What is tinnitus?
Tinnitus is a condition in which you hear sounds when there is no outside source of the sounds. The sounds can have many different qualities (ringing, clicking, buzzing, roaring, whistling or hissing) and can be perceived as soft or loud.
Usually, the person experiencing the tinnitus is the only one who can hear the sounds. Tinnitus can occur either with or without hearing loss, and can be perceived in one or both ears or in the head.
Approximately 50 million Americans have some form of tinnitus. For most people, the sensation usually lasts only a few seconds or up to a few minutes at a time. For others about 12 million people, the tinnitus is constant or recurs and interferes with their daily life so much that they seek professional treatment. For these individuals, tinnitus may result in a loss of sleep, difficulty with concentration or reading, and can create negative emotional reactions such as despair, frustration and depression.
People of any age can suffer from tinnitus, although it not as common in children. Everyone who has bothersome tinnitus should have it evaluated by a healthcare provider such as an otolaryngologist and audiologist.
Symptoms and Causes
What causes tinnitus?
Although the exact cause of tinnitus is unknown, the most common identifiable causes of tinnitus include:
- Hearing loss
- Exposure to loud noises
- Head injury
- Medication side effects
- High or low blood pressure
- Wax buildup in the ear canal
- Fluid buildup behind the eardrum
- Problems of the heart, blood vessels, neck, jaw or teeth
It is important to have your tinnitus evaluated by a medical professional to rule out a medical cause for it. It is especially important to see an otolaryngologist (ear, nose and throat doctor) if you experience:
- Tinnitus in only one ear
- Tinnitus that sounds like your heartbeat or is pulsating (pulsatile tinnitus)
- Tinnitus with sudden or fluctuating hearing loss
- Pressure or fullness in one or both ears
- Dizziness or balance problems accompanying tinnitus
Otherwise, see an audiologist for a hearing test and to begin a discussion about your tinnitus.
Management and Treatment
What is the treatment for tinnitus?
Ruling out any medical reasons for the tinnitus is important so that appropriate medical treatment can be taken. The majority of tinnitus, however, has no known cause, so the next step is determining the best option for relief of the condition. Treatment options for tinnitus include:
- Hearing aids. Many people who have tinnitus also have hearing loss. Hearing aids may help provide relief from tinnitus by making sounds louder and the tinnitus less noticeable. This is done by increasing the volume of the soft environment sounds (such as refrigerator noise, washing machine sounds, lawn mowers outside) while increasing soft speech. Hearing aids not only help with tinnitus, they also improve communication.
- Sound generators. These adjustable ear-level devices produce a broadband sound (pleasant shower-like sound) that is delivered directly to the ear. These devices help people pay less attention to their tinnitus by masking it with another sound from the device.
- Combination instruments. A hearing aid and sound generator can be housed in a single unit. These units are best for people who need hearing aids and may benefit from the use of additional sounds from the sound generators.
- Environmental enrichment devices. A variety of simple-to-use devices can be used to generate background sound in order to decrease the perception of tinnitus. These include tabletop sound machines that can generate different types of sounds (for example, rain, wind and waterfalls), CD/mp3 recordings of music and/or nature/environmental sounds. There are a variety of apps specifically created for tinnitus relief that can be used with smartphones or tablets.
- Relaxation techniques. Many people who have tinnitus find that it becomes more bothersome when they are under stress. Learning techniques to increase relaxation and ease stress can help people better deal with the frustrations of tinnitus. This can be achieved through meditation or mindfulness therapy.
- Counseling options. Cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) with a psychologist can help people learn ways to limit the attention given to tinnitus and also help them better manage the stress and anxiety caused by the condition.
- Other options. Some tinnitus is produced by stress on the jaw and neck muscle or temporomandibular disorder (TMD). A dentist may be of value in helping to control dental issues, such teeth clenching and grinding, which are associated with tinnitus. An examination by a physical therapist may identify problems with the movement of the head, neck and jaw that can contribute to tinnitus. Follow-up physical therapy can help restore the proper movement of the neck and jaw and improve posture, which may reduce the severity of tinnitus.
Can tinnitus be prevented?
Certain behaviors can make tinnitus worse and should be avoided whenever possible. These include:
The use of hearing protection devices (earmuffs or earplugs) is advisable in all situations where the exposure to sound is too loud for too long).