While there’s no cure for chronic tinnitus yet, plenty of treatments can bring great relief. Hearing aids can help a lot, especially when you have hearing loss as well. While they can’t reverse hearing loss or cure tinnitus, they can make both conditions more bearable. Moreover, hearing aids can slow down the progression of both hearing loss and its associated tinnitus.

Let’s explore what causes tinnitus, how a hearing aid can help, and what you should watch out for.

What is tinnitus and what causes it?

The statue of a woman with closed eyes and her left hand perched in front of her right ear, as if listening to sound coming from her back.

Pexels Tinnitus has no external stimuli.

Tinnitus is a phantom noise heard in one or both ears. It typically presents as a high-pitched ringing, but many people also experience it as a persistent hiss, whiz, buzz, roarclickhum, or whoosh noise. Each person’s tinnitus is unique and varies in pitch and volume between individuals. A single person can even experience great variations in their own tinnitus.

Type of tinnitusDefinition
Subjective tinnitusOnly the affected individual can hear the sound
Objective tinnitusThe sound can also be heard by the examiner, for example, due to rapid blood flow through malformed arteries and veins that causes a whooshing sound (bruit)
Pulsatile tinnitusDescribed as producing sound of regular pulsations, which may be subjective or objective
Primary tinnitusThis variety doesn't have a known cause and may or may not be associated with sensorineural hearing loss (SNHL). The SNHL should be symmetrical
Secondary tinnitusThis is associated with a specific underlying cause other than symmetrical SNHL
Acute or recent onset tinnitusStarted less than six months ago
Chronic tinnitusHas been persisting for more than six months

The causes of tinnitus are as diverse as its manifestation. An ear infection, ear canal blockage, or various medications (e.g., aspirin or antibiotics), can lead to reversible ringing in the ear. Likewise, short-term exposure to loud noise can cause temporary tinnitus that fades within a few hours. Chronic tinnitus can result from sensorineural hearing loss (SNHL), vascular disease, diabetes, hypertension, autoimmune disorders, degenerative neural disorders, and injuries that affect the ear or the brain.

Tinnitus is commonly associated with noise-induced SNHL. According to the Hearing Loss Association of America (HLAA), 90% of people with tinnitus experience some degree of noise-induced hearing loss, and just one in five people who could benefit from hearing aids actually use them.

A digital drawing of how noise-induced hearing loss impacts the ears. The one on the left shows how sound travels into the ear and the right is a close-up fo the middle and inner ears.

Noise-induced hearing loss is usually a result of damage to the stereocilia, which are located in the organ of the Corti. This organ rests inside the cochlea.

Age-related and noise-induced SNHL result from damage to stereocilia in the inner ear. The destruction of these hair cells leads to reduced sensitivity to certain sound frequencies. The associated neurons, however, can still send signals to the brain. Consequently, tinnitus correlates with abnormal neural activity along the auditory pathway, which reaches from the inner ear into the brain. Current research proposes that tinnitus originates in the central auditory system. In other words, the phantom noise we perceive as tinnitus is likely a product of our brain.

Read more: Can headphones cause tinnitus?

How can hearing aids help with tinnitus?

A receiver-in-canal hearing aid with description of its components.

Oticon A hearing aid amplifies external sounds, which can mask tinnitus.

Tinnitus is frequently correlated with hearing loss. When the two conditions are linked, a hearing aid alone can ease the ringing in the ears. By amplifying external sounds, the hearing aid can mask the tinnitus as the brain will focus on real sounds instead. With a properly fit hearing aid, listening also becomes much easier, which can significantly reduce stress and calm the tinnitus.

Learn more: How do hearing aids work?

Severe cases of tinnitus can involve insomnia, anxiety, and depression. Since those cases require more comprehensive interventions, many hearing aids include custom tinnitus programs that can make the constant noise more bearable. When you’re in the market for a hearing aid that can also treat your tinnitus, look for one of the features listed below.

While hearing aids can produce frequencies that extend beyond 8kHz, audiologists rarely test or correct for hearing above 8kHz as it’s not required for communication. If your tinnitus fires at a higher frequency, you might benefit from dedicated masking devices.

Sound therapy

Close up of faders on a mixing console.

Alexey Ruban The right mix of sounds can drown out your tinnitus.

Most types of sound therapy block out the tinnitus with low-level white noise. In an auditory context, white noise is a random collection of equally intense sounds that cover the audible frequency range (20 to 20,000Hz). Exposure to static white noise is a form of masking that distracts your brain from the tinnitus. Your audiologist can customize the sound spectrum to your tinnitus.

Tinnitus Notch therapy

Tinnitus Notch therapy is a feature found in Signia hearing aids. It’s designed to treat tonal tinnitus, which manifests as a mostly continuous and stable frequency. This therapy eliminates the tinnitus frequency from amplified sound and can quiet the tinnitus. In rare cases, this therapy can even make the humring, or buzz disappear. The method is based on so-called windowed sound therapy, which has proven effective after four to five months of treatment.

Tinnitus retraining therapy

A female counselor sits across from her male patient the same way one would during tinnitus-focused therapy.

Pexels Counseling is a core part of tinnitus retraining therapy.

Tinnitus retraining therapy (TRT) combines counseling with sound therapy. According to TRT, when people suffering from tinnitus accept it as harmless stimuli, the noise becomes less irritating, and negative reactions like insomnia or anxiety disappear. This process is known as habituation. While sound therapy can mask the irritating noise to some degree, TRT counseling can interrupt the brain’s damaging feedback loop. The process can take up to two years.

Since audiologists typically administer TRT, you’re bound to come across it when you shop for hearing aids.

Tinnitus masking therapy

Similar in theory to TRT, tinnitus masking therapy focuses on the acoustic stimulation with counseling being mainly educational, rather than therapeutic. The goal is to mask the tinnitus completely.

What other tinnitus treatments can help?

A flowchart depicting the suggested assessment and management pathway in patients with tinnitus.

AJGP Bothersome tinnitus, whether it’s the primary or secondary type, can be treated with a hearing aid, sound therapy, or CBT.

Tinnitus isn’t always associated with hearing loss. Below are tinnitus treatment options in case you don’t require a hearing aid, but find your symptoms bothersome.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is used for a range of conditions, including depression, anxiety, panic attacks, and tinnitus. CBT targets the patient’s thoughts and behaviors. Ideally, CBT results in a change in thought patterns and subsequent attenuation of the symptoms. In the case of tinnitus, relaxation techniques can divert the attention from the noise to other stimuli. It’s similar to the counseling part of TRT.

White noise machines and masking devices

A white noise machine with six programs, volume control, night light, and a timer; this can more effectively treat tinnitus than hearing aids if the users tinnitus manifests above 8kHz.

Amazon A white noise machine can help you find sleep more quickly.

White noise is commonly used to drown out or mask tinnitus. Depending on your tinnitus frequency, similar noises, such as nature or ambient sounds, can also be effective. With the right app, such as ReSound Relief, your phone can be a white or ambient noise machine. You can also find earbud-style tinnitus maskers or radio-like white noise machines, such as the one shown above. These masking devices can cover the full sound spectrum.

Meditation

Like TRT and CBT, you can train your mind to focus on something other than the tinnitus through meditation to bring relief. As your attention shifts away from the tinnitus, the noise becomes less of a distraction, and it might even quiet down over time.

The best thing you can do to prevent tinnitus or its progression is to prevent (further) hearing loss.

Next: Why you should buy noise cancelling headphones

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