Tinnitus Treatment

In many cases, there is no specific treatment for tinnitus. It may simply go away on its own, or it may be a permanent disability that the patient will have to "live with." Some otolaryngologists have recommended niacin to treat tinnitus. However, there is no scientific evidence to suggest that niacin helps reduce tinnitus, and it may cause problems with skin flushing.

Alternative Treatments
Some people have taken minerals such as magnesium or zinc, herbal preparations such as Ginkgo biloba, homeopathic remedies, or B vitamins for their tinnitus and found them to be helpful. Others have experienced tinnitus relief with acupuncture, cranio-sacral therapy, magnets, hyperbaric oxygen, or hypnosis. A few of these therapies have been researched in an attempt to verify the anecdotal claims. But the results have not conclusively identified these treatments as helpful for tinnitus. Your doctor might give you clearance to try them for tinnitus anyway given that they generally carry little risk to health and some people find them helpful.

Amplification (Hearing Aids)
Some tinnitus patients with hearing loss experience total or partial tinnitus relief while wearing hearing aids. There are many variables that determine success. However, if a patient has a hearing loss in the frequency range of the tinnitus, hearing aids may bring back in the ambient sounds that naturally cover the tinnitus.

Biofeedback
Biofeedback is a relaxation technique that teaches people to control certain autonomic body functions, such as pulse, muscle tension, and skin temperature. The goal of biofeedback is to help people manage stress in their lives not by reducing the stress but by changing the body's reaction to it. Many people notice a reduction in their tinnitus when they are able to modify their reaction to the stress in their lives.

Cochlear Implants/Electrical Stimulation
A cochlear implant has two components: 1) an electrode array that is threaded into the cochlea, and 2) a receiver that is implanted just beneath the skin behind the ear. The electrode array sends electrical sound signals from the ear to the brain. Because electrode implantation destroys whatever healthy hair cells were left inside the cochlea, these implants are prescribed to deaf or near-deaf patients only. In one study, half of those who had tinnitus before their cochlear implants experienced tinnitus relief after their cochlear implants.

Why do cochlear implants help tinnitus? There are two possible reasons: 1) The tinnitus might be masked by the ambient sounds that these devices bring back in. 2) The tinnitus might be suppressed by the electrical stimulation sent through the auditory nerve by the implant. Some forms of electrical stimulation to the ear can stop tinnitus briefly.

Cognitive Therapy
Cognitive therapy is a type of counseling that is based on treating a patient's emotional reaction to tinnitus rather than the tinnitus itself. To accomplish this desired change in perception, a counselor will help the patient identify negative behaviors and thought patterns, then alter them. Counseling programs are individually designed for patients and are most effective when coupled with other tinnitus treatments, such as masking or medication.

Drug Therapy
Many drugs have been researched and used to relieve tinnitus, but there is not a drug that has been designed specifically to treat tinnitus. Some drugs that have been studied include anti-anxiety drugs like Xanax, antidepressants like nortriptyline, antihistamines, anticonvulsants like gabapentin, and even anesthetics like lidocaine. All successfully quieted tinnitus for some people.

The American Tinnitus Association cannot recommend which treatment, drug or otherwise, is right for you. This is for you and your healthcare provider to determine. Remember to talk to your provider about side effects and about other medications you currently take. Because side effects can happen with any drug or drug combination, patients have to decide for themselves if an undesirable side effect is worth the trade off of tinnitus relief.

Many people ask why pharmaceutical companies aren't actively researching a drug designed specifically for tinnitus. Partly, this is because of the cost-prohibitive nature of prescription drug development. A report in the December 2003 Wall Street Journal reported that large pharmaceutical companies spend an average of $1.7 billion to develop a new drug therapy. This price tag includes the creation of the drug, testing, approval from the Food and Drug Administration, and marketing.

Creating new drugs involves a certain level of failure. Only about one out of eight drugs tested on animals actually make it to the consumer market.

Sound Therapy
Various treatment strategies use sound to decrease the loudness or prominence of tinnitus. Sound therapies include both wearable (hearing aid-like devices) and non-wearable devices (such as table-top sound machines or even a whirring fan). Often, sound is used to completely or partially cover the tinnitus. Some people refer to this covering of sound as masking. Sound therapies should always be combined with counseling.

TMJ Treatment
Tinnitus can be a symptom of a jaw joint (temporomandibular joint, or TMJ) dysfunction. This can happen because muscles and nerves in the jaw are closely connected to those in the ear and, under the right circumstances, can interfere with the ear's nerves. Dental treatment or bite realignment can help relieve TMJ pain and associated tinnitus. See your dentist if you think you have this problem.

Is there anything to do to lessen intensity of the tinnitus?

It is important to realize that the hearing system is one of the most delicate and sensitive mechanisms in the body. Since it is a part of the general nervous system, it is sensitive, to some degree, by anything that affects the overall health of the individual (both physical and psychological). Therefore, in order to lessen the intensity of tinnitus, it is advisable to make every effort to:

• Avoid exposure to loud sounds and noises.
• Control blood pressure.
• Decrease salt intake.
• Avoid nerve stimulants such as coffee and colas (caffeine) and tobacco (nicotine).
• Reduce anxiety and stress
• Try to stop worrying about the tinnitus. Often times, the more you worry and concentrate on the noise, the louder it will become.
• Get adequate rest and avoid fatigue.
• Exercise.
• Utilize masking noise. Tinnitus is usually more bothersome when the surroundings are quiet, especially when you are in bed. A competing sound such as a ticking clock or a radio may help mask tinnitus. Small hearing aid like devices which generate a competitive sound may help reduce the awareness of the tinnitus.
• Avoid aspirin or aspirin products.