“Tinnitus is a constant companion for me; like anything constant, it is usually unnoticed in the background, but when I do notice it, it can be extremely annoying. If I am having difficulty sleeping, my tinnitus becomes an overwhelming high-pitched whining in the quiet night, and adds to my inability to sleep.
The tinnitus can also be instructive. I’ve noticed a correlation between my tinnitus and tension. Usually headaches and tinnitus go together, and my headaches are usually related to stress or tension. In a noisy environment the tinnitus is not generally noticeable, but if I have a headache and pay attention, the tinnitus is there. In fact, I can often get an indication of my current stress level by paying attention to my tinnitus.” – Peter’s perspective
Tinnitus is the medical term for the phantom ringing or buzzing we hear in our ears. Sounds may include ringing, buzzing, humming, hissing or even beating in time with your heart (pulsatile tinnitus). This condition means that the noise we hear is not happening in our environment. No one else can hear the particular ringing except a single individual.
In many cases, tinnitus is mild and disappears on its own. In severe cases however, it may be accompanied by hearing loss, dizziness and poor concentration. Currently, tinnitus affects about 1 in 5 individuals and more people are being affected daily as the condition is growing more common.
Although tinnitus affects our ears, it is not considered a medical condition. It is classified as a symptom resulting from an underlying medical condition. Any underlying medical condition is classified as a disease, infection or disorder of some type.
If someone has tinnitus, they need to check to see what larger problem it is a symptom of. Be evaluated by an Audiologist or an otolaryngologist (ENT) specialist. There are two basic types of tinnitus, subjective and objective.
Subjective tinnitus can only be heard by an individual and it is the form of tinnitus people commonly develop. It can develop because that individual had medical problems with their inner, middle or outer ear. In addition to problems hearing, the auditory nerves may also be affected. Our auditory nerves, located in the brain, is responsible for interpreting the nerve signals that we hear into sounds.
Objective tinnitus is phantom noise the physician can hear while they are examining the ears. This is a rare form of the condition. It is often caused by issues with blood vessels, muscle contractions or a medical condition of middle ear bone.
The ringing in our ears is very annoying and bothersome can be a clue to other conditions and affect us emotionally to the point of suicide.
However, the condition in itself is neither serious nor fatal. Veterans Affairs notes that auditory conditions such as hearing loss and tinnitus are the number one and number two most prevalent disability claim in the VA, according to Dr. Tanisha Hammill, from the Department of Defense Hearing Center of Excellence in San Antonio.
Unfortunately, there is no cure for tinnitus. But by identifying the underlying cause and a particular treatment, symptom improvement happens.
What Causes Tinnitus?
Researchers cannot find an exact reason why Tinnitus occurs. We are living in very noisy times – noise pollution is common. Numerous health conditions can worsen ear problems. From what researchers have learned, inner ear cell damage is the common cause of tinnitus. The delicate, small hairs located in our inner ear sway according to the pressure of the sound waves we hear.
Our ear cells are triggered to release the transmitted electrical signal to our auditory nerve and then to our brain. As with sight, our brain is responsible for interpreting the electrical signal as sounds. Each part of the process needs to work properly.
Any time the delicate, small hairs in our inner ear become broken or bent then they cannot work properly. Instead, they create electrical impulses that are more randomly sent to the brain and since the brain is responsible for interpreting these pulses difficulty begins. The incorrect brain interpretation is how we hear ringing or buzzing in our ears when no one is ringing or buzzing a bell.
The most common causes include:
Noise Pollution – Being in an environment with an extremely loud noise or continuous sound. A concert, listening to music too loud and heavy equipment can easily cause tinnitus. When we are exposed to loud noise or loud noises our ears are damaged.
Hearing loss – A loss of hearing that occurs because of age. Hearing loss typically starts between 40 -60 years.
Physical Changes in the Ear – Changes to the ear bone. Our ear bone in our middle ear can stiffen and change the way we hear.
Earwax blockage – Earwax blockage occurs because of wax buildup in the ear and change hearing perception.
Inflammation – Inflammatory processes in the auditory nerve, or as a result of the movement of inflammatory particles and elements from the nasopharynx to the mucous membrane of the Eustachian tube. In this case, it pushes the eardrum, which leads to short-term deafness.
Medications – Certain medications can either cause the condition or make it worse. What happens is the higher the dosage of medication, the worse the ringing in the ears become. The phantom noise tends to disappear when the individual stops taking the medication. Some medications are known to cause tinnitus or make it worse. For example, some antibiotics and antidepressants may cause or worsen tinnitus. Taken in high doses, aspirin can cause tinnitus or make tinnitus worse. Quinine medications and water pills, called diuretics, often cause tinnitus. Certain cancer medications like vincristine and mechlorethamine cause ringing in the ears.
