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Tinnitus

Everything you need to know about Tinnitus

Put simply, tinnitus is hearing noises that aren’t actually there. One in two of us will experience this at least once in our lifetimes – usually it’s a buzzing, humming, whistling or ringing sound, with one in five people developing chronic tinnitus.

Overview:

In this section, you can find out what tinnitus is, what might cause it, and tips about how to live with tinnitus.  

What is tinnitus?

Tinnitus is a phantom noise that doesn’t come from an external source. It develops in the inner ear and in the brain, but exactly how it develops is still a mystery. The only thing we do know is that it’s not a condition in itself, but a symptom of something else.

The sounds that people with tinnitus hear are different for everybody – they can vary in pitch, volume, and tone. Sometimes it’s only heard in one ear, and some even say that they can ‘hear’ it in their head, rather than their ears. It can appear in phases, in waves, or it can be continuous. Tinnitus is frequently associated with hearing loss.

Is tinnitus harmful?

Tinnitus and mental health

If your brain hears a noises and thinks it might be threatening, it activates emotional reinforcement mechanisms in your limbic system, the part of your brain that processes emotions.

Not everyone who has tinnitus is badly affected by it and there are two types:
  • Compensated tinnitus is when the tinnitus is described as not particularly intrusive. People with compensated tinnitus can usually block out the noises, and they’re unaware of them most of the time.
  • Decompensated tinnitus is tinnitus that the person can hear all the time. A person with decompensated tinnitus is constantly aware of it, which can trigger insomnia, stress, anxiety, depression and even social isolation. It might even set off headaches, earaches, and dizziness.

How long does tinnitus last?

Tinnitus might last a few days, a few months or it may last a lifetime. This is split into three categories:
  • Acute – lasts for less than three months, and often stops spontaneously. Sometimes, medication can help.
  • Subacute – always recurs within three to twelve months. It can sometimes be treated with medication or relaxation techniques.
  • Chronic – lasts persistently for over twelve months. Chronic tinnitus rarely subsides without therapy or medication.

How do you get tinnitus?

Even if no one else can hear the noises and doctors can’t diagnose tinnitus, the condition isn’t a hallucination or an imaginary disorder. But we still don’t know how it develops or how to get rid of it for good. We do know one thing, though – the most common causes of tinnitus are injury, illness, or some other kind of change in the ear. Here are some different ways that tinnitus can develop:

In the inner ear

Tinnitus can develop in the inner ear following exposure to a sudden loud noise, or it can be linked to age-related hearing loss. These things can damage the sensory cells in the cochlea, resulting in some sounds only being faintly heard by the brain, or not heard at all. Hearing experts suspect that this makes the auditory response area in the brain try to ‘make up’ for the missing sounds – creating noise that isn’t there.

In the middle ear

Some forms of tinnitus can’t be measured externally. This makes it difficult for doctors to determine the what might trigger it, which makes it even more difficult to treat. The cause of tinnitus could be in a number of different areas of the ear, in the nerves, or even in the brain. It could be caused by a problem with the eardrum, or by inflammation somewhere in the ear.

In some patients, tinnitus may also be due to a malfunction in the brain . In this case, the tinnitus disappears if the auditory nerve is severed. Potential causes of the malfunction include meningitis or a tumor in the auditory center of the brain. In addition, tinnitus sometimes has a psychological cause.

In the brain

For some people, tinnitus could be caused by problem in the brain. This is very rare, and could be linked to a much more serious condition like meningitis or a brain tumour.

Objective tinnitus

Objective tinnitus is pretty unusual – it means that the noises in the ear can actually be detected by a doctor. In these cases, it’s often a problem with blood vessels in the ear or damage to the middle ear. Objective tinnitus is usually a side effect of another disorder like Ménière’s disease, a disorder of the inner ear. This kind of tinnitus can be treated with medication or surgery.

What can trigger tinnitus?

Stress
Recent studies have shown that people with tinnitus have been under stress more often than other people with ear, nose or throat problems. Tinnitus can be linked to long-term stress like work-related worries, or to a larger one-off incident such as a family bereavement.
Medication
Tinnitus could be a side effect of certain medication. Some some antidepressants and malaria treatments may trigger it. Certain types of pain relief, rheumatism medication and oral treatments for blood pressure could also play a part.
Noise
Loud noise is the most common trigger for tinnitus. If you regularly spend time in a noisy environment for years hearing protection, you’re at a much higher risk of developing tinnitus. It can also be brought on by a sudden, very loud noise.

Click here to read our section about hearing protection.
Stimulants
Some hearing experts believe that alcohol and nicotine are linked to tinnitus.

What should I do if I’m affected by tinnitus?

Sudden noises in the ear usually disappear on their own. But what can you do if the whistling or whooshing noises just won’t go away? If the noises last longer than 24 hours, you should seek the advice of an expert. The earlier you do something about tinnitus, the more treatable it is.

Who should I go to for help?

See your GP if you think you might have tinnitus. They can refer you to a specialist ear, nose and throat doctor.

Treatments for tinnitus

Medication
Acute tinnitus (tinnitus that lasts less than three months) can be treated with medication like cortisone that stimulates circulation.

For tinnitus that has been ongoing for more than three months, there are treatments that can help you cope long-term tinnitus. Your doctor can choose the right treatment depending on the type of noises you’re hearing.
Tinnitus retraining therapy
The most successful method to help people living with tinnitus is called tinnitus retraining therapy (TRT). TRT aims to help you get to know your chronic tinnitus so that, over time, you’ll be able to start ignoring it. In other words, TRT helps your brain get used to the tinnitus so it no longer perceives it as strongly. TRT is best-suited to people who only hear slight or chronic noise.

The cornerstones of TRT:
  1. Education and advice: having the right information and being confident in your knowledge of tinnitus can help you find the noises in your ear less scary.
  2. Sound therapy: by concentrating on pleasant sounds, like fountains, the sounds of nature, or music, the noises in your ear fade into the background.
  3. Psychological and physical wellbeing: this can range from behavioural therapy and counseling to yoga and tai chi – it varies for everybody.
Hearing aids and noisers
Hearing aids with tinnitus noisers built in work in two ways:
  • They allow you to hear better over the tinnitus noise
  • They distract you from the tinnitus noise by using pleasant sounds.
Around 80% of people affected by tinnitus are also experiencing hearing loss – so a device that can tackle both is a winner!

Tips for dealing with tinnitus

  • Reduce stress and find a relaxation technique that suits you (autogenic training, yoga, tai chi, etc.).
  • Stop smoking.
  • Watch what you eat and consume alcohol in moderation.
  • Lead an active lifestyle and exercise. Physical activity helps reduce stress and distracts you from the sounds in your ear.
  • Get enough sleep. Well-rested people perceive chronic tinnitus less intensely.
  • Engage in activities you enjoy to distract you from the noises.
  • Always wear hearing protection when you are exposed to noise or loud music.