You're trying to talk to your son who's in college across the country on the phone, but his voice keeps getting drowned out by strange noises in background and ringing. Annoyed, you ask if he could go somewhere a bit quieter, but he doesn't know what you're talking about – he's in his dorm room and it's silent. Must be the phone, you think, but when your conversation is over, the sounds don't go away. What's going on?
Chances are, you're suffering from a condition that's far too common – it's called tinnitus, and about 1 in 5 people have it to some degree or another. In the United States alone, that translates to around 50 million people who have some symptoms of tinnitus, 16 million for whom the problem is bad enough that they see a doctor about it, and 2 million who suffer so severely that they have trouble functioning normally.
What exactly is tinnitus? The simplest way to describe the condition is that it's a sound that no one else can hear. People suffering from tinnitus can hear “phantom” sounds in either ear or even just in their head. When describing tinnitus, most people call it a “ringing” in the ears, but in actuality the condition can resolve itself in a variety of different kinds of noises – clicking, chirping, whistling, roaring, hissing, and more. These sounds can be incredibly quiet (practically the level of a whisper) or horribly loud (as if someone were screaming inside your head). It's also possible to hear single tones or multiple tones, and for the noises to occur continuously or intermittently. This may seem better than hearing constant noise, but it also makes the condition unpredictable so that you can be fine one moment and in extreme discomfort the next.
Causes of Tinnitus
There are a wide variety of things that are believed to be involved with someone experiencing tinnitus, but despite ongoing research efforts, no one has quite been able to determine specific and definite causes. What researchers have been able to discover is that tinnitus can be made worse due to a number of problems. What are they?
- Loud noises. If you are regularly around moderately loud sounds for long periods of time or get too close to something earsplitting, like a jet taking off, it can really damage the cilia (or hair cells) in your inner ear. Unfortunately, these cells can't be fixed or replaced after damage occurs, so once they're gone, they're gone. Generally speaking, anything under 85 decibels won't cause problems, but once you go over, then it gets dicey. Just to give you an example of the kinds of noises we're talking about, average traffic tends to be about 85 decibels, while subway trains and blow dryers are around 100 dB, thunder or a screaming child get up to about 105 dB, and a jackhammer reaches 110 dB.
- Wax build-up. Too much wax in your ears can cause not only difficulty hearing and distinguishing sounds, but also create an interior space where phantom noises are made worse and more likely to occur.
- Cardiovascular disease. Something about cardiovascular disease – perhaps related to differences in the way your heart can beat if you suffer from problems, has been known to increase the effects of tinnitus.
- Jaw misalignment. When your jaw is not aligned correctly, it can throw your hearing off because it's closely intertwined with the ears and problems with the nerves can occur.
- Trauma to your head and neck. Besides vertigo, headaches, and loss of memory, hurting your head or neck can cause you to hear a ringing in your ears.
- Ototoxicity. When medications are toxic to your ears, they are called ototoxic. Not only can these medicines harm your inner ears generally, they can cause you to start suffering from tinnitus as a side effect. This is something that may go away with time or may be permanent – it just depends on the dosage you took. That's why it's so important to make sure your doctor knows if you have any ear problems before starting new medication.
- Specific disorders. There are some disorders that include tinnitus as one of the symptoms. If you are able to successfully treat the disorders themselves, the tinnitus should be alleviated and may even disappear altogether. A few of the disorders that fall under this category include fibromyalgia, Lyme disease, thoracic outlet syndrome, Meniere's disease, and hyper- and hypothyroidism.
- Pulsatile tinnitus. This is an extremely rare type of tinnitus that can manifest itself when the veins and arteries close to your inner ear have blood flow that's abnormal. Most often, it sounds like a rhythmic pulsing that occurs in time to your heartbeat. It can also be caused by a brain structure that is irregular.
- Tumors. Not all tumors are related to tinnitus, but certain types – such as brain tumors – have been associated with starting or worsening tinnitus.
Treatment for Tinnitus
The real question, of course, is how tinnitus can be treated. First off, it's important to understand that, as of now, there is no cure in existence. That being said, there are a number of methods that different doctors use to alleviate the symptoms while organizations like the American Tinnitus Association search for a way to eliminate the problem completely. Here are a few of the most popular.
- Hearing aids. Many tinnitus patients have reported experiencing relief from the condition while they are wearing hearing aids. Experts believe this is likely due to the way in which hearing aids amplify ambient sounds so that they can mask the unpleasant tinnitus noises.
- Cochlear implants. Because these implants destroy any remaining cilia inside the cochlea, it's important to know that they are only used for patients who are deaf or near-deaf. If that describes you, though, and you're still suffering from tinnitus, these have been shown to help roughly half of the people who get them. Like hearing aids, this may partially be due to the return of ambient noises that cover the symptoms, but the electrical stimulation from the implants has also been shown to stop tinnitus for a time.
- Biofeedback. Because many doctors have found a strong correlation between tinnitus and stress, a number of professionals have begun using biofeedback so that patients can learn how to control how their bodies react to it. This can include things like moderating your skin temperature and pulse, as well as relieving muscle tension. Alternatively, some professionals have had success using cognitive therapy to affect the way patients perceive tinnitus sounds.
- Drugs. Though a number of drugs are used to relieve tinnitus symptoms, there are none at present that have been specifically designed to treat it, despite many being studied at length. Just a few of these are gabapentin, nortriptyline, Xanax, lidocaine, and a variety of antihistamines. All of them worked for some people some of the time, but nothing has been so effective as to be declared a tinnitus drug.
- Transcranial Magnetic Stimulation. Remember how the cochlear implant affected tinnitus through electrical stimulation? Well, this technique does something similar by using a pulsed magnetic field to affect your brain's electrical activity. When manipulated correctly, this has been able to reduce the effects of tinnitus in some people.
- TMJ treatment. Because jaw misalignment can cause problems, those who suffer from TMJ can experience relief from their tinnitus when the problems with their jaw are dealt with by having their bite realigned.
- Home Remedies. There is a wide array of home remedies that you can use to lessen the effects of tinnitus. One of the simplest is sound therapy, a method by which people use background noise or white noise to make their tinnitus more bearable. This is similar to how tinnitus can be alleviated when people wear hearing aids, but those with otherwise normal hearing can benefit, too. Examples of sound therapy include turning on a fan or a sound machine to cover the ringing. Beyond sound therapy, some sufferers have found success with “natural” solutions like zinc, magnesium, B vitamins, or Ginkgo, while others turn to things such as hypnosis, magnets, and acupuncture.