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All About Tinnitus
Tinnitus – ‘the perception of sound in the absence of any external stimuli’, or more commonly known as ‘ringing in the ears’ is commonly experienced by Australians of all ages, with prevalence increasing with age.
Many people who experience tinnitus do so at night time, in a quiet environment, or after exposure to loud noise, such as after a concert. Both of these are completely normal and the person may be experiencing the ‘background hum’ of the auditory system, or the auditory system signalling that it has reached overload. In most cases, people are able to habituate to the tinnitus noise, or it disappears and they no longer notice it. For other people, tinnitus can be severe and intrusive impacting on their ability to sleep, concentrate, work, as well as many other side effects, which can be physical, emotional and/or psychological in nature.
Tinnitus is a ‘symptom’ and the cause can be varied, but it is often related to activity in, or damage to the auditory system. Most noticeable are those which damage the auditory system, such as noise exposure, the ageing auditory system and auditory disorders such as Meniere’s disease. Other people have no auditory symptoms, with other causes including, temporomandibular joint dysfunction, physical trauma, head and neck injury, general health conditions such as diabetes, psychological stress/trauma, prescription and over the counter medications; and the list goes on. For some, the cause may remain unknown.
For people who experience annoying tinnitus, defined as, ‘being present for more than five minutes of the day and not just after noise exposure’ their concerns must be addressed seriously. A thorough case history of their experiences, symptoms and concerns will help to determine direction for assessment and management. Referral to an audiologist for a hearing test and audiological assessment and management may be appropriate, as may be referral to a psychologist to help manage any mental health reactions that the person may have. Other appropriate referrals could include Ear Nose and Throat specialists, dentists, physiotherapists and pain management clinics. These referrals may help to identify the underlying cause of the tinnitus and therefore the direction of management.
Some common management strategies can include:
1: Sound stimulation: This aims to provide the person with a ‘sound enriched environment’ to help them to focus on sounds around them, rather than the tinnitus noise. This may be in the form of a hearing aid to address the hearing loss, should the person need it. Other forms of sound stimulation can be bedside sound generators, environmental sounds (there are many apps on the app store), television, radio, classical music. Formal tinnitus therapies may also be recommended by an audiologist.
2: Relaxation: Often people with tinnitus have high stress levels, or find their tinnitus increases with stress. Relaxation helps the body to better cope with the tinnitus.
3: Cognitive Behavioural Therapy (CBT): For many people, it is not the tinnitus sound which is bothersome, but the brain’s reaction to it. CBT helps to train the brain to think about the tinnitus in a more neutral way and therefore lessen it’s reaction.
4: Management of exacerbators: Understanding what makes a person’s tinnitus worse can help them to better manage it. For some people this is stress and fatigue or lack of sleep, for others it may include caffeine and alcohol. Some medications also have tinnitus as a side effect, so this is something to keep in mind.
If you would like more information, or see a person who is troubled by tinnitus and wants free unbiased information about tinnitus, then you can direct them to the Tinnitus SA website tinnitussa.com.au which is maintained by Can:Do Hearing. Can:Do Hearing is South Australia’s only not-for profit audiology clinic providing independent audiology services and advice.