What is Tinnitus?
Who Does Tinnitus Affect?
Tinnitus Remedies: Natural Treatments, Alternative Medicines & Home Remedies
The Two Main Types of Tinnitus
Tinnitus Risk Factors, Causes and Associated Conditions
Tinnitus Facts and Figures
Is There a Cure for Tinnitus?
How to Treat Tinnitus
Tinnitus Questions for Your Doctor
Getting a Diagnosis
What To Do for Your Tinnitus Right Now
Luis’s friends shook their heads. One of them let out a long sigh.
“Sorry guys, not tonight. Maybe next week.”
The text message had just come through. Luis was canceling on them. Again.
They didn’t understand. Their vibrant friend just wasn’t anymore. The guy who used to lead crowd cheers at the local high school football games, tell the best stories at the annual company picnics and never missed their weekly darts league night, was suddenly different now. He was distant. Disengaged. Sullen.
“Maybe he’s worried about retiring?” one friend offered half-heartedly. The rest of them shrugged, sipped their beer and started the game on a sour note.
Across town, Luis’s wife was worried, too. She folded and unfolded her notes from this afternoon’s doctor appointment, glancing at the word circled and underlined a dozen times.
Could this be right? Could this be what was causing her husband and her family so much pain? The sleepless nights? The irritability? The withdrawal from everything he used to love?
It seemed like a lot to lose for such an unknown condition.
But Luis was tough. A veteran with three tours of duty under his belt. This man did not complain. So if something was bothering him, it was really bothering him.
The doctor had scheduled a follow-up visit to talk more, but the information he left her with wasn’t much comfort. “No cure,” he had said. “But you can manage it.” She shook her head. This wasn’t going to be easy. She could barely get her husband to take a cough drop when he needed it, let alone manage a condition.
She sighed, then steeled herself. She wanted her husband back. She opened her laptop, pulled up the search engine, thought for a moment and typed:
Do natural tinnitus remedies really work?
Does the story above sound familiar? You’re not alone. Millions of patients as well as their families and friends struggle daily with the realities of tinnitus. They read up on all aspects of the condition, dig deep to provide understanding and support for those who are hurting, and search for treatment options that will bring relief. This article will touch on all of these topics and more. But before we get to the natural tinnitus remedies, let’s go over what is tinnitus and who does it affect?
Tinnitus is when you hear a sound that doesn’t have an external source. Patients usually experience tinnitus as a persistent, high-pitched ringing in the ears, but it can also be a buzzing, humming, roaring, shrieking or the sound of your own heartbeat. Many tinnitus patients experience anxiety related to their disorder. Headaches and dizziness can also co-occur with tinnitus symptoms.
Though tinnitus can affect any person at any age, there are groups who are more likely to count tinnitus sufferers among their members including older people, men, military veterans, people with past ear damage and anyone with hearing loss.
Many patients find their tinnitus to be manageable—a background noise that’s easy to ignore. But for millions of others, tinnitus is an unbearable and debilitating chronic condition. They are desperate for treatment options. While no tinnitus-specific prescription or surgical cures exist, there are natural tinnitus treatment options include lifestyle changes, using sound machines or hearing aids, preventing ear infections, reducing noise exposure, cognitive behavioral therapy and more, all of which we will explore at length.
Over 45 million Americans struggle with tinnitus, making it one of the most common health conditions in the United States. Of those, 20 million people deal with bothersome tinnitus on a regular basis, and two million suffer chronically from their extreme symptoms.
- Adults: about a third of North Americans age 55 and older have experienced tinnitus at some time in their lives. Ten to 15 percent of those patients are bothered enough by their symptoms to seek out treatment.
- Children: though many people assume it’s an adult disease, tinnitus doesn’t discriminate. Unfortunately, children don’t always have the language to describe their symptoms, or they are fearful of what the ringing means. This leads to children underreporting their conditions. Often when they do, their complaints are not taken seriously. Children who do get care for tinnitus often have other co-occurring conditions related to the ears or the brain that includes hearing loss, chronic ear infections, migraines or juvenile Meniere’s disease. As many as 12 to 36 percent of hearing children and up to 66 percent of children with hearing loss, experience tinnitus. Of those, approximately three to 10 percent report being troubled by their symptoms.
Demographic Trends with Tinnitus
Tinnitus can affect anybody. Any age group, race and gender. However, there are some groups who are more likely to develop acute and chronic tinnitus for a variety of reasons. These groups include:
- Men: men get tinnitus more often than women. This may be because a greater percentage of men do jobs in loud environments like those who work in manufacturing, construction and in the military. Men are also more likely to participate in loud activities, such as hunting and motorsports. Of course, women who work in loud jobs or enjoy loud activities are at an equally high risk.
