Tinnitus Management Strategies: Finding Relief from Ringing in the Ears
Tinnitus, often described as the sound of ringing in the ears, can also manifest as roaring, buzzing, hissing, or clicking sensations inside the head. The sounds may be intermittent or constant, ranging from a mild annoyance to a severely debilitating condition. These sounds can occur in one or both ears, significantly impacting an individual's quality of life.
The experts at Cleveland Clinic emphasize that they are here to help find ways to manage your tinnitus. They listen to what you’re experiencing and take the time to get to know you. Working as a team, they can find solutions to each challenge you face - letting you get back to enjoying life.
Understanding Tinnitus
The distant peal of bells from a town square or church can be a lovely and even comforting sound. The ringing of tinnitus in your ears is quite the opposite. Constant noise. Ringing in your ears. Tinnitus can feel like an ever-present distraction in your life.
There are many causes of tinnitus. Loud noise can damage your hearing, whether it’s a loud burst or years of prolonged exposure. Tinnitus is often seen in people with hearing loss. It also can be a side effect of some medicines. In rare cases, it's caused by a tumor involving the nerve responsible for hearing. Your healthcare provider may be able to figure out the underlying cause, which can then be treated.
Diagnosing Tinnitus at Cleveland Clinic As you start down the road towards tinnitus management, your healthcare providers will take the time to talk to you about the details of this condition as you go. This starts with discussing what tinnitus is, the types and why you might have it.
There are two types of tinnitus that you can have:
- Somatosensory tinnitus: Sounds your brain perceives when you move the muscles in your jaw or neck.
- Subjective tinnitus: Sounds only you can hear.
When it comes to why this is happening to you, there might not be a simple answer. Tinnitus can have many causes. Our approach means you see a team of specialty providers to find the best ways to manage it. Before scheduling your appointment, we ask you to:
- Have a hearing test during the six months before your appointment: Understanding how hearing loss may be contributing to the tinnitus helps us determine next steps.
- See a doctor who works on the ear, nose and throat (called an otolaryngologist): They’ll make sure you don’t have any conditions that need to be medically or surgically treated first.
Then you’ll have two sessions with our experts. You begin with a 1.5- to 2-hour small group educational session. You’re not alone during this appointment. You’ll be with other people who are experiencing tinnitus. During this session, our specialists talk about causes of tinnitus and explain strategies for managing symptoms.
The second session includes an in-person individual screening with each of your providers. That’s when we’ll provide recommendations for managing your tinnitus. You’ll also get a report outlining everything we discuss with you.
We believe in working as a team to take care of you. With this approach, there are a variety of different healthcare providers you’ll work with, including:
- Neurologist: Our neurology experts talk with you about your medical history and look at the muscles and bones in your head and neck. They review any medications and supplements you take to see if tinnitus may be a side effect.
- Dentist: Cleveland Clinic dental experts examine your neck, jaw and bite (how your teeth come together). They look at the temporomandibular joint (TMJ), which connects your jawbone to your skull, for signs of TMJ disorders.
- Audiologist: Our audiology (hearing) experts determine whether sound therapy would be effective in helping you manage tinnitus.
Strategies for Managing Tinnitus
Currently, there is no known cure for tinnitus. However, several management strategies can help reduce its impact on daily life.
Hearing Aids
Hearing aids can benefit individuals with tinnitus who also experience hearing loss. Using a hearing aid helps make the sounds louder that you are having trouble hearing.
Maskers or Sound Generators
These devices provide help for some people by making tinnitus less noticeable. This device looks like a hearing aid and produces sounds (such as nature sounds) that make tinnitus seem quieter. "The sound distracts the brain, and tinnitus symptoms become easier to tolerate. If you have hearing loss as well as tinnitus, the masking device and hearing aid may operate together as one instrument," Alscher says.
Sound Therapy
Our audiologists may recommend a device worn in the ear to help you listen to sounds other than tinnitus. We may also recommend headphones or earbuds playing sounds you enjoy.
You don't always need a fancy ear device to mask tinnitus sounds. Playing music or "white noise" helps distract your brain, so you pay less attention to the tinnitus. It's especially helpful at night, when it's quiet and tinnitus can interfere with sleep. "Using a bedside sound generator or a fan can help people with tinnitus fall asleep easier and reduce tinnitus distress. Earbuds or headphones will also do the job. "It's just individual preference," Alscher says.
Medicines
Some medicines may ease tinnitus by addressing a problem linked to the condition. Our experts may suggest adjusting certain medications or supplements when tinnitus is a side effect.
Tinnitus Retraining Therapy (TRT)
This therapy uses a combination of counseling and maskers. Consider giving tinnitus retraining therapy a try.
Cognitive Behavioral Therapy (CBT)
CBT helps you identify negative thoughts about tinnitus and reframe the way you think about and react to tinnitus. Tinnitus can cause - and result from - anxiety and stress. We teach you strategies to cope with anxiety.
Lifestyle Adjustments
Several lifestyle changes can also play a significant role in managing tinnitus:
- Reduce Stress: Being stressed out may increase your perception of tinnitus and increase your reaction to it.
- Stay Socially Active: Sometimes tinnitus can become so unbearable that it leads to isolation, loneliness, and a focus on tinnitus symptoms. Make it a point to spend time with people whose company you enjoy, even if it's just a text or phone call.
- Exercise: "Regular physical activity can reduce the frequency and intensity of tinnitus, and the distress it causes, in some people," Alscher says.
- Try Mindfulness: "A program called Mindfulness Based Tinnitus Stress Reduction builds skills in deep breathing, yoga, relaxation, and meditation to help a person to deal with tinnitus," Alscher says. We also offer mindfulness training to help distract you from tinnitus.
Coping Strategies
We help you manage how tinnitus affects your life. Strategies include: Auditory distraction: We teach you to distract yourself from tinnitus by creating a sound-enriched environment. We recommend white noise such as a fan or low-level television sounds for you to focus on.
Other Therapies
- Oral appliances: Cleveland Clinic dental experts may recommend oral appliances like nightguards to ease muscle pain in your jaw and neck.
- Physical therapy: We may recommend you see a physical therapist who will design exercises to strengthen your jaw, neck and back. They may teach you how to stretch your neck and shoulders.
Additional Tips
- Learn your triggers. Write down the circumstances when tinnitus symptoms bother you. "It helps you to anticipate, prevent, and change situations that may make tinnitus worse," Alscher points out.
- Join an online tinnitus support group. "These groups can promote feelings of hope and control. Members often share strategies they have found successful in dealing with their tinnitus," Alscher says.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Know why a new medicine or treatment is prescribed, and how it will help you.
With tinnitus, there’s often no one answer on how to make it go away. It can take several different treatments that you do all at the same time to find relief. At Cleveland Clinic, we use a team to treat your tinnitus. Working together, we’ll work through each part of the issue to help you enjoy your daily life.