Tinnitus

What is Tinnitus?

Other than a ringing sound, a person can hear a hissing, pulsating, roaring, chirping, whistling, clicking or whooshing sound. It can occur in one or both ears at the same time.

Tinnitus is a very common problem. Chronic tinnitus affects 36 million or about 1 in 5 people but everyone has had transient sounds of ringing in the ear. Others have annoying and constant symptoms, sometimes needing medical attention. In many cases, the cause of tinnitus is unknown.

Tinnitus is not a disease in and of itself but is instead considered a symptom of another disease or condition. Sometimes the character of the sound heard can point toward the origin or cause of the tinnitus.

The causes of tinnitus will be discussed in the next section but suffice it to say there are many causes of the disorder, including secondary to loss of hearing, exposure to loud noises, Meniere’s disease, toxic drugs, head injury, anemia, stress, high blood pressure, wax in the ear, caffeine and smoking.

Tinnitus can be heard at any time of the day but is much worse at night. By day, the usual distractions of daily life make it seem that the tinnitus is less. In the quiet of the evening, the tinnitus can seem to increase.

When you have tinnitus, you will be seen by a certified audiologist to see if you have lost hearing as part of your tinnitus. The audiologist will direct you toward any number of treatments that might control your symptoms. The audiologist will ask you a number of questions related to the strength and character of the noise you hear.

In some cases, the underlying cause of tinnitus can be treated. There can also be complementary medical treatments including biofeedback, electrical stimulation, hypnosis, counseling, relaxation therapy, habituation therapies, sound machines and tinnitus maskers. All block the perception of noise.

A hearing aid may improve the situation with tinnitus. It improves your hearing and reduces the perception of tinnitus. There are also tinnitus maskers that cover up the perception of sound.

Symptoms of Tinnitus

Tinnitus is not life-threatening; it is mainly annoying and can cause anxiety and depression when left unchecked. It can be one of any type of noise, including a ringing sensation, a buzzing noise, a roaring sound, a clicking sound or a hissing sensation. It can be a low roar that interferes with your sleep or an annoying high squealing sound. You may hear it in one ear or in both ears. It can come and go or can be steady in nature. It can interfere with the way you concentrate and can be so loud that it blocks external noise.

There are basically two kinds of tinnitus:

  • Subjective tinnitus. This is tinnitus that only you can hear. It is the type of tinnitus that occurs secondary to trauma to the ear and is the most common type of the disorder. It can be caused by outer, middle or inner ear problems. It can also be caused by damage to the auditory nerve or to the aspect of the brain that controls hearing and the hearing pathways.
  • Objective tinnitus. This involves tinnitus that the doctor can hear with the naked ear or with a stethoscope. This is much more rare than subjective tinnitus and is often secondary to a problem with a blood vessel, an inner ear problem or muscle contractions.

Call your doctor regarding your tinnitus because the tinnitus can be a symptom of an underlying medical condition, including high blood pressure, low thyroid condition or blood vessel disease. If you notice tinnitus associated with pain in the ear or drainage from the ear, see the doctor as you may be suffering from an ear infection. If you experience dizziness along with your tinnitus, it’s possible you have Meniere’s disease or some type of neurological disease. Your doctor should be able to sort out whether or not your tinnitus is dangerous.

Causes of Tinnitus

In objective tinnitus, the doctor can hear the sound, too. It usually beats in time to your pulse and is a result of altered blood flow to the ear from atherosclerosis or from a carotid artery aneurysm. People with giant cell arteritis can also give rise to a sound that the doctor can hear.

In subjective tinnitus, there are dozens of causes. Most of them come from ear diseases—the same that cause hearing loss. Noise is the greatest cause of hearing loss that also leads to tinnitus. Occupational hearing loss is especially great. A person can also be exposed to ototoxic drugs that damage the hearing nerves and cause ringing in the ear. Some drugs increase the sensitivity of the ear to noise, even if the doses themselves are not toxic. Stopping benzodiazepines can cause tinnitus that passes after several months.

