Biofeedback Health Solutions, LLC
Do You Hear It Now?
by Janice Surina Cise, PhD, RN
Do you have ringing in your ears, but no one else can hear it but you? You and 50 million other Americans may have tinnitus – the sensation of a sound coming from inside one’s head when there is no sound outside the body (American Tinnitus Association). If so, you are not alone. Celebrities with tinnitus include Barbara Streisand, Steve Martin, David Letterman, William Shatner and many others.
In a 1996 interview with David Letterman, William Shatner described his tinnitus experience, “Some people have it really badly; I mean really stressfully bad . . . It can be suicidal in some people - nasty and madness. In my case it came about with an explosion on the [Star Trek] set . . . [Even though we were] in the desert, I kept hearing the ocean. For me, I hear it 24 hours a day - and the fear is that it is getting worse!”
Barbara Streisand’s tinnitus began when she was 9 years old. “It just happened one day. I started to hear these strange noises and I couldn’t block them out. I started to put scarves around my head, but the scarves around my head drove the sound deeper inside me and made the sounds louder. I lived with this secretly-I was afraid to find out what it was.”
Almost everyone experiences tinnitus for a short time. Attending a loud concert can trigger short-lived tinnitus. Tinnitus that lasts more than six months can become chronic.
Tinnitus is a symptom not a disease
Tinnitus may be an irregular or continuous sound - anything from a low roar to a high squeal, a hum, clicking or buzzing sound. Severe tinnitus is also associated with disturbed sleep, increased stress, fear, problems concentrating and difficulties with communication. Tinnitus can be so bothersome that it can lead to depression or anxiety. It’s not the noise itself – it’s our reaction to it. The more the person concentrates on the sound and worries about it, the worse it becomes.
Symptoms
Tinnitus is often associated with recurring noise exposure, ear complications like excessive ear wax, infections, auditory muscle spasms, and hardening ear bones. Reaction to medications and aging are also thought to cause tinnitus. Prior to any treatment, it is important to undergo a thorough examination and evaluation by your otolaryngologist (ENT doctor) and audiologist before deciding on treatment.
Treatment
Currently there is no cure for tinnitus and that can be discouraging. The goal of therapy is to get the brain to ignore it. The Tinnitus Patient Management Program at the University of California at San Francisco recommends several patient-directed strategies to help you reduce the symptoms of tinnitus.
- Health counseling provides intensive, individualized education regarding the causes and effects of tinnitus and coping strategies
- MaskingSound generators that produce a white noise; use of electric fans, radios or television. Avoid total silence.
- Hearing aids: help to amplify speech as well as environmental noise
- Music Therapy: especially classical passages that don't contain wide variations in loudness can be both soothing to the limbic system (the emotional processor in the brain that is commonly negatively linked to a patient's reaction to tinnitus)
- Stress Management- Relaxation, guided imagery and self-hypnosis are examples of self-help methods used to help combat the stress, anxiety and sleep disturbances associated with tinnitus.
- Biofeedback: a technique of making unconscious or involuntary bodily processes detectable by the senses in order to manipulate them by conscious mental control. Biofeedback therapy is used extensively by major tinnitus clinics. Biofeedback with counseling can help relieve stress patterns that can worsen the perception of tinnitus. For more information
- Lifestyle: Reduce exposure to extremely loud noise, decrease salt intake, monitor blood pressure, avoid stimulants such as caffeine and nicotine, exercise.
- Support Groups: Peer support groups offer emotional support to patients and a place to discuss and share treatment techniques.
- Dental Treatment: Jaw joint disorders, called temporomandibular (TMD), may exacerbate tinnitus. Splints and exercises may relieve these problems.
Resources:
Tinnitus Patient Management Program, https://www.ucsfhealth.org/programs/tinnitus_patient_management_program/
American Tinnitus Association, https://www.ata.org/
Aetna Policy Statements: http://www.aetna.com/cpb/medical/data/100_199/0132.html , https://www.aetnabetterhealth.com/pennsylvania/assets/pdf/provider/guidelines/medical/Medical/Tinnitus-Treatments.pdf
American Academy of Otolaryngology http://www.entnet.org/content/tinnitus
Janice Surina Cise, PhD, RN is a Clinical Nurse Specialist and board certified biofeedback practitioner. Contact Dr. Cise at Email: info@BiofeedbackHealthSolution.com
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