Other causes include; Hormonal changes in women, Outer ear infection, Vitamin deficiency, Thyroid disease, Anemia, Mercury poisoning, alcohol, lead or nicotine.
Possible Medical Conditions
Some medical conditions like Ménière’s disease may cause this condition, but that is not common. More commonly, head or neck injuries can cause damage to our brain and hearing nerves. The damage usually causes tinnitus in only one ear. Acoustic neuroma, a noncancerous tumor in our cranial nerve, can cause ringing in one ear.
Blood vessel disorders are also the cause of tinnitus. However, this link between blood vessel disorders and this condition is rare. Some vessels disorders that cause ringing in our ears include atherosclerosis, high blood pressure and turbulent blood flow.
Besides medications, what treatments work?
When does it make sense to get a hearing aid? A hearing aid may be considered if tinnitus is accompanied by hearing loss too. Hearing aids amplify the sound waves that reach the ear, making it easier to hear and join in conversations again. Some believe that the improved hearing can help mask out tinnitus sounds so they are perceived to be less bothersome.
Cognitive Behavioural Therapy (CBT) may also be considered as a treatment. Those who have had CBT reported that they had a better quality of life compared to people who did not have CBT. The studies also suggested that CBT can help reduce depression symptoms.
Other treatments (may or may not help depending on individual factors)
Acupuncture – “Auricular Therapy” or acupuncture of the ears. The ears contain reflexology areas that when stimulated by acupuncture needles.
Ear massage – A sensitive point is identified with either a finger or a small blunt stick. By attaching a seed with a plaster on to a sensitive defined point, the patient can easily work when required between treatments.
Hyperactivity and deep brain stimulation – Researchers have observed hyperactivity in neural networks after exposing the ear to intense noise. Understanding specifically where in the brain this hyperactivity begins and how it spreads to other areas could lead to treatments that use deep brain stimulation to calm the neural networks and reduce tinnitus.
Wearable sound generators – Small electronic devices that fit in the ear and use a soft, pleasant sound to help mask the tinnitus. Some people want the masking sound to totally cover up their tinnitus, but most prefer a masking level that is just a bit louder than their tinnitus. The masking sound can be a soft “shhhhhhhhhhh,” random tones, or music.
Tabletop sound generators – An aid for relaxation or sleep. Placed near the bed, can program a generator to play pleasant sounds such as waves, waterfalls, rain, or the sounds of a summer night. If the tinnitus is mild, this might help with falling to sleep.
Acoustic neural stimulation – A relatively new technique for people whose tinnitus is very loud or won’t go away. It uses a palm-sized device and headphones to deliver a broadband acoustic signal embedded in music. The treatment helps stimulate change in the neural circuits in the brain, which eventually desensitizes you to the tinnitus.
Cochlear implants – For those who have tinnitus along with severe hearing loss. A cochlear implant bypasses the damaged portion of the inner ear and sends electrical signals that directly stimulate the auditory nerve. The device brings in outside sounds that help mask tinnitus and stimulate change in the neural circuits.
Resetting the tonotopic map – Taking advantage of the tonotopic map, which organizes neurons in the auditory cortex according to the frequency of the sound to which they respond. A change in the organization of the tonotopic map after exposing the ear to intense noise could be a technique to bring the map back to normal and relieve tinnitus.
Relaxation techniques – progressive muscle relaxation, mindfulness, autogenic training or yoga.
Ginkgo biloba – Has been used in many parts of the world to relieve tinnitus symptoms. As it is a drug, Ginkgo can also interact with other medications. For example, it can increase the effect of anticoagulant (blood-thinning) medication, which can lead to bleeding.
Hyperbaric oxygen therapy – This involves sitting in a special high-pressure chamber and breathing in pure oxygen. The aim is to increase the transport of oxygen to the ears and brain.
Dietary supplements – Such as certain vitamins or zinc supplements may help.
Electromagnetic stimulation – Electromagnets are used in various treatments to try to influence the nerve signals that are responsible for tinnitus. One example is known as repetitive transcranial magnetic stimulation (rTMS). This procedure involves placing a special coil on the scalp, where it generates a magnetic field.
Sound therapy – Special noise generators produce a sound (usually a quiet shushing sound). Some noise generators, known as “noise maskers,” distract patients from the tinnitus sounds by drowning them out. Others integrate the tinnitus sounds into different sounds in order to make them less noticeable. They can be worn like hearing aids.
Filtered music – Smartphone Apps such as Tinnitracks or Tinnease alter the frequency of music you play on your phone, taking your personal tinnitus frequency into account. Listening to music using the app for one to two hours per day is claimed to reduce the volume of tinnitus sounds.
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