Demystifying Tinnitus: What is Tinnitus?
Nobody else can hear it – the tinnitus – but you hear it all the time. It’s a ringing, buzzing, clicking, roaring or humming noise playing in your ears, and it’s exasperating. Some people hear it in one ear and others hear it in both. People with severe tinnitus may have problems hearing, working, communicating, or sleeping.
Fortunately, the ringing in your ears can be managed.
Where does the ringing come from?
The sounds you hear when you have tinnitus are generated by your brain. Tinnitus can be caused by a variety of factors, some of which you can’t control, such as simply aging. Most people who suffer from tinnitus have some form of hearing loss. And when you have hearing loss, your brain sometimes overcompensates by creating its own background noise, so to speak.
Tinnitus has also been associated with ear infections, earwax and sensory nerve disorders. Stress, high blood pressure and even alcohol could potentially also set off tinnitus. Most often, though, tinnitus is caused by repeated exposure to excessively loud noise.
Some forms of tinnitus can also be related to muscle movements near the ear, or problems with blood flow in the face or neck. On its own, however, tinnitus is not a sign of a serious medical problem.
How to stop the ringing…
If you suspect that you have some form of tinnitus, the first step is to undergo a professional evaluation. Tinnitus is not a disease — it is a symptom. It is an indication that something is possibly wrong with your auditory (hearing) system. A full diagnostic audiological tinnitus assessment will be able to determine where the dysfunction is. The assessment involves objective testing looking at outer, middle, and inner ear functioning. There are a variety of different conditions that can cause tinnitus and a thorough assessment will be able to determine what the cause is.
The goal of treatment/ management is to help you manage your perception and reaction of the sound in your head. There are many treatments available that can help reduce the perceived intensity of tinnitus, as well as its presence.
- Hearing aids: Most people develop tinnitus as a symptom of hearing loss. When you lose hearing, your brain undergoes changes in the way it processes sound frequencies. A hearing aid is a small electronic device that uses a microphone, amplifier, and speaker to increase the volume of external noises. This can mollify neuroplastic changes in the brain’s ability to process sound. If you have tinnitus, you may find that the better you hear, the less you notice your tinnitus.
- Sound-masking devices: Sound-masking devices provide a pleasant or benign external noise that partially drowns out the internal sound of tinnitus. The traditional sound-masking device is a tabletop sound machine, but there are also small electronic devices that fit in the ear. These devices can play white noise, pink noise, nature noises, music, or other ambient sounds. Most people prefer a level of external sound that is just slightly louder than their tinnitus, but others prefer a masking sound that completely drowns out the ringing. Some people use commercial sound machines designed to help people relax or fall asleep. You can also use headphones, television, music, or even a fan.
- Behavioural therapy: Tinnitus is associated with a high level of emotional stress. Depression, anxiety, and insomnia are not uncommon in people with tinnitus. Cognitive behavioural 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. CBT involves working with your audiologist once per week, to identify and change negative thought patterns. CBT was initially developed as a treatment for depression and other psychological problems, and significantly improves irritation and annoyance that often comes with tinnitus.
- Tinnitus Retraining Therapy: Advances in tinnitus research have brought about several new kinds of tinnitus therapy. Tinnitus Retraining Therapy (TRT) is one of them. TRT is a process of learning to cope with your tinnitus on a conscious and subconscious level. This technique has helped a lot of people. This therapy can be compared to the sound of raindrops falling on a roof being noticed when it first starts raining, but going unnoticed and put out of mind after some time. TRT requires close co-operation with hearing professionals. The therapy is employed at the perceived source of the tinnitus and aims to teach the brain to ignore it. The end goal is complete habituation of the noise.
- Antidepressants and anti-anxiety drugs: Tinnitus treatment often involves a combination of approaches. Your doctor may recommend medication as part of your treatment. These drugs may help make your tinnitus symptoms less annoying, thereby improving your quality of life. Anti-anxiety drugs are also an effective treatment for insomnia.
- Treating dysfunctions and obstructions: Occasionally 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. Physiotherapy or chiropractic treatment may also alleviate the symptoms. Tinnitus can also be a sign of excess earwax. Removal of an earwax blockage may be enough to make mild cases of tinnitus disappear. Foreign objects lodged against the eardrum can also cause tinnitus.
- Exercise: Exercise contributes significantly to your overall well-being. Tinnitus can be aggravated by stress, depression, anxiety, lack of sleep, and illness. Regular exercise will help you manage stress, sleep better, and stay healthier.
- Mindfulness-based stress reduction: This technique teaches individuals to develop the skills to control their attention through mindfulness training. Traditionally, the program was designed to draw people’s attention away from their chronic pain, but it can be equally effective for tinnitus. The similarities between chronic pain and tinnitus have led researchers to develop a mindfulness-based tinnitus stress reduction program.
- DIY mindfulness meditation: A daily mindfulness and breathwork practice is very useful and we encourage our patients to practice, meditation and breathing techniques that can help draw your focus away from tinnitus.