- Older people: tinnitus often accompanies hearing loss, a common side effect of aging. Tinnitus tends to peak between ages 60 and 69.
- Caucasians: white, non-Hispanics report more incidents of tinnitus than other racial and ethnic groups. The reason why is unclear.
Some groups that are particularly vulnerable to developing tinnitus include:
- Senior citizens: with age-related hearing loss accelerating after age 60, older seniors are particularly prone to developing tinnitus with roughly 30 percent of seniors experiencing symptoms.
- Military personnel and veterans: exposure to gunfire, explosions and loud machinery puts active military personnel at very high risk for developing noise-induced hearing loss and tinnitus. In fact, tinnitus is the leading service-related disability among U.S. veterans, even surpassing reported cases of post-traumatic stress disorder.
- Musicians and music lovers: professional musicians spend their lives around loud, amplified music, putting them in particular danger of developing tinnitus. Music enthusiasts also risk developing noise-induced tinnitus from attending loud concerts and listening to music with the volume turned up too high. In fact, with the explosion in popularity of personal listening devices like smart phones and iPods, more people (especially young people) are at risk of developing tinnitus than ever before.
- People in loud workplace environments: workers involved in agriculture, mining, construction, manufacturing and transportation are particularly at risk.
- Motorsports and hunting enthusiasts: exposure to loud engines and firearms make these activities particularly risky.
People with mental health concerns: patients with a history of depression, anxiety and obsessive-compulsive disorder can be more prone to suffering from tinnitus. While these mental health issues do not cause tinnitus, they may interfere with a patient’s ability to cope with the sound. This makes their condition worse.
Tinnitus Remedies: A Comprehensive List of Natural Treatments, Alternative Medicines and Home Remedies for Tinnitus
Tinnitus treatments are unique to each patient. What works wonders for some may not help others. In their search to find relief, some patients have found natural or alternative treatments to be the most helpful. These include:
Acupuncture is a traditional Chinese therapy where fine needles are inserted into certain points in the body. While some controlled studies have shown acupuncture to improve tinnitus, others have shown no benefit. Regardless, acupuncture is a pain-free and highly relaxing therapy that many tinnitus patients enjoy.
Acupressure Points and Reflexology
Acupressure is much like acupuncture, but instead of needles pressure is applied to key points on the body. Here are a few acupressure exercises you can do one your own:
- Place your fingertips about 1/8th of an inch from your ears. Feel for hollow spots, and fit your fingertips into each of these indentations. Take slow deep breaths as you briskly massage this area for two minutes.
- Bring your knees to your chest slowly five times. This flattens the curve in the lower back that relieves lower back aches and is good for the kidneys.
- Press between your belly button and pubic bone and take slow deep breaths for 5 to 10 minutes.
Apple Cider Vinegar (ACV)
Many herbalists believe apple cider vinegar can be an effective remedy for tinnitus. ACV contains various kinds of acids, enzymes, 18 types of alcohol, polyphenols and other substances that may help treat ear infections that lead to tinnitus.
Often, tinnitus can be significantly improved through therapy. Not just to make us feel better, but to change how we react to and interpret the symptoms. Therapies that help tinnitus patients include:
- Cognitive Behavioral Therapy: a therapy that emphasizes challenging negative beliefs and self-talk, and finds new ways to think about what’s causing you distress.
- Mindfulness-Based Stress Reduction: emphasizes “mindfulness,” non-judgmental awareness and acceptance.
- Acceptance and Commitment Therapy: teaches patients to stop avoiding tinnitus and fully experience thoughts, perceptions and emotions in a non-judgmental way.
- Tinnitus Activities Treatment (TAT): a variation of cognitive behavioral therapy that focuses specifically on tinnitus management. TAT explores four areas impacted by tinnitus: thoughts and emotions, hearing and communication, sleep and concentration.
- Tinnitus Retraining Therapy: combines cognitive behavioral therapy with supplemental sound masking to get patients used to the sound of tinnitus and lessen their stress response to it.
- Progressive Tinnitus Management (PTM): developed by the U.S. Veterans Administration, PTM involves patient education, behavioral therapy and supplemental sound therapy.
Biofeedback uses mild electrical stimulation to help you become aware of changes in your body caused by stressors. Patients learn to put mind over matter.
In Chinese medicine, chronic tinnitus is believed to be caused by kidney weakness. Practitioners believe this can be treated with a combination of acupuncture, herbs and supplements and lifestyle changes.
