inner ear vs everything else using some of the large array of audiologic testing available today. For example, it would seem to us that tinnitus should intrinsically "mask" sounds of the same pitch, and that this could be quantified using procedures that are "tuned" to the tinnitus.
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.
There seems to be a two-way-street relationship between tinnitus and sleep problems. The symptoms of tinnitus can interfere with sleeping well—and poor sleep can make tinnitus more aggravating and difficult to manage effectively. In the same study that found a majority of people with tinnitus had a sleep disorder, the scientists also found that the presence of sleep disorders made tinnitus more disruptive.
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. 
Now make your toes as tight as you can, really scrunch them up. Hold them like this for a moment – and relax. Now do the same with your ankles, then your calf muscles, your thighs… work all the way up your body to your head, making sure you tense, hold for a moment, and then release the tension. Once you’ve done this with your whole body, focus again on your breathing – notice the rhythm, it should be even and calm.
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.

^ Tyler RS, Pienkowski M, Roncancio ER, Jun HJ, Brozoski T, Dauman N, Dauman N, Andersson G, Keiner AJ, Cacace AT, Martin N, Moore BC (2014). "A review of hyperacusis and future directions: part I. Definitions and manifestations" (PDF). American Journal of Audiology. 23 (4): 402–19. doi:10.1044/2014_AJA-14-0010. PMID 25104073. Archived (PDF) from the original on May 9, 2018. Retrieved September 23, 2017.
Often people bring in very long lists of medications that have been reported, once or twice, to be associated with tinnitus. This unfortunate behavior makes it very hard to care for these patients -- as it puts one into an impossible situation where the patient is in great distress but is also unwilling to attempt any treatment. Specialists who care for patients with ear disease, usually know very well which drugs are problems (such as those noted above), and which ones are nearly always safe.

Microvascular compression may sometimes cause tinnitus. According to Levine (2006) the quality is similar to a "typewriter", and it is fully suppressed by carbamazepine. It seems to us that response to carbamazepine is not a reliable indicator of microvascular compression as this drug stabilizes nerves and lowers serum sodium. Nevertheless, this quality of tinnitus probably justifies a trial of oxcarbamazine (a less toxic version of carbamazepine).


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).

MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
Treatment of the underlying primary disorder may help to improve or cure rhythmic tinnitus. For example, the treatment of blood vessel disorders (e.g. dural arteriovenous shunts) can include certain medications or surgery. A surgical procedure known as sinus wall reconstruction can successfully treat pulsatile tinnitus due to sigmoid sinus diverticulum and dehiscence. In fact, most individuals have experienced complete resolution of their tinnitus following this surgery. Surgery may also be necessary for rare cases of pulsatile tinnitus caused by a tumor.
Michael Chrostowski, PhD is the founder of Sound Options Tinnitus Treatments Inc. His dedication to improving the lives of tinnitus sufferers drives his vision of providing effective, affordable and accessible treatments for the many tinnitus sufferers he has met throughout his research career. With over 8 years of research in the field of tinnitus and collaborations with leaders in the field, Dr. Chrostowski was able to make use of cutting-edge research to develop software that can customize an effective and personal treatment for tinnitus. Dr. Chrostowski received a BASc in electrical and computer engineering at the University of Toronto and a PhD in neuroscience at McMaster University.
Though the exact cause of tinnitus — as in the specific mechanism that creates these phantom sounds in some people — remains unknown, contributing factors and triggers have been identified. Excessive exposure to loud noise is often a factor because of the damage done to your auditory system. Tinnitus may also result from jaw-joint dysfunction (e.g., teeth grinding, temporomandibular joint disorder) or chronic neck muscle strain.
Herbal home remedies (ginkgo biloba, melatonin), and the vitamin zinc are not recommended by the American Academy of Otolaryngology. Lipo-flavonoid is a supplement being marketed as a way to relieve tinnitus, but there is no current evidence it is effective for most cases of the condition; however, it may be helpful for symptoms of Meniere's disease. Check with your doctor or other health care professional before taking any herbal or over-the-counter (OTC) natural remedies.
ABR (ABR) testing may show some subtle abnormalities in otherwise normal persons with tinnitus (Kehrle et al, 2008). The main use of ABR (ABR test) is to assist in diagnosing tinnitus due to a tumor of the 8th nerve or tinnitus due to a central process. A brain MRI is used for the same general purpose and covers far more territory, but is roughly 3 times more expensive. ABRs are generally not different between patients with tinnitus with or without hyperacusis (Shim et al, 2017).

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.
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