Tinnitus - Treatment 

Treating tinnitus 

CBT expert

Professor David Clark explains how cognitive behavioural therapy (CBT) works and who could benefit from it.

Media last reviewed: 24/04/2013

Next review due: 24/04/2015

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In most cases, tinnitus isn’t harmful and will often improve over time.

If your tinnitus is caused by an underlying health condition, treating the condition will help stop or reduce the sounds you hear.

For example, if your tinnitus is caused by a build-up of earwax, eardrops or ear irrigation may be recommended. Ear irrigation involves using a pressurised flow of water to remove the earwax.

However, in most cases a cause for tinnitus can't be found so the aim of treatment will be to help you manage the condition on a daily basis.

There are a number of treatments that can help you achieve a positive state of mind and reach a point where you're no longer really aware of your tinnitus (see below).

Correcting hearing loss

Any degree of hearing loss you have should be addressed because straining to listen makes tinnitus worse.

Correcting even fairly minor hearing loss means that parts of the brain involved in hearing don't have to work as hard, and therefore don't pay as much attention to the tinnitus.

The specialist will test your hearing and recommend appropriate treatment. This could involve having a hearing aid fitted or surgery.

Improving your hearing will also mean sounds you wouldn't otherwise hear will now be audible, which may help override the sounds of your tinnitus.

Sound therapy

Tinnitus is often most noticeable in quiet environments. Therefore, the aim of sound therapy is to fill the silence with neutral, often repetitive sounds to distract you from the sound of tinnitus.

Having the radio or television on can sometimes provide enough background noise to mask the sound of tinnitus. Listening to natural relaxing sounds, such as the sound of rain or the sea, can also help.

Environmental sound generators are electronic devices that look similar to a radio. They produce quiet, natural sounds, such as a babbling brook, leaves rustling in the wind and waves lapping on the shore. White noise generators are similar devices that produce a continuous 'shushing' sound at a level that's comfortable and soothing.

Sound generators can be particularly useful when placed by your bedside because they can distract you from your tinnitus when you're falling asleep. Many sound generators have timers so they can turn themselves off after a set period of time (after you've fallen asleep).

An ear-level sound generator is a small device that resembles a hearing aid. It may be recommended if you have normal hearing or mild hearing loss. For more severe hearing loss, some hearing aids have built-in sound generators. These are known as combination instruments.

Tinnitus counselling

Understanding tinnitus plays an important part in learning how to cope with the condition and manage it more effectively.

Tinnitus counselling is usually carried out by hearing therapists, audiologists (hearing disorder specialists) or doctors. It's a talking therapy that helps you learn more about your tinnitus and find ways of coping with it.

Talking about your tinnitus and how it affects your everyday life will enable you to gain a better understanding of your condition and may possibly help lessen its effects.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is often used to treat mental health problems, such as anxietydepression and post-traumatic stress disorder (PTSD).

CBT is based on the idea that your thoughts affect the way you behave. Treatment aims to retrain the way you think in order to change your behaviour.

This technique can be effectively applied to tinnitus. For example, if your knowledge about tinnitus is limited, you may have certain ideas about it that make you feel anxious and depressed. This can make your tinnitus worse.

Changing the way you think about your tinnitus and what you do about it can help reduce your anxiety and enable you to accept the noises, which after a while may become less noticeable.

CBT can also teach you how to cope with negative thoughts and feelings and how to think more positively.

Read more about CBT.

Tinnitus retraining therapy (TRT)

One theory about tinnitus, known as the neurophysiological model, suggests that the limbic system prioritises tinnitus sounds. The limbic system is the area of the brain responsible for emotions.

According to the neurophysiological model, tinnitus sounds have great significance to a person with the condition and perceived as loud or persistent.

Tinnitus retraining therapy (TRT) uses your natural ability to get used to a sound so it becomes part of your subconscious, rather than part of your conscious perception.

For example, after a while the sound of air conditioning units, computer fans and refrigerators become background noises we're able to tune out of. We don't tend to hear these sounds unless we deliberately tune back into them.

