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Tinnitus Treatment

The Facts About Tinnitus

My Ears Are Ringing: The Facts about Tinnitus

Tinnitus (literally “ringing” in Latin) is characterized by ringing, buzzing, or noises that originate in the ear or the head, and can cause discomfort and stress. Tinnitus is an abnormal perception of a sound that is unrelated to an external source of stimulation. Tinnitus is a very common disorder. Roughly 25 million Americans have experienced tinnitus. Some cases are so severe that it interferes with their daily activities. People with severe cases of tinnitus may find it difficult to hear, work, or even sleep. It may be intermittent, constant or fluctuate, mild or severe, and may vary from a low roaring sensation to a high pitched type of sound. It may or may not be associated with a hearing loss.

Though this condition is usually not dangerous, it can be a symptom of another health problem or underlying condition. Tinnitus can cause many stressful side effects, including fatigue, sleep problems, concentration difficulty, memory problems, depression, anxiety, and irritability. Though it's not necessarily serious, it can be quite debilitating.

Tinnitus is a symptom much like a headache, pain, temperature, hearing loss or vertigo. With tinnitus, the reported distress is usually subjective and difficult to record and appreciate by others.The quality of the tinnitus refers to the description by the client of the tinnitus: It may be a ringing, buzzing, cricket, ocean, etc., type of sound. The quality may be multiple sounds or a singular sound.

What Causes Tinnitus?

Tinnitus may originate from various lesions and from different sites. The auditory system involves highly complicated inner ear structures, many afferent(to the brain) and efferent(away from the brain) nerve pathways and a great amount of nuclei that form a complex mesh-work. We have heard it said that tinnitus has been localized to at least 29 areas in the auditory system. To pinpoint tinnitus to a certain structure becomes difficult. This is demonstrated by clients who have had intractable tinnitus after having surgery on their ear or incurring severe diseases of the ear. In an attempt to relieve the tinnitus, cutting the auditory nerve has been done and yet the tinnitus was persistent, indicating the site of lesion causing the tinnitus must have shifted into the central nervous system.

Tinnitus could be explained by abnormal neural activity in the auditory nerve fibers, which may occur if there is a partial breakdown of the myelin covering of individual fibers. A defect in the hair cell would trigger the discharge of connected nerve fibers. For chronic cochlear disorders, there may also be increased spontaneous activity in the hair cells and neurons resulting in tinnitus. In the auditory nerve there are two different kinds of afferent fibers: Inner hair cell fibers with large diameters and outer hair cells fibers with small diameters. Thus, loss of signals from the cochlea might trigger tinnitus as a manifestation of a functional imbalance between the two sets of fibers. In addition, other abnormal changes of the cochlear fluids may result in tinnitus.

There is not one type, one site or one origin of tinnitus, but a multitude of types, sites, and origins. It is also unlikely that one hypothesis on the cause of tinnitus could explain all the features.

To determine your case, your doctor may begin investigating the condition to assess what kind of tinnitus you suffer from. There are two general types of tinnitus: subjective and objective tinnitus.

Subjective tinnitus means that only you can hear the noise or ringing in your ears (most common). Objective tinnitus means that it may be possible for your physician to also hear the noise or ringing while performing an exam (less common).

Tinnitus can also be caused by certain medications and a variety of health problems. Your physician will take a detailed history of your health and medications, perform a thorough examination, and possibly order a hearing test or or conduct other tests of the auditory system.

What causes tinnitus?

  • Hearing loss. Most people who have tinnitus also have some kind of hearing loss.
  • Loud noise. Exposure to loud noise can cause permanent hearing loss and tinnitus. Continued exposure can make the tinnitus and hearing loss get worse.
  • Medicine. More than 200 medicines, including aspirin, can cause tinnitus. If you have tinnitus and you take medicine, ask your doctor or pharmacist whether your medicine could be involved. 
  • Other potential causes. Allergies, tumors, problems in the heart and blood vessels, jaws, and neck can cause tinnitus.

What should I do if I have tinnitus?

The first step is to see an Audiologist or hearing specialist for an evaluation or consultation. A careful history and audiometric testing will lead to the most likely causes and best treatment for your tinnitus. Discuss the results with your hearing specialist You may be referred to an ear, nose and throat examination to complete the diagnosis.

How will hearing experts treat my tinnitus?

Although there is no cure for tinnitus, audiologists, hearing specialists, scientists and doctors have discovered several treatments that may give you some relief. Not every treatment works for everyone, so you may need to try several to find the ones that help.

Treatments can include:

Hearing aids. Most people with tinnitus have some degree of hearing loss. Hearing aids create a dual benefit of enhancing hearing and masking or covering up the tinnitus. The majority of patients with tinnitus receive partial or complete relief from their tinnitus with the use of hearing aids.

Maskers. Tinnitus maskers are small electronic devices that look like hearing aids and are tuned to generate sound that masks or covers up the tinnitus. Like hearing aids, they may provide relief from the tinnitus, but will not enhance hearing and may interfere with understanding speech. Many types of devices, such as fans, radios and sound generators can be used as tinnitus maskers to help tinnitus sufferers to fall sleep or get back to sleep.

Medicine or drug therapy. Some tinnitus sufferers develop anxiety and other strong emotional responses to their tinnitus. Certain medicines may provide relief from these emotional reactions and provide some relief from the tinnitus. Other medicines and nutritional supplements have provided relief in some patients.

Neuromonics Tinnitus Therapy. This treatment uses a combination of testing, counseling and specialized masking to help you to effectively manage and gradually reduce your response to the tinnitus. This treatment can take six months or more to complete but has the highest rate of success.

Counseling. People with tinnitus may experience anxiety, depression and other psychiatric problems. You may be referred to a psychiatrist our counselor as needed.

Relaxing. Learning how to relax is very helpful if the noise in your ears frustrates you. Stress makes tinnitus seem worse. By relaxing, you have a chance to rest and better deal with the sound.

What can I do to help myself?

Think about things that will help you cope. Many people find listening to music very helpful. 

Focusing on music might help you forget about your tinnitus for a while. It can also help to mask the sound. Other people like to listen to recorded nature sounds, like ocean waves, the wind, or even crickets.

Avoid anything that can make your tinnitus worse, such as smoking, alcohol and loud noise. If you are a construction worker, an airport worker, or a hunter, or if you are regularly exposed to loud noise at home or at work, wear ear plugs or special earmuffs to protect your hearing and keep your tinnitus from getting worse.

If it is hard for you to hear over your tinnitus, ask your friends and family to face you when they talk so you can see their faces. Seeing their expressions may help you understand them better. Ask people to speak louder, but not shout. Also, tell them they do not have to talk slowly, just more clearly.

What is the next step?

Discuss the results with your hearing specialist.

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