How to Treat & Manage Tinnitus

Reviewed by Dr. Porter on October 24, 2018

Welcome to “Your Hearing Health” brought to you by Dr. Day-Moran, Au.D. at Harbor Audiology with offices in Gig Harbor, Tacoma and Silverdale, WA.

In this episode, we discuss, “How to Treat & Manage Tinnitus.”

How to Treat & Manage Tinnitus

The term tinnitus comes from the Latin word tinnire, meaning “to ring,” Tinnitus is the perception of sounds that originate inside the head, not outside the ears.

Sometimes tinnitus is subjective. Only the person who has tinnitus can hear the sound. In other cases, tinnitus is objective. Other people standing near the individual who has objective tinnitus can hear the sounds that the patient hears.

Ringing in the ears after hearing a gunshot at close range or after attending a concert with modern amplifiers is a common experience. This kind of tinnitus usually resolves itself in a few hours.

In other cases, tinnitus is a symptom of an underlying disease, not the disease itself.

There can be unilateral tinnitus, caused by an abnormality in just one ear, as well as pulsatile tinnitus, hearing sounds with a distinctive pulse, or fluctuating tinnitus, tinnitus that comes and goes. Every case of tinnitus needs to be diagnosed by a professional audiologist to be sure of the underlying cause.

How Many People Have Tinnitus?

If you have tinnitus, you are not alone. Audiologists estimate that between 10 and 15 percent of North Americans have tinnitus. That is between 35 and 45 million people.

Tinnitus affects people of all ages, from children to senior citizens. As many as 85 percent of children who have chronic ear infections also have tinnitus.

The overwhelming majority of people who have chronic ear problems of any kind develop tinnitus, especially people over 40 who have some degree of hearing loss.

Uncorrected Hearing Loss Can Cause Ringing in Your Ears

Tinnitus is a common consequence of uncorrected age-related hearing loss.

The human brain is very good at filtering out background noise. Usually, it eliminates meaningless, distracting sounds so we can focus our attention. That’s how it is possible to use the Internet in a crowded coffee shop, or chat with a friend at a football game.

This ability is called habituation. We ignore sounds that do not have meaning for us, but our brains go on high alert when we hear sounds that are potentially important,

As the acuity of your hearing diminishes with age, your brain receives fewer and fewer signals from sounds of all kinds.

It does not get enough input from sound to distinguish what’s important from what’s not, so you become very aware of sounds that previously were relegated to background noise.

In the early stages of age-related deafness, you can experience a condition called hyperacusis, super-sensitivity to sound. Your brain works overtime to make sure you hear any sounds that potentially could signal danger.

Ironically, in the early stages of hearing loss, the less you can hear, the harder your brain works to interpret the sound that you can hear. Tinnitus puts the brain in fight-or-flight mode. You can experience a constant state of anxiety. You can have trouble getting to sleep and staying asleep. Your brain does not produce as much growth hormone because you do not get enough deep sleep, and your general health goes into decline.

Age-related hearing loss is usually correctable with hearing aids. But there are other causes of tinnitus that may need to be treated, too.

Medical Causes of Tinnitus

Taking aspirin increases the risk of tinnitus. There is a lot of individual variation in sensitivity to aspirin, but people who take more than about 10 adult aspirin a day (3,000 mg) usually develop tinnitus.

Aspirin is an ingredient in many common medications, including drugs for colds and flu and arthritis formulas.

Diuretics, especially Lasix (furosemide), can cause tinnitus. The severity of symptoms increases with increasing dosage. Sometimes tinnitus from taking Lasix and similar diuretics goes away when you discontinue the drug, but sometimes it doesn’t.

Chemotherapy with drugs that contain platinum, such as cis-platin, can cause this condition.

Tinnitus is a common complication of TMJ, temporomandibular joint syndrome. If you have TMJ, you are about 1.6 times more likely to have tinnitus. Dental pain with tinnitus raises the risk even more.

Pulsatile tinnitus and tinnitus in just one ear can be caused by a slow growing (usually non-cancerous) tumor.

And tinnitus that is accompanied by dizziness can be a symptom of Ménière’s disease.

All of these conditions have serious implications for your health. Accurate diagnosis is the first step in timely treatment. But how do you know that you need to schedule an exam with your audiologist for your symptoms?

What You Can Expect When You Go to the Audiologist

It’s not that hard to determine whether you need to be examined by an audiologist for possible treatment of hearing loss and/or tinnitus. If you have ringing, buzzing, clicking, or a high-pitched electronic sound in your ears some or all of the time, you need to make an appointment for a complete hearing exam.

The first thing the audiologist will do will be to take your health history. It is particularly important for your audiologist to know about any history of:

  • Smoking
  • Reduced sleep (less than 6 hours a night)
  • Stress
  • High cholesterol or high triglycerides
  • Osteoarthritis
  • Rheumatoid arthritis
  • Asthma
  • Depression
  • Thyroid disease
  • Injury to the eardrum
  • Hearing loss in one or both ears from a previous disease
  • Noise exposure from earphones
  • Noise exposure in or outside of the workplace
  • Brief exposure to intense noise
  • Smoking

Then your audiologist will look inside your ears with a device called an otoscope. This will reveal whether there are any obstructions (such as ear wax) that could affect your hearing.

The next step is something called a pure tone test. You will put on headphones, and the examiner will ask you to indicate whether you can hear tones at different frequencies. The audiologist will do a speech audiometry test, asking you to repeat the speech you hear played through headphones. The audiologist may do a tinnitus pitch and loudness match to determine which sounds cause you the most difficulty.

Your audiology exam can confirm that your tinnitus is not due to a tumor. The next step is treatment; we hope you’ll contact us when that time comes!

Tinnitus Is Treatable

About 50 percent of cases of subjective tinnitus are improved with prescription hearing aids. Your audiologist can also prescribe neuromonics, synthetic music with modified pitches to train your brain to ignore tinnitus. There are biofeedback programs for reducing the anxiety and depression that can occur with tinnitus, and alternative treatments like transcranial repetitive electromagnetic stimulation in some cases.

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