TRT uses a combination of sound therapy and counselling to help you retrain the way your brain responds to tinnitus sound so you start to tune out and become less aware of it.

TRT is widely available privately, and may be available on the NHS for people with very severe or persistent tinnitus. It should only be carried out by someone specially trained in the technique.

Self-help

Some people find self-help techniques useful for managing their tinnitus. These techniques include:

  • relaxation - stress can make your tinnitus worse so regular exercise such as yoga may help you relax
  • listening to music - calming music and sounds may also help you relax and fall asleep at bedtime
  • support groups - sharing your experiences with others who have tinnitus may help you cope better (see below)

Action on Hearing Loss (formerly the RNID) has a tinnitus forum and provides further details about online support groups. They can also put you in touch with support groups in your area. Their free telephone number is 0808 808 6666.

You may also find the British Tinnitus Association a useful source of information. You can call their confidential helpline free of charge on 0800 018 0527.

Medication

There's currently no specific medication to treat tinnitus. However, as tinnitus can sometimes cause anxiety and depression, antidepressants may sometimes be prescribed in combination with other types of treatment such as counselling.

Page last reviewed: 12/09/2013

Next review due: 12/09/2015

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Comments

The 17 comments posted are personal views. Any information they give has not been checked and may not be accurate.

edz2002 said on 09 August 2014

Hello, I have had Tinnitus since I was 13. I am now 47 and there is still no cure. I remember seeing my doctor and him giving me two options. Option 1: A masking device. Option 2: A complete ear destruction.
Well not much option so have decided to live with it. It would be nice to have a break from the constant ringing in both ears, it doesn't even take time off at Xmas lol .
I have managed to in some ways ignore it. If you think about it to much it will crack you up. I am also envious of people when they talk about "peace and quite" as I have forgot what thats like.
I think the only way that can help is having a strong mind.
Do things that take your mind off it. I personally find that doing things that require my total concentration makes me forget about it. Drinking booze tends to make it worse but hey we are only human.
This isn't something I talk about to anyone as people don't understand it and I can't be bothered explaining anymore.
It's a tough cookie is tinnitus but there are people with worse things. Battle through, think positive, try not to think about it and don't let it get you down. Good Luck.

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the equaliser said on 14 July 2014

I can understand the frustation expresed on this subject as I have tinnitus. I think mine is as a result of the trade I was in. I find that caffeine makes it worse in my case. So I drink decaff tea and coffee though not exclusively. Some medication I must take is also reputed to increase the effect. I do believe in the power of the mind to ingnore it , otherwise why is it I can fall asleep and miss a good film on television that I really wanted to see. Hope this is of some help.

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pippymick1234 said on 04 July 2014

I rang. My. Gp. There's nothing. I. Can. Do. He. Said not. Even. Come. To. The. Surgery. @ lie. Take. A. Look. In. Other. Words. Just. Get. No. With. It.

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Che1 said on 19 June 2014

I started with tinnitus in July 2013 and after 6 months it really started affecting my sleep, everytime I went to bed, I laid down on my right ear, or even turned overto my right during the night or waking up, I would get the most horrible high pitched ringing noise in my right ear. I have been under extreme emotional distress from a family matter and from authority intervention, and family courts, which I believe caused the emotional pathways of my Brain to 'tune in' to the sound of tinnitus, because one of the nhs theories is its related to emotions. Anyway I visited my gp in feb 2014 and was referred for tinnitus treatment and assessment at huddersfield royal infirmary within a few weeks. I was prescribed betahistine dihydrochloride, which helped reduce the pitch if the tinnitus, but I was still getting it frequently at night time, and was now a mid pitch ringing noise. In may 2014 i started a treatment with a device that creates white noise. It's tiny and sits comfortably in my ear. It's now only a month after starting the treatment and I am sleeping well, and it's a week or so since I last heard the noise.. Which to say it was so high pitched annoying and destroying my quality of life is absolutely amazing! I hope that it's got rid of it.. I've had a week of peace.. :D so touch wood I'm cured!