Craniosacral therapy is a quiet, relaxing, hands-on therapy designed to improve the flow of cerebrospinal fluid around the brain and spinal column.
Essential Oils and Aromatherapy
Essential oils are liquid plant extracts obtained from the roots, leaves, flowers, seeds, tree bark and resin of plants. Some essential oils recommended for tinnitus symptom relief are lavender oil, cypress oil and juniper oil. Practitioners say they can deliver numerous therapeutic properties including:
- Improving circulation of air and blood throughout the body, providing relief from earaches
- Soothing inflammation from ear infections
- Decreasing congestion in the respiratory airways especially in the Eustachian tube
- Relieving ear pain and discomfort with their analgesic properties
- Reducing stress and depression
- Helping to increase focus and concentration that are often disrupted by tinnitus
Eustachian Tube Drainage
Eustachian tube drainage is a naturopathic technique used to relieve congestion in the tube behind the eardrum by draining fluid away from the ear. This practice is said to help tinnitus if it’s caused by congestion in the ear, nose or throat. It’s also a good technique to expedite curing a simple ear infection, or to unblock your ears after diving or flying.
Researchers around the world are exploring new ways to control—and hopefully cure—tinnitus. Below are some of the more promising prospective treatments. Please note that these treatments are experimental and are generally not available for patients outside of controlled clinical research trials. More data is needed to validate the safety and efficacy of these treatments before they are approved for the general public.
- Repetitive Transcranial Magnetic Stimulation (rTMS): Repetitive Transcranial Magnetic Stimulation uses a powerful magnetic coil positioned next to the patient’s head to deliver electromagnetic pulses into the brain. Because tinnitus is believed to be a function of hyperactivity in the brain’s neural cortex, many researchers believe that stimulation can reduce tinnitus symptoms. Studies so far have delivered mixed results.
- Transcranial Direct Current Stimulation (tDCS): Transcranial Direct Current Stimulation is another form of non-invasive electromagnetic treatment. Patients wear electrodes on their scalp that transmit electromagnetic pulses through the skull and into the brain. Research on tDCS has been promising. Some studies show up to 40 percent of patients receive some benefit from the treatment. More large randomized clinical trials are needed.
- Deep Brain Stimulation (DBS): Deep Brain Stimulation is already an accepted treatment for patients with Parkinson’s Disease, tremors and other chronic medical conditions. It’s based on the concept of stimulating the brain with electromagnetic energy. Unlike rTMS and tDCS, DBS requires surgical implantation of electrodes directly into the brain.
- Brain Surface Implants: some researchers are experimenting with the use of brain surface implants or electrodes surgically positioned on the exterior of the brain. Like other brain stimulation techniques, there is promising early evidence on brain surface implants, but further research is needed.
- Vagus Nerve Stimulation (VNS): the vagus nerve runs through the neck and connects the brain to the heart and digestive system. The use of an implanted electrode to electrically stimulate the vagus nerve has already been shown to be effective in the management of epilepsy and depression. Some researchers believe that the same practice can assist patients with tinnitus.
Individuals who lead healthy lifestyles are much less susceptible to developing tinnitus. Patients who do develop the condition can help reduce or alleviate their symptoms by making healthier choices. These include:
- Eat a healthy diet: a health-conscious diet can reduce hypertension and weight, increase blood flow, heighten energy levels and improve emotional well-being, all of which can improve your tinnitus. Some patients choose to track and cut back their caffeine and alcohol consumption if they find it exacerbates their symptoms. Also, patients with tinnitus related to Ménière’s disease are encourage to adopt a low-salt diet as there is a very strong correlation between salt consumption and Ménière’s symptoms.
- Exercise more: exercise isn’t just good for your body, it’s also good for your emotional well-being by reducing stress and helping minimize the burden of tinnitus. As an added bonus, patients can incorporate daily exercise that includes a relaxation component, such as yoga or tai chi.
- Spend time with others: as communication becomes a challenge and sound sensitivity and irritability are heightened, many tinnitus patients feel isolated. But time spent with friends, family and peers can positively distract patients from tinnitus symptoms. It can boost emotional wellness and general feelings of contentment and optimism. Plus, sharing your tinnitus experiences can help you develop a support network that may help you through your most difficult days.
- Enjoy activities and hobbies: tinnitus patients should participate in activities that make them happy and provide positive distractions from their tinnitus symptoms. Minor adjustments or precautions may be needed for certain activities that involve loud noise. Patients should talk to their doctors about appropriate hearing protection.
- Reduce stress: any activity that lowers stress can also help reduce the severity of tinnitus symptoms. In addition to making good choices about diet, exercise and socialization, patients can explore other relaxation methods including meditation.
