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Hearing tinnitus, the sounds perceived inside your ears or head, can be unsettling, especially when things are quiet around you.
The good news is what you’re hearing is genuine, and there is a clear reason for it.
This short guide explains how the ear and brain create the sounds of tinnitus (ringing, rushing, clicking etc), and why it seems louder sometimes. It’s important to know that something can be done for tinnitus. With evidence-based assessment and treatment by an audiologist, the impact of tinnitus can lessen over time.
If you would like to know more about what’s happening when you experience tinnitus, click here for a free instant downloadable ebook from our free resources page.
Two classifications of tinnitus & common causes within each:
Tinnitus is usually sorted into two types, depending on whether a medical cause can be found. This is the classification your doctor and audiologist work from to make decisions about treatment (Tunkel et al., 2014)
Primary tinnitus: This is the most common and often exists with some degree of hearing loss from noise exposure or the natural changes with aging. Some people with tinnitus have normal hearing however. The defining feature of primary tinnitus is that no specific cause is found when assessed medically.
For this classification of tinnitus, therapy focuses on managing the way you perceive tinnitus loudness or intrusivenness (using sound therapy, mindfulness, distraction and other skills), and working with the reactions that can cause distress (using CBT for tinnitus primarily).
Secondary tinnitus: This tinnitus is linked to a specific cause that can be found and diagnosed. examples include:
Build-up of ear wax
Middle ear infection
Meniere’s disease
Otosclerosis
Jaw issues such as TMJ
Certain medications (for example, Aspirin can cause tinnitus in some people)
Eustachian tube dysfunction
Somatic/ muscular disorders of the middle ear and or neck
Vascular (can cause pulsatile tinnitus).
Finding and treating the cause is important and your doctor will help in this process.
When to see your doctor:
Most tinnitus is not a sign of anything dangerous. Even so, some patterns need a doctor to assess your symptoms. These include:
Tinnitus in one ear only
A pulsing or whooshing sound that is in time with your heartbeat
Tinnitus that starts suddenly
Sudden hearing loss (see a GP or emergency medical centre immediately)
Dizziness, or balance problems
Tinnitus with facial weakness or numbness
Tinnitus that’s causing you distress, low mood, or trouble sleeping.
Your GP can check for earwax, medication effects, possible ear conditions, and refer you to an ENT speclialist if needed.
What to do next:
Many people have been told there’s nothing you can do about tinnitus, but this is not based in evidence.
Treatments ususally combine the following elements: sound therapy, CBT for tinnitus which is a structured treatment plan to manage the impacts of tinnitus, educational counselling, and recognised combinations treatments such as Neuromonics (sound and CBT treatment to help you habituate and reduce distress).
The next step is a full tinnitus assessment by an accredited audiologist. This looks at your history: hearing, aspects of the tinnitus, severity and impacts of the tinnitus and how it’s affecting your mood, sleep, concentration and/or quality of life. This helps plan your treatment.
Haven’t seen your doctor yet?
That’s okay. When we carry out a tinnitus assessment, your clinician at the clinic can recommend any referrals based on your history and results. We refer you for hearing tests too.
The above article has used evidence-based clinical guidelines for reference
