Tinnitus refers to hearing a sound, usually ringing, buzzing or whistling sounds, when there is no external stimulus.
Tinnitus is like pain - you can't really measure it, but it certainly is there. Millions suffer from it. ATA (the American Tinnitus Association) estimates that 50 million persons have tinnitus. Some persons simply accept it and "put it out of their minds". Those persons don't need treatment. However, millions cannot simply dismiss their tinnitus, and they do need help.
Cetainly tinnitus needs to be evaluated by a physician and an audiologist to be certain the tinnitus you experience is not a warning sign, or a symptom of a dangerous situation. In some cases, tinnitus can be the first symptom of a medical condition that requires attention. It is virtually impossible for the patient to self-diagnose and therefore, a professional examination is required.
Tinnitus can be like a "phantom limb." The idea of a phantom limb is that many people have reported that even though a limb may be missing, they can still "feel it." With tinnitus, you may feel or hear the sound even though there is no hearing there. In the audiology and otolaryngology (ear nose and throat) literature, there are many examples of deaf patients -who still have tinnitus! The treatment is often the same.
Tinnitus is subjective. Unlike a fractured bone, or a cut finger, you can't take a picture or an X-ray to show it. There is usually no physical evidence of tinnitus, but it is there and it is perceived by the patient -- just like pain is felt without being "seen." It is not imaginary or psychosomatic, it is real. Consider the patient with a headache or lower back pain, or even dizzinessall very real, and all (usually) impossible to prove.
Nonetheless, tinnitus is real, and it can start and stop. For instance you can initiate tinnitus with hypertension and then clear it up with blood pressure medication. You can get tinnitus from too much salicylate (aspirin) medicine and the tinnitus will cease, when you stop taking too much aspirin.
Anxiety makes it worse:
In most tinnitus patients, stress builds up an "anxiety reinforcement cycle." When the patient perceives tinnitus, the patient gets nervous. The more nervous the patient becomes, the more the patient becomes tense, which affects circulation. The more tension, the worse the tinnitus, the more stressed they feel. The "anxiety reinforcement cycle" feeds on itself and the problem becomes magnified. One way to stop this is to give huge doses of nerve pills. But these nerve pills have serious side effects.
In the 1970's, I was the first to publish the response to biofeedback for tinnitus management. Basically, when the muscles are relaxed, you can't have anxiety and you no longer feel the stress. Biofeedback simply means that you are given information about your body so you can change it. Usually we stick on sensitive sensors (also known as electrodes) that record the electricity your muscles naturally emit.
Because the forehead is where the muscles show worry and anxiety, we measure from there. The computer we use for biofeedback control, can emit a noise you can listen to, or a picture you can observe, or both. You use this "biofeedback" information to lower the electricity - and most importantly-- relax the muscle. When the electrical output is reduced by relaxing the muscles, feelings of being stressed melt away.
Almost any symptom - itching finger, toothache, and indeed, tinnitus -- can be made worse by anxiety. The more it itches the more worried you get, the more it itches. It is important to break this circle of the anxiety making the condition worse.
Cognitive Therapy for tinnitus uses "teaching" to explain that tinnitus is not a threat. In my Tinnitus Relief program we do this by explaining what tinnitus is, so it is no longer thought of as a danger.
Of course, most biofeedback techniques require a computer, electrodes and a teacher! However, there is a way to create a biofeedback system at home, for little more than pocket change.
Simply sit in front of a mirror. Look at your face. SEE the forehead relax, see the face relax, see the jaw relax. It is best to do this by breathing in at the count of four and out at the count of six. This puts you into a relaxation state longer than a contraction state. The mirror is used to "feedback" to you what your face is doing so that you see to do it right.
Once there is full relaxation of the muscles, the anxiety reinforcement cycle is reduced and the tinnitus can dissipate.
Wear a watch:
It is important to do mirror biofeedback 10 minutes a day. This can be a minute at a time for a total of 10 times. Ideally every hour on the hour. Wear a watch to remind you to do this.
In my Tinnitus Relief.net program we provide a special watch with a rotating bezel that you can use to count the 10 times. Each time you check the time of day on the watch you are reminded to do the steps.
By doing the mirror biofeedback 10 times a day, a minute at a time, you can reduce that part of the symptoms that anxiety makes worse. It is important to use a watch that you wear to keep doing this. Keeping a notebook doesn't work as well - it's often in the desk, out of sight.
MASK the tinnitus:
Whatever covers-up (masks) the tinnitus is desirable. You should have music playing as much as possible. If you have a hearing loss, using hearing aids to bring in more outside sound to cover the tinnitus is often successful.
Go to a healing place:
Throughout history man has had healing places - hot springs, Delphi, Lourdes and many others. Turns out these places did work! When the person arrived, he/she felt relaxed and confident that the place would help him get well. Try relaxing and in imagery or with the help of music, imagine you go to a wonderful place where your symptoms are made better.
In the Tinnitus Relief program, a CD is provided with various types of guided imagery to places of healing. When persons successfully imagine they are in a healing place, if we were to draw blood, we would find a beneficial change in the blood chemistry.
Recall in great detail when you didn't have tinnitus:
One of the techniques often successful in pain therapy is to relax and visualize when you didn't have the pain. This may direct the body to do whatever it did then to take away the pain.
This can be used in tinnitus therapy too. Relax and in great detail, recall a day when you didn't have tinnitus. This visualization directs the body to do whatever it did before to correct the tinnitus. This is one of the guided visualizations on the CD of the Tinnitus Relief program.
In this program patients are able to ask questions and interact with the doctor at the web site, www.tinnitusrelief.net.
Patients tell us that this particular visualization - being told to recall the time before you had tinnitus - has been the most helpful suggestion of all.
In my tinnitus program, we emphasize
1- Learning that tinnitus is not a threat.
2- Using the watch to remind one of 10 minutes of the relaxation activity.
3- Using the instruction from the CD, the guided imagery, to direct the body to the right activity.
4- Using the interactive web site for further instruction and information.
If you include some of these actions in your daily activity, I believe you will be helped.
Articles by Murray Grossan M.D. on Tinnitus:
The Twenty Dollar Tinnitus Masker-a drug free approach to Managing Tinnitus. The Hearing Journal. June 1995. 48:39-40
Treatment of Subjective Tinnitus with Biofeedback. Ear Nose and Throat Monthly Nov 1976.
A Brief Introduction to Biofeedback for Otolaryngologists. O.R.L. Digest, February 1975