The BEST Tinnitus Treatment Plan

Most doctors will tell you that there’s nothing they can do about your tinnitus and that you should just hope it goes away. But, when the weeks start to go by and you still have that ringing in your ears, it can start to become a real nuisance and affect the way you experience the world around you. 

Tackling tinnitus is about taking the right steps, but the problem for most people is figuring out which steps to take. Some tinnitus patients will go through several doctors and supposed treatments before finding any sort of relief. In the meantime, they’re left to deal with trouble concentrating, sleep issues, stress, anxiety, and a host of other symptoms. 

Tinnitus Functional Index 

The Tinnitus Functional Index (TFI) is a self-report questionnaire used to assess the severity of these tinnitus symptoms and their function impact on the person’s daily life. It is typically used at the beginning and end of a tinnitus treatment plan to measure its success. According to the criteria set by the researchers, there needs to be at least a 13-point reduction in the TFI scores for the tinnitus treatment to be considered effective. 

Get an ENT Evaluation

The first step in this tinnitus treatment plan is reaching out to your Primary Care Physician (PCP) for a referral to an ENT, or otorhinolaryngologist. The purpose of this appointment is to rule out a medical or physical cause of the tinnitus. Even if the appointment doesn’t reveal the direct cause of tinnitus, it can rule out other  potential causes, such as hearing loss, ear or sinus infections, or a disorder in the physical structures of your ear. 

Your ENT will perform a head/neck examination and other routine tests, while your audiologist will perform a comprehensive audiological exam to assess your general hearing health. This will bring you one step closer to the root cause of your tinnitus. Finding the root cause of your tinnitus is useful for customizing a treatment plan, but it isn’t always clear.

It’s normal to leave the ENT appointment feeling disappointed if the root cause isn’t clear. While there is no cure for tinnitus, with the help of tinnitus specialists, most tinnitus patients find relief from their symptoms through the use of evidence based tinnitus treatment programs which aim to help reduce the tinnitus awareness and disturbance, eventually leading to habituation to the tinnitus.

Practice Healthy Hearing

According to the Hearing Loss Association of America (HLAA), about 90% of patients with tinnitus have hearing loss. In most cases, treating this hearing loss helps reduce tinnitus symptoms. This is especially common in patients with high-pitch hearing loss where tinnitus symptoms have more of an impact on everyday life than the hearing problem. 

Treating hearing loss usually comes in the form of hearing devices such as hearing aids. Modern hearing aids even have tinnitus features designed to mask tinnitus sounds, or provide sound therapy while simultaneously providing amplification and promote habituation. Earmuffs and other forms of hearing protection can be useful to prevent fluctuations in your tinnitus levels if your tinnitus is triggered by loud sounds. 

Practicing healthy hearing also includes proper earwax removal techniques since blocked ear canals can trigger tinnitus symptoms. This includes avoiding bobby pins and foreign objects like q-tips to clean your ears and opting for ear drops or professional earwax removal instead. 

Consider Changing Medication

Even though there’s no medication to treat tinnitus, certain medications can make tinnitus worse. Your primary care physician or ENT should review any medications you take to determine if any of them are ototoxic. Ototoxicity is a side effect of certain medications and other substances that cause damage to the auditory system. 

Over 600 categories of drugs have been linked to hearing and balance problems, as well as tinnitus. Some of these include common pain relievers, diabetes medication, chemotherapy drugs, antibiotics, hypertension medication, and antimalarial drugs. If you notice your tinnitus started, stopped or fluctuated around the same time as starting the medication, it might be worth discussing alternatives with your physician.

Use Environmental Sound Enrichment

Once you take care of the medical aspect of the tinnitus, it is time to focus on your home environment (or any private indoor space). 

The world is full of sounds, but our brains usually filter them by importance, so we might not even notice everyday noises like the hum of a refrigerator or the whir of a computer fan. Over time, the human brain evolved to use environmental sounds to protect us from threats. For example, rustling leaves might alert us to a predator during a walk, while birdsong is soothing and doesn’t provoke fear. This is part of our fight-or-flight response, which belongs to the autonomic nervous system. Unfortunately, tinnitus can trigger this system, causing many sufferers to live in a heightened state of fight-or-flight due to their condition.

Tinnitus cannot hurt you, but the brain can overreact to the phantom sounds and can trigger the body’s fight-or-flight system. Sound enrichment with soft and/or soothing sounds can help the brain re-categorize the tinnitus as a neutral sound. 

