There is no absolute cure for tinnitus, but there are many ways to make it go away
There is no treatment to cure tinnitus, but there are many ways to help patients manage it effectively.
But these methods are not singular. There is no single medical measure that can combat tinnitus, nor is there any one physical therapy or special diet that can make it go away.
This may be because at present we do not fully understand the causes of tinnitus. As a result, there are as many possible treatments for tinnitus as there are causes. It is only a matter of time before some tinnitus can be controlled by medical treatments and others cannot.
Traditional Approaches – Surgery and Medications
Is surgery an option?
There is no surgical procedure that can cure tinnitus, and even severing the auditory nerve will not make it go away. This fact supports the fact that tinnitus is a sensory disorder of the auditory conduction pathway at a higher level of the brain.
Pharmacological treatment of tinnitus
The local anesthetic lidocaine given intravenously can suppress tinnitus, but this pharmacological effect lasts for a short period of time.
Some medications can cause tinnitus when applied in high doses, so read the instructions carefully and consult your doctor when applying the medication.
Pharmacological treatment of acute tinnitus
The therapeutic view of acute tinnitus is to improve blood circulation and increase the oxygen supply to the organs, especially to the inner ear. This is usually achieved by administering medication to thin the blood and raise the partial pressure of oxygen.
Our view of chronic tinnitus is different. Chronic tinnitus is not caused by a decrease in the oxygen supply to the inner ear. Therefore the treatment of acute tinnitus cannot be applied to chronic tinnitus. However, doctors and patients seem to prefer to apply medications that increase the oxygen supply to the organs.
However, there is no scientific evidence that these medications can improve blood circulation in the inner ear or combat tinnitus.
The benefits of relaxation exercises
Since stress is a component of tinnitus, we highly recommend relaxation exercises. Some of these exercises include.
*Progressive muscle relaxation (Jacobson)
*Bodywork (Feldenkrais)
*Biofeedback
*Breathing therapy
*Tai chi, medicine and yoga
The most important advice for managing tinnitus is to rest your body and avoid being too quiet.
Some additional treatment methods
On average, each tinnitus patient tries at least 10 treatments, which indicates that there is no absolute effective treatment for tinnitus.
Effectiveness of laser treatment
This treatment was widely promoted a few years ago, but clinical findings have shown that it is not effective.
Hyperbaric oxygen therapy
Hyperbaric oxygen therapy can increase the partial pressure of oxygen and can be used to treat acute tinnitus. However, it has no definite efficacy for chronic tinnitus.
Retraining treatment for tinnitus
Currently, retraining for tinnitus is the most effective treatment for chronic tinnitus in the long term.
Tinnitus retraining is a scientific approach to the treatment of tinnitus based on Professor Jastreboff’s neurophysiological model. This treatment has been applied in the United States and the United Kingdom, and in field trials in many countries, 70% of participants reported significant improvement in their condition.
As mentioned earlier, detectable tinnitus is not a very strong sound. The loudness of the sound perceived by tinnitus patients is really produced in the brain and can be considered as the result of a negative learning process. This process allows the patient’s attention to be focused primarily on the tinnitus.
The goal of tinnitus retraining therapy is to change the patient’s perception from negative to neutral. By working with an audiologist and following the retraining therapy approach, tinnitus can be habituated and accepted by the patient.
Retraining is not about making the tinnitus inaudible to the patient. In fact, modern tests such as positron emission tomography (PET) can show specific activity in the cerebral cortex associated with tinnitus.
Originally, tinnitus is not a psychiatric disorder, and the recognition that damage to the hair cells of the inner ear is the most common primary cause of tinnitus is indisputable. After a certain point, however, tinnitus is no longer associated with the inner ear cause of its origin. Thus, tinnitus can still exist when auditory signals cannot be transmitted from the ear to the brain, for example, when the auditory nerve is severed.
