Tinnitus Recovery Timeline (And How To Improve With Tinnitus Retraining Therapy)

Tinnitus retraining therapy is one of the most common protocols used to treat tinnitus. It can improve the distress, anxiety and reaction to tinnitus. As a result of that, the volume shifts into a more manageable state. In Tinnitus Retraining Therapy (TRT), you follow a protocol that works for about 80% of patients. TRT protocols recommend sound therapy and psychology. The cognitive aspect of tinnitus is important: managing reactions, expectations, worries, and fears.

How Long Does Tinnitus Recovery Take?

Two to four months into Tinnitus Retraining Therapy, you may start to feel better. That benefit compounds over time. You can get better and better. Eventually you might reach a plateau. At that point, the volume of the tinnitus may not shift any softer. The plateau may occur between 6-18 months after the onset of your bothersome tinnitus. The results vary by the individual, of course.

Tinnitus Retraining Therapy (TRT) is an approach to treat tinnitus. It has some elements that are similar to cognitive behavioral therapy. Tinnitus Retraining Therapy is typically performed by an audiologist. Tinnitus Retraining Therapy commonly uses hearing aids or ear-level sound generators. The brain does not differentiate between the source of sound therapy. For example, your brain does not know the difference between a hearing aid in your ear playing white noise versus a speaker in your room playing white noise. The reason most patients following Tinnitus Retraining Therapy use ear-level sound (through hearing aids or sound generators) is because they make it easier to have constant sound therapy. Ear-level devices are more sustainable for active individuals, as opposed to carrying around a white noise machine everywhere you go.

There many different types of sound therapy. It is best to use sounds that calm you. Use sounds you actually don’t mind listening to. If white noise creates a negative reaction for you, then we don’t want that, that’s actually not helping you. For some people, the sound of crickets has a positive effect with their tinnitus because it mixes with the high-pitch tinnitus.

Mentioned in the Textbook of Tinnitus, one research study of Tinnitus Retraining Therapy showed significant patient improvement in three months. That group of subjects used constant sound therapy. They also had the educational counseling of a well-trained audiologist. Within three months, they showed improvement with their distress, their reaction, and how much they were bothered by tinnitus.

Research that measures tinnitus treatment does not track the volume of tinnitus. Tinnitus research questionnaires measure the psychological distress of tinnitus. There’s not a correlation between the loudness someone reports their tinnitus and how much they’re bothered by it. A hallmark tinnitus study showed 80% improvement with tinnitus distress within 12 months. It does take time.

Within the first few months, you may notice some shifts of your tinnitus. Success rates of 80% have been widely reported from audiology researchers. Another study looked at the long-term treatment effects of Tinnitus Retraining Therapy at 18 months after beginning treatment. The treatment affects lasted as long as the researchers were in contact with the participants. They found that Tinnitus Retraining Therapy produced significantly better results than the standard of care.

The 4 Most Important Factors To Improve Tinnitus

To best understand your recovery, you may want to learn the different factors that affect tinnitus. Are the multiple factors that caused your tinnitus? Was it just hearing loss that caused tinnitus? How about stress, medication, or trauma?

1. Hearing Loss

Many people with tinnitus have hearing loss. For those who have tinnitus with hearing loss, not everyone is bothered by it. Hearing loss is unlikely the sole cause of very loud and obtrusive tinnitus. Sometimes you can have tinnitus without hearing loss.

2. Stress

Is stress affecting your tinnitus? Persistent stress and anxiety have been known to occur around the same time as bothersome tinnitus. This includes in your workplace or home.

3. Medication

Did you take a medication that triggered tinnitus? Sometimes high doses of anti-anxiety medication can make it harder to improve with tinnitus. Overall, low doses of these medications are typically okay. Medication side effects can be complicated. Best to talk to your doctor about your medications.

4. Trauma

Was there any emotional or physical trauma around the time your tinnitus became loud or bothersome? Maybe you got a vaccine which triggered your tinnitus, and it’s been loud ever since. These events can be traumatic. Examples of emotionally traumatic experiences at a hearing clinic include: ear surgery, ear infection, eardrum perforation, and earwax removal. Tinnitus can linger in the ear after these events, even though the medical condition that caused it improved.

Can You Regain Silence Once You Have Had Tinnitus?

Are we striving to reduce tinnitus to silence? Are we striving to reduce the volume, 50%, so it’s more manageable? Are we trying to get your tinnitus back to a place where it may have been years ago, where it was mild and not causing much of a concern?

Most patients plateau their progress with Tinnitus Retraining Therapy in 6-18 months. That’s not a bad thing. It means you’ve got your tinnitus to as good of a state that your body and mind allow. Most people do not reach complete silence. Setting a goal of silence might be shooting a little too high and lead to disappointment. Occasional periods of silence are great, but you may not want your goal in tinnitus management to be all-or-nothing. If you can reduce the volume or reaction of tinnitus 50%, that would be a big win.

There was an original tinnitus research study completed by Heller and Bergman in 1953.

They had a large group of individuals with normal hearing go in a very silent audio booth. The study showed that 97% of normal hearing adults perceived phantom auditory signals when placed in that silent room for five minutes. The study suggested that sub-auditory perceptions are always present, but are masked by ambient sounds averaging around 35 decibels. Even people with normal hearing in the quietest place hear tinnitus.

There are these sub-auditory perceptions. There is this buzz, this charge of the nervous system of the brain. And your auditory system picks it up when you’re in a quiet enough place. Most people hear sounds in a very quiet place. When you’re managing the expectations of how much you can reduce your tinnitus, you may want to first start with your reaction to tinnitus. Then your tinnitus may improve slowly and by gradual percentages. If someone is still having challenges with anxiety and daily stressors, or having a hard time letting go of the trauma around the original incident of the onset of tinnitus, then it can be hard to reach that plateau.