Understanding Tinnitus
Some people with tinnitus (aka ringing in the ears) only notice the sound in a quiet room, whereas many others experience the sound all day long and can interfere with daily life. These phantom sounds can cause depression and anxiety, affect concentration, sleep, and work, and get in the way of hearing.
Too many people dismiss the ringing when, in fact, this sound essentially represents an internal alarm alerting you that something is not as it should be. Tinnitus is not normal. But it is common. Tinnitus is experienced by up to 90% of people living with hearing loss (incl. “subclinical” hearing loss.) Many people notice their tinnitus prior to the symptoms associated with hearing difficulties. And vice versa – 90% of people with tinnitus have some hearing loss. Tinnitus is the result of damage to neural connections within the brain.
What Causes Tinnitus?
The initial cause of tinnitus can vary. The #1 cause is aging, followed by noise exposure (single or long-term exposure), medication, and viruses (e.g. Covid). Regardless of the cause, the underlying pathology in almost every patient is the same – a breakdown in the neural integrity of connections between the ear and brain. In 98% of cases, it is caused by damage to the auditory system, typically in the inner ear or cochlea.
- The remaining 10% of tinnitus cases can result from other medical conditions, including:
- Hypertension
- Thyroid disease
- Vascular disorder
- Temporomandibular joint (TMJ) disorder
- Craniofacial abnormalities
- And more.
In some patients, prescription and over-the-counter medications can result in damage to the auditory system and cause or exacerbate tinnitus. Generally, if tinnitus is a side effect of the drug, the tinnitus reduces or disappears when the drug is discontinued.
The Theory Of Tinnitus And How It Relates To Hearing Loss
When the brain is not adequately stimulated by the ears (even in the very earliest stages of hearing loss), the brain will increase the neural activity to make up for the missing input – and the result is that you will hear a sound. The more technical way to describe this is that tinnitus is most often the result of a ‘central gain’ in neural activity that occurs when there is a loss of proper neural stimulation from the ear. This ‘central gain’ results in the false (aka phantom) perception of a sound and is neurologically analogous to an amputee’s perception of a ‘phantom limb’. As the brain tries to adapt to the decrease in sound stimulation from the ears and the damage to the nerves in the brain, it will begin to experience a gain of activity that results in our (false) perception of sound.
Tinnitus Treatment
There is no cure for tinnitus (despite what the internet may have told you!). There is also no cure for diabetes, Parkinson’s disease, dementia, and many other progressive degenerative disorders. The good news is tinnitus is treatable and you can live a life with less tinnitus. Since tinnitus arises from the deprivation of sound to the brain, you can reduce the tinnitus by stimulating the brain with sound.
The medical treatment of tinnitus and hearing loss can decrease, sometimes eliminate the ringing, improve quality of life, increase cognitive reserves and may reduce the risk of cognitive decline and dementia. Tinnitus and sound stimulation – direct treatment – is the single-most effective treatment option available for patients suffering from tinnitus. Specifically, it is being fit with prescribed technology capable of stimulating the ear-to-brain neural connections.
It has been determined that anxiety and stress can exacerbate your awareness of the ringing in your ears. Tinnitus symptoms can be ‘triggered’ when feeling stressed, sad, or overwhelmed. Additional indirect therapy options can help boost the effect of the devices, i.e. lifestyle changes, diet, supplements, cognitive-behavioural therapy, etc.
We cannot stress enough the importance of having a good attitude when dealing with tinnitus. It goes a long way in how you manage your symptoms. While treating tinnitus with sound stimulus might seem to be an easy fix, it isn’t always that easy! Many factors contribute to the success of treatment, including what type of technology is being used to provide sound, how long the person has had tinnitus, what triggered the tinnitus, the severity of the tinnitus, the number of hours treated per day, length of treatment, etc.
The underlying cause in the vast majority of patients is the progressive breakdown of the neural integrity of the ear-to-brain connections. Direct treatment of tinnitus is to focus on neural preservation by stimulating remaining neurons and slowing the progression of the pathology.
How Long Will It Take For My Tinnitus To Reduce?
Treating tinnitus can take time. For some, it can be immediate relief. For others, it can take 6 to 18 months. Generally, early detection and treatment increase the chances of noticing a quicker reduction in tinnitus.