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NHS Choices - Treating tinnitus

(09/10/2013)

In most cases, tinnitus isn’t harmful and will often improve over time.

If your tinnitus is caused by an underlying health condition, treating the condition will help stop or reduce the sounds you hear.

For example, if your tinnitus is caused by a build-up of earwax, eardrops or ear irrigation may be recommended. Ear irrigation involves using a pressurised flow of water to remove the earwax.

However, in most cases a cause for tinnitus can't be found so the aim of treatment will be to help you manage the condition on a daily basis.

There are a number of treatments that can help you achieve a positive state of mind and reach a point where you're no longer really aware of your tinnitus (see below).

Correcting hearing loss

Any degree of hearing loss you have should be addressed because straining to listen makes tinnitus worse.

Correcting even fairly minor hearing loss means that parts of the brain involved in hearing don't have to work as hard, and therefore don't pay as much attention to the tinnitus.

The specialist will test your hearing and recommend appropriate treatment. This could involve having a hearing aid fitted or surgery.

Improving your hearing will also mean sounds you wouldn't otherwise hear will now be audible, which may help override the sounds of your tinnitus.

Sound therapy

Tinnitus is often most noticeable in quiet environments. Therefore, the aim of sound therapy is to fill the silence with neutral, often repetitive sounds to distract you from the sound of tinnitus.

Having the radio or television on can sometimes provide enough background noise to mask the sound of tinnitus. Listening to natural relaxing sounds, such as the sound of rain or the sea, can also help.

Environmental sound generators are electronic devices that look similar to a radio. They produce quiet, natural sounds, such as a babbling brook, leaves rustling in the wind and waves lapping on the shore. White noise generators are similar devices that produce a continuous 'shushing' sound at a level that's comfortable and soothing.

Sound generators can be particularly useful when placed by your bedside because they can distract you from your tinnitus when you're falling asleep. Many sound generators have timers so they can turn themselves off after a set period of time (after you've fallen asleep).

An ear-level sound generator is a small device that resembles a hearing aid. It may be recommended if you have normal hearing or mild hearing loss. For more severe hearing loss, some hearing aids have built-in sound generators. These are known as combination instruments.

Tinnitus counselling

Understanding tinnitus plays an important part in learning how to cope with the condition and manage it more effectively.

Tinnitus counselling is usually carried out by hearing therapists, audiologists (hearing disorder specialists) or doctors. It's a talking therapy that helps you learn more about your tinnitus and find ways of coping with it.

Talking about your tinnitus and how it affects your everyday life will enable you to gain a better understanding of your condition and may possibly help lessen its effects.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is often used to treat mental health problems, such as anxietydepression and post-traumatic stress disorder (PTSD).

CBT is based on the idea that your thoughts affect the way you behave. Treatment aims to retrain the way you think in order to change your behaviour.

This technique can be effectively applied to tinnitus. For example, if your knowledge about tinnitus is limited, you may have certain ideas about it that make you feel anxious and depressed. This can make your tinnitus worse.

Changing the way you think about your tinnitus and what you do about it can help reduce your anxiety and enable you to accept the noises, which after a while may become less noticeable.

CBT can also teach you how to cope with negative thoughts and feelings and how to think more positively.

Read more about CBT.

Tinnitus retraining therapy (TRT)

One theory about tinnitus, known as the neurophysiological model, suggests that the limbic system prioritises tinnitus sounds. The limbic system is the area of the brain responsible for emotions.

According to the neurophysiological model, tinnitus sounds have great significance to a person with the condition and perceived as loud or persistent.

Tinnitus retraining therapy (TRT) uses your natural ability to get used to a sound so it becomes part of your subconscious, rather than part of your conscious perception.

For example, after a while the sound of air conditioning units, computer fans and refrigerators become background noises we're able to tune out of. We don't tend to hear these sounds unless we deliberately tune back into them.

TRT uses a combination of sound therapy and counselling to help you retrain the way your brain responds to tinnitus sound so you start to tune out and become less aware of it.

TRT is widely available privately, and may be available on the NHS for people with very severe or persistent tinnitus. It should only be carried out by someone specially trained in the technique.

Self-help

Some people find self-help techniques useful for managing their tinnitus. These techniques include:

  • relaxation - stress can make your tinnitus worse so regular exercise such as yoga may help you relax
  • listening to music - calming music and sounds may also help you relax and fall asleep at bedtime
  • support groups - sharing your experiences with others who have tinnitus may help you cope better (see below)

Action on Hearing Loss (formerly the RNID) has a tinnitus forum and provides further details about online support groups. They can also put you in touch with support groups in your area. Their free telephone number is 0808 808 6666.

You may also find the British Tinnitus Association a useful source of information. You can call their confidential helpline free of charge on 0800 018 0527.

Medication

There's currently no specific medication to treat tinnitus. However, as tinnitus can sometimes cause anxiety and depression, antidepressants may sometimes be prescribed in combination with other types of treatment such as counselling.

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