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Tinnitus Management

While tinnitus is a fairly common problem, there are many effective methods to treat (or at least reduce the impact of) the sensation.

What should I do?

Since tinnitus is a symptom of a problem, the first thing you should do is to try to find out the underlying cause. You should have a medical examination with special attention given to checking factors associated with tinnitus. A full hearing evaluation can identify hearing loss that may be associated with the tinnitus.

Tinnitus can be associated with conditions that occur at all levels of the auditory system. Some of these conditions are:

  • Impacted wax (external ear)
  • Ear infection
  • Middle ear tumors
  • Otosclerosis
  • Vascular problems (circulation disorders)
  • Ménière’s disease
  • Ototoxic medications (more than 200 medicines can cause tinnitus)
  • Noise-induced hearing loss (inner ear)
  • At the central level—the eighth cranial (auditory) nerve and other tumors, migraine, and epilepsy

Should I see an audiologist?

Your hearing should be evaluated by an audiologist certified by ASHA to determine if a hearing loss is present. Since tinnitus can be associated with a number of auditory conditions, the audiologic evaluation can yield extensive information regarding the cause and options for treatment.

Can tinnitus actually be measured?

Tinnitus cannot be measured objectively. Rather, the audiologist relies on information you provide in describing the tinnitus. The audiologist will ask you questions such as:

  • Which ear is involved? Right … left … both?
  • Is the ringing constant? Do you notice it more at certain times of the day or night?
  • Can you describe the sound or the ringing?
  • Does the sound have a pitch to it? High pitch … low pitch?
  • How loud does it seem? Does it seem loud or soft?
  • Does the sound change or fluctuate?
  • Do you notice conditions that make the tinnitus worse—such as when drinking caffeinated beverages, when taking particular medicines, or after exposure to noise?
  • Does the tinnitus affect your sleep … your work … your ability to concentrate?
  • How annoying is it? Extremely so or not terribly bothersome?

In discussing your answers to these questions, the audiologist can give you information that will increase your understanding of the tinnitus.

Knowing the cause of your tinnitus can provide relief instead of having to live with the uncertainty of the condition. When the possible cause of your tinnitus is understood, your stress level (which can make tinnitus worse) is frequently reduced. You can “take charge” by anticipating, preventing, and changing situations that make your tinnitus worse.

How is tinnitus treated?

The most effective treatment for tinnitus is to eliminate the underlying cause. Because tinnitus can be a symptom of a treatable medical condition, medical or surgical treatment may correct the tinnitus.

Unfortunately, in many cases, the cause of tinnitus cannot be identified, or medical or surgical treatment is not an option. In these cases, the tinnitus itself may need to be treated. Be sure to discuss with your doctor any treatment options you are considering prior to beginning the treatment.

Forms of tinnitus management include:

  • Biofeedback
  • Hypnosis
  • Electrical stimulation
  • Relaxation therapy
  • Counseling
  • Habituation therapies
  • Tinnitus maskers

Audiologists and otolaryngologists (ear, nose, and throat doctors, or ENTs) routinely collaborate in identifying the cause and providing treatment. A treatment that is useful and successful for one person may not be appropriate for another.

The American Tinnitus Association (ATA) has information on various treatment options.

Will a hearing aid help my tinnitus?

If you have a hearing loss, there is a good chance that a hearing aid will both relieve your tinnitus and help you hear. Contact an ASHA-certified audiologist to determine if you will benefit from using a hearing aid. The audiologist can assist with the selection, fitting, and purchase of the most appropriate aid. The audiologist will also help train you to use the aid effectively.

What is a tinnitus masker?

Tinnitus maskers look like hearing aids and produce sounds that “mask,” or cover up, the tinnitus. The masking sound acts as a distractor and is usually more tolerable than the tinnitus.

The characteristics of the tinnitus (pitch, loudness, location, etc.) that you described for the audiologist determine what kind of masking noise might bring relief. If you have a hearing loss as well as tinnitus, the masker and the hearing aid may operate together as one instrument.

Like all other treatments for tinnitus, maskers are useful for some, but not all, people. As with a hearing aid, a careful evaluation by an audiologist will help decide whether a tinnitus masker will help you.

Are there other devices that can help me?

Sound machines that provide a steady background of comforting noise can be useful at night or in a quiet environment. Fish tanks, fans, low-volume music, indoor waterfalls, and so forth can also be helpful. Today there are even applications for iPod portable media players that offer a variety of masking sounds that may reduce the annoyance of tinnitus.

Should I join a self-help group?

Tinnitus can be debilitating because it is can be difficult to describe, predict, and manage. Self-help groups are available in many communities for sharing information and coping strategies for living with tinnitus. People with mild tinnitus generally do not require treatment. Often a self-help group promotes feelings of hope and control. Members of the group share strategies they have found successful in dealing with their tinnitus. It can help to be reassured that you do not have a rare disease or serious brain disorder or are not going deaf. With support, people with tinnitus usually find that they can cope with or ignore their tinnitus.

Your audiologist can connect you with a self-help group in your area. For additional information or help in finding a group near you, contact the American Tinnitus Association (ATA).

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