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David has 12 years of experience helping over 3000 patients to better hearing. He graduated from the MacEwan University HAP - Hearing Aids Practitioner Program. He is also a TRT Specialist that allows him to help those suffering from tinnitus.
David is the President of the College of Hearing Aid Practitioners (CHAPA), a certified Lyric trainer and a certified Cerumen Management Trainer.
To learn more about David click here.
Last Updated December 10, 2019
What Is Tinnitus?
Tinnitus, or ringing in the ears, is a stress-induced symptom that creates the annoying sensation of hearing sounds when there is no external sound being produced. It can be difficult to live with, as it almost always creates more stress, which is what is likely causing tinnitus in the first place.
Stress can include mental, physical, emotional and so on, but hearing loss is the most common “stress” to our tinnitus.
It can be present in one or both ears, and either some or all of the time. It can range from being unbearably loud to very soft. It is often more noticeable in quiet situations, or at night when you’re trying to relax or sleep. Tinnitus can be mild or in some cases, very bothersome and disruptive to daily routine.
01 | How Does Tinnitus Affect Us?
Tinnitus can cause great distress in those who suffer from it, and it can often have a significant impact on getting through day-to-day activities. Some people have taught themselves to ignore it. For others, tinnitus symptoms can worsen to the point that getting a full night’s sleep is almost impossible. In turn, a bad night’s sleep affects you negatively the next day, causing more strain and stress.
When we consider that tinnitus is usually a symptom of stress, it’s easy to see how a vicious cycle can start. The strain of tinnitus can affect a person’s work and social life, and in severe cases, it can cause headaches, tiredness, insomnia, anxiety, irritability, and depression.
Seeking help with your tinnitus when the symptoms occur is important for your overall health. Although your tinnitus may not go away entirely, small changes can make life with tinnitus more manageable.
02 | How Common Is Tinnitus?
Tinnitus is a condition that affects about 10% to 15% of the overall population. One in five people over the age of 55 report some tinnitus symptoms. It can take on many forms, such as buzzing, hissing, ringing, roaring, or clicking. It’s not a medical condition; tinnitus is a symptom, and most commonly accompanied by some degree of hearing loss. Even if you aren’t experiencing communication difficulties, you may have a hearing loss that you are unaware of. Even a mild hearing loss can cause tinnitus.
Many people come into the clinic seeking relief from tinnitus even if they don’t really know what it is. In fact, the question “what is tinnitus?” is a common conversation starter in the world of audiology.
03 | Is The Ringing In My Ears Tinnitus?
The simplest answer is that tinnitus is the technical term for an experience known as “ringing in the ears”—something many people tend to be familiar with as a point of reference.
Tinnitus, however, is much more than the relatively brief ear-ringing you might experience after sitting in the stands at a loud and raucous sporting event or a highly-amplified concert full of screaming fans. It is a situation in which one actually seems to hear “phantom” sounds on a consistent basis. To understand what that means, we need to step back and look at how we hear in the first place.
How Healthy Hearing Works
- Soundwaves enter the ear canal, where they vibrate the eardrum
- The eardrum, in turn, sets a series of small bones in motion
- The last of those small bones vibrate against an inner-ear organ called the cochlea
- Inside the cochlea, small hair cells translate vibrations into electrical impulses
- Those electrical impulses travel along the auditory nerve to the brain
- Inside the brain, those impulses are recognized as sound
04 | What Might Be Causing Tinnitus
Tinnitus occurs when the information that eventually reaches the brain has been somehow damaged or corrupted. How is this sound information damaged? The causes include hearing loss, stress, physical trauma, Misophonia, noise exposure, and the aging process, among others.
05 | Are the Sounds Of Tinnitus Real?
The experience and strain of tinnitus is very real, but the answer here is a tricky one. Stress and other causes can interrupt the signal of sound that our brains are trying to perceive. When sound signal is corrupted, missing, or even unexpected, tinnitus can be caused.
In those instances, the brain actually begins to register sound that isn’t really there. The sounds of tinnitus can include (but aren’t limited to) ringing, buzzing, hissing, roaring, buzzing or even clicking—and they can vary in both pitch and intensity.
What’s interesting about this is that studies show tinnitus can actually be induced when test subjects who normally don’t suffer from tinnitus are placed in a completely silent space. How is this possible? We hear sounds all the time, so the lack of sound can put our auditory system into overdrive as it tries to find sound, inducing tinnitus. This has allowed us to understand more about why people suffer from tinnitus, and to recognize that tinnitus itself is a symptom.
