How Do We Treat Tinnitus?

Hi again, Audiology fam!

We at Andros hope you are all healthy and relatively happy, and continuing to #maskup as we all find our way through the current landscape.

Welcome to part TWO of our tinnitus series – oh, how time flies when we’re all having fun (sincerely hope). Today we’re going to be discussing the various ways that we (your neighborhood friendly audiologists) treat and/or manage tinnitus.

First, I’m going to get this statement out of the way: you won’t find any magic bullet cure here that will immediately disappear your tinnitus. I am so sorry, but we just aren’t there yet. HOWEVER (and you see, I used the capital letters to indicate emphasis because that is a major however), there are many many many ways to manage tinnitus successfully and make life better for people who suffer from tinnitus.

The first type of management strategy we’ll discuss is the use of sound therapies. Sound therapies involve changing a person’s perception of or reaction to their tinnitus, and they do this in a variety of ways. This can mean reducing the prominence of the tinnitus in relation to background noise by partially or completely covering your tinnitus with a sound of your own choosing, using soothing sounds to reduce the stress associated with tinnitus, using an interesting sound in order to distract yourself, or increasing the level of background sound to promote your brain’s habituation or acceptance of your tinnitus over time.

It should be noted that there is an insufficient amount of research available to fully support the use of sound therapies in the treatment of tinnitus, particularly because there are many different ways to implement sound therapy. However, many authors have seen high anecdotal rates of success with different types of sound therapy, and it is still considered a good option for patients with chronic, bothersome tinnitus, as long as realistic expectations are taken into consideration.

The devices used for sound therapy were, at one point, stand-alone devices; purely made for sound generation. Those devices still exist and are available, but at this point, most hearing aids are now what’s considered “combination” devices, and have tinnitus maskers that come standard in many, if not all of the current offerings. As stated in previous blogs regarding this subject – hearing loss is a common comorbidity (pal) of tinnitus, and if we’re treating the hearing loss with a hearing aid, it only makes sense to get a device that is also capable of sound generation. Many people find that the act of treating the hearing loss, and giving the brain something else to listen to (amplification! Birdsong! The ticking of your car turn signal!) helps to minimize their tinnitus, without having to do any other type of sound generation, but more options is better than no options. A very common type of sound therapy that many people (including the friendly neighborhood audiologist writing this article) come to on their own without having to be coached is something called sound enrichment. Sound enrichment is the use of sound in the background during the day or going to sleep to help distract from your tinnitus. Many people use music, podcasts, or even a common household box fan for this task – it is an easy and simple way to give your brain a little relief.

Next management technique is also pretty straightforward: counseling and education! Surprisingly, for some people, just knowing what exactly tinnitus is, and potentially why it is happening helps them adjust to their new normal and go from there. If you’ve been following this series from the beginning, then you already have more information about tinnitus than the general public – go you! The goal of patient education is to increase knowledge about tinnitus, which will hopefully help people to cope and manage their reactions to their tinnitus a little better. The level and type of counseling providing will vary based on individual needs – for many patients, a little education will go a long way. For others, the counseling needed may prove to be outside the scope of the audiologist, and a referral to someone who specializes in cognitive-behavioral therapy (a type of therapy that focuses on reframing thought patterns and behaviors) may be necessary. This does not mean the work you’ve done with your audiologist has failed – this means that you are continuing on the path to better quality of life with tinnitus, and just need someone else to guide you along the path for a little while.

Another subset of tinnitus management strategies include guided tinnitus protocols, where the audiologist and the patient work through a series of prescribed activities and counseling sessions. There are several currently en vogue, including, but not limited to such protocols as TRT (Tinnitus Retraining Therapy), or PTM (Progressive Tinnitus Management). The guided tinnitus protocol favored by Andros Audiology and Hearing Aid Center is a protocol called the Tinnitus Activities Therapy (TAT), which was developed by the University of Iowa. The Tinnitus Activities Therapy integrates sound therapy (see above) with counseling (also see above) and Cognitive Behavioral Therapy (also see above. Gee, I’m thorough). There are four major components or aspects to this form of tinnitus management, each with its own series of activities and counseling to move through: thoughts and emotions, hearing and communication, sleep, and concentration. While the TAT protocol has not been studied systematically, because it is a more modern protocol, there is evidence backing each component used in TAT (sound therapy, counseling, and CBT, as previously discussed).

And with that, we close out our THIRD tinnitus discussion! Next time, we’ll be discussing some tinnitus odds and ends, a few things that are important to note, but don’t really fit in the previous categories.

I hope you all are having a wonderful time taking this wild ride into tinnitus education with me!

Until next time, please stay safe, be well, and as always, remember that Andros Audiology and Hearing Aid Center is here to help.

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