Hypnotherapy promotes relaxation and reduces anxiety. It may also alter neural connections between areas of the brain helping to lessen the brain’s stress response to symptoms.
Tinnitus patients with sound sensitivity often benefit from earmuffs, earplugs, canal caps and other sound mufflers that protect them from painful sounds and further damage to the auditory system.
Herbal Medicines and Beneficial Plants
Many naturopaths promote the use of herbs and plants to treat tinnitus symptoms. Some of the more popular remedies include:
- Ginkgo biloba: ginkgo biloba is said to improve circulation to the head and brain.
- Holy basil: naturopaths recommend blending holy basil into a paste and putting it into the ear to help clear out bacterial infections.
- Mustard oil: mustard oil is said to be an antifungal agent that helps to clear infections from your ear and boost the immune system.
- Onions: onions contain antibacterial properties. A few drops of the juice of a heated-up onion may clear out bacteria from your ear.
- Garlic: naturopaths use garlic to treat tinnitus caused by high altitudes or cold weather to help reduce inflammation. To use, make a paste with sesame oil and garlic. Add a few drops into your ear.
- Pumpkin: pumpkin is packed with vitamin A. Deficiency in vitamin A has been found to contribute to tinnitus.
- Pineapple: pineapple can help lessen inflammation and also contains vitamin A.
Neural therapy is an injection technique for pain control used to reset and correct the misfiring nerve impulses. A pain medicine (usually 1% or 2% Procaine) is injected into specific trigger points throughout the body. In the case of tinnitus, the trigger points will be similar to the acupuncture points, found mostly around the ears.
Osteopathy involves a specially trained physician manipulating and massaging the body to correct skeletal or posture imbalances. Cranial osteopathy is designed to reduce restrictions in the patient’s body including in their head. A cranial osteopath will take a full medical history from the patient in order to establish the cause of their tinnitus. They will then formulate a treatment program to help control the tinnitus symptoms and reduce its impact on the patient. Treatment may involve the gentle manipulation of the patient’s spinal column, their lower back and their skull.
Reddit Tinnitus Cure
This trick (spread via viral video) promotes temporary relief from tinnitus symptoms:
- Place the palms of your hands over your ears so your fingers wrap around the back of your head.
- Set your middle fingers on the top of your neck right at the base of your skull.
- Put your index fingers on top of your middle fingers and apply pressure.
- Now snap them on the back of your head over and over like you’re drumming.
- Repeat about 50 times.
Some researchers suspect this trick works because it functions like some maskers. Maskers are devices that can be placed in the ear to emit sound and temporarily suppress the noise of tinnitus. However, some people have damage to the bones in their ear so regular maskers don’t work. These patients sometimes use special devices called bone-anchored hearing aids that transmit sound through bone vibration. The people in the Reddit video are tapping the spot on the skull where these bone anchored hearing aids are placed, generating sound vibrations to the cochlea that mask the tinnitus in the same way other maskers function.
Sleep Sound Therapy and Other Sound Therapies
Sound therapy means using external noise to alter a patient’s perception of or reaction to tinnitus. Like other tinnitus treatments, sound therapies do not cure the condition, but they may make life with tinnitus easier by providing some much needed respite from the noise.
Sound-based therapies function on four general mechanisms of action:
- Masking: exposing the patient to external noise to cover the sound of their tinnitus.
- Distraction: using external sound to divert a patient’s attention from the sound of tinnitus.
- Habituation: helping the patient’s brain reclassify tinnitus as an unimportant sound that can be ignored.
- Neuromodulation: using specialized sound to minimize neural hyperactivity that could be causing tinnitus.
There are many devices that offer different levels of sound therapy including:
- Sound masking devices: these are devices that provide generic background noise. This is often white noise, pink noise, nature sounds or other ambient, subtle sounds. Almost any sound-producing device can be used for masking purposes including computers, radios, fans, miniature tabletop fountains and TVs.
- Hearing aids: hearing aids can increase auditory stimuli and divert attention from tinnitus symptoms.
- Modified-sound/notched-music devices: these medical-grade devices play algorithmically-modified sounds with specific frequencies and tones emphasized often at a level not consciously perceivable by the listener. Notched-music devices are generally worn only during designated therapy sessions or when symptoms are at their most intense. Patients typically get the best results when they also participate in a tinnitus counseling and education program along with using devices.
- Vibroacoustic therapy: vibroacoustic therapy is deep-tissue, low-frequency sound massage using audio waves transmitted to the body by embedded transducers in beds, mattresses, chairs and pillows.
