Tinnitus Treatment Options
What Treatments are Available?
Depending on the cause of your tinnitus and other factors, several treatments are available, including medical options as well as alternative therapies.
Generally, most patients will not need any medical treatment for their tinnitus. Although there is no cure for tinnitus, there are many effective treatments available. There is no pill or surgery that has been shown to eliminate tinnitus in scientific studies that have been replicated and accepted by the healthcare community.
There are some important exceptions to this. Some forms of tinnitus can be related to something going on medically. For example, middle-ear tinnitus, can be treated. Sometimes a medication can cause tinnitus, and stopping or changing medications can eliminate the tinnitus (check with whoever prescribed the medication).
For patients who are greatly bothered by tinnitus, they may use several techniques and other treatments, such as:
- Counseling. Your physician or hearing specialist will also be able to refer you to psychological treatment or support, as tinnitus can be life-changing and hard to deal with, especially when it is a chronic problem.Counseling or CBT (Cognitive Behavioral Therapy) can be beneficial with helping with negative thoughts and emotions, sleep and concentration.
- Sound Therapy. Many tinnitus sufferers report that the presence of background sound reduces the prominence or the loudness of their tinnitus. The background sound can be present in the environment (e.g. fan noise). Listening to a fan or radio generally is more advantageous if one is attempting to go to sleep. There are non-wearable devices that produce pleasant background sound (e.g. waterfall, ocean, rainfall). Additionally, wearable maskers or sound generators are available that produce a ‘shhh’ noise (these can also be combined with hearing aids).
- Hearing aids improve not only communication but reduce the stress associated with intensive listening, and also can partially mask the tinnitus. Several studies have shown power amplification in itself can be very effective in the treatment of tinnitus (Surr et al., 1985: Kochkin et al., 2008: Searchfield, 2005: Searchfield et al., 2010: Bo et al., 2007).
- Combination Devices- A combination unit is an ear-level device combining the amplification of a hearing aid with the ability to provide a background sound like a sound generator (white noise, pink noise, speech noise, high tone noise, brown noise).
- Biofeedback training - This is effective in reducing tinnitus in some patients. It consists of exercises the patient learns in order to control various parts of the body and relax the muscles. When a patient is able to accomplish this type of relaxation, tinnitus generally subsides. Most patients have expressed that the biofeedback offers them better coping skills.
- The Neuromonics Tinnitus Treatment involves listening to an acoustic signal that is customized for each person's unique hearing profile. The acoustic signal is embedded in music, making it pleasant and relaxing to listen to. This signal targets your brain's neural pathways and re-programs them to filter out the tinnitus sound while reducing the disturbance and impact of tinnitus on your quality of life.
- Widex Zen Technology- Music can also be very effective in the treatment of tinnitus. Zen is a unique music program based on what is known as Fractal technology. Zen plays random, soothing chime-like tones that can be used for relaxation and for making tinnitus less noticeable. The Widex Zen hearing aid not only offers amplified sound of the highest quality across a broadband frequency range of 10,000 Hz, but also offers sound stimulation to reduce the contrast between the tinnitus and the acoustic sound environment, and helps the tinnitus suffer relax. The majority of the participants found that the Zen tones were relaxing. They prefer Zen tones to hearing aid amplification alone or broadband noise apparently. They reported a reduction in the perceived degree of tinnitus as a result of using the Zen program (Kuk et al., 2008; Kuk et al., 2010; Sweetow et al., 2010B).
- Medications - There are some medications utilized to suppress tinnitus. Some patients benefit with these drugs, and others do not. Each patient has an individual response to medication, and what works for one patient will not always work for others. Some of these medications have been proven, however, to decrease the intensity of the tinnitus and make it much less noticeable to the patient. There is, however, no drug anywhere which will eliminate tinnitus completely and forever.
- Self-help Books. There are also some excellent self-help books available.
Tinnitus Retraining Therapy (TRT)
What Is TRT?
One treatment that incorporates sound therapy is called Tinnitus Retraining Therapy (TRT), also known as habituation therapy. This therapy attempts to retrain your brain into perceiving the tinnitus in a different way.
About 75% of people with tinnitus are not bothered by it because their brains process it and file it as another everyday noise. TRT tries to teach your brain how to process the noise so that it doesn't bother you anymore (or not as much).
Tinnitus Retraining Therapy (TRT) was developed by Dr. Pawel Jastreboff and Dr. Jonathan Hazell in the 1980s. Dr. Jastreboff is a neurophysiologist who has conducted research at universities such as Yale, U. of Maryland, and at this time, he is located at Emory University in Atlanta, Georgia.
More than two decades ago, Dr. Jastreboff and his wife Margaret, an associate professor of otolaryngology, combined their backgrounds in neurophysiology, neuroscience, electroacoustics, biophysics, biochemistry and pharmacology to study how the brain processes information within the auditory pathways. Dr. Jastreboff's work lead to the conclusion that by retraining the brain to habituate, or ignore certain noises, patients could eventually be free from the annoying symptoms. The method of treatment based on these principles is known today as Tinnitus Retraining Therapy (TRT).
TRT is based on a new clinical approach for the treatment of tinnitus that results in significant improvement for more than 80% of the patients treated. Tinnitus Retraining Therapy (TRT) uses a combination of sound therapy and directive counseling to assist in overcoming the bothersome effects of tinnitus, thus making the patient no longer aware of their tinnitus, except when they focus their attention on it, and even then tinnitus is no longer annoying. Hyperacusis is a decreased tolerance to sound and can be a serious and frustrating problem. Tinnitus Retraining Therapy can also be used in the treatment of Hyperacusis to totally or partially restore normal levels of sound sensitivity.
The goal of TRT is to retrain the patient's brain so that they learn how to treat tinnitus and hyperacusis the way they treat the sound of a refrigerator in their kitchen; a sound which they normally are not aware of but when they do hear it, it is not bothersome. TRT helps people recover from tinnitus by using the very basic theory of brain plasticity. The human brain is capable of increasing or decreasing the amount of attention paid to various external and internal stimulation. This increase or decrease happens on a subconscious level in the brain, in a physical location of the central nervous system that also caretakes essential body functions such as heart rate, sleep cycles, emotional feelings of well being or distress, hormone productions, and other important, unconscious regulatory functions.
When a symptom like ear noise happens, such as tinnitus, this subconscious brain response can be called into action. If the person feels alarm or concern related to the tinnitus, then deep seated areas of the brain, including the limbic system and the autonomous nervous system, can start a sequence of events that evolve into a serious problem. Negative emotions and negative conscious reactions can become firmly attached to benign symptoms, like tinnitus.
TRT should always consist of two components: counseling and sound therapy usually with the use of sound generators. Because of the complexities involved, it is extremely important that the course of treatment is conducted by specialists who are appropriately trained.
Patients who have been thoroughly tested and diagnosed will begin therapy with a counseling session in which the diagnosis and treatment progression is explained. The patient learns to understand the mechanisms of hearing and basis of the brain function. Specifics of sound therapy, including potential use of variety of instruments such as tabletop sound generators and/or wearable sound generators, hearing aids, or devices consisting of a sound generator combined with hearing aid. Once the patients understand the mechanisms of hearing, principles of tinnitus perception, and reasons why tinnitus is creating problems, then they are instructed to follow a specific regimen of sound therapy. Significant improvement occurs typically after about three months, with further improvement noted in six months to a year.