06 | What Are The Symptoms Of Tinnitus
When discussing the symptoms of tinnitus, it’s important to note that tinnitus actually IS a symptom. The presence of tinnitus in the ear means there is something not right, and having an evaluation done by a physician or hearing health professional is an important step.
What Does Tinnitus Sound Like?
The sounds of tinnitus could be ringing in the ears, hissing, buzzing, whistling, roaring, even clicking. Sometimes it’s constant, sometimes it comes and goes. Whatever the sound the individual hears, it is heard even though nothing nearby is actually making that sound. The brain misinterprets the reduced signals from the ear, resulting in a perception of sound, or tinnitus.
So what is it that creates that perception of sound when there is none present? Sound waves travel through the ear canal to the middle and inner ear. Hair cells in the inner ear help transform the sound waves into electrical signals which then travel to the brain. The brain translates the signals into meaningful information so you can interpret the sounds you hear.
When hair cells get damaged, the brain doesn’t receive the accurate signals it needs. There can be different causes of why your hair cells get damaged and subsequently lead to tinnitus. Sometimes, the cause is not related to inner hair cells.
Experts suspect that, in many cases, tinnitus relates to the brain trying to adapt to a loss of hair cells. The brain misinterprets the reduced signals from the ear, resulting in a perception of sound, or tinnitus.
07 | What Are Common Causes Of Tinnitus?
What Might Be Causing My Symptoms Of Tinnitus?
It could age-related hearing loss, excessive noise exposure, physical injury, cardiovascular difficulties, something interfering with the eardrum or another cause. Whatever the source, the presence of tinnitus is signified by the same experience; the person with tinnitus hears a persistent sound for which there is no external source.
Tinnitus is usually representative of an inner-ear problem and is often caused by prolonged exposure to loud noise. Depending on the intensity of the sound, your hearing may be damaged temporarily or permanently; whether or not temporary damage will become permanent is something that can’t always be determined.
Other possible causes of tinnitus are certain medications, diet, head trauma, stress, eardrum blockage, jaw joint disorders, and hearing loss. Mechanisms that cause tinnitus in the brain and inner ear are the subjects of ongoing research.
When discussing causes, it’s important to remember that tinnitus is not a condition or illness. It is a symptom of some other problem occurring in the body.
More About Common Causes of Tinnitus
Stress is a common cause of tinnitus. In fact, it’s often referred to as a “stress-induced symptom,” meaning that it is an indicator of stress in an individual’s life. While it can cause much strain to those dealing with it, it’s important to work to find sources of stress that might be causing it in the first place. When seeking treatment for tinnitus, it’s likely that a hearing health care provider will check for any hearing loss but definitely look for sources of stress that could be triggering the tinnitus. In many cases, if the source of stress can be addressed, so can the tinnitus.
Noise (Noise-induced Tinnitus)
Most people know constant exposure to overly-loud noises can damage their hearing, but those same noises can lead to noise-induced tinnitus. Here’s how: sound is measured in units of pressure, called “decibels.” To better understand this measurement, think of your eardrum as a snare drum. Softer sounds are like a jazz drummer using brushes on that drum; loud noises are like a rock drummer hitting the same drum with a solid stick. So, the louder the noise, the more pressure that noise puts on your hearing mechanisms.
Constant exposure to loud noises (e.g., loud music, loud machinery at home or work, loud recreational activities) can literally overwhelm the mechanisms of the inner ear, causing the kind of damage leading to “phantom” sound signals being sent to the brain.
Trauma that results in injury to the inner ear can interfere with the proper functioning of the cochlea, an organ located in the inner ear. Inside the cochlea are many thousands of tiny hair cells that translate the vibrations of soundwaves into electrical impulses for the brain, where those impulses are recognized as sound.
Should trauma cause hair cells in the cochlea to be damaged, they can begin to “misfire,” so to speak, sending the brain signals about a sound that isn’t really there.
Hearing loss contributes to 90% of tinnitus cases. Research shows you are more likely to hear ringing if you have hearing loss. At least some level of age-related hearing loss is a fact of life for most people and hearing loss related to the aging process tends to involve the mechanism of the inner ear. As some hair cells die from the natural process of aging, the resulting hearing loss can include tinnitus.
