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The Ringing and Buzzing of Tinnitus

Ear Rings
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WebMD Feature

Tinnitus -- "ringing in the ears" -- affects an estimated 35 million Americans. But tinnitus isn't just a ringing, it can also be heard as a buzzing, roaring, hissing, clicking, high-pitched whining, low-pitched hum, even a heart-like pulsing.

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Tinnitus is actually a symptom of some common medical problems, such as:

  • ear infection
  • wax impaction
  • noise exposure (like rock concerts)
  • TMJ (temporomandibular joint) disorders
  • even a side effect of medications such as aspirin, ibuprofen, caffeine, or birth control pills

Tinnitus may also be a symptom of more serious illnesses such as high blood pressure, anxiety/depression, diabetes, thyroid disorders, Ménière's disease, blood vessel disorders, or tumors.

There are two types of tinnitus:

  • subjective tinnitus, when the sounds a sufferer hears may be perceived as very loud and only heard by them
  • objective tinnitus, a less common condition when the sounds can be heard by the sufferer and a medical provider using a stethoscope

Finding a cause for tinnitus can be simple or require extensive diagnostic tests. In many cases, a cause is never found -- a frustrating fact for many tinnitus sufferers and their medical providers.

If a cause is determined, then treatment can be quite focused. For example, if a tinnitus sufferer is taking aspirin and is found to have high blood pressure, the aspirin is stopped and medications are given to control the blood pressure.

Even if a specific cause is never found, there is still hope for successful treatment. A combination of therapies over time usually offer the best hope.

  • Biofeedback, relaxation training, counseling, and individualized psychotherapy helps manage stress and helps you change your body's reaction to the tinnitus. Tinnitus Retraining Therapy (TRT) combines counseling with special background sounds designed to help people suppress the sounds of their tinnitus.
  • Antianxiety medications, such as Valium or Xanax, as well as a wide range of antidepressant medications, are very helpful for tinnitus sufferers. Other medications, such as diuretics (water pills), muscle relaxants, anticonvulsants medications, and antihistamines, are also used.
  • Special hearing aids, electronic masking devices, or both, are often used when other methods have failed to achieve control. Cochlear implants and cochlear stimulation devices are being investigated for severe, intractable tinnitus cases. Surgical injections of lidocaine directly into the inner ear are also being used in some cases.
  • Alternative treatments such as hypnosis, acupuncture, chiropractic adjustments, vitamin/mineral supplements, and herbal remedies may have some promise, but there is little, if any, meaningful research as to their effectiveness. Ginkgo biloba -- which is being studied to determine its effectiveness for tinnitus -- is said to improve blood flow and nerve function. Use ginkgo biloba with caution if you have a bleeding disorder or take blood thinners. Explore alternative options carefully, with the cooperation of your medical providers.

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