- Combination devices: many hearing aids now come with integrated sound generation technology that delivers white noise or customized sounds to the patient on an ongoing basis.
- Sound and sleep apps: a variety of apps are available to help with tinnitus symptoms and getting a good night’s sleep. Experiment with a few to see which works best for you since many are free.
- Tinnitus relief app: as part of a tinnitus management program, the ReSound Relief app offers patients a combination of sound therapy, relaxation exercises, meditation and education.
Tinnitus Ear Drops
Tinnitus is often more troublesome when patients’ ears are full of wax. Earwax softening drops can help, though many people find them to be too harsh or drying. Olive oil may be the better solution as it is readily available, gentle and does not need to be warmed before use. Start by using two or three drops twice a day for one to two weeks.
Tinnitus Homeopathic Remedies
This is a 250-year-old practice with German origins that uses plant, mineral and animal materials in small doses to help patients’ innate “healing forces” overcome their tinnitus symptoms.
TMJ Dysfunctions Treatments
When tinnitus is caused by dysfunction in the jaw joint (temporomandibular joint or TMJ), dental treatments, massage or bite realignment may relieve symptoms. Your dentist can help diagnose the problem and set up a treatment plan.
Removing Obstructions in the Ear
Tinnitus can be sometimes be caused by excessive earwax, a loose hair or another object in contact with the eardrum. See your doctor to remove objects safely.
Treating Head and Neck Injuries
Injuries to the head and neck can cause damage that results in tinnitus. Treating the underlying physical trauma via drug therapy, osteopathy, physical therapy, chiropractic care or even surgical options may relieve tinnitus symptoms.
Recognizing Ototoxic Medication Reactions
When tinnitus is side effect of a medication you are taking, changing prescriptions or dosing schedules may fix the problem. You should not adjust or stop taking any medication without first talking to your doctor.
Several supplements and vitamins have been shown to improve tinnitus symptoms including:
- Flavonoids: lemon bioflavonoids (specifically the bioflavonoid eriodictyol glycoside) help support ear health.
- Melatonin: melatonin is a substance produced naturally in the brain and is also available over-the-counter to help regulate sleep and wake cycles. Many tinnitus patients experience improved sleep when using melatonin.
Vitamin B12: vitamin B12 deficiency has been reported in people exposed to loud noises, and who have then developed occupational tinnitus and hearing loss. B12 supplements are available over the counter. Intramuscular injections of B12 are generally only available in the doctor’s office.
The Two Main Types of Tinnitus
This type of tinnitus can only be heard by the patient. Subjective tinnitus is the most common form. It accounts for 95 percent of tinnitus cases, and is found in over 80 percent of hearing loss patients. Subjective tinnitus can be a symptom of many health conditions including almost every known ear disorder. It can also be brought on by over-exposure to loud noises that damage the hair cells of the inner ear, chronic ear infections, side effects to medications and other causes. Like pain, subjective tinnitus is subjective. That means two patients can experience tinnitus in completely different ways, even if the perceived volume and pitch levels are the same. For example, one patient can experience their tinnitus as background noise that’s easily ignored, while another can experience that same tinnitus as highly distracting, distressing and debilitating. That means the severity of subjective tinnitus isn’t determined by the strength of the symptoms, but by how strongly patients react to the condition. That said, many subjective tinnitus sufferers share common experiences including finding it difficult to sleep or concentrate, and feeling depressed or anxious about their symptoms.
Objective tinnitus is sound that can be heard by both you and your doctor. Your doctor detects the sound by listening to your ear with a stethoscope or a sensitive microphone. Objective tinnitus is much less common than subjective tinnitus, but it often has a cause that your doctor can identify and even cure. Objective tinnitus is often vascular in nature or related to your arteries veins and blood flow. It can also be associated with abnormalities or disruptions in your Eustachian tube as well as with muscle contractions inside your ear.
While tinnitus is often described as “ringing in the ears,” it can actually sound like a lot of different things: ringing, hissing, static, crickets, screeching, whooshing, roaring, pulsing, ocean waves, buzzing, dial tones or even music. In general, there are three ways to describe a patient’s perception of their personal tinnitus sound:
- Tonal Tinnitus: this is when the sounds of tinnitus are near-continuous and sometimes overlapping with well-defined pitches. The perceived volume of the tinnitus often varies with symptoms often seeming loudest at night or during times of stress.
- Pulsatile Tinnitus: this is when the patient perceives pulsing sounds that are often in time with their own heartbeat. Pulsatile tinnitus is often a symptom of vascular abnormalities that can be treated. Rarely, pulsatile tinnitus can be a symptom of a serious condition like a brain aneurysm, so patients should be evaluated by their doctor soon after symptoms develop.