When the ear canal becomes blocked (e.g., by excessive earwax) the pressure built up in the canal can result in tinnitus-like symptoms by interfering with the eardrum. A blockage that makes contact with the eardrum can cause the same symptoms.
Head and Neck Injuries
Head or neck trauma can cause problems with your nerves, muscles and overall blood flow, which can eventually lead to tinnitus. Most of the time this will cause tinnitus in only one ear.
Motor Vehicle Accidents
Bow River Hearing has established a custom program to support individuals suffering from tinnitus as a result of a motor vehicle accident. Seeking help after an accident can feel overwhelming, with insurance claims and multiple service providers to coordinate. Bow River Hearing can perform the necessary testing, and make sure the cost is coveredby your insurance company.
Can Some Medications Cause Tinnitus?
Some medications can affect hearing, so it’s wise to consider if there might be a connection. There are drugs out there that, while they treat illness, have a quality known as “ototoxicity”—meaning, essentially, they can be toxic to one’s ability to hear properly.
There are many medications and herbs with ototoxic effects, ranging from temporary to long-term, so ask your doctor about the possible side effects of any medication that is prescribed or that you are considering taking over-the-counter.
The drugs to be most concerned about are NSAIDs (non-steroidal anti-inflammatory drugs), some antibiotics, certain cancer medications, water pills, diuretics, and medications that are quinine-based.
Can Illness Or Health Conditions Cause Tinnitus?
Tinnitus has been reported in connection with various medical conditions, including anemia, anxiety, atherosclerosis, tumours, depression, fibromyalgia, high blood pressure, hyperthyroidism, hypothyroidism, Lyme disease, Ménière’s disease, otosclerosis, stress, and temporomandibular joint disorder. Hypertension and factors that increase blood pressure, such as stress, alcohol, and caffeine, can make tinnitus more noticeable.
08 | What Is Pulsatile Tinnitus?
There is another type of tinnitus known as “pulsatile tinnitus” in which the perceived sound is the result not of damaged sound impulses, but rather the pressure of blood flow in the inner ear; it essentially mirrors the individual’s pulse rate.
In rare cases, a blood vessel disorder may result in pulsatile tinnitus, which sends pulsing signals in concert with your heartbeat. It can be caused by a tumor of the head or neck head, a buildup of circulatory system cholesterol, elevated blood pressure, blood flow turbulence or malformed capillaries surrounding the ear.
If you suspect you are suffering from pulsatile tinnitus, contact your family physician for check-up.
09 | What Should I Do If I Think I’m Suffering From Tinnitus?
In seeking tinnitus relief, it is important to note that tinnitus is always an indication of something that has prevented accurate information from reaching the brain. It’s a symptom, not a condition in and of itself. It can be temporary or it can linger permanently.
If you suspect tinnitus in yourself or a loved one, the best course of action is a thorough hearing evaluation by certified hearing healthcare professionals.
10 | Is There A Cure For Tinnitus
Most people suffering just want to know – is tinnitus curable? It’s understandable that most sufferers just want to know how to get rid of tinnitus. Hearing professionals can help you find out what’s causing your tinnitus and explore possibilities for reducing its effect on your life. Sometimes, simply changing your diet or medication regimen can help with your symptoms. Relaxation techniques can also be a source of relief. But at present, there is no cure for tinnitus.
How you think about your tinnitus can influence your emotional reactions. The brain may interpret the sound of tinnitus as something harmful to your well-being. When you respond to tinnitus as a threat, you become stressed and anxious. The stress and anxiety you feel can make the sound of tinnitus seem even more bothersome. This is an understandable human reaction. The brain misinterprets the reduced signals from the ear, resulting in a perception of sound, or tinnitus.
Our hearing care providers are committed to better hearing and are trained to provide treatment methods that can help lessen the impact of tinnitus. Hearing technology can, in most cases, relieve the burden caused by the combination of tinnitus and hearing loss.
11 | Tinnitus Treatment Options
- Manage stress from all sources – exercise, meditate, improve diet, etc.
- Hearing Technology that can improve hearing overall and eliminate perceived ringing.
- Maskers that are fitted to the ear like hearing aids and produce low-level sounds to distract the wearer from tinnitus.
- Tinnitus Retraining Therapy which combines sounds therapy and counselling to remove the negative associations with ringing sounds, retraining your brain to not be bothered by ringing.
12 | What Is Tinnitus Retraining Therapy (TRT)?
