It wouldn’t be unrealistic to describe tinnitus as a universal phenomenon. For those that do not suffer on a day to day basis, when asked to listen in a quiet environment they will hear tinnitus sounds. Numerous studies tell us that tinnitus is one of the most common physical symptoms experienced by humans. If this is the case we must ask ourselves, why is it so common?
A number of risk factors have been associated with tinnitus. It is well documented that it tends to increase with age and is also more prevalent in women than men. Unsurprisingly, noise and hearing loss also play their part. General health has been proposed as a risk factor with observations that hypertension and cardiovascular disease can reduce cochlear function and thus generate tinnitus. And interestingly studies have shown tinnitus to be most common in both ears but thereafter showing a dominance in the left ear. Despite this, it’s origin is still unknown.
And whilst most research focuses on tinnitus in adults, let’s not forget that children complain of tinnitus too. It is often thought that tinnitus in children is rare or non-existent, but it is quite the opposite with prevalence figures very similar to adults. Far less common however are children seeking help for tinnitus.
Being told, “there is nothing you can do” is as distressing for some patients as the symptoms themselves. A real understanding of the mechanisms involved in tinnitus is important in acceptance and having a sense of control. How other systems in our brain interact with the auditory system and facilitate the response to the tinnitus helps to explain why we either suffer with it or we don’t. Of most significance is the reactions of our autonomic system (behavioural response) and our limbic system (human emotional response). The brain and auditory system are not static and there is research in abundance about how tinnitus arises because of the malleable nature of these systems which in turn helps us understand how it can be manipulated through therapy, using a holistic approach for this very reason.
Whilst the research into tinnitus treatments does not always make for positive reading there have been some optimistic results from some traditional treatments and newer approaches show exciting results albeit in their infancy.
Sound therapy has shown to help especially when combined with counselling either Cognitive Behavioural Therapy or Tinnitus Retraining Therapy but unfortunately the long term success lets it down. Biofeedback and relaxation training can improve reports of tinnitus but evidence suggests they need to be part of a more comprehensive treatment plan rather than as a standalone treatment. Drug therapy and psychoactive medications show promising results but much more research is needed. Cochlear implants have shown significant improvements for sufferers of tinnitus with single sided deafness (SSD) but is the only surgical treatment that is really justified.
What we do know is that whilst there isn’t a strong evidence base for many conventional or alternative treatments, anecdotal evidence often differs and there is without doubt a strong placebo effect which supports the fact that tinnitus management does help. Taking the time to understand, educate and empower those with tinnitus cannot be underestimated.