- Musical Tinnitus: also known as Musical Ear Syndrome, this is when the patient perceives music or singing. Sometimes the same song on a constant loop. Musical tinnitus is very rare.
Severe tinnitus and anxiety are strongly correlated with one often feeding the other. But why?
Many people assume severe tinnitus would be characterized by the sound the patient hears: how loud it is, how high-pitched, how frequent. But studies show that the severity of tinnitus is not determined by the quality of the sound, but by how the patient reacts to it. Some people have the good fortune of being completely unperturbed by their tinnitus. They experience it as non-threatening background noise, easily ignored or forgotten. But for others, tinnitus triggers a vicious stress loop. Consciously or unconsciously, these patients’ brains perceive the sounds of tinnitus as a threat, linking it with negative emotions likes fear, anger and anxiety. This can cause body tension, other biological stress responses or more signals to your brain that danger is present. And, because stress exacerbates tinnitus, the responses can lead to the patient experiencing tinnitus even more intensely. This can eventually lead to severe anxiety, depression, insomnia and even suicidal thoughts or actions.
Tinnitus Risk Factors, Causes and Associated Conditions
There are many different medical disorders and lifestyle conditions that can put people at higher risk for developing tinnitus. These include:
- Frequent exposure to loud noise
- Hearing disorders
- Hearing loss tied to aging
- History of ear and upper respiratory infections
- History of smoking, drug use or excessive alcohol consumption
- Cardiovascular disorders
- TMJ disorders
- Head, neck or jaw injuries
- Having acute anxiety, insomnia or depression
Tinnitus is not a disease itself, but a symptom. A sign to you and your doctor that something else is going on in your body. While the exact mechanism of tinnitus isn’t understood, most doctors and researchers believe it has something to do with damage inside the ear and how your brain reacts to it. Damage to the cilia (the microscopic, hair-like sensor cells inside the ear) can distort how certain sound signals are sent to your brain. Tinnitus may be the brain’s way of filling in the missing sound frequencies it’s no longer receiving from the auditory system.
There are 200 different health disorders that can generate tinnitus as a symptom including:
Tinnitus often accompanies sensorineural hearing loss. In fact, many patients don’t even realize they are experiencing it. A trained audiologist can perform sensitive tests to determine if hearing loss is contributing to your tinnitus. Hearing loss is generally brought on by one of two factors:
- Age: hearing often deteriorates in both ears as people get older, typically starting around the age of 60.
- Noise: exposure to loud noises can damage the auditory system and result in hearing loss and tinnitus. This can happens either in a single traumatic experience or over time.
As many as 260 different over-the-counter and prescription medications are considered ototoxic, meaning they can temporarily or permanently damage your hearing and lead to symptoms of tinnitus. These include but are not limited to:
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- Certain antibiotics
- Certain cancer medications
- Water pills and diuretics
- Quinine-based medications
- Benzodiazepines, especially during withdrawal
In most cases and for most drugs, tinnitus is a short-lived reaction. However, if you are worried about tinnitus as a possible side effect of your medications, talk to your doctor or pharmacist. Never never stop taking a medication without their guidance.
Obstructions in the Middle Ear
Blockages in the ear canal can cause pressure to build up or irritate the eardrum leading to tinnitus symptoms. In many cases, removing the blockage will make the symptoms go away.
Common obstructions include:
- Excessive earwax
- Head congestion
- Loose hair
- Dirt or foreign objects
Head and Neck Trauma
Severe head and neck injuries can affect your nerves, blood flow and muscles in ways that cause tinnitus. Often, patients with trauma-induced tinnitus report more severe symptoms.
Temporomandibular Joint Disorder (TMJ)
The temporomandibular joint (TMJ) is where the lower jaw connects to the skull. TMJ disorders cause pain and stiffness in the face and jaw in addition to popping or crackling sounds while chewing or talking. Because the TMJ is very close to the auditory system, TMJ disorders can lead to tinnitus. Fortunately in many scenarios, fixing the TMJ disorder will also fix the tinnitus symptoms. Your dentist can help you come up with a treatment plan that’s right for you.
Nasal congestion from colds, flus or sinus infections can create pressure in the middle ear causing tinnitus symptoms.