During its chronic course, tinnitus takes on a “life of its own”. Unlike other environmental noises, the brain cannot dismiss tinnitus from its consciousness.
As a result, the tinnitus no longer comes from the ear, but is centralized with the powerful involvement of the limbic system associated with emotions. This explains why many of the past measures targeting only the inner ear have been ineffective.
What to expect from retraining
The aim of retraining is to habituate the patient to tinnitus, i.e., to make it no longer occupy the patient’s primary consciousness. Retraining does not guarantee a cure for tinnitus, and it is important to understand this.
One advantage of retraining is that it is effective for any cause of tinnitus (some causes of tinnitus are not known for sure). The goal of retraining is to improve the patient’s general quality of life.
Another benefit is that retraining requires the active participation of the patient. However, it requires insight, time, patience and determination.
Retraining is absolutely harmless, has no side effects, does not require the administration of medication and does not damage hearing.
From other studies
Eighty percent of tinnitus patients report that tinnitus does not impair their daily life, including those who describe their tinnitus as “very loud”. This suggests that there is no direct correlation between the subjective perception of the loudness of tinnitus and its impact on the patient’s quality of life.
Since tinnitus is not eliminated due to the lack of a cure, the actual goal of patients should be to be part of that 80% group for whom tinnitus is no longer important.
What retraining treatment does not guarantee
Sometimes, tinnitus disappears after retraining. But retraining does not guarantee a cure; its goal is to accustom the patient to the tinnitus rather than to make it go away.
Many patients who participate in retraining therapy report that their tinnitus continues to exist, but no longer bothers them. When asked, many patients must actively seek out the tinnitus in order to hear it again. Others even report that the tinnitus disappears. But tinnitus disappearance should not be the patient’s expectation of treatment; the patient’s expectation of treatment should be realistic.
Retraining treatment is a time commitment
In general retraining is a long term treatment process with the goal of lasting improvement. Therefore, retraining often lasts 12-24 months. However, patients report significant improvement after 6 months of treatment.
Retraining as an outpatient treatment
Retraining is generally an outpatient treatment. However, it makes sense to start treatment on an inpatient basis, especially if the patient is under severe stress. Long-term hospitalization is not necessary.
The role of auditory hypersensitivity
Auditory hypersensitivity is an over-sensitivity to general sounds in the environment and retraining is very effective for auditory hypersensitivity.
Elements of retraining therapy: providing counseling and TCI
Jastreboff laid the groundwork for retraining therapy in the early 1990’s. According to him, retraining consists of providing ongoing counseling (including thorough information and ongoing instruction) and wearing a Tinnitus Control Instrument (TCI).
Like any therapeutic intervention, retraining has undergone a series of changes and its application has varied from country to country. As a result, a four-branch concept is often proposed that includes counseling, psychological guidance, relaxation methods and the wearing of a TCI.
Retraining is group work
Retraining is a group effort that sometimes cannot be done effectively by individuals alone. Each element of retraining is equally important. Good directional counseling and proper adjustment of the tinnitus control device by an audiologist is critical.
Potential benefits: return on investment
Numerous clinical trials have been conducted in several centers in the US, UK and Germany, and several years of practice have shown a high chance of success. But we should look at success rates especially in terms of long-term benefits. Many patients report significant improvement within 6 months of treatment, but the chances rise to 70-80% after 24 months.
However, it is important not to confuse improvement with cure. The goal of retraining is to make the patient unaware of the presence of tinnitus, which typically results in a reduced awareness of the tinnitus.
Retraining Therapy – An Ongoing Discussion
Retraining is an approach that is currently of interest to many medical professionals. Of all the treatments available for tinnitus, retraining therapy is the most scientifically based. However, there are different views.
For example, perhaps because retraining is a newly discovered method, the number of long-term participants is insufficient relative to medical standards. It is also difficult to qualify the “my tinnitus improved” report because there are no strict criteria between study groups. But even critics have not disputed the proven benefits of retraining.