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Guide to Tinnitus

Tinnitus is not a widely understood or discussed medical condition. However, according to the National Institute for Health & Care Excellence (NICE), it affects 7.1 million people in the UK.

The risk of developing tinnitus increases with age, but it can happen in children as well as adults. It is also equally likely to affect women and men.

Here, we look at what is tinnitus, what causes it, and whether there are treatments for this medical condition.

Meaning of tinnitus

The British Tinnitus Association describes it as “the sensation of hearing a sound in the absence of any external sound.”

There is a misconception that this is always a ringing in your ears. In fact, the sound you hear when you have tinnitus could be buzzing, whistling, humming, roaring or ‘swooshing’. In less common cases, tinnitus can be musical in its effect, and even sound like a familiar tune. This is known as ‘musical tinnitus’ which generally happens to older people with a strong interest in music.

How loud the sound is, varies from person to person, and can be a whisper or highly intrusive. Also, tinnitus can be intermittent and doesn’t have to be a continuous noise.

Some people experience it in one ear, or both, while others report that the noise appears to be difficult to pinpoint or central in their head.

Tinnitus causes and symptoms

When people first experience the sounds associated with tinnitus, they often look for an external cause. For example, hunting through their home for something that is ringing or buzzing, or asking others to help them to identify its source.

In fact, the sound is internal and can only be heard by you.

Some people have an episode of tinnitus, and then it goes away. While others have this condition for the rest of their life. Fortunately, many people with long-term tinnitus become accustomed to it and can carry on their normal daily activities unhindered. More on this later.

At present, little is known about the cause of tinnitus. Though evidence suggests you are more at risk of developing it if you have existing hearing loss or an auditory health issue. This in turn is often something that occurs as we age.

A widely held theory is that tinnitus is linked to the way our brains process sensory information, in this case, sound. Normally, our brains make sense of what we are hearing, and either create a memory or initiate a task. The brain filters out any ‘unwanted’ background sound too, to focus on what is necessary.

If you have a head injury, an ear health issue, or some other illness, this sensory processing system can ‘malfunction’. The brain becomes ‘stuck’ trying to identify or use a sound and continues to ‘hear’ it.

In other words, the belief is that tinnitus is not a defect in the mechanisms of your ear, but is actually a sensory processing ‘blip’ in your brain.

This also means you can get tinnitus after a period of prolonged stress for example, or it can result from Post-Traumatic Stress Disorder (PTSD). PTSD from situations involving loud noises – like explosions – can potentially increase the risk of getting tinnitus.

Tinnitus as a symptom of stress, PTSD or an ear infection, can be temporary. Why it becomes a lifelong medical condition for some people is a bit of a mystery. This is true of many health issues resulting from brain activity.

Tinnitus diagnosis and treatment

If you experience a sound that is not coming from an external source, it is important to raise that issue with your GP. Various tests would be carried out, your auditory system would be examined, and a full medical history would be taken.

Then, your GP may refer you to an Ear, Nose and Throat (ENT) specialist for further tests. These can check to see if there are underlying problems, and will evaluate your level of hearing. You may also need an MRI scan to check the mechanisms in your ear.

If there is an infection or some other physical issue, you can have treatment for that, which may stop the tinnitus. It could be that a foreign body in your ear, or an inflammatory condition, can be dealt with to alleviate your tinnitus.

You may also be advised on how to tackle stress and PTSD if they are a factor.

However, there is no medication or procedure that can ‘heal’ tinnitus that continues after initial treatment for an associated problem. Or indeed, if your tinnitus has no obvious cause.

Can it indicate a serious medical problem?

It is rare for people who experience tinnitus to then be diagnosed with a major medical condition.

However, if the tinnitus is linked to age-related degenerative hearing loss, benign (non-cancerous) tumours in your brain or an otosclerosis growth in your middle ear, then it is more problematic to deal with.

Some people have a rare medical condition known as pulsatile tinnitus. It’s linked to blood flow and your pulse rate and can be due to anaemia, blocked arteries or high blood pressure (hypertension).

If you did have a more serious medical condition, particularly in terms of growths, you would usually have other signs and symptoms too, such as problems with balance or speaking.

Living with tinnitus

The first evidence of tinnitus can be on a scale of mildly irritating, to very distressing. It can also be a distraction and make you less confident socially.

Living well with long-term tinnitus means trying to ignore it, You may find that making small adjustments help you to ‘get used’ to the sound. For example, having background music on when you do tasks, so that is what you focus on.

This is logical really. In quiet situations – when there are no physical sounds to process – your tinnitus sound will seem more stark and obvious.

Mention has already been made of the connection between stress and tinnitus. It stands to reason that if you become anxious and very conscious of it, the sound can appear louder and more intrusive. The more you relax, the less obvious it should start to become.

Many people find that eventually, it goes away, or that they notice it less and less.

Also, if your tinnitus is a symptom of hearing loss due to an irreparable problem with your ear mechanisms, you may be issued hearing aids. These can make your tinnitus ‘sound’ less noticeable.

Sleep and tinnitus

One of the most unpleasant side effects of tinnitus is that it could interfere with your normal sleep pattern. Either by reducing your ability to fall asleep or by waking you during the night.

It can become even more of a problem if you start to get anxious or over-tired, and your internal sound, therefore, seems even more intrusive.

The best way to get a healthy night’s sleep with tinnitus is to learn and then use appropriate relaxation methods. This could be breathing exercises or low-key music when you first go to bed, for example. Some people find soft, soothing sounds transmitting all night helps to address the effects of tinnitus.

Keeping to a regular sleep routine is also recommended, as you may be able to train yourself to ignore the sound as your body instinctively gets ready to rest.

More tips on managing tinnitus

The best ways to prevent tinnitus include avoiding loud noises, particularly prolonged exposure to sound levels that can lead to hearing loss.

Following diagnosis, as with many other medical conditions, chatting with others in the same position can sometimes help. Support groups for tinnitus enable you to feel less alone and could provide ideas for what worked for other people.

Unfortunately, severe long-term tinnitus – though rare – can be debilitating. Making it hard to concentrate at work, or on conversations for instance. This can lead to depression, and it is important to seek help if your mental health does start to suffer.