You may have heard tinnitus described as a ringing in the ears. However, whooshing, hissing, whistling and humming are also common sounds of tinnitus. Tinnitus results from a multitude of potential causes and treatment options are just as varied. If your tinnitus can't be treated, there are also tinnitus relief strategies that may help.
Describing your tinnitus
The first step in treating tinnitus is uncovering what may be causing it. One of the challenges in tinnitus evaluation and treatment is everyone experiences it differently. Measuring a subjective experience is very difficult. A hearing care professional will start by asking lots of questions about your symptoms such as:
- How long has this been going on?
- Is it irregular or constant? Is it worse at certain points of the day?
- Is it a pulsating sensation?
- Which ear is causing the issue? Both?
- How loud is the noise? Is the pitch high or low?
- It the issue extremely bothersome or a little irritating?
- Are there certain conditions that make it worse such as exposure to noise or caffeine intake?
- Does the sound change?
The practitioner will also ask you to report your medical history. After a thorough discussion of your symptoms and health history, the physical examination will begin with a visual inspection of your ears and standard behavioral tests of your hearing ability.
There are a few specific tests a hearing care professional may administer to help get a better understanding of the tinnitus you're experiencing. Here are some examples:
- A pitch match test will help your hearing care professional determine the approximate frequency of sound that you are hearing. For this exam, you will be asked to identify the pitch of your tinnitus as best as possible by comparing it to externally presented tones.
- A loudness match test will help quantify the level of the sound you are hearing, which could range from a whisper to a shout. It is more common for people to experience soft sounds than loud.
- A visual analog scale can be used to determine perceived loudness, because the tinnitus is often perceived much louder than the decibel level that matches. On a scale from zero to 10, you'll be asked to scale the loudness. About 70 percent of patients will report a loudness value of six or higher.
Treating your tinnitus
Depending on the results of your hearing evaluation, you may get a recommendation for one of the following types of tinnitus treatment.
- If you have hearing loss as well as tinnitus, hearing aids can often remediate your tinnitus. Some hearing aids on the market include tinnitus treatment features.
- Tinnitus masking or noise suppression devices are common treatment options for tinnitus sufferers. This type of device is worn in the ear like a hearing aid and produces either a constant signal or tonal beats to compete with the sounds you're hearing. The hearing care professional will use the pitch matching and loudness matching tests to set the signal at a level and pitch similar to the tinnitus you're perceiving.
- Tinnitus Retraining Therapy (TRT)(tm) uses cognitive behavioral therapy alongside a masking device to help a patient learn to ignore the background ringing noise in their ear.
- Tinnitus sufferers can also use a free-standing white noise generating machine. Tinnitus generally worsens when you're in a quiet space, so being able to bathe a room in background sound might be all you need to help you ignore the constant ringing in your ears.
Healthy Hearing answers: Are hearing aids a good tinnitus treatment?
Treating the underlying cause of your tinnitus
Sometimes tinnitus is a symptom of a larger medical condition. In those cases, treating the underlying medical condition may remediate your tinnitus. For example, your doctor may have to remove excess ear wax which has built up and blocked the ear canal, causing hearing loss and a ringing noise.
Tinnitus is a very common side effect of many medications. If you experience tinnitus after starting a new medication or changing a dosage, discuss it right away with your pharmacist or physician to determine if you should stop, reduce or change the medications you are currently taking.
There are many common and less common causes of tinnitus. It is important to recognize the symptoms and see a hearing healthcare professional or physician for a full evaluation to investigate possible causes.
Although drugs cannot cure tinnitus, there are a few that will help suppress the symptoms you are experiencing. Tricyclic antidepressants, like amitriptyline and nortriptyline, are two of the most commonly prescribed medications. If a patient is experiencing severe tinnitus, one of these drugs may be used. However, it's important to know that these medications may come with side effects such as dry mouth, blurry vision and heart issues. Discuss any looming conditions or medications you are currently taking with your audiologist. Niravam and Xanax can also be prescribed, but each of these medications can cause drowsiness and nausea, and they can be habit-forming.
Homeopathy, hypnosis and acupuncture are also thought to suppress tinnitus conditions. Studies have been conducted that show acupuncture can help relieve symptoms of tinnitus, but sufferers should expect to attend 10 to 15 sessions. Homeopathy, which uses plant, mineral and animal material in doses to help relieve ailments, can also be used as a treatment. Some remedies can be used to suppress load roaring noises, echoing, dull humming and other tinnitus symptoms.