"Tinnitus is characterised by hearing unwanted sounds, such as a ringing or buzzing in your ears, without a corresponding external sound. It’s one of the most frequently occurring chronic conditions, affecting 12%–30% of the adult population worldwide. Although tinnitus occurs in all age groups, it’s more common in older adults."
The Conversation


Tinnitus is a medical condition which is characterized by buzzing, clicking, ringing, whistling, or whining noises in the ear, despite the lack of external stimuli which might create these sounds. In addition to being irritating, tinnitus may also be a symptom of more troubling underlying problems such as tumors, infections, or hearing loss. Patients who experience tinnitus should consult a doctor to determine what the cause is and receive treatment. A doctor may not be able to make the sound go away, but he or she can help patients manage it.

One or both ears can be afflicted by tinnitus, depending on the cause. The word comes from the Latin tinnitus, or ringing. Humans have reported cases of tinnitus for thousands of years, and a number of treatments from the mundane to the bizarre have been attempted. Because the causes are so varied, tinnitus has also historically been challenging to treat, and this remains true today.

There are technically two types of tinnitus. The vast majority of cases are subjective, meaning that only the patient can hear the sounds. In other instances, known as objective tinnitus, a doctor can hear the noises as well when he or she examines the patient. The two types of tinnitus have different underlying causes, and objective tinnitus can sometimes be treatable, whereas subjective tinnitus is much more difficult.

Common Causes of Tinnitus
Common causes of tinnitus include head trauma, damage to the nerve endings in the ear, blocked canals, ear infections, and the use of certain prescription drugs. When the cause is something like a tumor or earwax obstruction, the tinnitus can be treated by removing the offending item. If the cause is medication, a doctor may recommend a change of medication, or change the dosage. Things like nerve damage are not as easy to treat, unfortunately. A case of tinnitus may also be caused by temporary damage to the ears, such as exposure to an explosion or similar loud noise, in which case the tinnitus will subside after a period of time.

When a patient complains of tinnitus, a doctor will usually perform screening to eliminate causes such as systemic infections, just to be rule out any potential causes not seen on physical examination.

In a case where a doctor cannot eliminate the tinnitus, the patient learns how to manage it. Many patients use masking devices such as fans or ear implants to create pleasant white noise. Patients are also encouraged to manage their stress well, since stress appears to be linked to recurrent tinnitus.

How to prevent Tinnitus
Tinnitus is defined as internal sounds heard by a person, sometimes around the clock, that can significantly interfere with a person's enjoyment of life. Sounds heard can be ringing or buzzing in the ears and they are normally shrill and difficult to ignore. The condition is often paired with some hearing loss, which can make tuning out these sounds challenging, since exterior noises may not be enough to distract from the ones you're hearing inside your ear. There are numerous treatments for tinnitus, many with satisfactory results.

Diagnosis of tinnitus is essential in order to best address treatment. In some cases, tinnitus can be caused by transient conditions like ear infections, blockage in the ear canal or trauma. If the cause is something like an ear infection, normally clearing the ear infection will treat the condition. Tinnitus caused by traumatic injury to the ear should cease once the injury has healed.

People with anemia, thermandibular joint (TMJ) problems, high blood pressure, hardening of the arteries, or low levels of thyroid may also experience tinnitus. Again, these conditions, when controlled, may help control tinnitus. In some cases, they completely reduce or eliminate the condition.

On rare occasions tinnitus, especially when it can be heard by an examining physician (called objective tinnitus), can indicate a small tumor in the blood vessels or an aneurysm. Because there is a slight chance of having this condition, diagnosis should be made by an ear, nose, throat (otolaryngologist) specialist. These conditions can then be addressed.

Once diagnosis is made, and frequently there is no specific cause, treatment can begin. For those with hearing loss, using hearing aids can make all the difference in the world. Being able to tune out the inner sound and focus on exteriors helps some people significantly. Another common treatment for tinnitus is called masking.

Masking is a way of exposing the ears to other background or ambient sounds so that they can focus less on or tune out tinnitus sounds. Different noises may be used. Running water is a popular choice since many people report tinnitus is better when they are showering. Masking can be done either by always playing background low-level sounds, or by using earphones. Some people listen to radio static at night with earphones, or merely keep their radio tuned to a static station to help block out tinnitus.

A few medications are available for tinnitus sufferers who are not helped by masking. The most efficacious of these appears to be Xanax, a tranquilizer. The disadvantage of using this medication is that the body can quickly become addicted to it. Instead, some anti-seizure medications, which are also used for bipolar conditions, may reduce tinnitus or make it more tolerable. Antihistamines can sometimes be effective too.

