Tinnitus

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 not a disease or illness; it is a symptom generated within the auditory system.

The noise may be in one or both ears, or in the head, or it may be difficult to pinpoint its exact location. The noise may be low, medium, or high pitched. There may be a single noise or two or more components. The noise may be continuous or it may come and go.

Worldwide research continues but the actual mechanisms, or processes of tinnitus are not yet fully understood. We do know that tinnitus is real, not imagined, and that it is a symptom of a malfunction, usually somewhere in the hearing system (includes ear and brain). The inner ear, or cochlear, is involved for many people.

HOW CAN I PREVENT IT

Tinnitus can’t always be prevented and there are many causes and reasons why people experience the condition. Here are a few examples of ways you can help protect yourself from tinnitus in certain situations:

Infections: Ear infections can cause Tinnitus. If you use earplugs or hearing aids, make sure you keep them clean.if you are worried about a build-up of wax, talk to a GP

Stress and anxiety: Tinnitus can sometimes start when you are anxious or stressed, so try and keep a healthy life balance. Do things you enjoy and de-stress everyday by taking some time out for yourself. Stay fit, eat well and enjoy life.

Use earplugs:If you are going to be exposed to loud sounds over 85dB (see How loud is loud). You can get sound meters to measure sound if you want to get an idea of sounds, and there are several apps available which can also be helpful.

Take a break: Your ears can cope better with loud sounds if you give them regular breaks – so if you are in a noisy environment, take some time out and let your ears have a rest.

WHAT CAN I DO ABOUT IT

Tinnitus almost always improves over time, because in most cases it gets less annoying with time as the brain loses interest in it. In some cases, the tinnitus even disappears. This process is called habituation, but the length of time for habituation to occur varies in individuals.Most people who experience tinnitus initially consult their GP.Most GPs will take a history, examine the ears with an otoscope (a magnified light source), remove wax, treat any underlying infections, and provide advice and reassurance. Some may perform other investigations such as a blood pressure check. Some will refer on to support groups. In the absence of a cure, many people with tinnitus are told that there is no treatment available and they should “learn to live with it.” This is not acceptable or true.You may be given a tinnitus assessment questionnaire. These, together with open ended questions, help to assess the impact of the tinnitus and any other associated symptoms such as hearing loss, hyperacusis and dizziness.There are many ways to help manage tinnitus and live well.

• Information/education – most people find that being given a detailed explanation of tinnitus together with being told “it will almost certainly improve” hugely beneficial and reassuring. Tinnitus does spontaneously decrease over time in the clear majority of cases.
• Hearing aids – correcting even quite a mild hearing loss can be very helpful because it brings in sounds that you may not hear. This makes the tinnitus less audible and removes the strain from hearing. It may also reverse tinnitus related changes in the brain. Sometimes a combination device (both a hearing aid and wearable sound generator) may be fitted.
• Counselling – addressing underlying worries and concerns and getting support with your tinnitus can be effective.
• Relaxation therapy – many people find that their tinnitus is worse when they are stressed but better when they are relaxed.
• Sleep management – some people with troublesome tinnitus have sleep difficulties and specific advice on what to do at home to help you sleep (sleep hygiene) will be beneficial.
• Sound enrichment therapy – the use of sound, either desk-top devices or wearable sound generators to help both reduce the starkness of the tinnitus and promote habituation.
• Cognitive behavioural therapy (CBT) – this is a specific form of therapy which addresses any negative thoughts you may have about your tinnitus and through both counselling and practice help you rethink the way you perceive this condition.
• Tinnitus retraining therapy (TRT) (habituation therapy) – modified versions of this therapy are available based on the Jastreboff neurophysiological model which use counselling and sound enrichment.
• Psychological support – this may be offered to help people with tinnitus deal with accompanying feelings of anxiety and depression.
• Medication – it is possible that some people may benefit from medication such as anti-anxiety medication, anti-depressants or sleeping tablets for other conditions they have in addition to their tinnitus. There is no medication for tinnitus.

Tinnitus is not simple. Everybody’s tinnitus is individual to them, although of course there are several major types e.g. ringing, buzzing, whistling, roaring, humming etc. Its causes are many (though excessive noise and some medications are the major PREVENTABLE causes). The range of tinnitus is very wide from mild to severe. It is usual for tinnitus to fluctuate with stress or tiredness and this has no sinister significance.

If tinnitus is troubling you… ACT NOW