Acute barotrauma that is caused by extreme or rapid changes in air or water pressure can damage the middle and inner ear. Barotrauma can be caused by:
- SCUBA diving and snorkeling
- Extreme, abnormal elevation changes while flying (this is generally not a concern in normal commercial air travel)
- Explosive blasts
Traumatic Brain Injury (TBI)
Traumatic brain injuries can damage the brain’s auditory processing areas causing tinnitus symptoms. TBI-induced tinnitus is particularly common among military personnel and veterans. In fact, nearly 60 percent of all tinnitus cases diagnosed by the U.S. Veterans Administration are brought on by traumatic brain injuries.
Other Diseases and Medical Conditions
Tinnitus is a reported symptom of the following medical conditions:
- Metabolic disorders including hypothyroidism, hyperthyroidism and anemia
- Autoimmune disorders including lyme disease and fibromyalgia
- Blood vessel disorders including high blood pressure and atherosclerosis
- Psychiatric disorders including anxiety, depression and stress
- Vestibular disorders including Ménière’s disease, thoracic outlet syndrome and otosclerosis
- Tumor-related disorders (which are very rare) including acoustic neuroma, vestibular schwannoma, other tumorous growths
Overdosing on certain prescription drugs, recreational drugs or alcohol
Tinnitus Facts and Figures
- Ten to 15 percent of people experience some degree of tinnitus.
- In children with normal hearing, 12 to 36 percent experience tinnitus. Up to 66 percent of children with hearing loss experience tinnitus.
- Adults over age 60 commonly suffer from tinnitus symptoms brought on by age-related hearing loss.
- Doctors believe the primary cause of tinnitus is damage to the delicate hairs in your inner ear which changes how auditory signals reach your brain.
- Most tinnitus patients hear sounds that come and go, but 35 percent experience near-constant symptoms.
- Not every person with tinnitus finds symptoms intrusive or debilitating. Less than half say it has an effect on their quality of life.
- Anxiety is highly associated with severe tinnitus symptoms. Around 45 percent of people with tinnitus experience anxiety disorders during their lifetimes.
- A study done by the National Study of Hearing found that 25 percent of tinnitus cases worsen with age while 75 percent improve over time or stay the same.
While the search for a tinnitus cure is ongoing and real progress is being made, there is currently no clinically proven way to stop tinnitus. There are treatment options, and many ways for patients to actively manage their symptoms and take control of their condition.
Precautions with Tinnitus Treatment
If you are experiencing tinnitus symptoms talk to a doctor soon if:
- You’ve had a sudden illnesses like a fever, cold or infection, and your tinnitus symptoms last for more than one week after you’ve recovered.
- If you notice symptoms that occur suddenly or without cause, especially if you have other symptoms like dizziness or sudden hearing loss.
- If you are experiencing serious depression or anxiety. There are providers and therapists who can help.
How to Treat Tinnitus
Tinnitus Treatments with an Underlying Cause
When tinnitus is a symptom of a health problem, treating the underlying condition will often improve your symptoms or get rid of them altogether. For example:
- A middle ear infection can be treated with antibiotics
- Excessive earwax can be treated with eardrops
- Some inner ear disorders can be treated using an antihistamine
- Tinnitus brought on by medications will often go away if you work with your doctor to switch to another drug
Tinnitus Treatments Without an Underlying Cause
Many tinnitus patients find relief from their symptoms by distracting themselves from the noise. You can do this by using:
- Sound generators: these are especially helpful at bedtime because tinnitus symptoms often sound loudest in quiet rooms. You can use a fan, a radio or a TV turned down low. You can also purchase a white noise machine.
- Maskers: these noise generators are worn in the ear like a hearing aid and can mask tinnitus by producing sounds that counteract your particular symptoms.
Therapy: if your symptoms are more severe or persistent, cognitive behavioral therapy can retrain the way you perceive your condition that can help lessen symptoms. Or, tinnitus retraining therapy can help teach your brain to you tune out tinnitus noises.
Tinnitus Questions for Your Doctor
The first step to treating your tinnitus is scheduling an appointment with your personal doctor, who may then refer you to an audiologist. Ask your doctor and audiologist these questions so you better understand your condition.
- What is tinnitus?
- What causes it?
- Can you tell what’s causing my tinnitus?
- Will it go away on its own?
- Can other people hear the noise in my ears?
- Will tinnitus damage my hearing?
- Does having tinnitus mean I have hearing loss?
- What are the treatments for tinnitus?
- Are there any risks or side effects from the treatments?
- What can I do on my own to manage tinnitus?
- How can I stop tinnitus from getting worse?
