I’m going to talk about Tinnitus because it came up in clinic more than once this week, so here we go.

What is it?

“Ringing in the ears” is a common definition, but it’s not the same for everyone. It can be low or high-pitched sounds. They can be described as ringing as well as anything from whistling, humming, to grumbling.  It may sound different at different times.  It can be loud or soft.  No matter how it sounds, it is tinnitus if it is a sound you can hear but is not coming from an external source (your environment).  That means (with rare exception) no one else hears it.

Why do I have it?

That’s a really good question.  Firstly, you should know that it is common:  studies have found that somewhere between 7 and 14% of the population have experienced persistent tinnitus (meaning it lasts for more than a couple of weeks).  There are number of reasons.  Tinnitus can be cause by damage from loud noises. It can also be due to infections or illness (which is why some people have it – or find it much worse – after Covid-19; that can happen after viruses!). Sometimes medications can cause it as a side effect.  Impacted ear wax and hearing loss are two other common causes, but there are other less common ear problems that can also cause tinnitus.  Sometimes it can come on after a period of intense stress or grief (but that doesn’t mean that it is “in your head”).  Sometimes a cause isn’t found.

What do I do?

If you have just come home from a night spent next to the amplifier at a rock concert, don’t panic.  It’s festival season, so worth highlighting this one.   Hold tight.  Almost 1/3 of people may experience tinnitus short-term in their lives. If it is due to a short term insult to your ear, it may settle.  Same thing after a cold or flu.  However, if it isn’t settling, your first place to check is your GP to have  look in your ears. Your GP can look in your ears to look for common causes, and might recommend that you see an audiologist to have your hearing checked or a ENT consultant to check out other causes.

Why does tinnitus matter?

Firstly, it can be a sign that there is something wrong, but not always. However, even if no cause is found, it can be very distressing and disrupt sleep.

What else can be done?

• Your GP, ENT, or audiologist might have some advice or suggest some treatment after they check your ears. If there isn’t a cause that can be immediately fixed (like removing ear wax), then you can try:

  • Managing stress – really? Really. Studies have found that low mood,  stress, and anxiety can make tinnitus worse, so working on stress can really help. There are a number of evidence-based ways to manage stress.   I work on evidence-based stress management with my patients regularly.  In some cases, referring patients on for CBT can also really help.

  • If you are having repeated episodes of tinnitus that keep coming back after exposure to loud noise (work, concerts, hobbies involving machinery), consider getting good ear protection.

  • I highly recommend the resources at chime.ie to my patient as the next step!!

What doesn’t work?

There are many supplements , including ones with CBD, that claim to help tinnitus.  There is no evidence that any supplement or CBD helps tinnitus.  Neither is there any evidence that other marketed treatments including acupuncture, hyperbaric oxygen therapy, craniosacral therapy, chiropractor, or osteopathy can treat tinnitus.  However, studies have found that if patient found any of the treatment relaxing, the stress/anxiety reduction itself help the tinnitus.

Want to read more?  Check out the independent recommendations at https://tinnitus.org.uk/tinnitus-treatments/