Tinnitus (Noise in the Ears)

Tinnitus is a very common problem among adults. It is usually described by patients as a ringing or buzzing sound in one or both ears. It can be very aggravating and annoying for some people.

Tinnitus is caused by hearing damage, usually with a measurable amount of hearing loss (though not always). There is frequently a history of loud noise exposure in the past. (Tinnitus is very common among veterans, musicians, and industrial/construction workers).

If there is an easily treated form of hearing loss like an ear wax plug or fluid behind the eardrum, this can be treated and usually the tinnitus will go away. Unfortunately, most longstanding tinnitus is not so easily fixed.

While tinnitus can be very annoying, it is not a dangerous or life-threatening problem.

The noise sometimes is constant and other times it can come and go. Typically it is more noticeable (louder) in quiet settings like trying to sleep at night or sitting in an empty room. Background noise usually helps to drown out the tinnitus (we call this “masking”).

There are many factors that are known to make the tinnitus louder. These include stress, depression, anxiety, use of stimulants, caffeine, smoking, medications such as aspirin/ibuprofen/naproxen.

Most importantly, the more you focus on your tinnitus and worry about it, the louder it will seem. Conversely, the more you put it out of your mind and relax, the less it will bother you.

I like to use the analogy of walking into a room that smells bad. After several minutes, your brain will “tune out” the bad smell and you don’t notice it anymore. The same is true for tinnitus, though it will take longer than a few minutes. Our brains are very good at filtering out things that are not important.

Regarding treatment of tinnitus, there is good news and bad news. The good news is that tinnitus is not a dangerous problem like cancer or heart disease. The bad news is there is not an easy “cure” for the problem (despite what you might read in ads for certain herbal products).

I feel like the one best thing you can do is to relax and try to put the noise out of your mind. Just let it fade into the background. Your brain will eventually get the hint and the noise will stop bothering you so much.

A simple change that can help is to keep some background noise around you at all times. Run a fan or white noise generator in your room at night.

There are several other treatments that can be useful in patients with tinnitus. Hearing aids for patients with significant hearing loss can help with tinnitus. Also, there are devices called maskers which look similar to hearing aids but produce a noise at a similar pitch to the tinnitus to help drown it out. Both these options are dispensed by audiologists.

Lifestyle changes such as cutting down on smoking or caffeine, or avoiding aspirin/ibuprofen/NSAID medications can help as well.

Antidepressant medications such as amitriptyline and nortriptyline can be helpful in some patients (even without depression). Patients who ARE depressed can have a very difficult time with tinnitus, and they should work with their primary care doctor or psychiatrist to maximize the treatment of their depression.

Stress relief techniques including exercise, meditation, and yoga can be helpful.

Finally, there is an option called tinnitus retraining therapy (TRT) which is offered at certain centers around the country (though currently none in Texas). See www.tinnitus.org for more information.

There is also an association between tinnitus and pain in the jaw joint (temporomandibular joint or TMJ) and in the muscles around the jaw and ear. If this is the case, the TMJ pain should be treated.

Call (512) 550-0321 if you have any questions or to schedule an appointment!