Other causes of subjective tinnitus include:

  • External ear infection
  • Earwax impaction
  • Exposure to excessive noise
  • Age-related hearing loss
  • Meniere’s disease
  • Tumor within the ear
  • Lead or mercury poisoning
  • Certain antibiotics
  • Excessive use of aspirin
  • Certain chemotherapy drugs
  • Loop diuretics
  • Multiple sclerosis
  • Head injury—whiplash, closed head injury, skull fracture
  • Thyroid disease
  • Psychiatric disorders—depression, anxiety
  • Fibromyalgia
  • Lyme disease
  • Migraine headaches

Sometimes the cause of tinnitus is not known, which makes it difficult to search for a proper treatment.

Diagnosing Tinnitus

Tinnitus is difficult to diagnose and often the cause of the tinnitus is never found. Because the noise is usually heard by just the sufferer, it cannot be detected by the doctor himself. The doctor must rely on your subjective description of tinnitus to make the diagnosis

The doctor can examine your head, neck and ears as part of the evaluation of tinnitus that is objective. Tests can be done to see what is going on, including:

  • Having you move your head around or move your eyes. Certain types of tinnitus change with the position of your head.
  • Doing a hearing test. Low levels of hearing can be a cause of tinnitus. You sit in a quiet room and listen to certain sounds to see if you can detect them.
  • Imaging tests, such as a CT scan or MRI scan can detect small tumors which might cause the problem.
  • Paying attention to the underlying sound. If it is a clicking sound, this points to a different origin when compared to a rushing, humming or heart beat sound. Low pitched ringing sounds can point to Meniere’s disease and high pitched ringing sound can point to damage related to a blow to the ear or to a loud noise exposure.
  • Earwax, hair or a foreign body in the ear can be detected using an otoscope.

In cases of objective tinnitus, the patient and doctor can detect the sound and it is easier to find the cause of the tinnitus with the potential for a cure. In most cases, the exact diagnosis is not found and the treatment is directed at masking the sound.

The Treatment of Tinnitus

The treatment of tinnitus depends on the cause. With objective tinnitus, the tumor or aneurysm causing the problem can be surgically removed. Things like thyroid disease causing tinnitus can be treated with a reduction of tinnitus. Surgical correction of an arteriovenous malformation can completely eliminate the sound of the tinnitus.

In cases where there is no identifiable cause for the tinnitus, it can still be treated. If not, the symptoms might just go away or might become a chronic disability. Some medical treatments for tinnitus exist, including:

  • Niacin. While there is no scientific explanation as to why this works, it can be tried. Side effects include flushing and heat on the skin.
  • Neurontin. Also called gabapentin, it seems to reduce the annoying factor of tinnitus but did not actually change the intensity of the sound.
  • Campral. This is also called acamprosate. It is normally used to treat alcoholism but, in one study, showed an 87 percent relief rate when it comes to tinnitus.
  • Low doses of antidepressants. Especially if you try tricyclic antidepressants, you will receive a reduction in the amount of tinnitus you hear.
  • Benzodiazepines. These can relax you and make the frustration of tinnitus much less prominent.

There are relaxation techniques that can be used to help you cope with the disease.

You can practice meditation, Tai Chi, yoga, guided imagery or other form of relaxation that can make the tinnitus bearable. Counseling, therapy and support groups can also help with coping with the problem.

If the tinnitus is caused by ear wax, the doctor will remove the wax and this should take care of the unwanted noise. Treating an ear infection can also reduce the sensation of tinnitus. If you have TMJ syndrome, your doctor may refer you to see an ear, nose, and throat doctor or an orthodontist.

Hearing aids can be helpful in the management of tinnitus. When you can learn to hear better, it automatically blocks the sound of the tinnitus. If the tinnitus was from trauma to the ear, however, there may not be a resolution of the tinnitus and you may not get better.

Some patients receive benefit from the use of tinnitus maskers. These are tiny devices that resemble hearing aids. The devices play a more pleasant sound than the sound made by the tinnitus. There is a new device known as a tinnitus instrument, which provides the best qualities of a tinnitus master and hearing aid.

You can use external sound machines that provide you with a background noise for use especially at night. You can use fish tanks, low volume of music, fans, indoor waterfalls and other devices to block the sound of the internal tinnitus. Even getting an iPod can help with songs on it that you like to make the tinnitus effectively go away in favor of pleasant music you can listen to.

