Tinnitus: How to Manage Ringing in Your Ears

What Causes Tinnitus

“Tinnitus is poorly understood, and there are multiple theories about the cause,” says Kevin Gersten, M.D., an otolaryngologist with the Palo Alto Medical Foundation. “Most often it is associated with hearing loss, so anyone with ringing in their ear should have a hearing test.”

If you’ve been exposed to a lot of loud noises, such as firearms or a noisy workplace, your chances of having tinnitus go up. Among American military veterans returning from service, tinnitus is the top service-related disability. Tinnitus risk also increases as you age.

Tinnitus culprits also include many other health conditions, such as impacted ear wax, middle ear infections, certain painkillers and antibiotics, Ménière’s disease (an inner ear disorder), jaw misalignment and head injury. Because tinnitus is a symptom and not a disease, visit your doctor to see if you have a treatable underlying cause.

Tinnitus Relief

Once your doctor rules out treatable causes of tinnitus, the focus turns to managing your symptoms. Many people learn to adapt to their tinnitus without further intervention, Dr. Gersten says.

If you find your tinnitus bothersome, explore options for symptom relief. Combined approaches, which can include hearing aids, sound therapy, counseling and medication, often yield the best results.

“Tinnitus can be a challenging symptom to take care of,” Dr. Gersten says, so it will likely take time and patience to develop the right program for you.

Hearing Aids

Hearing aids that amplify external sounds provide at least some relief to most people, according to the American Tinnitus Association. Increasing the volume of background noise helps mask tinnitus sounds and may stimulate auditory pathways in your brain that no longer get enough stimulation due to hearing loss. Today’s digital hearing aids can also play white noise directly into your ears to cover tinnitus sounds. (See “New Reasons to Use Hearing Aids.”)

Sound Therapies

Sound therapy uses external noise to counteract your perception of tinnitus. You can use a portable device that generates white noise or other ambient sounds, or a fan, music player or tabletop fountain to mask or distract you from your tinnitus. Another option: medical-grade ear devices programmed to deliver customized sounds.

Many people find listening to music helpful, particularly songs that maintain a fairly constant loudness.

Behavioral Therapies

Changing how you think, feel and react to your tinnitus can make it much less burdensome.

Mindfulness programs, such as Mindfulness-Based Tinnitus Stress Reduction, can help to decrease the annoyance and experience of tinnitus.

Tinnitus Retraining Therapy

This promising approach combines directive counseling and sound therapy to change your perception of tinnitus at both a conscious and subconscious level.

Tinnitus retraining therapy (TRT) uses FDA-approved devices to expose you to a low-level broadband noise, helping you to become habituated to your tinnitus. “It essentially tries to get your brain to tune it out and make the tinnitus seem like white noise,” Dr. Gersten explains.

“TRT is not yet widely available, but certain specialty clinics and universities do offer programs,” Dr. Gersten says.

Medications

No FDA-approved drugs exist specifically for tinnitus, but antidepressants or antianxiety drugs may help relieve its psychological effects. Because negative emotions make tinnitus seem worse, treating underlying anxiety and depression may make it less troublesome.

Avoid over-the-counter remedies that promise to cure your tinnitus. “There’s a lot of hocus-pocus out there, where this supplement or that is advertised to treat tinnitus,” Dr. Gersten says. “Unfortunately, none of these has been proven to be effective.”

Positive Mindset

Physical activity, reducing stress, eating a well-balanced diet and staying social improve your well-being and can reduce the burden of tinnitus, Dr. Gersten adds.

“For people with chronic tinnitus, it is often more effective to develop strategies to manage the problem, rather than only looking for a cure” Dr. Gersten says. Focus on activities you enjoy, such as hobbies or spending time with friends and family, he advises. And consider joining a support group that offers emotional support and a place to share resources.