How to Get Relief From Tinnitus: All About Diagnosis and Treatment ...

How to Get Relief From Tinnitus: All About Diagnosis and Treatment
Sometimes wearing a hearing aid can make tinnitus less bothersome.iStock
When most people think about tinnitus, they associate it with “a ringing in the ears.” While that’s accurate in many cases, the condition can be far more complex.
“It could be a ringing, but it could also be a buzzing, a whistling, a sound like ocean waves, leaves rustling — all those types of things,” says Brett Comer, MD, a surgeon and associate professor of otolaryngology at the University of Kentucky College of Medicine in Lexington.
He says tinnitus can be classified as “pulsatile” or “nonpulsatile” — the former meaning it aligns with a person’s heartbeat, potentially sounding low and throbbing like a heartbeat. And in some very rare cases, a person’s tinnitus may even be audible to other people, which is known as “objective tinnitus,” because it’s a sound a doctor or someone other than the patient can hear. This form of tinnitus can be caused by “turbulent” blood flow or unusual muscle contractions near a person’s ear, according to previous research. (1)
One important distinction to make is that tinnitus itself is not considered a disease; rather, it’s a symptom that signals something is wrong with the auditory system. Potential causes of tinnitus include age-related hearing loss, taking certain medicines, an underlying health problem, and other reasons, so the way to take care of the problem varies. But the first step is identifying that the symptom exists, Dr. Comer says.
Though in some cases making a diagnosis isn’t as straightforward as some people might assume, he adds.
How Doctors Diagnose Tinnitus
After asking a patient what they’re hearing, Comer says the next step in making a diagnosis involves asking questions about the onset of tinnitus, such as: When did it start? How often is it noticeable? Your doctor will also try to measure the severity of the tinnitus.
There are several types of tests a doctor or health professional who specializes in ear health can use to gauge the strength and tone of someone’s tinnitus, including a machine that helps produce a sound that aligns with what the patient is hearing. A doctor might also use a noise-producing machine to measure the patient’s “minimum masking level,” or the amount of sound needed to cover up her tinnitus. (2)
Early on, tinnitus patients will also undergo a hearing exam. “Most of the time, that test will show the classic pattern where you’re missing some high-pitched hearing,” Comer says. He says this pattern of hearing loss — and the tinnitus that results — is common among people who have been exposed to loud noises like firearms or live music concerts.
In some cases — especially if the hearing in one ear is much worse than in the other — Comer says a patient will need an MRI or other form of imaging test. “We’re looking at specific structures near the ear,” he says. A benign tumor — including one type that grows on the nerve connecting the inner ear to the brain — may turn up, as well as cancerous tumors. Though Comer adds that tinnitus-causing cancerous tumors are rare.
For patients with pulsatile tinnitus — the rhythmic kind that may mimic a heartbeat — imaging may show that the patient’s carotid artery or jugular is “high-riding,” and comes into contact with the cochlea or other parts of the ear, Comer explains. In these cases and for patients with tumors or other clear tinnitus triggers, an operation or some other procedure may relieve their tinnitus.
“But in most cases, there’s not an easy explanation or remedy for the symptom,” he says.
There Are Treatments That Can Help Minimize or Get Rid of Tinnitus
Can tinnitus go away on its own? “In some cases, yes it can. Although we don’t understand why,” Comer says. Since the condition is almost always subjective, it’s possible that some patients just learn to ignore it. It’s also possible that their brains naturally readjust to hearing loss in ways that “squelch” the tinnitus, he says.
And for some people, treating (or addressing) the underlying condition that’s causing the tinnitus can make the symptom go away. In cases when impacted earwax, a blood vessel condition, or a certain medication is causing tinnitus, fixing these treatable problems could make the tinnitus go away. (3)
But for most people, tinnitus doesn’t go away by itself. Fortunately these patients have several options when it comes to managing the condition.
Surprising Ways Hearing Affects Your Health
Hearing loss can have a lot of consequences, from affecting brain health to emotional health.
Noise-Masking Can Make Tinnitus Less Noticeable
Patients who experience the classic high-pitched, ringing type of tinnitus may only notice it in a quiet room — and especially at night while trying to sleep, Comer says. In these instances, turning on a fan or white noise machine — anything to break up the silence — can obscure the tinnitus ringing and therefore provide relief. “It may not make the tinnitus go away, but it makes it less noticeable to the brain,” he says. Some of these same masking methods — along with turning on a television or music — can also help during the daytime, too.
There are also some “medical grade” sound machines that a health professional can tune specifically to block out a patient’s tinnitus. (4)
A hearing aid can also help. Comer explains that some people who no longer hear well are more aware of their tinnitus because of the absence of ambient noise. “If they use a hearing aid and can pick up more background noises, that can help,” he says.
Lifestyle and Behavioral Modifications Can Help With Tinnitus
“Stress tends to make tinnitus worse,” explains Michael Kilgard, PhD, a professor of neuroscience at the University of Texas at Dallas. Research has helped solidify this connection, and it also suggests that some hormones and neurotransmitters that peak when a person is tired or stressed may affect the brain in ways that heighten tinnitus symptoms, according to work published in Frontiers in Neuroscience. (5)
For all these reasons, getting a good night’s sleep and keeping stress in check — both much easier said than done — may help some people rein in the severity of their tinnitus. There’s some evidence linking mindfulness practices to lower levels of stress and better quality of sleep, and that suggests mindfulness may also help people with tinnitus, too. (6) The same is true of relaxation techniques, including exercise and yoga.
Cognitive Behavioral Therapy Approaches Can Help With the Most Debilitating Cases of Tinnitus
For patients who are especially troubled or debilitated by their tinnitus, a handful of cognitive behavioral therapies (CBTs) can help. They are designed to help individuals learn to control their emotional reaction to tinnitus — and uncouple the symptom from the distressful response they have to it — rather than trying to cover it up or avoid it.
CBT has proved effective in helping people overcome phobias and pain-related conditions. A meta-analysis of 28 studies concluded that CBT may be an effective tool to reduce the negative impact of tinnitus on quality of life and is safe, but added that further research is needed to look at long-term benefits. (7)
Medication Won’t Cure Tinnitus, But It Might Help Manage Underlying or Resulting Distress
There is no pill that will cure a person’s tinnitus. But for patients who have anxiety or depression as a result of their tinnitus, there are drug options. “We have patients who come in and say they’re going to do something really bad to themselves if they don’t get some relief, and antidepressants can help them cope,” Comer says. Anti-anxiety drugs may also help individuals manage their response to tinnitus, Dr. Kilgard adds.