Risk Factors for Tinnitus

Anyone can come down for tinnitus but there are certain factors that increase your risk. These include:

  • Exposure to loud noise. Occupational or other exposure to loud noise over time can do damage to the sensory hair cells in your ear and can damage your hearing. This can be replaced by tinnitus with otherwise poor hearing.
  • Age. The number of good nerve fibers in your inner ear goes down, which can cause hearing problems and secondary ringing in the ears.
  • Gender. It is usually men who are more likely to come down with tinnitus.
  • Smokers. These people have a greater risk of getting tinnitus.
  • Heart disease. If you have high blood pressure or narrowed arteries, you can have a risk of getting tinnitus.
Complications of Tinnitus

While it seems like a minor thing, tinnitus has the ability to affect the quality of life in a significant way. While it affects people to different degrees, if you have tinnitus it can cause you to experience other symptoms that can negatively influence your life. Some of these symptoms include:

  • Tiredness. You can have a poor quality of sleep or increased stress that makes you feel tired all the time.
  • Stress. The mere fact that there is a constant sound going on in your head all the time can stress you out and is why stress-relieving techniques work wonders on this annoying problem.
  • Sleep difficulty. Unless you use some kind of external or internal tinnitus masker, you can have difficulty finding the quietness it takes to get enough sleep.
  • Trouble concentrating. With ongoing sound in your ear, it can be difficult to fully concentrate on external tasks or even conversations.
  • Memory problems. If you can’t concentrate, you can’t memorize that which you couldn’t concentrate on in the first place. Memory is strongly associated with focus and you need to be able to reduce distraction if you’re going to focus.
  • Depression. Tinnitus over time can lead to depressive symptoms in need of antidepressants.
  • Anxiety. Nervousness is a part of having an annoying sound in your ear all the time.

any medical problems that do exist.

  • Avoiding activities that are exacerbating the condition. Taking frequent breaks from repetitive motion activities is recommended.
  • Wearing a wrist splint, especially at night. Some people also prefer to use it during the day as well.
  • Using nonsteroidal anti-inflammatory medications to ease the pain and swelling of
  • the affected tendons and nerves.
  • Oral corticosteroids or injectable corticosteroids are used. The injections are given into the area where the median nerve is pinched.

Surgery is sometimes used when all other remedies have not been successful or if there is already damage to the median nerve. During the surgery, the doctor cuts the “roof” off the carpal tunnel by cutting the overlying ligament. This immediately relieves the pressure off of the median nerve and the nerve eventually heals.

The only time the surgery is unsuccessful is when the nerve has already been damaged by carpal tunnel syndrome or if the nerve is damaged from other causes, such as diabetes.

If you or a loved one has suffered traumatic carpel tunnel syndrome as a result of someone else's negligence and would like to discuss your legal options with an experienced Sacramento Personal Injury Lawyer, contact us online or call us at 916-921-6400 or toll-free at 800-404-5400 to set up a FREE consultation.

Client Reviews
  • Me and my wife; had a car accident. We were amazed how easy, professional, friendly attorney Ed Smith is along with his staff. Everybody is amazing. Thank you so much, we are very impressed!
    Sincerely, Alex & Dinah M. ★★★★★
  • Ed Smith and his office team took on a difficult personal injury case on my behalf and for the passenger in my car. Ed is a top- notch attorney. His staff couldn't have been more helpful and kind. No need to look elsewhere. I give Ed Smith my highest recommendation. Beverly ★★★★★
  • Ed and Robert have been taking great care of my husband and I for the past 5+ years. They are always there when you have a problem and a quick resolution! Even when the issues have nothing to do with them. They are willing to help ease the pain off your shoulders. They are as good as it gets! Thank you again for everything. Annie T. ★★★★★
  • Very professional. Great team, staff and service all around. Mr Smith was very honest, straight forward with his advice. He gives the word "attorney" an honest reputation. I will seek his council anytime, and would recommend him at the drop of a dime. Jeremy M. ★★★★★
  • I would highly recommend Ed Smith to any friends or family in need of a personal injury attorney. Ed, and his staff, are very caring on top of being very experienced in this field. The staff always keeps you informed of the status of your case and they are always easy to reach by phone. Shannon D. ★★★★★
  • Edward Smith law offices provide competent, thorough, and personable help for victims of personal injury. When you first meet the staff you know you contacted the right office. This law office treats clients like people. I recommend this office to anyone seeking representation regarding personal injury. David M. ★★★★★