TREATED - Coping With Tinnitus Sept 15 Proof1Most people who live with tinnitus will tell you that it’s not a condition which receives a huge amount of coverage; and those who have had no first-hand experience of tinnitus will often not know much about it as a result. But it is nonetheless a condition which affects a considerable segment of the UK population.

Those who have heard about tinnitus or have had some experience with it may know it more broadly as ‘ringing in the ears’. However, this is quite a limiting description of the condition. The NHS provides a more thorough definition, terming it as hearing sounds which originate from inside the body, as opposed to outside it.

Ringing is certainly a common sensation among these. But people with tinnitus may also hear hissing, humming, buzzing, whistling or even grinding noises. Some may also notice that their hearing in general becomes inhibited, and that they're more likely to perceive other noises which resemble singing, or which keep time with their heartbeat. The latter of these is called 'pulsatile tinnitus'.

As you might expect, this is something which can cause considerable frustration for the person experiencing it.

Fortunately, there are ways those who have tinnitus can reduce the extent of the condition, and prevent it from occurring quite as often.

To discuss this further, we got in touch with tinnitus expert Nic Wray, editor of Quiet magazine and communications manager for the British Tinnitus Association.

Level of Incidence

One of the first and most important facts for someone who has recently discovered that they have tinnitus to know? They're far from being alone. In fact, it is a much more widespread phenomenon than its relatively low profile suggests.

'Tinnitus is very common and is reported in all age groups,' says Nic, 'even young children may experience it. About 30 percent of people will experience tinnitus at some point in their lives but the number of people who live with persistent tinnitus is approximately 10 percent.'

Furthermore, the NHS estimates that around one per cent of people in the UK will have a form of tinnitus which has a detrimental impact on their quality of life. As a percentage, this figure may not sound like much; but it still represents well in excess of half a million UK residents.

Nic goes on to explain that: 'Tinnitus is more common in people who have hearing loss or other ear problems, but it can also be found in people with normal hearing.' Interestingly, reported cases are higher among women than they are men, and that ‘there is a trend for women to describe more complex tinnitus sounds.' Nic also notes that: 'Tinnitus is slightly more common in unskilled rather than professional social groups, but this difference is not explained by differences in noise exposure.'

Possible Causes

There is still a great deal about tinnitus which we do not know; why it occurs, as well as why it affects some people but not others, is not entirely clear.

What we do know is that it is not a disease or an illness.’ explains Nic. ‘It is generally agreed that tinnitus results from some type of change, either mental or physical, and this may not necessarily be related to hearing.

So what might these changes be?

  • Hearing loss. The delicate hair cells in the inner ear may reduce in number due to ‘wear and tear’ as people age. This gradual change can cause hearing loss, which makes tinnitus more noticeable as it is not masked by external sound.’
  • Exposure to loud noise.Hair cells can also be damaged by exposure to loud noises, which could lead to tinnitus.

  • Stress and anxiety.It is not always clear whether stress causes the onset of tinnitus; however, tinnitus may be more noticeable if you are anxious or stressed.’

  • Ear infections.Middle ear infections can cause hearing loss and tinnitus. Symptoms will normally be temporary, but it is important to have the underlying infection treated by a GP.

Seeing a Doctor

As with most conditions, getting help for the condition starts with your GP. Those who notice tinnitus sounds should make an appointment; particularly if these sounds occur on a persistent basis.

Patients may need to be referred to an Ear, Nose and Throat (ENT) Surgeon or an Audiovestibular Physician.’ says Nic, and it’s typical for people with tinnitus to have an MRI IAM scan, to investigate possible inner ear symptoms.

The specialist will rule out any medical factors, assess the person’s hearing and probably give some information about what tinnitus is and how best to manage it. Some hospitals have hearing therapists or specially trained audiologists who are available to offer more support, if needed.

The British Tinnitus Association also provides free support and information to those experiencing the condition.

What Treatment Options Are Available?

Tinnitus is not a condition which is definitively ‘curable’; no one solution is currently available which can completely eradicate it.

But as Nic highlights, it is manageable through the employment of certain strategies:

  • Being knowledgeable. ‘People generally feel better when they find out more about the condition, and that it is very common and that they are not alone.
  • Taking measures to treat hearing loss.If tinnitus is accompanied by any hearing loss, then the use of hearing aids can often be very helpful.
  • Counselling. ‘Techniques such as Cognitive Behavioural Therapy (CBT) can be helpful, either as a standalone therapy or combined with sound therapy.
  • Sound therapy.If the noises seem louder at quiet times, particularly during the night, it may help to have some environmental or natural sound from a CD, a sound generator, a fan or even a ticking clock in the background. Some people may choose to use in-ear sound generators, which are small devices designed to distract the user from hearing tinnitus sounds.’
  • Relaxation.Learning to relax is probably one of the most useful things people can do to help themselves. Those who practice relaxation techniques say that it reduces the loudness of their tinnitus and helps them to become indifferent to it.

Perhaps the most crucial thing to keep in mind for those living with tinnitus, Nic emphasises, is to try not to let it disrupt everyday life:

It’s important for someone with tinnitus to keep doing the things they enjoy. If they start living their life differently to accommodate tinnitus, it’s just going to seem more of a problem. People may need to do some things differently, for example reading with some background music on, but it’s important that they do them nonetheless.’

Will Tinnitus Improve?

The prospect of living with tinnitus might seem alarming for someone who has only just learned that they have the condition. But the good news is that these sounds will often become less apparent over time.

Most people find that their tinnitus does seem to settle down after a while, even without doing anything in particular.’ says Nic. ‘This is referred to as habituation. It’s a bit like walking into a room with a noisy fan or air conditioner. Initially, it seems really loud and then after a while, you stop noticing it as much. Tinnitus can often be much the same – initially, it’s more noticeable but people gradually notice it less as time goes on.’

Preventative Techniques

Like other conditions, taking certain precautions and looking after your hearing can help to reduce the extent of tinnitus; and make it less likely to develop in those who don’t have the condition.

Frequent, prolonged exposure to loud noise increases the risk of getting tinnitus, or of making it worse,’ explains Nic, ‘so people should take care to avoid very loud sounds, or protect their ears against them. Proper ear protectors (not cotton wool) should be worn when hammering metal, using power tools or near any noisy motors. Ear protection is also important when watching live music or playing in a band or orchestra.

But Nic also emphasises that ear protection is not a coping strategy which should be relied upon too much:

It should not be used if ordinary, everyday sounds are uncomfortable (this may be hyperacusis, or oversensitivity to sound). If earplugs are worn for blocking out such sounds, it can actually make hyperacusis worse.

Nic also identifies stress and anxiety as factors which can ‘aggravate tinnitus’, and it is therefore advisable to take measures to limit these.

Hearing loss due to a buildup of earwax can also make tinnitus seem louder,’ explains Nic; so whether you have tinnitus or not, practising good hygiene and keeping your ears clean is a must.

You can find out more about the British Tinnitus Foundation and how to make a donation by visiting their website.