Tinnitus Treatments to Stop the Ringing: Which Treatment is Right for You?
If you are one of the millions of people with tinnitus, you are probably looking to quiet the constant sound in your ears. Tinnitus can be treated effectively, especially if your diagnosis is clear.
The following will discuss the most effective treatments for tinnitus and the ways you can say goodbye to the ringing in your ears, for good.
What Is The Most Effective Treatment For Tinnitus?
The most effective treatment for tinnitus is through the use of a combination of therapies, depending on the cause of the ringing. This may include:
- Removal of earwax
- Noise reduction
- Cognitive behavioral therapy
- Tinnitus retraining
- Lifestyle changes
There is no scientifically proven “cure” for tinnitus.
However, these treatments can reduce the perceived burden of ringing or buzzing. In turn, this can allow for more comfort as you go about your daily activities.
This treatment involves wearing noise-canceling headphones if you work in noisy spaces or are exposed to loud noises. It also involves reducing the volume of your television and other electronic devices.
The first treatment for tinnitus is an overall change in lifestyle. This is a form of self-treatment that most people who experience tinnitus for the first time should implement.
Reduce your noise exposure. Since prolonged loud noise exposure can cause tinnitus, reducing the time, frequency, and intensity of the noise, can help with symptoms.
Removal of Cerumen
Since blocked earwax can impede sound and causes tinnitus, you may want to remove any built-up cerumen. An ENT doctor can remove this for you if it’s seated deep or is extremely large.
Turbulent blood flow and plaque in the arteries can cause tinnitus.
Be sure to avoid nicotine, caffeine, and alcohol as they can affect the flow and pressure of blood. Turbulent blood flow causes tinnitus, so you may want to reduce these triggers in your diet.
Similarly, exercising and reducing salty and high-fat foods can reduce your blood pressure. This is helpful because plaques in arteries also cause tinnitus. Daily exercise and a healthy diet can be effective tinnitus remedies and ease your symptoms.
Sleep improves tinnitus in many people. If you are sleeping adequately, then you’ll find that the tinnitus symptoms may lessen.
People with ringing in their ears often have insomnia. While it is unclear which comes first, you may want to analyze your sleep hygiene to see if it can help ease your tinnitus burden.
Hearing aids amplify external sounds. In turn, this makes the brain refocus on the external sounds while masking the internal sounds. Modern hearing aids are customizable.
In fact, some even have sound masking abilities, as they have built-in players for white sounds or ambient noise. You may also consider a cochlear implant as well. A hearing aid is not just a tinnitus treatment, it can also prevent tinnitus from worsening.
There are various types of sound therapies depending on the cause of tinnitus. They follow one of four mechanisms of action: masking, distraction, habituation, and neuromodulation. There are several treatment options available in sound therapy.
1. Sound Masking Devices
There are a variety of sound masking devices and white noise machines that can mask the sound of tinnitus. The devices deliver white noise, pink noise, nature sounds, and ambient sounds.
These include tabletop devices, music devices, or bedside machines. If you do not want to splurge, a whirling fan can also have the same effect. Music and sound devices can retrain your hearing by habituating it so that the tinnitus is less observed even when the device is switched off.
2. Sound and Sleep Apps
There are several sound and sleep apps for tinnitus. You can choose one based on your sensitivity and the amount of relief it provides. The benefit of these apps is that you can take your phone with you everywhere.
Behavioral therapy requires a coordinated effort from your ENT, audiologist, and behavioral health therapist.
1. Cognitive Behavioral Therapy
CBT or Cognitive Behavioral Therapy is an umbrella term that encompasses many therapies. A behavioral therapist will counsel you and then begin a chosen therapy to see if it relieves the ringing. They may also employ other behavioral therapies.
This is particularly helpful for those who suffer simultaneously from anxiety or depression. Some of these therapies include: Tinnitus Retraining Therapy (TRT), Progressive Tinnitus Management (PTM), and Tinnitus Activities Treatment (TAT).
Hypnotherapy has also been helpful for people with tinnitus and anxiety. It alters neural connections in the brain and thus, relieves tinnitus in some individuals.
Biofeedback works by changing your body’s reaction to tinnitus. After 10-12 hours, with each session one hour long, biofeedback dramatically improved tinnitus for at least 6-12 months.
4. Stress Reduction
Stress reduction is possible with any of the other behavioral techniques. Stress can cause and result from tinnitus. Reducing stress can improve tinnitus.
Mindfulness-based stress reduction therapy (MBSR) or mindfulness-based cognitive therapy (MBCT) can be used to help.
Alternatively, practicing meditation, deep breathing exercises, guided imagery, and affirmations, are also methods of reducing stress.
