What is tinnitus?

Tinnitus can be described as any noise originating in the ears with an unknown origin and the absence of any external stimulus.

It can happen in both ears, or just one, and is often described as a whistling, buzzing, hissing or ringing in ears. Sometimes it is a constant tone, and occasionally it can be pulsatile, or even musical.

Sometimes tinnitus will come and go, or only be experienced temporarily. Occasionally tinnitus doesn’t go away and is persistent. For some people, tinnitus isn’t that bothersome and they are able to ignore it. For others, tinnitus can affect them in a way in which it becomes an issue that severely impacts their quality of life.

Tinnitus is quite common, and 30% of people will experience it at some point.¹

The true cause of tinnitus is unknown; however, we understand that it is not a disease or an illness, but it is a symptom of a physiological or mental change.

For many people, tinnitus can be attributed to a change in hearing. When we hear, the ear takes sounds and converts it into electrical signals to be processed by our brains. The brain is very good at determining what information is important and what is not, but when there is a change to the signals being received, this can result in tinnitus. This may happen after a cold, from being blocked up with wax, or due to an ear infection.

Hearing loss isn’t the only problem that results in tinnitus though. Stress is known to also lead to tinnitus, and often when people get stressed and notice tinnitus, they think about the tinnitus and focus on it which in turn makes the stress worse, and can lead to the tinnitus becoming more noticeable.

Tinnitus is rarely a symptom of a serious disorder, although you should seek professional advice if it doesn’t go away and is becoming bothersome.

Tinnitus tends to be a symptom of an underlying condition, and, therefore, there is no one cure for tinnitus, and supporting someone who experiences tinnitus may be reliant on addressing that individual’s underlying problem. When treating the underlying condition doesn’t help alleviate the tinnitus, treatment is focussed on helping make the tinnitus become less noticeable and bothersome.

Here are some of the ways we can help:

Hearing aids: if hearing loss is present, a hearing solution or hearing aids will often help as it helps reintroduce some of the sounds that you have not been hearing as well. Hearing loss is normally quite gradual, and isn’t always apparent as it affects people’s ability to hear differently.

Sound/noise: for some people tinnitus becomes more of an issue when there are no other sounds to help mask it e.g. at night or in quiet environments. There are plenty of apps, sounds to play through a speaker, or devices that can be used to introduce sound to help. Hearing aids can also be programmed to introduce masking sounds or noises to help make the tinnitus less noticeable in certain environments.

Cognitive Behavioural Therapy (CBT): CBT is designed not to actually change the tinnitus, but change your response to it, and there is evidence to suggest this can work effectively as an approach to tinnitus when it is causing distress.

CBT aims to identify negative automatic thought, and replace it with a more positive response. This approach takes time, and should be done with the support of a qualified professional.²

Mindfulness: Practicing mindfulness can help you to deal with tinnitus in a different way and, similarly to CBT, aims to change your response to tinnitus by encouraging acceptance.

If you are suffering from tinnitus (any noise within the ears with an unknown origin), we offer tinnitus support appointments, which are designed to help investigate this further.

At this appointment, the audiologist will take a detailed medical history, and ask questions to determine the impact of your tinnitus, and how it is affecting your quality of life.

Following this, a full examination of your ears will be conducted, using video otoscopy, to check on the health of your ears. This will proceed to a full audiometric hearing evaluation, which checks if there is any hearing loss present and to what extent.

We will also perform ULLs (Uncomfortable Loudness Level Checks) to determine the levels of sound which you deem uncomfortable. We may also be able to match your tinnitus for loudness and pitch which will help us further understand the sounds you are experiencing.

Following this, the audiologist will be able to make recommendations on how to proceed and determine if any further referrals are required. If there is hearing loss present, you will be offered to try a hearing solution and a demonstration will be carried out.

Other things that may be recommended are mindfulness or noise therapy, as well as a referral to a CBT practitioner, if appropriate.

The British Tinnitus Association at tinnitus.org.uk is a fantastic resource for people suffering with tinnitus, or who want to understand more.

It also has lots of information about research being conducted into tinnitus, and evidence around current treatments.

1. https://www.tinnitus.org.uk/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3936550/

Article by Adam Bostock