Tinnitus is often a symptom of an underlying health condition that involves perception of a sound that often can’t be attributed to a source in the environment. While there is a list of underlying causes associated with tinnitus, it is important to see a physician or an audiologist for a comprehensive evaluation to determine potential associations and discuss management plans moving forward.
What Are Symptoms of Tinnitus?
Tinnitus can be perceived as different sounds and pitches for each individual. The sound can be heard in one ear, both ears, or in the head.
Tinnitus sounds include buzzing, ringing, roaring, and hissing and can be at different pitches (low, mid, or high). In some cases, the sound can rhythmically pulse along with one’s heartbeat, which may suggest blood vessel involvement. Tinnitus can be occasional (every few weeks or months), intermittent (daily or weekly), or constant. Temporary occurrence of tinnitus can occur after loud noise exposure events (e.g. concerts, hunting). Tinnitus is determined to be bothersome if it interferes with one’s quality of life (e.g. sleep, concentration, emotions).
According to the National Institute on Deafness and Other Communication Disorders (2021), approximately “10 percent of the U.S. adult population, or about 25 million Americans, has experienced tinnitus lasting at least five minutes in the past year.”
Tinnitus prevalence increases with age, the highest rate being among those aged 60-69 years old (Bhatt, Lin & Bhattacharyya, 2016; Shargorodsky, Curhan & Farwell, 2010). Hearing loss, age, occupational noise exposure (e.g. agriculture, forestry, fishing, and hunting industries, manufacturing, and musicians), recreational noise exposure (e.g. hunting, motorsports, music lovers), and previous/active military service pose higher risks for developing or experiencing tinnitus.
Other risk factors for tinnitus include heart disease, drugs and medications, ear infections and/or inflammation, head or neck trauma and injury, hyper- and hypothyroidism, loud noise exposure, ear disorders, presbycusis, sudden changes in hearing, and a tumor on the hearing nerve (Hoffman & Reed, 2004).
How Is Tinnitus Diagnosed?
Audiologists are hearing healthcare professionals with the job scope to assess, diagnose, and manage individuals with tinnitus (ASHA, 2018).
If you’re experiencing constant or intermittent tinnitus, discussing it with your physician is important to rule out any underlying medical conditions that could be associated with tinnitus. Because a majority of those with tinnitus have hearing loss, a comprehensive hearing evaluation is recommended to identify if there is a hearing loss.
A tinnitus diagnosis often relies on a patient’s self-report because it is commonly a subjective experience. Questionnaires help healthcare professionals determine the overall burden of tinnitus on a patient’s quality of life and specific areas (e.g. concentration, sleep disturbance, relaxation). These questionnaires are helpful for determining the extent of how impactful tinnitus is on an individual’s life and developing a management plan.
To obtain objective information about a patient’s tinnitus, a tinnitus assessment protocol involves measuring the loudness, pitch, and minimum masking level (the level at which a narrowband noise reduces the perception of tinnitus).
Because tinnitus can also be a symptom of other health conditions or medications, it’s important to work with your healthcare provider to appropriately manage these conditions.
Why is Tinnitus Sometimes Irreversible?
Tinnitus can be short in duration or persist for a long time. Because tinnitus is often a symptom of a chronic disorder (e.g. hearing loss or heart disease), an individual’s tinnitus may be present as long as the chronic disorder is present. However, this does not mean that tinnitus cannot be effectively managed or that it will remain the same over the years. Management of an underlying condition may also reduce tinnitus.
Most commonly, long-term tinnitus is associated with hearing loss. There are several theories about why there is an association between tinnitus and hearing loss. With hearing loss, the usual sound signals being sent to the brain get disrupted. The brain changes itself based on the signals it receives, so tinnitus is thought to be a result of the change in how the brain is hearing sounds with a hearing loss.
How Can You Get Your Tinnitus to Subside?
While there is no single cure for tinnitus, there are many effective management strategies:
- Sound therapy (enjoyable music, white noise such as fans, soothing sounds such as ocean waves crashing)
- Relaxation techniques/stress relief (mindfulness, deep breathing exercises)
- Hearing protection in loud environments
- Healthy diet
- Restful sleep
- Proper management of the health conditions or medications associated with tinnitus
The goal for many effective tinnitus management strategies is to refocus your brain’s attention away from the tinnitus and onto more pleasant activities. Cognitive behavioral therapy is another effective option for those with significantly bothersome tinnitus.
It’s important to work with a healthcare professional on an appropriate tinnitus management plan because each individual has different needs, hearing, and medical histories.
How is tinnitus treated?
The majority of individuals are able to learn to live well with tinnitus. While there is no current clinically proven cure for tinnitus, there are many effective management options for the impacts that tinnitus can have on quality of life for individuals. Because each individual and their experience with tinnitus differs, it’s important to work with a healthcare professional on developing the appropriate treatment and management plan specifically tailored to each person’s needs.
There are experimental therapies focused on electromagnetic stimulation, deep brain stimulation, and vagus nerve stimulation currently being developed, although they are not yet clinically proven to be effective.
What Are Complications of Tinnitus?
Tinnitus can affect an individual’s quality of life by way of emotional distress, poor sleep, difficulty concentrating, poor physical health (associated conditions that may or may not be related to the person’s tinnitus), and economic well-being (effect on work or education, combined with the potential costs associated with tinnitus care and management).
Working with a healthcare provider to manage either the single or multiple associations with tinnitus supports successful outcomes. Additionally, if the proper referrals to appropriate physicians are not made, potential underlying conditions will not be addressed and managed.