The Ultimate Guide to Tinnitus For 2022

What is Tinnitus

According to the National Institute on Deafness and Other Communication Disorders, approximately 25 million Americans (10 percent of the population) were diagnosed with some form of tinnitus-related hearing difficulty lasting at least five minutes in 2008 alone. Yet by 2014, that number had surged to nearly 15 percent.

But the past two years alone have seen an unprecedented amount of stress in our environments, placing an overwhelming strain on both our physical, mental and emotional health. Sadly, few individuals living with tinnitus are entirely unaware that it can impact all aspects of our lives. Chronic tinnitus is far from a benign condition. It’s one whose cumulative effects can be inestimable for millions of people each day.

But while there is currently no known cure, living with tinnitus isn’t necessarily a hopeless proposition. It may require a change in lifestyle and habits, both of which will likely take a certain level of adjustment. But it is manageable—and helping to manage your tinnitus can also have an exponential affect on both your physical and mental wellbeing.

What is Tinnitus?

The most common definition of tinnitus is a sensorineural condition affecting the cochlea of the inner ear, auditory nerves and portions of the brain; most notably the precuneus and related neural networks which govern functions including cognition, memory and sensory perception. While patients diagnosed with tinnitus may frequently experience it as a “ringing” in the ear lasting five minutes or more, it can also manifest as a roar, a hiss or a buzzing sound occurring in either ear at varying degrees of pitch, volume and discomfort.

What Causes Tinnitus?

It’s important to remember that tinnitus is a symptom, not necessarily a cause. And the common assumption that tinnitus is solely the result of consistent exposure to noise isn’t necessarily a correct one. Noise exposure may frequently be at the root of it, but it’s not the only cause. While minor and occasional cases of tinnitus may seem benign, it can be the result of much more severe underlying neurological and physical conditions. And if left unchecked, it may lead to hospitalization and partial hearing loss.

Some of the more common conditions which tinnitus has been linked to include:

• Recurring ear and sinus infections.
• Age-related hearing loss.
• Existing heart disease.
• Fibromyalgia
• Generalized depression and anxiety disorders.
• High blood pressure and cholesterol.
• Hormonal changes (sometimes linked to both menopause and pregnancy.)
• Jaw misalignment, in particular temporomandibular joint (TMJ) disorders.
• Lyme disease.
• Ménière's disease.
• Thyroid abnormalities.
• Traumatic brain injuries.

Wax buildup, stress, excessive alcohol, nicotine and caffeine usage and insomnia as well as other sleep disorders have also been known to contribute to tinnitus. While over 200 different types of medications (including NSAIDs, common antibiotics, some diuretics and certain antidepressants and MAOI inhibitors) have been linked to many instances of tinnitus, there is no conclusive evidence suggesting that both over-the-counter and prescription medications are primary cause of the condition. 

What Are the Different Types of Tinnitus?

There are four primary types of tinnitus: subjective, objective, neurological and somatic. 

Subjective tinnitus is the most commonly reported form of tinnitus and can appear and disappear without warning and for the most part inaudibly, detectable only by the patient themselves. While it’s frequent that subjective tinnitus occurs as a result of prolonged exposure to excessive noise above 85 dB (the maximum threshold for normal hearing,) in some cases it can last no more than 12 months. In severe diagnoses, however, it may last throughout a patients’ life.

Objective tinnitus is a much rarer form of tinnitus, estimated to occur in less than five percent of all cases. Yet it’s also one of the more treatable forms. Unlike subjective tinnitus, the objective form can be heard as a pulse beating synchronously with the heartbeat of a patient. Objective tinnitus is frequently the result of abnormal muscular contractions in the inner ear as well as vascular deformities, both of which can be treatable through surgical procedures and (in some cases) implants.

Neurological tinnitus is typically caused by any number of disorders affecting the connection between the inner ear and the brain’s auditory functions. Some of the more common causes of neurological tinnitus can be the result of acoustic neuroma, multiple sclerosis, head injuries, noise exposure, otosclerosis, meningitis and Ménière's disease.

Somatic tinnitus is a musculoskeletal condition which occurs when contractions of the neck and jaw muscles correlate with the pitch, loudness and other acoustic effects common with subjective tinnitus. While most commonly caused by TMJ disorders, recent studies have indicated that controlled treatment with electroacupuncture and electric nerve stimulations have proven responsive in helping to minimize its effects.  

