Tinnitus Management

Tinnitus is the perception of sound in the absence of external sound. This phantom noise can range from ringing, whistling, or buzzing, to more complex sounds. It is often associated with hearing loss but can also be caused by other factors such as exposure to loud noises, certain medications, and stress. Tinnitus can be temporary or permanent, and while there is no cure, there are various treatments that can help manage symptoms.

It is estimated that 10-15% of world’s population has tinnitus. 85% people with tinnitus will also have hearing loss. Some people start to experience tinnitus after a temporary hearing loss due to noise exposure or earwax/ear infection etc. About 1 in 7 people in UK have tinnitus. About a fourth of people who experience tinnitus, are actually bothered by it. Fortunately, a vast majority of people who have tinnitus, do not feel stressed about it. There are a range of management techniques that a healthcare professional can discuss with you, depending on your individual circumstances. There is help available for everyone. In our experience, over 85% of those who seek help for tinnitus, feel better after two appointments.

Tinnitus can be caused by various factors, including:

1. Hearing loss: One of the most common causes of tinnitus is temporary or permanent hearing loss.
2. Exposure to loud noise: Prolonged or sudden exposure to loud noise can cause permanent damage to the ears and lead to tinnitus. Interestingly, sometimes noise does not cause hearing loss on audiogram and only affects the part of the Inner ear that helps us understand the speech. It is called a hidden hearing loss.
3. Ear infections: Middle ear infections can cause inflammation that can lead to tinnitus.
4. Cardiovascular problems: Tinnitus can also be a symptom of certain cardiovascular problems, such as high blood pressure or atherosclerosis.
5. Medications: Some medications, including aspirin and certain antibiotics, can cause tinnitus as a side effect.
6. Jaw problems: Tinnitus can also be caused by problems with the jaw, such as temporomandibular joint (TMJ) disorder.
7. Other health conditions: Tinnitus can also be a symptom of other health conditions, such as auto-immune disorder, cochlear migraine, diabetes, Meniere’s disease, and thyroid problems etc.

This is not an exhaustive list. It is important to note that in some cases, the exact cause of tinnitus may not be determined, but help is available.

Tinnitus treatment depends on the underlying cause, but may include the following:

1. Treating the underlying cause: If tinnitus is caused by a treatable condition, such as an ear infection or medication side effect, treating the underlying issue may alleviate tinnitus symptoms.
2. Hearing technology: If tinnitus is caused by hearing loss, a hearing device can help amplify external sounds, reducing the perception of tinnitus.
3. Sound therapy: Listening to soothing sounds, such as sea-shore noise, can help the tinnitus and provide relief.
4. Tinnitus advice and information: It involves retraining the brain to tune out tinnitus by using sound therapy, counselling and other tools specific to your situation.
5. Cognitive behavioural therapy (CBT): CBT can help individuals with tinnitus manage their stress and anxiety related to the condition.
6. Medications: While there is no medication specifically designed to treat tinnitus, certain medications, such as anti-anxiety drugs or antidepressants, may be prescribed to manage related symptoms.

It’s important to note that there is no cure for tinnitus. The treatment is directed at managing the condition and its effect on one’s life. The effectiveness of treatment varies for everyone. A healthcare professional can help determine the best course of treatment based on the individual’s specific situation.

There is no cure for tinnitus because tinnitus is not actually an illness in and of itself. In most cases, tinnitus is a symptom of other hearing health issues like noise damage, temporary or permanent changes in the mechanism of the ear or acquired hearing loss.

Moreover, the exact mechanism behind the condition is not fully understood. Tinnitus can have multiple causes, ranging from damage to the inner ear to psychological factors, medications and other health issues. It manifests differently in each individual. This makes it difficult to develop a one-size-fits-all cure.

Additionally, tinnitus is a subjective experience, meaning that it can only be perceived by the individual who has it. This makes it challenging to diagnose and treat the condition accurately.

While there is no cure, there are various treatment options available that can help manage the symptoms of tinnitus, such as sound therapy, cognitive behavioural therapy, and medications. Research into the underlying mechanisms of tinnitus is ongoing, and it is possible that a cure may be discovered in the future.

Alternative treatments for tinnitus, such as herbal remedies or acupuncture, may provide some relief for some individuals with the condition. However, the effectiveness of alternative treatments for tinnitus has not been well-studied, and their effectiveness may vary from person to person.

While alternative treatments may provide relief for some individuals, it is important to keep in mind that there is currently no cure for tinnitus, and the most effective way to manage symptoms is through established treatment options, such as sound therapy, cognitive behavioural therapy, and medication.

The widely respected NICE guideline on Tinnitus assessment and management -NG155 recommends that hearing care professionals must consider amplification device for people with tinnitus who have a hearing loss even if they do not have practical difficulties in conversations etc. Hearing devices can help people with tinnitus in several ways:

1. Amplifying sound: By amplifying external sounds, hearing devices can reduce the relative loudness of tinnitus, making it less noticeable.
2. Masking sound: Hearing devices can also be equipped with tinnitus maskers, which are sounds specifically designed to distract the user from tinnitus.
3. Improving hearing: For people with tinnitus and hearing loss, hearing devices can help improve hearing, which can have a positive impact on tinnitus symptoms.
4. Improving communication: Hearing devices can improve communication, which can have a positive impact on social, emotional, and mental well-being, and in turn, reduce the impact of tinnitus.

