Using Multiple Treatment Approaches to Improve Tinnitus

angry woman screaming in room

By Lori Zitelli, Au.D., CH-TM, Managing Audiologist, UPMC Audiology

We estimate that approximately 15% of the population of the United States experiences tinnitus, a noise in the ears or head. Some are bothered by these sounds and others are not. For those who are bothered, there are a variety of different management strategies available. We use the word “management” rather than “cure,” because the goal is not to make the tinnitus disappear. Even people who do not have chronic tinnitus experience noises in their ears or head from time to time; this is normal. Rather, the goal is to provide strategies to make the tinnitus less noticeable or bothersome.

Improvements in tinnitus can be seen in a variety of different ways. For example, some people who are bothered by tinnitus at night when they are trying to fall asleep or stay asleep may feel that their tinnitus is improved if they are able to use soothing sounds at night that make their tinnitus less noticeable and increase their ability to relax. For other people who may not struggle with sleep, the definition of improvement may look different. Another example: Some people feel that their tinnitus interferes with their ability to concentrate on a specific task. In this case, success may be found by using background sounds that are neutral (such as a fan or white noise machine) in order to reduce their awareness of their tinnitus and improve their ability to focus on the task at hand.

A common treatment-related goal for tinnitus is habituation. Habituation is the process of your brain learning to tune something out. This happens all the time when you are exposed to things regularly that do not have significant positive or negative meaning attached. In the case of tinnitus, when habituation occurs, our brains do not focus on the sounds as much and they become easier to ignore. Habituation is often achieved over time (sometimes without formal treatment), but many people require professional help to make their tinnitus less bothersome.

Research has demonstrated many treatment options for tinnitus that people may find helpful. Most available guidelines for treatment of tinnitus support the use of hearing aids (when hearing loss is present) and cognitive behavioral therapy for tinnitus-related distress. It is important to work with your hearing care provider to find the options that are most appropriate.

In our clinic, we divide treatment options for tinnitus into three categories:

  • Interdisciplinary Care

    In some instances, tinnitus may be related to another disorder and medical management may be appropriate. Ear disease, mental health disorders, and temporomandibular disorders are a few common examples. In each of these cases, treatment of the underlying medical issue may make the tinnitus significantly more manageable. A Primary Care Provider (PCP) is likely an important ally here. Your PCP is someone who can oversee all of your care and provide appropriate specialty referrals when indicated. This being said, many cases of tinnitus do not result from an underlying disorder that can be managed medically, and in these instances, a person will rely primarily on strategies from the categories described below.

    • Self-Care

    Many people prefer to utilize self-care options. These options require a person to take action themselves in order to address a specific issue. Some self-care options come at no cost and others may have associated costs. In some cases, self-care can be guided by a professional even without direct interactions. Many self-care strategies can be employed by people who are looking for tinnitus relief. Common strategies include relaxation exercises, sound therapy, and seeking evidence-based education about tinnitus.

    • Audiologic Care

    The third category of care includes options that require an audiologist’s care. Audiologists are well-suited to be the professionals managing hearing, tinnitus, and balance-related care. An audiologist who specializes in tinnitus can take the time to explain what happens in your brain when tinnitus becomes a problem and how we use a variety of tools to treat it. Long-term treatment options often include on-ear devices such as hearing aids, tinnitus sound generators, or combination devices that provide both amplification and therapeutic sounds at the same time.

    Over time, new treatments for tinnitus will continue to be explored. Many researchers are focusing on strategies that employ different forms of brain stimulation (for example, transcranial magnetic stimulation and bimodal neuromodulation). As new treatments continue to become available, UPMC audiologists focus on matching appropriate treatments to individual people.

    If you are interested in scheduling a consultation for tinnitus, please call our office at 412-647-2030 to schedule either a group information session in a video format or a personalized consultation in the office.