There is one surgery for tinnitus, but it is usually considered a last resort, because it has only about a 50% success rate. In this surgery, the auditory nerve is split in two, which may diminish especially loud tinnitus. Usually surgery is conducted when tinnitus results from actual damage to the ears.

People with tinnitus are advised to quit smoking, since this can increase the noise and make the condition worse. For many, aspirin should be strictly avoided since this can cause the condition. In fact, if you ever note your ears ringing after taking aspirin, you should not take it again until you've spoken to a doctor.

There are a number of support therapies for tinnitus that might provide relief. Learning relaxation and meditative techniques may certainly help, as can doing exercises like yoga or Tai Chi. Some people benefit from biofeedback or hypnosis. Others swear by acupuncture. If you're suffering from tinnitus, ask a doctor?s advice about pursuing some of these alternative therapies in addition to traditional medical treatment.

What Can Make Tinnitus Worse?
1. Loud noise! - Exposure to sudden or long-term noise can damage your hearing with resultant deafness and tinnitus. High-risk groups include industrial workers, farmers, transport workers - and don't forget that noisy lawn mower! Reduce the noise source or protect your ears with earplugs, or ear muffs. Leisure noise can also be a hazard, e.g. rock concerts, boom boxes in cars and misuse of a Walkman - never play it loudly.

2. Stress and Fatigue - They make tinnitus worse! Keeping busy - trying to focus your energies OUTWARD AND AWAY from the tinnitus - is an excellent idea, but stress and fatigue only undermine you. Minimise them by rethinking your lifestyle. Relaxation therapy can help greatly if learnt and practised daily. Hypnotherapy from a qualified practitioner may help. Also good - sports, hobbies, yoga, t'ai chi, reflexology or massage.

3. Medications - It is essential to tell your family doctor about your tinnitus; some common medications cause tinnitus as a side effect or make your existing tinnitus worse. Take special care with medications for arthritis, rheumatic diseases, some antibiotics, and anti-depressants. Also aspirin - ask your doctor about alternatives.

4. Try easing off caffeine (tea, coffee, coca-cola, chocolate), and alcohol as they can temporarily worsen tinnitus for some people. Avoid quinine - as in tonic water. Nicotine and marijuana too. Smoking narrows your blood vessels which supply vital oxygen to your ears and their sensory cells. PLEASE - quit smoking!

Tinnitus FAQ

Does Tinnitus Mean That One Is Going Deaf?
Tinnitus is a symptom of a fault in the hearing system, so usually it is associated with a hearing loss. Sometimes tinnitus is present with normal hearing and for no discernible reason. TREAT TINNITUS AS A WARNING SIGNAL - PROTECT AGAINST EXCESSIVE NOISE AND SEE YOUR DOCTOR.

I Have Tinnitus - What Should I Do?
Do see your doctor and have your hearing checked by an audiologist (hearing scientist). Some audiologists run specialist tinnitus clinics to help you manage your tinnitus and they fit hearing aids and/or therapeutic noise generators if needed. Some people may require a referral to an ENT specialist. There may be a TREATABLE medical cause.

Hearing Aids
Good quality and properly fitted hearing aids reduce and even eliminate most tinnitus associated with hearing losses. Hearing aids take away the strain of listening and distract from the tinnitus by bringing you more environmental sounds from the outside world.

Tinnitus Retraining Therapy (TRT)
Aims to reduce and ultimately eliminate tinnitus perception. It combines auditory therapy - hearing aids and/or therapeutic noise generators - to provide the brain with maximum environmental sounds to reduce tinnitus perception. Directive counselling helps to change negative beliefs, distract from tinnitus and reduce stress.

Cognitive Behaviour Therapy (CBT)
Effective in alleviating distress and producing adaptation to tinnitus. CBT is threefold: changing the way a person perceives tinnitus; teaching ways to focus attention away from tinnitus and achieving control over stress. Offered by clinical psychologists.

Is There An Operation For Tinnitus?
For the vast majority of people there is no specific operation for tinnitus. However, following successful surgical treatment for some ear problems, an existing tinnitus may sometimes disappear, e.g. otosclerosis, Meniere's disease, middle ear infection.

More Links on Tinnitus
» Australia Tinnitus Association
» HealthDirect on Tinnitus (Aust Govt)
» The Coronavirus pandemic has made tinnitus worse
» Tinnitus - tips to help you adjust