Two more common forms of tinnitus include pulsatile tinnitus, where ringing aligns directly with a patient’s heartbeat as a result of a change in blood flow to vessels in the ear, and low-frequency tinnitus. The latter has proven a constant source of confusion for both sufferers and audiologists, as the tones take on a droning or humming quality which can’t always be effectively measured either internally or externally. 

When Should I See a Doctor About My Tinnitus?

In some cases, tinnitus is a periodic condition which can occur without warning. It may be bothersome and it may be alarming at first, but occasional flare ups of tinnitus as a result of noise exposure or seasonal changes don’t always need the care of a specialist. Minimizing your exposure to environmental factors and using protective filters and equipment (including earplugs) can help reduce the risk in many instances.  

But chronic tinnitus can have a decisive impact on your quality of life, disrupting daily activities which many of us take for granted. While otolaryngologists (ENTs) will generally be the first specialists to evaluate your case, they may also refer you to a qualified audiologist to review treatment and therapy options.

You should consider scheduling an appointment with an ENT if symptoms of your tinnitus (such as persistent ringing and buzzing in either of your ears) do not disappear within a week, particularly after experiencing an upper respiratory or sinus infection. However, if you’re experiencing vertigo, dizziness, noticeable hearing loss or acute anxiety in conjunction with tinnitus, do not hesitate to contact your doctor’s office immediately. These can be symptoms of a much more serious underlying neurological condition demanding specialized treatment.

Managing Your Tinnitus

While there is no known cure for tinnitus, experimental treatments (including electric and nerve stimulation therapies) are currently being researched by labs in conjunction with ongoing clinical drug trials. But effectively managing your tinnitus can often be a question of reducing harmful environmental factors and behavioral habits to minimize its effect on your life. An ENT or audiologist may suggest some of the following courses of treatment:

Hearing aids, including digital and analog models, are no longer cumbersome or uncomfortable. In recent studies, hearing aid fitting has been indicated to have a success rate of up to 85 percent in relieving the discomfort caused by tinnitus. While hearing aids may be effective in controlling outside sound levels, only an ENT or audiologist can evaluate whether or not they can be an effective treatment if your tinnitus is caused by an inner ear disorder.

• Cochlear implants are sometimes prescribed to patients diagnosed with tinnitus as a result of severe hearing loss. Implants stimulate auditory nerves through electrical signals by bypassing damages to the inner ear, masking the effect of tinnitus and helping to encourage shifts in the neural circuits. 

• Sound generators are a relatively inexpensive method of masking outside noise that some sufferers have found to be effective in managing tinnitus, a conclusion also reached during a recent study conducted by the University of São Paulo. Sound generators come in a variety of apps, including desktop, mobile and wearable programs, and with a variety of sources from barely audible pink noise to soothing natural sounds and music; while sufferers of insomnia and other sleep disorders have also reported that sound masking therapies have been productive in alleviating restlessness and anxiety.

Counseling programs have been known to help individuals facing emotional and mental distress  as a side effect of tinnitus by understanding how the condition occurs and the role it plays in their daily lives. Cognitive behavioral therapy, in particular, can help patients better understand coping mechanisms through relaxation exercises and assessments designed to directly improve the quality of their lives.

In addition, the role that diet, exercise and nutrition play in balancing your mind, body and emotions can’t be underestimated. If you haven’t yet cut back on your alcohol, nicotine or caffeine intake, 2022 is the perfect year to start. While some vitamin supplements (including zinc, magnesium, B12 and ginkgo biloba) have been found to help reduce stress factors, clinical trials have net yet proven their efficacy in combating tinnitus.

Another important part of managing symptoms (and preventing tinnitus in the first place) is using the right hearing protection. EARPEACE music earplugs are comfortable enough to wear all day and night. Earplugs for tinnitus can help both reduce the impact and prevent future damage.

Conclusion

One of the biggest misconceptions about tinnitus is that it results in outright hearing loss. But while the links between hearing loss and tinnitus have been well-documented, it’s not as frequent as you might think. Tinnitus is a symptom—one which doesn’t necessarily lead to outright degeneration of your hearing.

That doesn’t mean tinnitus won’t disrupt your life. The interface between our lifestyle and our health is a delicate one; and any upset to one can have an equal effect on the other. But tinnitus is a manageable condition, no matter how irritating it may seem. It’s not necessarily curable. But recognizing it and adjusting to it can make all the difference in your life and wellbeing. That’s the first step. The second?

Enjoying that difference.