Tinnitus: Causes, Treatment and Management
By Daniel T. Moore, Ph.D.
Tinnitus is relatively common condition that sounds or noises are heard which are not generated outside of the individual hearing it. The most common sound reported by suffers of tinnitus is a high pitched ringing sound. However, other noises can be heard (e.g., lower pitched sound like the sound of a telephone when you first pick it up, pulsating sounds, clicking sounds, roars). Some people are not bothered by these extra sounds. Some people are bothered quite a bit from the extra sound or sounds. Some individuals have attempted suicide to stop their tinnitus. The sound can be continuous 24/7 or episodic. The sound can wax and wane. The sound may disappear for a few months and then return.
It is estimated that 10 to 15% of individuals are sufferers of tinnitus. Of these sufferers, 85% of them also have a hearing loss. Thus most victims of tinnitus will need to be examined by an audiologist. As individuals age, it is common to have hearing loss. The most common type of hearing loss is the inability to hear high pitched sounds. These individuals will often respond to a digital hearing aide. Some digital hearing aids automatically include a sound generator to help "manage" tinnitus.
Not all audiologists are familiar with treating or management of tinnitus. The prospective patient should inquire as to the level of expertise and experience the audiologist has in successful treatment or management of tinnitus.
Some researchers talk about two types of tinnitus: objective and subjective. Objective tinnitus is caused by noise actually being generated by the body. It could be the bones of the inner ear clicking. Another type of noise can occur from the blood vessels and cause a pulsating noise as to the rhythm of the heartbeat. Sometimes others can hear the noises that are coming from within the sufferer.
Subjective types of tinnitus is where this is no source of the sound being generated from the body that others can hear. The sufferer definitely hears the noise, but others cannot. The subjective types are the most common.
Causes. The most common cause of subjective tinnitus is noise/ blast/Traumatic Brain Injury induced that was accompanied by loss of hearing. While this may be the most common, there are many other causes. These causes are often linked into categories such as hearing loss, internal ear problems, external ear problems (e.g., large secretion of ear wax), sensorineural hearing loss (e.g., , Meniere's disease, acoustic neuroma, mercury or lead poisoning, ototoxic medications), Ototoxic foods (e.g., caffeinated beverages, tea, coffee, aspartame, Mono Sodium glutamate), Neurological disorders (e.g., head injury, multiple sclerosis), metabolic disorder (e.g., thyroid diseases, hyperlipidemia, iron deficiency anemia, Vitamin B12 deficiency), psychiatric disorders (e.g., depression, anxiety, Post Traumatic Stress Disorder), fibromyalgia, vasculitis, hypertonia, Lyme Disease, migraine headaches, sleep paralysis, anthrax vaccines, withdrawals from a benzodiazepine (e.g., Xanax, Librium, Valium) nasal congestion, encephalitis, and TMJ syndrome. In addition, there are over 260 medications that report tinnitus as a possible side effect. It is possible for the tinnitus suffer to have multiple causes of the sounds that they hear.
Treatment. In our terms, treatment is the process of attempting to extinguish the noise or the tinnitus. Effective treatment involves a cure. A cure is defined as not having tinnitus for a substantial period of time (i.e., over a year).
The first step in treatment is to attempt to discover the cause of the tinnitus. If a definite cause has been identified, then treating the cause could lead to the extinction of tinnitus. For example, if the body has lead or mercury poisoning and that is the cause of the tinnitus, by getting the lead and/or mercury out of the body through detoxing or chelation, then one should see improvements in the tinnitus. If a medication is causing the tinnitus the stopping the medication or changing to one that is not ototoxic should cause the tinnitus to extinguish.
If enough neurological damage has been done, then the tinnitus may remain even after the cause has been addressed. If that is the case, then efforts in neuro-development should be attempted. The goal of neuro-development is to have the brain rewire itself so that brain can overcome the deficit. There are some audiologists who use neuro-development techniques in the treatment of tinnitus.
Sound therapy is another form of treatment. Some sound therapies act the same as neuro-development technique. The best providers of sound therapy are audiologists. Again, not all audiologist are familiar with tinnitus treatment. The Tomatis method is a sound therapy approach to treat tinnitus. Not all audiologists who use sound therapy use the Tomatis method. This method uses specially recorded classical music to stimulate the brain and rehabilitate the ear. If successful the tinnitus will go away.