Tinnitus can get worse in a quiet place and can make it difficult to focus or even fall asleep. Low-level background sound enrichment has proven useful in helping the brain reduce the tinnitus awareness and disturbance since there is another sound source present to distract away from the tinnitus as the primary sound source. This can include anything from nature sounds to classical music, but can be as simple as a TV in the background, or a ceiling fan.

Promote Habituation 

Though we might be unable to stop the phantom sounds, we can change the way our minds and bodies react to them. Getting ‘used to’ the tinnitus is a good thing. 

Habituation training is designed to help the brain gradually reduce the perceived importance of the tinnitus sound. This should, in turn, reduce the volume of the tinnitus. This approach requires commitment, as experts believe it can take as many as one to two years for habituation to be successful. 

Habitation training should involve techniques that provide a sense of progress, relief, control, security, and/or success. These include sound therapy, journaling, counseling, hearing technology, tinnitus devices, and lifestyle changes. 

Try Personalized Sound Therapy

Most times, when you hear patients say sound therapy didn’t work for them, it’s because they just pulled up ‘tinnitus sound therapy’ online, and expected a miracle. While sound enrichment through a mobile device or computer can be useful, it is much more effective with a customized or targeted approach. 

Modern sound therapy devices can be programmed by an audiologist to the specific pitch and quality of your tinnitus. Many of these devices are discreet and have Smartphone capabilities, making it easier to deliver customized sound therapy consistently and on the go. 

Get Coaching

Tinnitus treatment plans should involve some type of coaching or counseling. This can come in the form of Cognitive Behavioral Therapy (CBT) with an experienced tinnitus professional, Tinnitus Retraining Therapy (TRT), and sound therapy. 

Many patients with tinnitus struggle with sleep issues, stress, depression, anxiety, focus and concentration issues, and even anger problems These therapies are designed to address the mental and emotional toll of tinnitus symptoms and reduce their overall impact on quality of life. Tinnitus support groups and communities can also offer the support many patients need to manage their tinnitus.

Practice Muscle Relaxation

Reducing stress and tension is important for people who have tinnitus symptoms. Stress has been linked to tinnitus fluctuations, and can have other negative impacts on the mind and body. Tinnitus specialists recommend relaxation techniques to help manage everyday stress and prevent flare-ups. 

Daily progressive muscle relaxation can help settle the mind and body, calm the nervous system, and loosen tense muscles. It involves isolating, tensing, and relaxing one muscle group at a time. You don’t even need an instructor. Many patients use guided audio tracks that explain how and when to perform various stretches, and which parts of the body to focus on.

Muscle relaxation is just one way to reduce stress in your life. Improving sleep habits, good diet, and exercise all contribute to peace of mind. This should help create the ideal psychological environment for habituation. 

Use Mindfulness Breathing Techniques

Practicing mindfulness is an important part of Cognitive Behavioral Therapy. This may include short, conscious breathing exercises as a form of meditation to relieve mental and physical strain. Mindfulness breathing techniques are easy to learn, and you can do them anywhere at any time. 

Here’s an easy one: Assume a relaxation position, and if possible, find a quiet, comfortable place. Start by exhaling, then inhale slowly while counting to 4. Hold for 7 seconds, then exhale slowly for 8 seconds. Repeat this a few times everyday, focusing on controlling your breath and clearing your mind.

Foster Healthy Sleep Habits

Tinnitus can affect sleep, but poor sleep habits can also affect tinnitus. This is a cycle many tinnitus patients struggle with. Practicing CBT can help reduce anxiety and insomnia, and prepare the mind for sleep. Some patients use a sound therapy generator to mask and soothe tinnitus throughout the night.

Other ways to foster healthy sleep habits include sticking to a bedtime, creating a comfortable sleep environment, and using natural sleep aids such as chamomile tea to reduce nighttime anxiety. 

Tackle Tinnitus With the Treble Health Team

Tinnitus can be overwhelming and difficult to treat on your own, but our team of audiologists have helped thousands of patients find relief from their tinnitus. If you are ready to start your journey towards tinnitus relief, we encourage you to schedule a complimentary telehealth consultation with a specialist on our team.

During this 20-minute Zoom meeting, we will delve into your unique situation, providing answers to your questions and personalized strategies to manage and alleviate your tinnitus symptoms. We are committed to helping you regain control over your auditory world, guiding you towards a life of tranquility and well-being. Don’t wait; schedule your free consultation today and begin your journey to a quieter, more peaceful life.