Tinnitus can be managed with the implementation of Tinnitus Retraining Therapy (TRT). Developed in 1990 by a neurologist named Dr. Pawel Jastreboff, and an audiologist named Jonathan Hazell, TRT is the gold standard for tinnitus treatment. For those individuals whose tinnitus has become a significant annoyance, a systematic approach to ‘habituate’ to their condition can be delivered through TRT.
To understand how TRT works, it is important to understand tinnitus in greater detail. Tinnitus can be divided into two components. The first component is the auditory component, or the perception of the tinnitus (arises from the inner ear and auditory centers in the brain). The second component is the non-auditory component and this refers to the ‘bothersome’ nature of tinnitus. This non-auditory component arises from the limbic system (the emotional center of the brain) and the autonomic nervous system (the brain’s ‘alert system’ designed to give the message to the individual of ‘fight’ or ‘flee’ from a dangerous situation).
When the limbic system is activated by the tinnitus, the individual may feel a sense of extreme discomfort or panic. TRT can help a person “habituate” to their tinnitus or to grow accustomed to it. So, to habituate to tinnitus means to reach a state of mind where there is no longer a negative emotional response to the tinnitus.
“…TRT is the gold standard for tinnitus treatment. For those individuals whose tinnitus has become a significant annoyance, a systematic approach to ‘habituate’ to their condition can be delivered through TRT.”
Tinnitus Retraining Therapy is delivered by persons who have received specialized training in this therapeutic model. The treatment includes:
Intensive client education about the auditory mechanism and the role the brain plays in tinnitus perception. With education, the tinnitus will be ‘demystified’. This will help reduce distress and anxiety about the tinnitus.
Use of ear level or table-top sound generators and/or hearing aids to provide continuous stimulation of the auditory system to interfere with the perception of tinnitus. This would also include the use of environmental sounds. This will also help reduce distress and anxiety about the tinnitus.
It takes time for the brain to habituate to the perception of tinnitus. Most clients report a noticeable improvement in as little as 6-8 weeks. The duration of the TRT program can last between 16 –24 months.
Regardless of the cause of the tinnitus, with or without hearing loss, the success rate of TRT is 80%. This is the highest success rate of any treatment or therapy currently available. The effects of TRT are long-lasting and there are no side effects.
13 | Is It Time To Address My Tinnitus?
- Does your tinnitus make it difficult for you to concentrate?
- Do you have trouble falling asleep at night because of your tinnitus?
- Does your tinnitus make you feel frustrated?
- Is it difficult to enjoy life because of your tinnitus?
- Do you feel as though you cannot escape from your tinnitus?
If you answered yes to any of these then it would be a good idea to contact a medical professional or a Hearing Care Professional to have a hearing test as a first step.
At our Bow River Hearing clinics in Calgary and Airdrie, we are committed to treating tinnitus and improving the quality of life of those suffering from tinnitus symptoms. We offer one of the best tinnitus treatment centres in all of Western Canada.
Our audiologists and hearing health care providers are specifically trained in performing hearing tests to identify tinnitus, and how to properly treat those with tinnitus. We offer free TRT Initial Assessment and Complete Assessment for $450; our treatment package starts at $2100. If you have been dealing with tinnitus stop by one of our clinics and let us help you find relief.
What Most People Ask About Tinnitus
To answer that question, it helps to understand why you hear tinnitus in the first place. While the exact cause of tinnitus is unclear, researchers know you are more likely to hear ringing if you have hearing loss. The hearing loss in the ear will prevent the brain from receiving the proper stimulation it needs. As a result, the brain starts to produce its own phantom sounds.
An interesting fact—the pitch of your tinnitus is usually the same pitch where there is the most hearing loss. If you have a high-frequency hearing loss, it is likely you will hear a high pitched ringing sound.
It’s important to note that hearing aids are not a cure for tinnitus, but they can help. Once you are fit with hearing aids, your brain will start to receive stimulation at the pitches you had hearing loss. Over time, and with consistent hearing aid use, the perception of the tinnitus can be reduced.
There is a form of tinnitus referred to as “objective tinnitus” that your doctor can hear. This is typically the result of a blood vessel problem, an inner ear bone condition, or muscle contractions. If you place your fingers on your pulse and your tinnitus matches your pulse, you likely have pulsatile tinnitus. This could be a sign of turbulent blood flow, and you should be seen by your physician.
- Limiting exposure to loud noises
- Lowering your blood pressure
- Ingesting less salt
- Limiting exposure to alcohol