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.
Think about your breathing. Notice that it has a natural rhythm. Try to breathe in a steady, even rhythm. It helps to breathe in through your nose, hold your breath for a moment and then breathe out through your mouth. Wait a moment before breathing in again. Every time you breathe out, try to release a little bit of your tension. Do this for a few minutes, until you feel ready to move on to the next step.
It is also very common for jaw opening to change the loudness or frequency of tinnitus. This is likely a variant of somatic modulation of tinnitus (see above). The sensory input from the jaw evidently interacts with hearing pathways. The muscles that open the jaw are innervated by the same nerve, the motor branch of 5, that controls the tensor tympani in the ear. In other words, changing tension in the jaw may also change muscle tension in the ear.
Cognitive behavioral therapy (CBT). CBT uses techniques such as cognitive restructuring and relaxation to change the way patients think about and respond to tinnitus. Patients usually keep a diary and perform "homework" to help build their coping skills. Therapy is generally short-term — for example, weekly sessions for two to six months. A 2010 review of six studies by the Cochrane Collaboration (an international group of health authorities who evaluate randomized trials) found that after CBT, the sound was no less loud, but it was significantly less bothersome, and patients' quality of life improved.
Between 2007 and 2011, the researchers recruited 492 Dutch adults who had been diagnosed with tinnitus. The patients had to fulfil several criteria, including having no underlying disease that was causing their tinnitus, no other health issues that precluded their participation, and to have received no treatment for their tinnitus in the five previous years. Some 66% of adults originally screened for the study participated after screening.
Most people who suffer from tinnitus also experience hearing loss to some degree. As they often accompany one another, the two conditions may be correlated. In fact, some researchers believe that subjective tinnitus can only occur if the auditory system has been previously damaged (source). The loss of certain sound frequencies due to hearing loss may change how the brain processes sound, causing it to adapt and fill in the gaps with tinnitus. The underlying hearing loss typically results from exposure to loud noises or advanced age:
Traumatic brain injury, caused by concussive shock, can damage the brain’s auditory processing areas and generate tinnitus symptoms. TBI is one of the major catalysts for tinnitus in military and veteran populations. Nearly 60% of all tinnitus cases diagnosed by the U.S. Veterans Administration are attributable to mild-to-severe traumatic brain injuries.
Glenn Schweitzer is an entrepreneur, blogger, and the author of Rewiring Tinnitus and Mind over Meniere’s. He is passionate about helping others who suffer from tinnitus and vestibular disorders and volunteers as an Ambassador Board Member for the Vestibular Disorders Association (VEDA). Through his blogs, he continues raise awareness for tinnitus, Meniere’s disease, and other vestibular disorders, spreading his message of hope to those in need.
Cochlear Implants. These implants are a treatment option for patients that have a severe hearing loss along with tinnitus. Cochlear implants are designed to bypass any damaged parts of the inner ear and send the electrical signals sound makes directly to the auditory nerve. By bringing in outside noise, these implants can effectively mask your tinnitus, as well as stimulate your neural circuits to change.
Tinnitus is not a disease in and of itself, but rather a symptom of some other underlying health condition. In most cases, tinnitus is a sensorineural reaction in the brain to damage in the ear and auditory system. While tinnitus is often associated with hearing loss, there are roughly 200 different health disorders that can generate tinnitus as a symptom. Below is a list of some of the most commonly reported catalysts for tinnitus.
Avoid a too-quiet bedroom. People with tinnitus may find it easier to sleep in a less quiet bedroom, and may benefit from white noise or other sleep-friendly sounds that help mask and minimize their tinnitus. To my patients who are looking to introduce soothing sounds to their sleep environment, I recommend the iHome Zenergy Sleep System, which combines relaxing sounds with aromatherapy and sleep-promoting light therapy.
Due to the large variability in tinnitus, a one-size-fits-all approach (as offered by maskers) will have limited benefits. Indeed, there is evidence that being able to customize a sound therapy (e.g., using the tinnitus pitch or hearing loss profile), will provide greater benefits7,8 for tinnitus sufferers. Given the evidence supporting this line of thinking and the limitations of existing tinnitus management options, we were driven to develop and rigorously test an enjoyable, personalized sound therapy that has potential to provide lasting relief to tinnitus sufferers.
Meniere’s disease isn’t directly connected to tinnitus, but people with Meniere’s often experience it, at least temporarily. Meniere's disease is an inner ear disease that typically only affects one ear. This disease can cause pressure or pain in the ear, severe cases of dizziness or vertigo and a ringing or roaring tinnitus. While Meniere’s isn’t fully understood, it appears that several relief options for tinnitus can also help with this disease. Patients are often advised to reduce stress and lower their consumption of caffeine and sodium.