Hearing devices are not a cure for tinnitus, but they can be an effective tool for managing symptoms, especially for people with tinnitus and hearing loss. If you’re considering using hearing devices for tinnitus, it’s important to consult with an audiologist, who can help determine the best type of hearing device and tinnitus management strategy for your individual needs.

Sound enrichment is a form of tinnitus management that involves using external sounds to distract from or mask the perception of tinnitus. The goal of sound enrichment is to reduce the relative loudness of tinnitus and make it less noticeable. This can be achieved by providing a background of soothing or calming sounds, such as white noise, nature sounds, or music.

Sound enrichment can be delivered through various devices, including hearing technology, portable sound generators, or smartphone apps. The specific type of sound and delivery method will depend on individual preferences and the severity of tinnitus symptoms.

Sound enrichment is not a cure for tinnitus, but it can be an effective tool for managing symptoms, especially for people who have difficulty sleeping or concentrating due to their tinnitus. If you’re considering using sound enrichment for tinnitus, it’s important to consult with an audiologist, who can help determine the best type of sound and delivery method for your individual needs.

Earwax, also known as cerumen, is a natural substance produced by the glands in the ear canal that helps to lubricate the ear and protect it from dust, bacteria, and other foreign objects. Here are some tips for taking care of earwax:

1. Avoid using cotton swabs or other objects to clean your ears: These objects can push earwax further into the ear canal and potentially cause damage.
2. Use ear drops: Over-the-counter ear drops can help to soften and loosen earwax, making it easier to remove. Note that when the ear is completely blocked with earwax, the ear drops seldom help and it needs to be removed by an expert
3. Consult your audiologist: If you have difficulty with earwax, or if you experience pain, discomfort, hearing loss, or ringing in the ear, it’s important to consult your audiologist. We can examine your ear and recommend appropriate treatment, such as earwax removal using suction or irrigation.

It’s important to avoid using cotton swabs or other objects to clean your ears, as this can push earwax further into the ear canal and potentially cause damage. If you have difficulty removing earwax, or if you experience pain, discomfort, hearing loss, or ringing in the ear, it’s important to consult your audiologist for proper evaluation and treatment. 

If you are experiencing tinnitus, it is recommended that you see a healthcare professional, such as an audiologist or an ENT doctor. An audiologist is a specialist in hearing and balance who can evaluate your symptoms and determine the cause of your tinnitus. They can also provide you with advice and information on managing your symptoms and refer you to other specialists if necessary.

An ENT doctor can also evaluate your symptoms and rule out any underlying medical conditions that may be causing your tinnitus. They can also refer you to an audiologist or other specialists if necessary. 

It’s important to seek medical advice and information as soon as you start experiencing tinnitus symptoms, as early intervention and treatment can help prevent the symptoms from becoming more severe. Your healthcare professional can also provide you with information on available treatments, such as sound therapy, counselling, and medication, and help you determine the best course of action for your individual situation.

It’s recommended that you seek medical evaluation for tinnitus if:

1. Your tinnitus is sudden or severe: Sudden onset of severe tinnitus may be a sign of an underlying medical condition, such as a rapid build-up of earwax or an inner ear infection, that requires prompt medical attention.
2. You have hearing loss or difficulty hearing: Tinnitus can sometimes be accompanied by hearing loss, and if you’re having difficulty hearing, it’s important to have this evaluated by a healthcare professional.
3. Unilateral tinnitus: If you have tinnitus only in one ear, it may require further investigations.
4. Pulsatile tinnitus: If your tinnitus is pulsatile or in-sync with your heartbeat, you will need a medical opinion.
5. Your tinnitus is affecting your quality of life: If your tinnitus is making it difficult for you to sleep, concentrate, or participate in your daily activities, it’s important to seek medical evaluation to determine the best course of treatment.
6. Your tinnitus is accompanied by other symptoms: Tinnitus can sometimes be a symptom of a more serious underlying medical condition, such as a benign tumour or Meniere’s disease. If you’re experiencing tinnitus in conjunction with other symptoms, such as vertigo, hearing loss, or facial weakness, it’s important to seek medical evaluation.

In general, if you’re experiencing tinnitus, it’s a good idea to see a healthcare professional to determine the cause of your symptoms and develop a management plan. Early intervention and treatment can help prevent your symptoms from becoming more severe and improve your quality of life.

Audiology Planet is a well-established, local, independent audiology clinic. We provide a full range of hearing and balance services to all age groups in our community. Our audiology clinics are in Kent, Surrey and London. Our main clinics are in Sevenoaks (Springbank House) and Tunbridge Wells (Nuffield Clinic). We have abundant parking for our patients.

We provide a holistic care, tailor-made for individual circumstances of each and every patient. We use both the art and science of audiology to provide a need-based assessment and management. Our service is very well regarded by our patients and is run by one of country’s leading audiology experts, Dr Jay Jindal. Jay has a doctorate degree in audiology and over 17 years of experience of working in NHS and private sectors. Jay has written research papers in several peer-reviewed medical journals. He is also often invited to teach at various national and international educational events on all things related to audiology.