Tinnitus Is Often Described As Ringing In The Ears
Tinnitus is a Latin term “tinnire” meaning “to ring”. The actual experience of this sound can vary and have been described as whistling, clicking, humming, hissing and roaring.
What Causes Tinnitus?
Although tinnitus is common and may not pose a significant problems for most, many will experience tinnitus as a life altering and upsetting condition. Most often, tinnitus is related to hearing loss associated with ageing, with damage inside the ear and hair cells, frequently with exposure to loud noises. When there is no loss of hearing, tinnitus may be located inside the brain, a central cause. An audiogram, which is a common hearing test hearing test will determine if it may be due to hearing loss and is often the first place to start investigation.
A thorough history and examination by a health care provider is vital, considering possible causes related to cardiovascular, thyroid, tumors and a variety of medications, which include many commonly used pain relievers. Frustratingly, many investigations fail to locate a cause.
A study in Cases Journal. 2009 Sep 15;2:9237, found a genetic susceptibility to aspartame toxicity suggesting cessation of its use may prove helpful for some. It has also been recommended that one should give up caffeinated beverages like coffee, tea, soda and foods like chocolate to see if tinnitus symptoms are relieved.
In the Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery, May, 3013, there are indications that exposure to very low frequency electric and magnetic fields can damage outer hair cells of the ear, and this is possibly related to tinnitus. And in Environmental Health Journal. October 2013, there was a study noting several cordless phone frequencies bands was related to tinnitus. The journal PLoS ONE. 2009;4(3):e5026, suggests that some tinnitus sufferers may have a hypersensitivity to electromagnetic fields. Reduction of cell phone use may provide relief in some of these people along with cognitive behavioral therapy
There are many possible causes and this stresses that it is vital to have it evaluated by a health care professional. Factors involved may be loss of hearing, especially high frequency hearing loss, dizziness related to an inner ear disorder, blockage in the ear, hyperacusis – a sensitivity to noise, tumors, inflammation of the ear, sinus problems, headache and vascular disorders, metabolic disorders related to sugar like diabetes, thyroid or lipids, cervical arthritis, hormonal problems, stressful situations, anxiety, depression, medications that are toxic to the ear (ototoxic), stimulants, epilepsy and other disorders.
Is Tinnitus Related To Neck Problems
It is possible for neck conditions to be a cause of tinnitus. Strain of neck muscles, sprain of neck ligaments, whiplash injuries, along with degenerative cervical spine changes can make one more susceptible, aggravate, and may actually cause tinnitus. Motions involving some neck exercises and stretches, wearing a soft neck collar for a short period or a neck traction collar may help to confirm this relationship. Proper posture and an ergonomic set up for work while sitting at a computer can help with neck problems, along with and healthy and oxygenating breathing techniques help to alleviate stress and strain on cervical muscles. Seeing a Chiropractor for an examination can help determine if there are neck issues responsive to adjustment or manipulations, particularly the area of the upper cervical spine and I like a low force technique directed in this area called NUCCA, You can learn more and find a Doctor at National Upper Cervical Chiropractic Association.
A study in the International Tinnitus Journal. 2000;6(2):130-3. indicates that tinnitus can result from an unstable situation of the cervico-cranial junction, which is the relationship between the base of the skull and the first cervical vertebra or neck bone. There are a bundle of nerves and the brainstem, which extends to this region. It is often compromised in the typical forward head posture, where this area can be compressed. Tinnitus related to this area of the neck can cause a high pitch whistle. Tinnitus is known to resolve with surgical correction or stabilization in this area from correcting forward head posture. A disc herniation, injuries to the disc and ligaments or even metastatic diseases down to the third cervical area may cause tinnitus, which may also respond to surgical repair.
When there is a problem with the neck, it can cause problems for the nerves and muscles situated by the ears. If you also have stress related to neck problems then it can often make tinnitus worse. Arthritis in the neck may cause the blood supply of the inner ear to be constricted and that could cause tinnitus. Some have suggested taking Ginko herb for this.
In the journal HNO. 2006 Feb;54(2):125-31. Functional disturbances of the cervical spine in tinnitus, “Results of the statistical analysis show that patients with tinnitus have characteristic and specific patterns of abnormalities in the joints and paravertebral muscles. The dominant finding is an overall impairment of cervical spine mobility, to which various factors contribute. These include disturbed function of segmental joints of the head and the cervicothoracic junction as well as muscular imbalances of the shoulder and neck muscles.”
Thus, tinnitus may be related to or have an association with neck problems. Although adjustments did not help my tinnitus, it is reasonable to take easy to implement measures such as detailed at Neck Solutions or seek professional help as a secondary approach. The first approach should be medical. In practice, I have not seen a patient consult for tinnitus, nor have I had a response to any co-existing tinnitus condition.
