Why are My Ears Ringing? Managing Tinnitus
Tinnitus is a common condition that affects around 25 million Americans each year. Although not life-threatening, it can be extremely unpleasant and debilitating.
Luckily, up-to-date management and treatment mean the condition can often be cured completely, or the severity of the symptoms reduced.
Here we take a look at what tinnitus is, the causes of tinnitus, who is at most risk of developing the condition, and what treatment options and management are currently available to treat the problem.
What is Tinnitus?
Sufferers from tinnitus hear ringing or other noises, that aren’t from an external source and that can’t usually be heard by other people. The exception to this is pulsatile tinnitus, where sufferers hear sounds that coincide with their heartbeat (typically a swishing or whooshing noise). In cases of pulsatile tinnitus, a doctor can usually hear the noises when performing an examination of the patient). The noises may be continuous or intermittent. The volume and pitch may vary.
Although most people describe tinnitus as a ringing noise, some people describe their tinnitus as hissing, roaring, buzzing, or clicking.
The severity of tinnitus, and the extent to which it affects a sufferer’s quality of life, vary enormously. Some people find that their tinnitus causes relatively few problems and may resolve spontaneously. Others are unable to hear external sounds properly due to their tinnitus and find the volume and duration of the tinnitus noises extremely difficult to live with.
Causes of Tinnitus
Tinnitus is caused by damage to one or more parts of the body that control hearing, or as a side effect of some medications. The damage may be permanent, chronic, or temporary.
Typical causes of tinnitus include:
- An ear, nose, throat, or respiratory infection of some sort.
- Neck or head injuries.
- A blockage in the ear canal (usually a buildup of ear wax, but may also be due to the presence of a foreign object).
- Damage to the delicate hairs (cilia) in the inner ear (the cochlea). The hairs move in response to sound waves, converting mechanical (sound wave) energy into electrical energy, that’s then passed through nerves to the brain, where the signal is interpreted. The main cause of cilia damage is loud and/or prolonged noise.
- A side-effect of some medications, most notably antibiotics, anti-viral medication, painkillers, and medicines used for heart conditions. Some chemotherapy drugs and anti-inflammatory drugs may also cause tinnitus.
- Chronic conditions such as diabetes or Meniere’s disease.
- Degeneration of the inner ear due to age.
- Excessive bone growth in the inner ear.
- Mental health problems, such as anxiety and depression.
Who is at Risk of Developing Tinnitus?
People Exposed to Loud Noise
It’s well-known that exposure to loud noise causes damage to the cilia found in the inner ear. The louder the volume of a noise, the greater the amount of mechanical energy that reaches the cilia via sound waves. This energy can damage the cilia, which means they don’t work as effectively. Once cilia are damaged, they don’t recover.
Damage that causes tinnitus can occur after a single exposure to loud noise (such as a rock concert), and/or by repeated exposure. The CDC indicates that noises of around 70 decibels or more (so the noise of a washing machine, for example), can cause damage if individuals are exposed for prolonged periods of time. Noises of 120 decibels or more (such as being near a firecracker when it explodes or being close to emergency sirens) can cause immediate damage.
Anyone exposed (or who exposes themselves) to excessive noise increases their risk of tinnitus. Construction workers, soldiers, people who use heavy machinery, and people who work in noisy environments are particularly vulnerable.
Broadly speaking, the risk of tinnitus increases with age. Sometimes this is due to age-related degeneration. In other cases, cumulative damage results in tinnitus developing. Older people are also more likely to develop conditions such as Type II diabetes and high blood pressure, both of which increase the risk of tinnitus.
Treatment and Management of Tinnitus
In some cases, once the underlying cause of the tinnitus is resolved (if an inner ear infection is successfully treated with antibiotics, for example, or earwax that’s causing a blockage removed), the tinnitus will disappear spontaneously.
In other circumstances, tinnitus may resolve spontaneously, for no obvious reason.
Mild and/or intermittent tinnitus doesn’t usually require treatment. The condition isn’t dangerous and, as long as it’s not interfering with everyday activities, there’s no need to manage it.
If sufferers are experiencing significant and/or prolonged tinnitus, that can’t be cured by treating any underlying conditions and is affecting their quality of life, the following treatment and management options are suggested:
- Medication – alprazolam, lidocaine, misoprostol, or Elavil have been found to relieve tinnitus for some sufferers.
- Hearing aids – in some cases, suitable hearing aids can help to alleviate symptoms.
- Behavioral therapies – some people find therapies such as CBT (cognitive behavioral therapy), tinnitus activities treatment (TAT), acceptance commitment training (ACT), or Mindfulness-Based Stress Reduction (MBSR) helpful in minimizing the impact of tinnitus symptoms.
- Sound therapies– techniques such as neuromodulation, distraction, or habituation may all help to lessen the impact of tinnitus.
- Vagus nerve therapy – this is a new treatment that involves implanting a device that stimulates the vagus nerve.
- Avoid spending time in total silence, as this can increase focus on tinnitus noise.
- Practice relaxation and mindfulness techniques, both of which can help distract sufferers from tinnitus.
- Avoid loud environments, as these can make tinnitus worse.
- Join a support group – the American Tinnitus Association holds details of local groups.
- Sound masking machines – these create a pleasant background noise that some sufferers find reduces the impact of the tinnitus symptoms.
If you suspect that you are suffering from tinnitus, it’s important to consult your physician promptly. They will be able to accurately diagnose the cause of your symptoms, as well as recommend the type of treatment or management that’s likely to deliver the best outcomes.
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