What is tinnitus?

Tinnitus is essentially any sound that you hear in your head or ears which is not audible externally. It may be noticeable in one ear or both, or feel like it’s in the centre of your head. People report many different types of sounds, but tinnitus is frequently described as ringing, clicking, buzzing, crickets or roaring sounds.

Many people have tinnitus. Figures regarding the prevalence of tinnitus vary, but most studies estimate that 10-15% of the population have fairly constant tinnitus, although most people don’t generally find it a problem (Andersson et al 2005). Our hearing system tends to filter out sounds that are unimportant, so most people are able to tune out to their tinnitus after a while (habituation). However if you are anxious or concerned by your tinnitus, your brain may treat the tinnitus as an important sound, making it difficult for you to tune out to it.

Why do I get tinnitus?

There are many different causes of tinnitus. We do know that tinnitus can be linked to exposure to loud noise, hearing loss, ear or head injuries, some diseases of the ear, ear infections or emotional stress. It can also be a side effect of medication or a combination of all of these things.
However many people with tinnitus have never experienced any of the above. Tinnitus is rarely linked to any serious problem and people usually learn to manage it quite successfully.
Some of the known causes of tinnitus include:

Ear infections

If you have an ear infection it can cause discomfort and tinnitus and may lead to hearing loss, especially if it is left untreated. It is important to visit your GP, who will be able to treat the infection.

Noise exposure

There is a lot of evidence to connect continued exposure to noise with hearing loss and tinnitus. Loud sounds can damage your hearing, especially if you listen to them for hours at a time. 
Many people will experience temporary tinnitus after being exposed to loud noise. This usually goes away after a short time but can be a warning that you have been exposed to too much noise.
It is important to avoid excessive exposure to very loud noise (both industrial and recreational). Ear muffs and ear plugs are readily available and should be used if you are in noisy environments. Some people may find custom made earplugs are a more comfortable option.

Stress

Most people have some stress in their lives, it is almost unavoidable. While stress does not directly cause tinnitus, it can make it worse. Many things can cause stress and significant periods of stress or stressful events have been known to trigger tinnitus.
Tinnitus in itself can make people feel stressed.  This is why stress management is an important part of tinnitus management. By learning to relax and take control you can help your body and brain manage your tinnitus.

Drugs

Your GP will be able to talk to you about any possible side effects of drugs that you have been prescribed.  Although a large number of drugs list tinnitus as a possible side effect, not everyone will develop tinnitus as a result of taking that particular drug.
If you are concerned that a drug you have been prescribed is making your tinnitus worse, you should discuss this with your GP. You should not alter the dose of any medication you are taking, or stop taking it, unless the GP who prescribed the medication agrees it is safe to do so.

Will Tinnitus Cause Me to Lose My Hearing?

No, but tinnitus may be worse with a loss of hearing. The majority of people with severe tinnitus also experience some hearing loss, usually in the high frequencies, which may be produced by exposure to loud sounds as well as the ageing process.

Is Tinnitus Interfering with My Hearing?

No, tinnitus does not interfere with hearing, although it may affect your attention span. On the other hand, tinnitus will seem worse if your hearing loss increases because outside sounds will no longer cover up the tinnitus.

What is involved in a tinnitus assessment?

Your audiologist will conduct a thorough assessment and advise you of the most appropriate management options. A full tinnitus assessment takes 1.5 – 2 hours and includes:

• a thorough case history – this helps to determine how the tinnitus is affecting you as an individual
• full hearing assessment, including high frequency audiometry
• pitch matching of the tinnitus
• assessment of how much sound is required to cover the tinnitus
• measurement of your sensitivity to loud sounds
• recommendations for managing the tinnitus

Tinnitus is rarely an indication of a serious disorder, but your audiologist will recommend that you see your GP if there are any areas of concern. Should something be causing your tinnitus that could be medically treated, you might be referred to a specialist.

Relieving Tinnitus

Tinnitus does not interfere with the enjoyment of life for the majority of people who experience it. The goal of treatment is to help patients to understand and gain control over their tinnitus, rather than it having control over them. Ultimately we hope to help patients progress to the point where tinnitus is no longer a negative factor in their lives.
There are effective management strategies which can help to reduce the disturbance associated with the tinnitus. Recommendations will vary depending on how the tinnitus is affecting the individual.

Education

Research has indicated, that people with a low level of disturbance from their tinnitus, can benefit significantly from education about the tinnitus. This can help to lessen any anxiety associated with the tinnitus and promote habituation.

Environmental Sound Enrichment

Environmental sound enrichment uses the addition or enhancement of external sounds that can reduce the perception of tinnitus. It is available in several forms including hearing aids, CDs, and bedside units that can help with sleep or concentration; and pillows embedded with small speakers that can plug into a CD player, MP3, or sound generator.
Comprehensive treatment programs
For people who are finding that their tinnitus is significantly impacting on their quality of life, a more comprehensive treatment programme may be appropriate. Lions Hearing Clinics offers the Neuromonics tinnitus treatment, which has been shown to provide significant reductions in tinnitus disturbance in suitable individuals. Your audiologist can advise if this is suitable for you following a thorough tinnitus assessment.

Medical Intervention

If there is a possibility that the cause of tinnitus can be treated medically, this approach will be explored thoroughly.

Stress management

Many people find their tinnitus is more noticeable when they are tired or stressed. Relaxation exercises and stress management techniques can assist in bringing it down to a more manageable level.

Counselling 

Can include cognitive therapy, relaxation therapy, biofeedback, hypnosis, and stress reduction techniques
Avoiding Loud Sounds
Wear earmuffs or earplugs when using chain saws, guns, lawn mowers, loud music or power tools. Exposure to loud sounds can make tinnitus worse and can also cause additional hearing loss.

If you would like more information on tinnitus or to book for a tinnitus assessment please ring one of the Lions Hearing Clinics.

Reference: Andersson, G., Baguley, D., McKenna, L & McFerran, D. Tinnitus: A multidisciplinary approach. 2005 Whurr Publishers Ltd.

Links:  
http://www.tinnitus.org.uk/
http://www.tinnitus.org/
http://au.neuromonics.com/