What is tinnitus?

Tinnitus is the term for noises heard 'in the ear or ears' or 'in the head' when no obvious source of sound is apparent. The noises are usually described as ringing, whistling, hissing, buzzing or humming.

Tinnitus is not a disease or an illness, it is a non-specific symptom, that can be brought on by a mental or physical 'change', not necessarily related to hearing. In a mild form, tinnitus is extremely common. Almost everyone gets the occasional ringing in the ears, either without any clear trigger or after exposure to loud sounds, be it at work or socially. About 10% of us experience tinnitus frequently and approximately 5% of the adult population in the UK experience persistent or troublesome tinnitus.

Occasionally people have tinnitus that takes the form of recognisable musical sounds or even complete tunes rather than the more common ringing, hissing, buzzing etc sounds. This is referred to as musical imagery tinnitus or auditory imagery tinnitus. It usually occurs in older people who also have a hearing loss and quite often these people have a strong musical interest. The exact mechanism by which this form of tinnitus occurs is unknown but probably involves the auditory memory parts of the brain. Unfortunately, this form of tinnitus is sometimes initially mistaken for mental illness. However, once it has been recognised as tinnitus rather than a psychiatric condition it can be treated in the same way as other forms of tinnitus. Helping hearing loss with appropriate hearing aids is particularly important with musical imagery tinnitus.

What causes it?

Tinnitus may start suddenly or have a more gradual onset. Due to the non-specificity of the symptom the start may be related to mental or physical changes in relation to retirement, being made redundant, having concerns about your own health, or that of a close relative. It may be related to the discomfort of having your ears syringed or attending noisy night clubs or pop concerts. Tinnitus could also be related to perceived changes in hearing. Most sufferers become aware of the tinnitus in a quiet environment. Fortunately, tinnitus is rarely an indication of a serious disorder and a doctor will be able to check against this possibility.

Some medicines can have tinnitus as a temporary side-effect, the most common begin aspirin, but usually only when taken in high doses. The low dosage prescribed for heart problems is unlikely to have any effect. If you think a prescribed medication may be causing or aggravating your tinnitus, ask your doctor about it.

As it is the brain we hear with, it is not surprising that the brain is central to both the perception of and our reaction to the tinnitus signal. So the brain is also central to successful management of tinnitus.

What should you do?

If you think you have tinnitus, go and see your GP. You may need to be referred to an Ear Nose and Throat specialist or an Audio Vestibular Physician, who will take a full medical history and provide a thorough examination. Based on this, medical conditions related to the tinnitus can be confirmed or ruled out, and thereby provide a basis for more specific tinnitus management.

Do not worry about your tinnitus, and do not try to do things to get rid of it, as this only becomes tinnitus related activity, and could actually make tinnitus worse. Based on the medical investigations as indicated above, and information about how tinnitus is generated, the emotions related to the tinnitus perception can be changed. As the attitude to the tinnitus changes, the brain reverts to its usual activity of filtering out 'predictable' signals from the different sensory systems (hearing, smell, touch,
vision etc), thereby filtering out the tinnitus signal from your conscious mind. This is how we learn to live without our tinnitus.

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