One soldier suffering from subjective tinnitus (caused by a Traumatic Brain Injury from a blast) reported that he had overcome his tinnitus by resetting his hearing. Reportedly, he did this by wearing earplugs. The ear plugs were the common foam expandable ear plugs. At night he would wear ear plugs covered by headphones. Within a few months of doing this, his Tinnitus went away. This technique might not work for everyone, but may be worth a try for some. Always check with your physician to make sure that wearing ear plugs and head phones at night will not cause any harm.
Some may be unable to sleep with earplugs and headphones. Maybe something else would work that would cut off sound from the outer ear a night.
Management. There may be some tinnitus sufferers that no matter what they do, they will always be plagued with tinnitus. If a possible cause of the tinnitus is unable to be discovered, or if treating the cause has been ineffective, then managing the symptoms may be an appropriate intervention. The goal of management is not to cure the individual but to help the individual cope effectively with the noise or to help the noise be less bothersome.
Some people who are bothered by tinnitus and who have not responded to treatment, may need psychological counseling. Talk therapy is the primary treatment for tinnitus. Milton Erickson developed a management technique for tinnitus over 50 years ago. Other therapists will help the individual through relaxation exercises and cognitive therapy. This can improve the quality of life for those who are severely adversely affected by the tinnitus.
Sound therapy can be used for management as well. Another type of sound therapy involves the use of sound to distract or make the original tinnitus sound less in the forefront for the individual. Some hearing aids come with sound generators to help manage the symptoms of tinnitus.
Another management technique is the use of medications and supplements. The medications that appear to be most promising in tinnitus management are antidepressant medications and acamprosate (a medication used in the treatment of alcoholism). Herbs and vitamin supplements can also be used in the management of tinnitus. There exists some evidence that zinc supplementation can be helpful and for those who suffer from sleep problems, melatonin can be helpful. Some suggest that Lipo-flavonoids can be helpful for tinnitus caused by Meniere's disease. Dr. Christopher even has an herbal formula for tinnitus.
Step by Step to treat Tinnitus:
1. Identify if the tinnitus is objective or subjective. If it is objective there is a sound in the body causing it (e.g., bones on the inner ear, blood vanes and heart beat). If it is subjective, only the individual can hear it and it is not coming from sounds from the body. Sometimes objective tinnitus is treated differently than subjective tinnitus.
2. Identify the likely cause (e.g., side effect from medication, blast injury, TMJ, Lyme Disease) if possible.
3. With the help of a healthcare professional, and if possible treat the underlying cause and verify that the tinnitus has improved or gone away.
4. If the tinnitus continues, go to an audiologist familiar with tinnitus, receive treatment that cannot be provided by the physician.
5. If the tinnitus is causing much stress, anxiety, loss of sleep or depression, see a Psychologist familiar with treating tinnitus. Sometimes too much stress and depression can cause tinnitus. Mental Health professionals (e.g., Psychologist, Social Workder) can be helpful.
6. If tinnitus persists try safe alternative techniques (e.g., medications, herbal supplements).
7. If all treatments have failed, then the strategy would be to manage the symptoms.
8. While managing the symptoms continue to try various treatment approaches that appear to be promising without causing a stain on your budget.
9. Net work with other people who have had similar problems with a similar type of tinnitus. Tinnitus is relatively common and there should be many people with similar problems who have found effective solutions. If trying an herbal product, read the reviews on Amazon or other sources to see if a particular product is likely to beneficial for you. Always consult with your physician if trying a supplement to insure that it does not interfere with other medications you may be taking.
9. Keep a journal of what works, so that you can review the journal if the tinnitus returns or becomes more intense.
It was once believed that there was nothing that worked for individuals suffering with tinnitus. Many were told that they would have to live with it. This advice is no longer valid. There are options for effectively treating tinnitus and effectively managing tinnitus. We hope this article has given you some guidelines and have pointed you in the right direction.
If you can, please send us your success stories. What helps you deal with tinnitus effectively? You can send us an E-mail at firstname.lastname@example.org. If you want, we can share your success story with others.
Links to Additional Information:
Tinnitus No More: The Complete Guide On Tinnitus Symptoms, Causes, Treatments, & Natural Tinnitus Remedies to Get Rid of Ringing in Ears Once and for All [Kindle Edition] by Brian M. Lawrence (Author).
A Source for Sound Therapy with much information.