What Causes Tinnitus?

Anything that causes hearing loss also can cause tinnitus. The most common cause of tinnitus is loud noise. (In many cases, there is no known cause). Other causes include:

• Injury to the head or neck
• Various diseases
• Too much ear wax
• Stress
• Prescription drugs

Can Tinnitus be Cured?

A cure for tinnitus would mean that some treatment could silence it.

How are Reactions to Tinnitus Managed?

• Methods that are used in clinics include:
• Sound-based methods (Tinnitus Masking) Tinnitus Retraining Therapy
• Education
• Counselling/Psychotherapy (Cognitive-Behavioral Therapy)
• Progressive Tinnitus Management

What About “Alternative” Methods?

There are many “alternative” methods, including:

• Acupuncture
• Hypnosis
• Vitamins and herbs
• Homeopathy

(None of these methods has been shown by research to help people with tinnitus

more than placebo).

Isn’t There a Drug for Tinnitus?

All drugs used for tinnitus are meant for other problems – like depression, anxiety, and trouble sleeping. Some of these drugs can improve mood. A better mood can help to make tinnitus less of a problem. In some cases, a drug can reduce the loudness of tinnitus. However, drugs also can make tinnitus louder. Any use of drugs for tinnitus involves trial-and-error. Because of possible side effects, the use of drugs should be approached with caution

Most methods of tinnitus management involve using sound in some way.

Goals of Tinnitus Management

There are many methods for managing reactions to tinnitus. These methods are not intended to make your tinnitus quieter. They are intended to help you feel better – even if it’s just for a short time – without changing your tinnitus. The more you practice feeling better, the easier it will become to feel OK with your tinnitus just as it is. All of these methods have basically the same goals. They are to:

• Feel less stressed about tinnitus
• Have fewer emotional reactions to tinnitus
• Almost never think about tinnitus
• Feel like tinnitus has little effect on daily activities (concentration, work,
• sleep, etc.)
• Feel like tinnitus is not much of a problem
• Feel like there is no need for further help learning to manage tinnitus

All of these goals can be accomplished without changing your tinnitus. Go ahead and check the boxes above for the goals that apply to you. Use the space below to write down any other goals you have. Keep in mind that this workbook can help you with tinnitus problems, but not with trouble hearing. For help with trouble hearing, please talk to a hearing care professional.

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Using Sound to Manage Reactions to Tinnitus

In general, there are three types of sound that can be used to manage reactions to tinnitus:

1 Soothing Sound – makes you feel better as soon as you hear it. It helps reduce stress or tension caused by tinnitus.

2 Background Sound – reduces contrast between tinnitus and a quiet environment. It makes it easier to ignore tinnitus.

3 Interesting Sound – keeps your attention. It helps shift attention away from tinnitus.

Some types of sound can be used in more than one way at the same time. For example, interesting sound can help to shift attention away from tinnitus. At the same time it can help to reduce stress and tension from tinnitus.

Changing Thoughts and Feelings to Manage Reactions to Tinnitus

1 Practicing relaxation exercises

2 Increasing pleasant activities

3 Learning how to change your thoughts about your tinnitus

These may be new behaviors for you. You can learn and practice these new behaviors. Then you will have new skills to manage your reactions to tinnitus.

Some of the Tinnitus treatment used by professionals –

TINNITUS RETRAINING THERAPY (TRT)

The Tinnitus Retraining Therapy, which was developed by Dr. Jastreboff in mid ’80s and published in 1990 (Jastreboff, P.J. Phantom auditory perception (tinnitus): mechanisms of generation and perception. Neurosci. Res. 8:221-254, 1990), offers a potential solution to this problem. If we cannot erase the source(s) of tinnitus we should turn our attention to what is happening between the source of tinnitus (most frequently at the periphery) and the level where tinnitus is perceived — the cerebral cortex. The idea is to block tinnitus-related neuronal activity from reaching the level of the cortex where it is perceived, and from activating the limbic and autonomic nervous systems — to habituate tinnitus perception and tinnitus-induced reactions.

NEUROMONICS®

Neuromonics manufactures and distributes the patented and clinically proven medical devices designed for long-term, significant relief of tinnitus. The company also has received regulatory approval from the Therapeutic Goods Administration (TGA) in Australia.

SOUNDCURE®

Similar to some of the Neuromonics products, SoundCure is designed to be used on an as-needed basis and is also programmed using the patient’s audiometric configuration

Lenire

Lenire is a medical device that reduces the symptoms of tinnitus. It combines mild electrical pulses to the tongue with sound stimulation to treat tinnitus.

SOUND APPLICATIONS

“apps” is also gaining popularity for patients who have no hearing loss or those who are bothered by tinnitus when they sleep. Smartphone or tablet

users can download these apps for free, or with a minimal purchase fee.

COGNITIVE BEHAVIORAL THERAPY (CBT)

Often considered a more traditional approach, CBT services are provided by a licensed psychologist or psychiatrist. Cognitive Behavioral Therapy aims to harness the patient’s ability to become more aware of their negative thoughts towards tinnitus, which in turn allows for more positive thinking and “owning” of their current situation.

MINDFULNESS-BASED TINNITUS RELIEF

PROGRESSIVE TINNITUS MANAGEMENT (PTM)

Progressive Tinnitus Management, or PTM, is a stepped-care program that involves coordinated care between Audiology and Behavioral Health

SUPPLEMENTS AND MEDICAL MANAGEMENT

Some prescription medications hold potential for tinnitus relief; however, so far there appears to be a lack of replication of positive results in the literature.