There are no FDA-approved drugs to treat tinnitus.
However, drugs that are used to treat other conditions have been found to help people with tinnitus. Your doctor may try treating tinnitus with one of the following medications.
Common antidepressants that help people with tinnitus include: trimipramine, nortriptyline, paroxetine, and trazodone. In clinical studies, nortriptyline has been proven to reduce tinnitus loudness, tinnitus disability, and depression.
Various combinations of antidepressants are being studied to potentiate their benefits and are under trial. However, some antidepressants may also make tinnitus worse. Be sure to exercise caution and seek medical advice.
Studies have shown that alprazolam reduced tinnitus in 76% of the subjects. Similar effects were also found with Diazepam.
Conversely, Clonazepam performed somewhat better as it also reduced the loudness of tinnitus when compared to the other two antidepressants. It also reduced annoyance, making it the preferred choice.
Anticonvulsants like Vigabatrin (Sabril®) and Tiagabine (Gabitril®), are being studied in animals on their ability to reduce tinnitus. Vigabatrin has shown that it can reduce tinnitus, and so human trials are underway.
Intravenous Lidocaine, a local anesthetic, suppresses tinnitus in some populations. According to studies, it can cause large reductions in tinnitus. However, the effects are short-term.
A similar analog of Lidocaine and Tocainide, has been studied as an alternative. The results were not as promising.
5. Miscellaneous Drugs
Numerous other medications have worked as tinnitus therapy for some people but are not approved medications for tinnitus. These include anti-alcohol drugs like Acamprosate, which after 90 days of treatment, showed a significant reduction in tinnitus.
Carbamazepine has been shown to reduce tinnitus in roughly half of the studied population. It is more effective in those who respond positively to Lidocaine.
According to a case study, 200 mg of Valproate, twice a day, may also be effective in suppressing tinnitus.
Gabapentin and Sertraline also reduce anxiety and tinnitus annoyance, especially if it is noise-induced. The latter is successful in reducing tinnitus loudness as well.
Sulpiride, an antipsychotic drug, also suppresses tinnitus symptoms. Combined with Melatonin, it seems to be most effective.
There are plenty of drugs like Memantine, Neramexane, and Gacyclidine, all currently under study for the treatment of tinnitus.
TMJ treatments involve treating any dysfunction of the temporomandibular joint (TMJ) and its associated structures.
This includes dental therapy, decompression of the neck, and massage therapy for the head and neck muscles. Tinnitus patients may also benefit from neck surgery to relieve symptoms.
Scientists are studying several interesting experimental therapies.
1. Deep Brain Stimulation (DBS)
Deep brain stimulation is used for people with Parkinson’s disease. Here, the brain is stimulated with electromagnetic activity. Tinnitus relief has been reported as a benefit in people treated with (DBS).
2. Transcranial Magnetic Stimulation
In this therapy, electromagnetic pulses are delivered repeatedly to the underlying brain tissue. This stimulates the brain’s neural cortex. It has been observed that electromagnetic stimulation of the brain reduces neural activity.
Other experimental therapies include Transcranial Direct Current Stimulation (tDCS), Vagus Nerve Stimulation (VNS), and Brain Surface Implants.
Saying Goodbye To Tinnitus
While there is no cure for tinnitus, it can be effectively treated. If you choose not to, you may end up with hearing loss. Using a combination of the above treatment options can allow you to live a life free of tinnitus.
But, it is a question of finding what works for you. It is important to remember what works for one person may be different from another person. With trial, you can find a treatment that suits you best!
2. House JW. Treatment of severe tinnitus with biofeedback training. Laryngoscope. 1978;88(3):406-412. doi:10.1288/00005537-197803000-00004
3. Sullivan M, Katon W, Russo J, Dobie R, Sakai C. A randomized trial of nortriptyline for severe chronic tinnitus. Effects on depression, disability, and tinnitus symptoms. Arch Intern Med. 1993;153(19):2251-2259.
4. Johnson RM, Brummett R, Schleuning A. Use of alprazolam for relief of tinnitus. A double-blind study. Arch Otolaryngol Head Neck Surg. 1993;119(8):842-845. doi:10.1001/archotol.1993.01880200042006
5. Melding PS, Goodey RJ, Thorne PR. The use of intravenous lignocaine in the diagnosis and treatment of tinnitus. J Laryngol Otol. 1978;92(2):115-121. doi:10.1017/s002221510008511x
6. Menkes DB, Larson PM. Sodium valproate for tinnitus. J Neurol Neurosurg Psychiatry. 1998;65(5):803. doi:10.1136/jnnp.65.5.803