Tinnitus

That ringing, clicking, roaring or hissing sound that you hear isn't your imagination. Like millions of other Americans, you may suffer from tinnitus. The estimates of the number of people who suffer from some form of tinnitus ranges from about 12 million according to the American Tinnitus Association (ATA) to 36 million according to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). Millions of those have it so bad it makes it difficult to do many of things most people take for granted, things like, working, hearing normal conversations, even sleeping.

What is tinnitus

According to AAO-HNS tinnitus is a ringing or other sound in one or both ears that may be continuous or may come and go. (Read about "The Ear and Hearing") The type of sound may vary from person to person, and it may be present in one or both ears. Most people are more aware of their tinnitus in a quiet room. Although tinnitus affects a lot of people, it is not normal.

What causes tinnitus

AAO-HNS says that many cases of tinnitus are caused by nerve damage in the inner ear. (Read about "Nervous System") Microscopic endings of the hearing nerve can be damaged by loud noise (Read about "Noise and Hearing") or the normal aging process, which is called presbycusis. (Read about presbycusis in "Hearing Loss") Sometimes tinnitus is caused by a temporary problem, like a plug of earwax. Sometimes it is caused by a stiffening of the tiny bones of the middle ear. According to National Institute for Deafness and Other Communication Disorders (NIDCD), other health problems like high blood pressure, diabetes, thyroid problems, allergies, tumors, or problems with the jaw or neck can be the cause of all the noise. (Read about "Hypertension: High Blood Pressure" "Diabetes" "Thyroid" "Allergies" "Head and Neck Cancers" "Brain Tumors" and "Neurofibromatosis") It is important for your healthcare provider and pharmacist to be aware of all medicines you are taking, because one of them might be causing your problems. (Read about "Drug Interaction Precautions") NIDCD says that over 200 medicines can cause tinnitus. Make sure you include over-the-counter medicines in your list since even aspirin can cause tinnitus, according to AAO-HNS. Many over the counter medicines, including cold medicines and antidiarrheals, contain aspirin so be sure to mention them as well. Tinnitus can be very annoying or distracting, especially if it is constant. Tinnitus is often accompanied by some sort of hearing loss as well, according to AAO-HNS. Tinnitus may also be a symptom that accompanies balance disorders. (Read about "Balance Disorders")

Who treats tinnitus

It is important to get properly diagnosed and treated by health professionals who are familiar with the diagnosis, cause and treatment of tinnitus. You may have diagnostic tests, including x-rays (Read about "X-rays"), balance tests or lab work. Your primary healthcare provider may manage your overall care, but may also refer you to any one of the following kinds of specialists:

• An otolaryngologist, more commonly called an ear, nose, and throat (ENT) doctor is a medical doctor who has advanced skills to diagnose and treat problems with ears and hearing.
• An audiologist is someone who specializes in evaluating hearing and hearing loss. This person may perform a hearing test to determine whether hearing loss has occurred.
• Hearing aid specialists may also perform hearing tests and are licensed and trained to fit hearing aids or other devices used to treat tinnitus.
• A dentist may treat problems with the jaw to help lessen tinnitus symptoms. (Read about "Temporomandibular Disorder")

Treatments for tinnitus

ATA says that many treatments for tinnitus take a lot of time, sometimes over a year, to be effective, so patience is important. ATA says that although there is no definitive cure for tinnitus, some of the following treatments may be recommended for you, either alone or in combination:

• Hearing aids - Some people may experience total or partial relief from their tinnitus when they wear a hearing aid. Since tinnitus can be associated with some degree of hearing loss, a hearing aid can help bring back some of the background sounds that will help "cover up" the tinnitus symptoms.
• Masking - Devices that mask sound look like hearing aids and produce low-level sounds that are designed to reduce or eliminate the perception of tinnitus symptoms. Although these devices won't make the tinnitus go away, they may make the noise in your ears seem softer and less distracting. Some people find that having "white noise" in the room, like a fan or fish tank makes the tinnitus symptoms less bothersome.
• Medications - Some drugs have been used for tinnitus relief. Anti-anxiety drugs, antidepressants, antihistamines and anticonvulsants have all been used for tinnitus treatment. If your tinnitus is caused by a specific medication or if a medication that has been prescribed for your tinnitus is causing other side effects, you and your doctor may decide together whether the benefit of the treatment outweighs the side effects. (Read about "Medicine Safety")
• Counseling - Counseling doesn't treat tinnitus, but can help treat your emotional reaction to it. Counseling is individually designed for each person, and is often combined with other treatments. People with tinnitus may become depressed or anxious and find counseling helpful.
• Relaxation techniques - Stress can make tinnitus seem worse. (Read about "Stress") Relaxation techniques, including biofeedback (Read about biofeedback in "CAM Therapies"), can help you learn to control body functions like muscle tension, pulse and brain wave activity. By helping change your body's reaction to stress you may help ease your symptoms or make it easier to sleep or cope with your tinnitus. Improved circulation from relaxation can help with symptoms.
• Cochlear implants/electrical stimulation - The cochlea is a cavity in the inner ear that has many nerve endings. A cochlear implant is a device that is placed in the ear to send signals from the ear to the brain. (Read about "The Brain") Cochlear implants are usually used with total or severe hearing loss.
• TMJ treatment - Problems with the temporomandibular joint (TMJ) can cause tinnitus because the muscles and the nerves in the jaw are very close to those in the ear. If you think you have this problem, talk to your dentist.
• Alternative treatments - Some people have been treated with specific diets, herbs, vitamins (Read about "Vitamins & Minerals"), minerals, homeopathic remedies, acupuncture, hypnosis, magnets or other alternative therapies. (Read about acupuncture, hypnosis & other alternative therapies in "CAM Therapies") Always talk to your doctor before trying any new treatment to make sure it will be ok for you. (Read about "Herbal Precautions" "Complementary and Alternative Medicine")
• Other treatment may include exercising to improve circulation, avoiding exposure to loud sounds, avoiding stimulants like caffeine, and getting plenty of rest. Smoking and alcohol may worsen tinnitus symptoms. (Read about "Quit Smoking")

Treatment for tinnitus is usually geared toward masking or coping with symptoms and - when possible - preventing further damage to the nerves of the ear. Because everyone's experience with tinnitus is unique, your treatment may be different from another person's treatment. It is important to avoid anything that may make your tinnitus worse, like loud noise.

Prevention

According to the ATA, it is important to protect your hearing - starting today - to minimize problems you may have in the future or to keep the tinnitus you already have from getting worse. When a younger person has tinnitus, it is frequently caused by chronic or acute exposure to noise. As a rule of thumb, if you have to speak up to be heard over a noise, you should wear earplugs, move farther away from the source of the noise or turn it down if you can.

ATA recommends using earplugs or special earmuffs when you are exposed to sounds over 85 decibels (dB). Most people don't realize that the noise from a blow dryer (100 dB) is almost as loud as the noise from a power mower (105 dB) and we hold the blow dryer right next to our ears! Do you protect your ears when you use a vacuum cleaner?

By adopting healthy hearing habits, you may be able to reduce your risk of tinnitus. See your health provider early if you think you may have a problem.

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