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What is tinnitus?

The word “tinnitus” comes from the Latin word for “ringing” and is the perception of sound in the absence of any corresponding external sound. It is often known as ringing in the ears. Tinnitus is not a disease or illness; rather it is a symptom relating to the auditory system that can arise from a variety of causes, and is often associated with hearing loss and the use of hearing aids. Up to 80% of those experiencing hearing loss also experience some tinnitus.

Tinnitus is usually a subjective condition, which may change over time, and no two cases are the same. Noises may be heard in one or both ears or inside the head. For some patients, noises may be of uncertain location. The perceived sounds may be low, medium or high pitched, and may be a single noise or two or more components such as chirping, rushing, hammering, booming, ringing, trilling or rattling. These sounds may be continuous or intermittent. Associated side effects of tinnitus can include sleep disorders, increasing isolation and depression. Depending on the severity of symptoms, some tinnitus patients may experience severe disruption to their lives, for example they may be unable to work or experience difficulty in socializing. In less severe cases patients may only report their tinnitus symptom only as a minor annoyance.

Broadly speaking, tinnitus can be divided into two categories. Subjective tinnitus is the most common form of tinnitus and describes tinnitus that can only be heard by the person experiencing it. Objective tinnitus arises from actual sounds of the body, such as vascular flow, and may be heard by other people. Tinnitus (either objective or subjective) may also be pulsatile, occurring in a rhythmic pattern often reflecting pulse and heart beat. Some tinnitus may be short term, arising from a specific temporary cause. In other cases tinnitus will be chronic or long term.

WHAT CAUSES TINNITUS?

There is no single identified cause of tinnitus, which is a symptom of any of a number of other conditions. It is now generally accepted that tinnitus is not specifically an ear condition but also involves various areas of the auditory system and brain. Contributing factors can include exposure to loud noise, muscular or bone conditions, chronic stress, tensions, jaw joint deficiencies, certain medications, impacted earwax, sinus problems, vascular flow, or, less commonly, tumours. Some of these factors, including hearing loss due to aging or noise exposure, appear to work as triggers for a number of physiological responses that underlie chronic tinnitus such as abnormal firing of neurons in the brain.

HOW MANY PEOPLE HAVE TINNITUS?

Tinnitus in a severe form has a prevalence rate of 6%, or around 310 million people globally. Breakdown by country includes approximately 50 million in the US, 29 million in Europe, 140 million in China, and 7 million in Japan. Tinnitus has a higher prevalence in certain occupations where exposure to loud noise is a factor. For example, the U.S. Department of Veteran Affairs lists tinnitus as the most prevalent service-connected disability for new compensation recipients (i.e. younger veterans). 

WHAT OTHER TINNITUS TREATMENT OPTIONS ARE THERE?

There are a number of treatment approaches to tinnitus, and your doctor or audiologist will be able to advise.

Drug Treatments

There are no drugs specifically for tinnitus but one treatment option involves the prescription of medication for other, related conditions such as anxiety and depression.

Cognitive Behavioural Therapy (CBT)

CBT is a talking therapy that focuses on emotions and personal coping strategies to target challenges and problems including the distress of tinnitus symptoms.

Implants/Surgery

Surgical implants typically involve a surgical procedure and the implantation of some kind of device. It is an invasive option, and not indicated for most tinnitus patients.

Repetitive Transcranial Magnetic Stimulation (rTMS)

rTMS, like Cleanhearing Sono, is based on the application of pulsed electromagnetic fields for relief of tinnitus and other conditions. Due to the high intensity magnetic fields used in rTMS, a specialized team is needed to apply the treatment. Consequently, rTMS is only available in a very limited number of clinical settings.

Sound masking solutions

Sound masking solutions such as white noise files may provide temporary relief by masking tinnitus sounds.

Notched music

Notched music is a sound therapy that is designed to calm the overactivity of neurons in the auditory cortex and related brain areas that has been linked to tinnitus symptoms. For more information on notched music, see Cleanhearing tinnitus app.

Please also see the section ‘What should I do if I think I have tinnitus?’ below.

WHAT SHOULD I DO IF I THINK I HAVE TINNITUS?

The first step is to consult a doctor or audiologist to establish the cause of your tinnitus symptoms and recommend a treatment approach.

Where hearing loss is a factor in your tinnitus, correction of hearing loss may help and you are advised to discuss hearing aids or other options with your doctor or audiologist.

Lifestyle factors may also help in some cases of tinnitus. These include increasing sleep, avoiding stressful situations, or using coping strategies to deal with or reduce stress.

Some tinnitus patients may want to address diet and exercise, including maintaining a healthy weight, taking regular exercise, and gradually reducing tobacco, caffeine or alcohol intake where appropriate. To avoid possible adverse effects including increased physical or mental stress relating to changes in diet or exercise, any changes should usually be gradual and done in consultation with your doctor.

Tinnitus associations and other groups offer support, advice and resources for anyone experiencing tinnitus symptoms. For a list of these, see our resources page.