Tinnitus Treatment and Rehabilitation
It is important to understand that tinnitus is a symptom, not a disease. As such, the optimal treatment strategy should be directed toward eliminating the disease, rather than simply alleviating the symptom. Also, because tinnitus may be symptomatic of a more serious disorder, it is important to find the medical cause before deciding on treatment.
While there is no known cure for most forms of tinnitus, there are many management options available and most tinnitus sufferers can find varying degrees of relief from one or a combination of the following.
The quality of the tinnitus refers to the description by the patient of the tinnitus. It may be a ringing, buzzing, cricket, ocean, or other type of sound. Also, the quality may be multiple sounds or a singular sound. Tinnitus is a very common disorder, and may be:
- Intermittent, constant, or fluctuating
- Mild or severe
- Varied in nature, from a low roaring sensation to a high-pitched type of sound
- Associated with a hearing loss
Tinnitus is an abnormal perception of a sound, which is reported by patients as being unrelated to an external source of stimulation. 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. Tinnitus will not cause you to go deaf, and statistically, 50 percent of patients may express that their tinnitus decreases or is hardly perceptible as time passes.
Preventing and Minimizing Tinnitus
Here are a few things patients can do to help prevent and minimize tinnitus:
- Reduce exposure to extremely loud noise
- Avoid total silence
- Decrease salt intake
- Monitor one’s blood pressure
- Avoid stimulants such as caffeine and nicotine
- Reduce fatigue
- Manage stress
- Educate yourself
Types of Tinnitus
Tinnitus is also classified further into subjective or objective types.
- Subjective tinnitus – This is a noise perceived by the patient alone and is quite common.
- Objective tinnitus – This is a noise perceived by the patient as well as by another listener. This form of tinnitus is relatively uncommon, and the location of tinnitus may be in the ear(s) and/or in the head.
Tinnitus is a Symptom
Tinnitus is a symptom of neurologic disease. It may occur with a hearing loss, vertigo, or pressure symptoms in the ear or it may occur alone. This condition must always be thought of as a symptom and not a disease, just as pain in the arm or leg is a symptom and not a disease.
Because the function of the auditory (hearing) nerve is to carry sound, when it is irritated from any cause, it produces head noise. This phenomenon is similar to the sensation nerves elsewhere. If one pinches the skin, it hurts because the nerves stimulated carry pain sensation.
There is no single medication that works on all tinnitus patients. Some of the antidepressants and anti-anxiety medications available are helpful for certain tinnitus patients, however more research is needed in this area.
Auditory Habituation or Tinnitus Retraining Therapy
These techniques consist of two main components — directive counseling and low level sound generators.
- Directive counseling provides intensive, individualized education regarding the causes and effects of tinnitus on the ear, the brain, and the coping mechanism.
- Low-level sound generators produce broadband noise via hearing aid type devices at a soft enough level so that the brain perceives both the noise and the tinnitus. Eventually, the brain may relearn a pattern that will de-emphasize the importance of the tinnitus. These devices also may be helpful in desensitizing patients who are overly sensitive to sound.
The use of an externally produced sound to either cover up or in some way inhibit or alter production of tinnitus can offer relief for some. There are six main methods of acoustic stimulation.
- A sound generator, sometimes called tinnitus masker: an ear-level electronic device housed in a hearing aid case that produces a white noise.
- A tinnitus instrument: a combination hearing aid and sound generator.
- Hearing aids: help to amplify speech as well as environmental noise and thus stimulate areas of the ear and brain that otherwise may not be receiving adequate stimulation because of the hearing loss.
- A tabletop or portable sound generator: these can be purchased at certain electronic suppliers such as the Sharper Image.
- Home masking: such as the use of electric fans, radios or television.
- Music therapy (see below).
Unfortunately, some tinnitus sufferers find that masking noise may merely be a substitute of one annoying sound for another. It is thus better to try to relegate the annoyance of tinnitus to the background of one’s consciousness through habituation or retraining methods.
Many patients find that music, particularly classical passages that don’t contain wide variations in loudness (amplitude) can be both soothing to the limbic system (the emotional processor in the brain that is commonly negatively linked to a patient’s reaction to tinnitus) and stimulating to the auditory cortex. If a hearing loss is present, it may be necessary to alter the spectrum of the music so that the cortical neurons.
The use of hearing aids and a combination of hearing aids and maskers are often effective ways to minimize tinnitus. While it is not clear whether hearing aids help by amplifying background sounds that can mask out the tinnitus or by actually altering the production of tinnitus, most hearing aid wearers report at least some reduction in their tinnitus. This may be due to the reduction in contrast between tinnitus and silence, or because of the new stimulation provided to the brain.
Regardless of the cause of tinnitus, if a person is not bothered by the tinnitus, it ceases to be a problem. Psychological intervention aimed at successfully reducing the stress, distress and distraction associated with the tinnitus can be very productive and often produces the most attainable goals.
The very high correlation between stress and tinnitus disturbance underscores the need to maintain one’s composure and logic when trying to cope with tinnitus. Relaxation, guided imagery and self-hypnosis are examples of self-help methods used to help combat the stress, anxiety and sleep disturbances associated with tinnitus.