What To Expect During Your Tinnitus Doctor Appointment
There are a number of things that will happen when you see your doctor about tinnitus. First, your doctor will discuss your medical history including any history of anxiety, neurological disorders or ear disorders. Next, the doctor will likely perform a physical exam of your ears, neck, genitals, major arteries, blood pressure and breathing to check for signs of nerve damage or blood flow issues. They will ask you about the sounds you are hearing including about the pitch, location, frequency and intensity of your symptoms. Your doctor will check for other symptoms you may be experiencing including headaches, hearing loss, anxiety and vertigo. They may ask about your history of tobacco, alcohol and drug use since these can sometimes contribute to tinnitus.
Getting a Diagnosis: Tinnitus-Specific Tests
General Tinnitus Diagnostic Tests
Your doctor and audiologist may administer tests to get a better understanding of the symptoms you’re experiencing.
- A pitch match test uses tones played through headphones to help determine the frequency of sound you are hearing.
- A loudness match test will help determine the volume of the sound you are hearing that could range from a whisper to a shout.
- A visual analog scale can determine perceived loudness because the tinnitus is often perceived much louder than the decibel level determined in the loudness match test.
- A differential diagnosis should also be performed to rule out other potential sources of your tinnitus symptoms. For example, a commonly misdiagnosed condition that mimics tinnitus is radio frequency (RF) hearing. Patients with RF hearing can hear high-pitched radio transmission frequencies that sound similar to tinnitus.
Audiometric Evaluations for Hearing Loss and Tinnitus
Because tinnitus is often caused by hearing loss, your audiologist will begin your exam with a evaluation that measures your overall hearing health. These hearing tests include:
- Speech recognition test: measures how well you can hear and repeat certain words.
- Pure tone audiogram: measures your hearing across multiple frequencies and volumes.
- Tympanogram: measures the functioning of your middle ear, specifically the mobility of the tympanic membrane and the conduction bones.
- Acoustic reflex testing: measures the middle ear muscles’ response to loud sounds.
- Otoacoustic emission testing: measures the movement of hair cells within the middle ear using highly sensitive microphones.
Additional Tinnitus Testing
After your hearing evaluation, your audiologist may run a battery of tests to further understand your symptoms, how they affect your quality of life and what treatments may be appropriate. These tests include:
- Tinnitus sound matching: helps determine the quality of the tinnitus sound whether it’s a ringing, whistling, crackling, humming or other sound.
- Minimum masking level: determines the volume that an external noise can mask or cover your tinnitus sounds.
- Loudness discomfort level: measures the volume at which external sound becomes uncomfortable or painful.
- Pulsatile Tinnitus Test: determines if tinnitus symptoms are due to blood flow issues.
Tests to Measure Tinnitus Burden
Tinnitus can impact all areas of a patient’s life from their mental and emotional state to their physical health and wellbeing. There are several tests your audiologist may use to measure how tinnitus affects your life, including:
- Tinnitus Handicap Inventory
- Tinnitus Reaction Questionnaire
- Tinnitus Functional Index
- Tinnitus Severity Index
- Visual Analog Scales
What To Do for Your Tinnitus Right Now
There are several small changes you can make to your daily life that may make it easier to live with tinnitus and manage your symptoms. These approaches should be used along with any treatments recommended by your doctor.
- Learn what makes tinnitus worse for you: this could include certain foods, drinks or drugs including caffeinated drinks, alcohol, aspirin or salt that can exacerbate symptoms. Not everyone is affected the same way, so try to investigate your possible triggers one at a time by keeping a written log.
- If you smoke, quit: smoking can make tinnitus worse in two ways. It disrupts blood flow to your ears and acts as a stimulant in your body. Both of these can make the ringing in your ears sound louder.
- Try masking your symptoms: tinnitus may bother you more when it’s quiet. You can distract yourself by playing soft music, using a TV for background noise or turning on a fan.
- Plan time to relax every day: it’s normal to feel anxious when tinnitus symptoms are aggravated. But stress and worry can make your symptoms worse. Try incorporating at least 15 minutes of deep relaxation into your day. You can accomplish this by yoga, tai chi, meditation, guided imagery, progressive muscle relaxation and self-hypnosis.
- Get enough sleep: being tired can make tinnitus significantly worse. Incorporate a healthy sleep schedule into your routine and see your doctor if insomnia becomes a problem.
Your tinnitus can be as unique and individual as you are. It can be loud or soft, occasional or constant, a mild annoyance or a debilitating condition. The same can be said for tinnitus treatments. One patient’s miracle remedy may be a dud for someone else. That’s why it’s important to develop a curiosity about your tinnitus. Observe yourself and your symptoms. Notice what makes it worse, what makes it better and when symptoms disappear altogether. Over time, you’ll develop a toolkit of remedies and condition management skills personalized just for you. You’ll experience fewer symptoms by taking control of your tinnitus.