Intervention

There is no cure for tinnitus at this point in time.

Chasing cures for tinnitus is counterproductive as it encourages you to focus on your tinnitus.  It is better to learn to manage it so that it has little or no effect on your quality of life.  The search for a definitive cure is ongoing and real progress is being made, but there is currently no clinically proven way to fully eliminate the perception of tinnitus.

The primary objective for all currently available tinnitus treatment options is to lower the perceived burden of tinnitus, allowing the patient to live a more comfortable, unencumbered and content life.

Below is a list of currently available intervention treatments, organised into general categories.

Please note: TAV does not endorse or recommend any specific tinnitus products, treatments or providers.

Drugs

No specific drugs for treatment of chronic tinnitus that are both frequently effective and non-toxic have yet been developed, but research continues. On the other hand, sedatives, or anti-depressants can help relieve the stress, anxiety and depression related to tinnitus, minimising the psychological burden of the condition. They are quite often needed for treating the background state of the patient. Such drugs without counselling are rarely going to be effective though.

Surgery

Surgery for tinnitus is never justified. It often exacerbates the condition. If you are in doubt, obtain a second or even a third opinion.

Hearing Aids

Most patients develop tinnitus as a symptom of hearing loss, caused either by age, long-term hearing damage, or acute trauma to the auditory system. According to the general scientific consensus, hearing loss causes less external sound stimuli to reach the brain. In response, the brain undergoes neuroplastic changes in how it processes different sound frequencies. Tinnitus is the product of these maladaptive neuroplastic changes.

Patients with hearing loss and tinnitus may find relief from the use of hearing aids and other sound amplification devices. Hearing aids are small electronic devices worn in or behind the ear. Using a microphone, amplifier and speaker, hearing aids supplement the volume of outside noise and increase the amount of sound stimuli received and processed by the body’s auditory system.

In a 2007 survey of hearing health professionals, respondents self-reported that roughly 60% of their tinnitus patients experienced at least some relief when wearing hearing aids; roughly 22% patients found significant relief.

Hearing aids are effective for several reasons:

Masking and Attentional Effects

Hearing aids can augment the volume of external noise to the point that it covers (masks) the sound of tinnitus. This makes it more difficult to consciously perceive tinnitus and helps the brain focus on outside, ambient noises. The masking impact of hearing aids is particularly strong for patients who have hearing loss in the same frequency range as their tinnitus.

Auditory Stimulation

Increasing the volume of external noise also increases the amount of auditory stimulation received by the brain. There may be benefits to stimulating the brain’s auditory pathways with soft background sounds that might not otherwise be heard.

Improved Communication

Loud tinnitus can make it difficult — or even impossible — for patients to participate in regular communicative and social activities: follow a conversation, talk on the phone, watch television, listen to the radio, etc. Hearing aids help by augmenting the external volume of these activities above the perceived volume of tinnitus. As a result, patients may feel less personal frustration and social isolation.

 

Diet

Dietary regimes are occasionally helpful. This should start with careful questioning to detect possible tinnitogenic dietary components (e.g. caffeine), drinks or medication, and be followed by dietary exclusion trials to confirm or disprove the potential benefits for that individual. Do not become obsessed with diet. If you enjoy a particular food and you find it gives your tinnitus a temporary increase, so enjoy that glass of red wine, piece of chocolate or that coffee with the knowledge it will settle down!  However, it is beyond question that a healthy diet has myriad beneficial effects on the body, which may lessen the impact of tinnitus. A health-conscious diet can reduce hypertension and weight, increase blood flow, heighten energy levels and improve emotional well-being — all of which can benefit your tinnitus.

Hypnotherapy

Hypnotherapeutic techniques can be of indirect help, by aiding relaxation. Methods of alternative medicine, including acupuncture and herbal preparations, only rarely seem to have any beneficial effect on tinnitus, but can be of worthwhile supportive value if the patient believes they are helping. As such, it is often positioned as a good wellness option for patients with tinnitus.

Tinnitus Retraining Therapy

Professor P. Jastreboff and Dr. J.Hazell developed Tinnitus Retraining Therapy (TRT). They believe that if a sensory system is repeatedly exposed to a non-threatening stimulus, the system will eventually habituate to it. There are two components to TRT:

Providing counselling aims to demystify tinnitus and help the patient reclassify perceived ringing as an emotionally-neutral signal.

Exposing the patient to low levels of background noise. It is believed that the low levels of background noise facilitate the habituation process.

This procedure is not without controversy. It has been widely criticised for its lack of supporting data, its apparent disregard of widely held psychological principles, and the manner in which it has been promoted.

 

Jastreboff, P. and Jastreboff, M. (2000) “Tinnitus Retraining Therapy: An Update.” Hearing Review, Available at: http://www.audiologyonline.com/articles/tinnitus-retraining-therapy-an-update-1286  (Accessed March 11, 2015.)

Tinnitus Treatment and the Effectiveness of Hearing Aids: Hearing Care Professional Perceptions