Overview

Tinnitus is a condition where a person hears sounds internally that are not as a result of external noises and therefore cannot be heard by others.  Different people can hear different sounds as well as different pitches and volume. 

It is more common in adults and the older you get the more likely you are to develop the condition.  It affects people without hearing difficulties and around seventy percent of those who do have some form of hearing loss are also likely to have tinnitus.  There are two types of tinnitus the most common is called subjective tinnitus and can only be heard by the person who has it.  Objective tinnitus affects the blood flow in the vessels near the ear, so can be heard by a doctor with the use of a stethoscope and is rarer.

Symptoms

Symptoms of tinnitus can vary amongst individuals both in the type of sound they hear whether it affects just one or both ears, or if it only happens occasionally or is present permanently.  The sounds people hear are most often described as sounding like:

·      Buzzing

·      Chirping

·      Clicking

·      Grinding

·      Hissing

·      Humming

·      Ringing

·      Roaring

·      Whistling

Some people have even said they hear sounds that sound like singing or music but this is rare.

What makes symptoms worse

Loud noises can mask symptoms initially but will make them worse long term, and silence can often accentuate them.  Some people have also reported that their symptoms can worsen when they drink alcohol, smoke cigarettes or eat certain foods, and when they feel tired or stressed.

Causes of Tinnitus

There are a number of reasons why a person can develop tinnitus it’s how the brain responds to damage to the nerves or other parts of the ear that control hearing.  Ear damage caused by loud noises is the most common cause, this is because long term exposure can cause irrevocable damage to the cochlea, the spiral shaped organ in the inner ear.  It’s believed that a high percentage of people who have tinnitus have some level of noise induced hearing loss.  Other reasons for the condition developing can include:

Getting older

As we age the nerve fibres and cells in the inner ear that help you to hear sounds can break down which can result in hearing loss and tinnitus.

Ear infections or blockages

Ear and sinus infections along with a build up of wax, dirt or foreign objects can affect the pressure in your ear causing tinnitus.

Head or neck injuries

Suffering trauma or injury to the head or neck, can cause damage to nerves and muscles or affect blood flow which can cause headaches and memory problems and can result in tinnitus, which will usually only affect one ear.

Other medical conditions

Whilst less common tinnitus can be a symptom of other ear conditions, chronic health conditions, or illness which can include:

·      Allergies

·      Anaemia

·      Autoimmune disorders like rheumatoid arthritis or lupus

·      Blood vessel disorders such as high blood pressure or atherosclerosis

·      Cardiovascular disease

·      Circulatory problems

·      Diabetes

·      Fibromyalgia

·      Hormonal changes

·      Low vitamin levels

·      Meniere’s disease caused by abnormal fluid pressure in the inner ear

·      Migraine

·      Otosclerosis which causes the stiffening of the small bones in the middle ear

·      Temporomandibular joint disorders

·      Traumatic brain injury

·      Under or overactive thyroid

Prescribed medications

There are several types of medicines that can cause tinnitus, they can cause the condition either when you start or stop taking them, and it can be temporary or permanent, depending on the type of medication and the dosage taken.  Examples can include but are not limited to:

·      Antibiotics

·      Antidepressants

·      Chemotherapy drugs

·      Diuretics

·      Pain medications such as aspirin, ibuprofen and naproxen

·      Quinine medications

Risk factors and complications

Tinnitus can affect people differently depending on how well they are able to manage their symptoms.  For some it can have a negative affect on the quality of their daily life and lead to them to develop conditions such as:

·      Anxiety and irritability

·      Concentration and memory difficulties

·      Depression

·      Fatigue and sleep issues

·      Headaches

·      Insomnia

·      Problems coping with family, work and social life

·      Stress

Risk factors can include your age, being male as it is more common in men than women.  Having certain health conditions, smoking and drinking alcohol can also increase your chances of developing tinnitus.  Exposure to loud noises especially if you work in an industry or have a profession where you are regularly exposed to them such as:

·      Construction work

·      Factory work

·      Tree felling or landscape gardening

·      Musicians

·      Pilots

·      Soldiers

Diagnosis and available treatments

A doctor will diagnose the condition based on your symptoms and a physical examination. They may refer you for tests such as an audiology test, blood tests, or an MRI or CT scan to rule out any underlying medical condition.  Whether your doctor is able to cure your tinnitus will depend on the reason that is causing it.  In some cases if it has been caused by ear wax or a cold it can go away on its own, if its cause can be treated then symptoms may improve.  In the majority of cases however the condition is often permanent and treatment consists of managing the symptoms to try and make them less noticeable.

There are a variety of treatments available and which one will work best for you can be dependent on you age, physical health and the severity of your symptoms.  Treatment options include:

·      Hearing aids if symptoms are caused by hearing loss due to age or noise damage

·      Masking devices which produce continuous low level white noise that helps to suppress symptoms and are worn in the ear

·      White noise machines can be helpful to aid sleep as they produce sounds like falling rain, ocean waves or sounds similar to static

·      Ear wax removal can reduce symptoms caused by build up

·      Stopping or changing medications that are causing symptoms can reduce or stop them

·      Whilst there are no medications to treat tinnitus antianxiety or antidepressant medications can help to make symptoms more manageable

·      Surgical intervention for blood vessel conditions or tumours

Counselling and therapy can also help people to live with their symptoms and change the way they feel about them, therapies that have proven successful include:

·      Tinnitus retraining therapy

Which uses a combination of counselling and maskers and is performed by an audiologist and involves wearing a masking device whilst having a counselling session.

·      CBT (cognitive behavioural therapy)

Involves a mental health therapist helping you to learn coping techniques that will enable you to better deal with your symptoms, as well as managing any associated anxiety or depression.  Written by Jan, Jeana and Wendy at Barnsley Hypnosis and Counselling (UK). For more free Information click above link.