Tinnitus is the word for noises which some people hear 'in the ears' or
in the head' - buzzing, ringing, whistling, hissing, and other sounds
which do not come from an external source. Tinnitus is very common, and is
experienced by up to one in 10 adults. It occurs more often in people over
40 years of age than in younger people. Tinnitus signals come from the
natural background activity of the hearing nerve. This background activity
is present in nearly everyone.
It can happen to people with normal hearing as well as to deaf or hard of
hearing people. It is also possible to have a considerable hearing loss
without any tinnitus at all. Nearly everyone has experienced tinnitus
temporarily - for example, for a few hours after going to a disco, or when
listening carefully in a very quiet room.
Many things can cause tinnitus to emerge, but it is mainly related to
two factors: hearing disorders associated with ageing and exposure to loud
noise. Distressing tinnitus most commonly begins to persist after an
emotional upset, or an illness, injury or infection which may or may not
be related to the hearing mechanism. It can also appear as a reaction to
or side effect of a drug. Often a combination of such factors over a
period of time will trigger tinnitus.
This need not be a problem. Many people have permanent tinnitus but carry
on life as before, untroubled by their internal noises. Other factors
usually determine whether tinnitus persists and causes annoyance: it is
the effects of tinnitus which can make it an unpleasant condition. These
may include difficulty in sleeping and the tiredness and irritability that
follow; lack of concentration; anxiety and depression; withdrawal from
social activities; and fear of tinnitus and of the future. Tinnitus
Retraining Therapy aims to overcome these reactions to tinnitus,
and to reduce perception of the tinnitus sounds.
Occasionally, when underlying ear conditions are treated, tinnitus is
reduced. For example, antibiotics can clear up an infection of the middle
ear; wax can be removed from a blocked ear; changing or ending a course of
medication may put an end to the noise.
When tinnitus persists, there is no drug or operation which will
immediately get rid of it, at present. There are, however, a number of
ways to get significant relief from tinnitus, and it is nearly always
possible with appropriate treatment to reduce the distress that tinnitus
can cause and quite often virtually abolish it.
In all cases of tinnitus the right counselling, often combined with
relaxation techniques, is essential to relieve the worries that people may
have about their tinnitus. The fear that tinnitus may indicate a serious
disease (this is very, very rarely the case), or advancing deafness, can
usually be met with the reassurance that tinnitus is harmless. Normally
people get used to it so that, in time, it becomes much less noticeable
and intrusive.
Where tinnitus continues to cause distress, it often creates feelings of
annoyance, apprehension, anxiety or depression. Research with tinnitus
patients over a number of years has helped us understand how the emotional
and perceptual areas of the brain can magnify and maintain the awareness
and stress of tinnitus. This research has led to the development of
Tinnitus Retraining Therapy , which is proving very
successful in a number of tinnitus clinics in helping patients deal with
their noises.
Your GP can carry out an initial examination to check for wax build-up, infection, and so on, and may suggest ways of dealing with your tinnitus. If you'd like to see a specialist, your GP can refer you to a consultant, either through the NHS at a hospital's ear, nose and throat (ENT) and audiology department, or privately. A number of hospitals now have a special interest in tinnitus, and some have their own tinnitus clinic. Information on these is available from the RNID Tinnitus Helpline.
Some people with tinnitus have said that 'alternative' or 'complementary therapies such as acupuncture and hypnotherapy have been of benefit. Although they probably have no direct effect on tinnitus, they may help you relax and sleep better, which can improve your tinnitus. Most such treatments are only available privately, but some are available on the NHS. Check with your GP, or the freephone NHS Health Information Line on 0800 665544 (England/Wales) and 0800 224488 (Scotland). For Northern Ireland call 0345 581929 (Eastern Belfast); 0345 626428 (Northern); 0800 585329 (Western); 01762 336611 (Southern).
Although tinnitus occurs more in people in their middle or later years, it can affect younger people too, including children. Children tend to complain much less about symptoms and to accept them more readily. With any ear problem in children it is important to seek specialist help symptoms can often be effectively treated.
Research indicates that tinnitus does not cause deafness, although both tinnitus and deafness may have the same cause, particularly noise damage to the ears. Tinnitus may affect your ability to concentrate, so you could 'miss' conversation. The mistaken fear that tinnitus does cause deafness can make tinnitus louder. Having a hearing loss which has not been treated (for example, with the right hearing aids) makes having troublesome tinnitus more likely.
Most people with tinnitus are not distressed by it - it is simply
something which is there which does not affect their lives. Those who do
become distressed generally find their tinnitus to be threatening in some
way, seeing it (quite wrongly) as being caused by a serious disease, or as
going on forever, getting louder, and finally driving them mad. These
beliefs may lead them to monitor and magnify their tinnitus constantly.
Very loud noise can make tinnitus worse and cause hearing loss. You should
wear proper ear protection when using noisy power tools (ear muffs or
plugs, not cotton wool), and limit your exposure to very loud music played
through speakers or headphones. It is important not to use ear plugs or
muffs to exclude everyday sounds, even if your hearing seems rather
sensitive. This makes tinnitus and hearing sensitivity worse. If you
suffer from sensitive hearing, contacting the
RNID for their factsheet
Hyperacusis, Recruitment and Loudness Discomfort may be helpful.
Tinnitus does go up and down - either spontaneously, or it may be
temporarily aggravated by stress, certain drugs, and sometimes if you have
too much of some foods and drinks (notably caffeine and alcohol) - but it
doesn't usually get worse with time alone.
| RNID
Tinnitus Helpline, Castle Cavendish Works, Norton Street, Radford, Nottingham NG7 5PN Tinnitus Helpline: 0345 090210 (voice and text) from Monday to Friday, 1Oam to 3pm |
British Tinnitus Association 4th Floor, White Building, Fitzalan Square Sheffield S1 2AZ Tel: 0114 279 6600 Fax: 0114 279 6222 |
This factsheet based on 'Questions about Tinnitus', published by the Royal National Institute for Deaf People, 19-23 Featherstone Street, LONDON EC1Y 8SL Tel: 0171 296 8000, Fax: 0171 296 8199.