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pippymick1234 said on 12 June 2014

It's. Driving. Me mad constant buzzing I'm at my wits end wot. To. Do

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david 54 said on 18 May 2014

Sadly I have to agree with majority of previous comments ie that there is no cure. Being told to "ignore it" or "live with it" is like something out of the dark ages

I first contracted tinnitus in Feb 1990. I went thru 10 weeks of cognitive behavioral therapy and suprise suprise it made not one iota of difference - a noise is a noise and not something that can be wished away. I also tried sound thearapy in the form of a small device that emitted a sound - all this did was give be an extra sound to hear. When I did some research it seemed that this wad most peoples experience.

Maybe they will develop some drugs but they always seem to be 5 or 10 years away

The trouble with this disease is that A) there are no visible symptoms and B) no one who doesn't have can no what it is like so we have to keep the pressure up whenever we can

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XXXXXXOOOXXX said on 24 March 2014

This webpage, simply, shows that there is no cure.

Tinnitus sufferers do not need to be told to "stop thinking about it and it'll go away"

Its not "all-in-the-mind". And its running their lives.

They need a cure!

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John Berg said on 16 March 2014

At the age of almost 37 I have now got tinnitus and had it for about 3 months. I don't believe much in treatments involving drugs since it can have some nasty side effects.

I did some research and see that sound therapy seems to have a good effect. In the US, NIH, (National Institutes of Health) are funding a clinical trial for tinnitus treatment device <a href="http://www.topiconhealth.com/quiet-hope-tinnitus-sufferers-sound-therapy/">Read more about it here</a>. Are there any similar clinical trials in the UK?

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repsom said on 07 February 2014

I have suffered with tinnitus for 35 years after working in a very noisy environment. In the last two years it has got substantially worse and I am now going to seek treatment of some kind, as I can't get any relief from it at all.

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bjj said on 31 January 2014

I am due to go on a long haul flight 9+13+4 hrs in 6 days. Had Tinnitus (one ear) so thought I would get ear wax syringed to stop possible pressure pain. Doc found inflamed and so got antibiotic tabs. 5 days later still tinnitus and so got new antibiotic spray. Am due to go back to Docs Monday who says if not clear may be something else requiring further investigation. Will I be able to fly?

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Sunny76 said on 04 December 2013

I started with tinnitus in my right ear back in August and it has just started in my left ear last week. I have only had it a short time but it is driving me mad especially at night. I haven't slept properly for weeks and I am so tired it's unbearable. I have tried the radio, music, the sound of waves, herbal sleeping tablets and nothing is helping. I am desperate and it fills me with dread to think this isn't going to go away. Can anyone come up with any suggestions????

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chrb said on 02 December 2013

@Ravonseed this page can't tell you how to cure tinnitus, because for the vast majority of sufferers there is no cure. Research is ongoing, and maybe in five or ten years there will be a cure or drug-based management, but right now the best thing we can do is turn on the radio and try to ignore it. Sad but true.

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Eme1978 said on 25 November 2013

I suffer with tinnitus and have done for the past 5years or so but recently it is all the time and it's driving me mad!
I don't need CBT or anti-depressants I just want it gone,
How the hell they think that talking about something will make it better is beyond me! I have don't CBT so I do no it doesn't work!!
We all need medical help not therapy.
I'm a quiet person who likes a quiet room to sleep in not a room with noise.
I'm getting desperate now as I really can't take much more!!

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Ravonseed said on 26 October 2013

I feel giving advice on how to ignore Tinnitus is of very little help to sufferers. More helpful would be a medical page explaining with diagrams and facts where and why the sound is produced and how to fix/cure it.

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Ravonseed said on 26 October 2013

This is not very helpful to me. I would like to know what produces the tinnitus sound in my ear and how to stop it. Teaching sufferers to Ignoring it is not a cure. There is no 'suffer in silence' with tinnitus. If anyone can help me I would appreciate direction to a more informative site.

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gt1985 said on 10 March 2013

this page only demonstrates how completely inadequate current treatments for tinnitus are.

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aditech said on 05 May 2011

This post has been extremely insightful and useful to increase my knowledge in this field. Thank you very much, I will certainly come back to visit often. Keep posting and expressing your knowledge and opinions strong!

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