Often related to neck problems, temporomandibular disorders may affect tinnitus and one should avoid clenching and grinding of teeth and use jaw and neck relaxing exercises. A November 2013 study in the Journal of Prosthetic Dentistry found a correlation between tinnitus and temporomandibular disorders. Tinnitus was found to be 8 times higher in those with temporomandibular disorders. Treatment directed to the jaw helped in almost 50% of individuals. The tinnitus is usually one sided and on the same side as the jaw problem, which may be effected by jaw movements. A dental appointment can assess the need for proper bite and/or a bite plate fitting to wear at night and/or therapy directed to the muscles.
What Helps Tinnitus
For the affective component of tinnitus related to stress, anxiety and depression, patients may find relief with tricyclics, an older class of antidepressants. Doctors may also prescribe antiseizure drugs, sleeping pills, muscle relaxants, or benzodiazepenes like diazepam (Valium) or clonazepam (Klonopin).
Masking the noise is a common approach to lessen the tinnitus. Many people are only bothered by tinnitus when it is quiet like before sleeping. Masking involves using the noise from a fan, humidifier, turning between radio stations and using the noise that is produced or using music or other soothing sounds through headphones or earphones.
People with hearing loss may find a hearing aid helps reduce tinnitus. Additionally, masking can be incorporated into the hearing aid itself. By boosting lower frequencies in the hearing aid, those with high frequency hearing loss may find relief from tinnitus.
The Journal of Psychosomatic Research. 2010 Mar;68(3):245-51, found that a self-help book, without therapist assistance, may help in alleviating distress associated with tinnitus and can provide inexpensive treatment that is not bound by time or place. They call this bibliotherapy, which is book therapy. The book they used is Tinnitus: A Self-Management Guide for the Ringing in Your Ears.
Tinnitus Retraining Therapy (TRT) uses a combination of ear devices that emit low volume sounds and counseling. This type of therapy may be expensive and take a couple of years as the brain is trained to turn tinnitus into background noise.
People who suffer from tinnitus are likely to experience depression, anxiety or sleep disorders. Regardless of cause and effect, these symptoms should be addressed. It has been shown that cognitive behavioral therapy (CBT) can help with tinnitus. This therapy focuses on the emotional response to tinnitus and attempts to break patterns of thinking and behavior that contribute to anxiety and depression. The Cochrane Database of Systematic Reviews 2010 Issue 2 concluded, “We did not find a significant difference in the subjective loudness of tinnitus, or in the associated depression. However we found a significant improvement in the quality of life (decrease of global tinnitus severity) of the participants, thus suggesting that cognitive behavioral therapy has an effect on the qualitative aspects of tinnitus and contributes positively to the management of tinnitus.”
Since early tinnitus can be distressful, trying to address it at this point can help prevent it from becoming a chronic problem. Tinnitus-related sleeping disorders, anxiety, as well as life satisfaction are important factors related to problems with chronic tinnitus distress. A study in the International Journal of Clinical and Experimental Medicine, August 2013 found the Heidelberg Model of Music Therapy approach used early in tinnitus can help with prevention of the chronic condition
An article in Medical Hypotheses Journal. March 2010 indicates Melatonin has been proposed as a treatment for tinnitus, especially on the basis of its positive effects on sleep and its vasoactive and antioxidant properties. It explores melatonin use in relief of tinnitus, explaining its effect on central nervous system resulting in a protective mechanism against an exaggerated sympathetic drive; its capacity to induce a more steady hemodynamic condition, through a multifactorial and multi-organ activity, resulting in a more regular labyrinthine perfusion; a possible action on the skeletal muscle tending to a reduction of the muscular tone, which could relieve tinnitus of muscular origin from contractions of the tensor tympani; its possible reported antidepressive effect, which could indirectly act on tinnitus; a direct regulation of inner ear immunity as proposed in literature when melatonin was reported to be present in the inner ear. They state, “… these observations seem to indicate melatonin as a tool deserving a greater attention than other antioxidants in the attempt of relieving tinnitus, justifying its application from a more precise rationale based on a series of physio-pathological aspects.
Lately, a new therapy called transcranial magnetic stimulation (TMS), which sends an electrical current into the brain has shown some promise along with electrical cortical stimulation (ECS), however, further clinical trial studies are needed. If you are interested in participating in any of these clinical trials, you can follow the link at government approved Clinical Trials for Tinnitus from the U.S National Institutes for Health.
More Information On Tinnitus
A great source for information and to find support groups for tinnitus in your area is the American Tinnitus Association (ATA), and I highly recommend it for anyone who sufferers from or cares for someone suffering from tinnitus. You are not alone, tinnitus reduces quality of life for 250 million people worldwide. There is a test you can take to determine the effects that tinnitus has on the quality of your life called the Tinnitus Handicap Inventory. It is also a means to monitor the progression of tinnitus and the effects of therapy measures.
To summarize; there is no cure for tinnitus, however, you don’t “have to live with it”. There are methods to control and relieve tinnitus, mainly through medication and instrumentation, and new methods are being studied. In my case, I have been suffering from tinnitus for a couple of years. Beyond the initial panic, I have been able to control it through medication and the intensity has reduced over time along with the duration. My tinnitus has been evaluated to be related to high frequency hearing loss, however, there are different causes and you need to be professionally evaluated.