The American Tinnitus Association describes tinnitus as the perception of sound when no external sound is actually present. While most people perceive their tinnitus as a ringing sound, it can also be perceived as whistling, buzzing, roaring, humming, chirping and several other sounds. It can sound as if it is coming from one ear, both ears, somewhere in your head, or somewhere external. Tinnitus can be constant, intermittent, or pulsatile. Over 50 million Americans experience some form of tinnitus. Most of us have experienced short-term tinnitus following a concert or after exposure to loud noise. When tinnitus has been present for more than 6 months it is classified as chronic tinnitus.
Possible causes of tinnitus include hearing loss, hazardous noise exposure, ototoxic drugs, middle ear problems, head and neck problems, ear wax, TMJ, sinus pressure and barometric pressure trauma, TBI, metabolic disorders, autoimmune disorders, and more. Some drugs that can cause or worsen tinnitus are: aspirin and other anti inflammatory drugs, certain antibiotics, antimalarial drugs, certain anticonvulsants, certain cancer drugs, loop diuretics, and tricyclic antidepressants. If you are on any of these types of medications and have noticed tinnitus since beginning these drugs, contact your doctor to discuss tinnitus management or alternative treatment options. Tinnitus can present anywhere along the auditory pathway. One of the most common causes of tinnitus is damage to the inner hair cells of the cochlea which results in hearing loss. When the brain doesn’t receive the signals that it is expecting from the auditory pathway due to damaged inner hair cells it generates a noise in the form of tinnitus to alert you that the brain isn’t receiving the signal that it should be. In turn, the brain is attempting to compensate for the present hearing loss and “turn up” the volume in an effort to appropriately detect the sound signal. The tinnitus typically matches the pitch of where the hearing loss is present. Often if a person reports low-pitched tinnitus they have a low-frequency hearing loss and vice versa with high pitched tinnitus. In a way, tinnitus is similar to phantom limb pain in an amputee. The brain is producing abnormal nerve signals to compensate for missing input.
Tinnitus evaluations entails a comprehensive case history of tinnitus and hearing, a physical examination, and a series of testing to find the source of the problem. While most tinnitus can primarily be managed by an audiologist, patients with pulsatile tinnitus warrant an additional medical evaluation to see if an MRI or CT scan is necessary. There are also musculoskeletal factors such as jaw clenching, teeth grinding, muscle tension in the neck, and more that can increase the intensity of tinnitus. When tight muscles are an issue, massage therapy can also aid in tinnitus relief.
What are your tinnitus treatment options?
Research evidence has revealed that stress, lack of sleep, caffeine intake, and alcohol can cause tinnitus or increase the intensity of a person’s tinnitus. Proper monitoring of alcohol consumption and caffeine intake can lead to tinnitus relief. If you have routine problems sleeping that are unrelated to your tinnitus, consult with your physician on ways to promote better sleep habits. Additionally, promoting proper relaxation techniques such as breathing exercises, yoga, tai chi, etc. can help with stress management and lead to a reduction in the intensity of your tinnitus.
Tinnitus masking is typically completed through the use of hearing aids. Tinnitus masking programs introduce another noise for the brain to focus on in an attempt of reducing the perception of the tinnitus. Tinnitus masking can also be accomplished with the use of a radio, fan, noise generator, sound pillows, or other external sources of noise. For individuals who only experience bothersome tinnitus when they are trying to fall asleep, a white-noise generator or fan can provide effective tinnitus masking to allow them to fall asleep.
Tinnitus Retraining Therapy (TRT)
TRT is a therapy program to habituate the auditory system to the tinnitus and make it less noticeable and bothersome. The main components of TRT are individualized counseling and sound therapy.
Cognitive Behavioral Therapy (CBT)
CBT is a behavioral therapy technique designed to change the way that a person thinks about and responds to their tinnitus. The therapy is typically short term and can make tinnitus significantly less bothersome and improve a person’s quality of life!
Biofeedback and Stress Management
Biofeedback is a relaxation technique to help control stress. Electrodes are placed on the skin to record psychological processes on a monitor. Patient’s are guided through how to alter their stress responses by changing their thoughts and feelings.
For information regarding treatment options for your tinnitus, contact our Scottsdale, Mesa, Peoria or Surprise offices and schedule an appointment for a tinnitus consultation to determine what is the most effective treatment method for you.
Written by: Alexa Patton, Au.D., Doctor of Audiology.