Tinnitus Causes and What You Can Do About It

Let's talk about some of the common causes of tinnitus and what you can do about it. Tinnitus is a sensation of noise or "ringing" in the ears -  a common problem that affects approximately 15 to 20 percent of individuals, so roughly 1 out of 6 people suffer from it. With those kinds of numbers, we feel it's a topic worth exploring, and in fact, it's an important part of our practice at Tinnitus & Hearing Center of Arizona. The Rohe Method ^®  of Tinnitus Treatment  was created as a unique blend of Cognitive Behavior Therapy (CBT) and Tinnitus Retraining Therapy to facilitate retraining the brain. Retraining activates plasticity in the brain, which allows the nervous system to change its function in various ways, typically for learning or self-repair.

The Two Types of Tinnitus

• If you have tinnitus and it is bothering you, affecting your sleep, or affecting your ability to hear naturally or concentrate.
• You develop tinnitus following an upper respiratory infection, like a cold,  and it doesn't improve within one week.
• You have dizziness or hearing loss with your tinnitus.
• You have tinnitus that arises without any apparent cause or comes on suddenly.

• Meniere's disease. Tinnitus may be an early indication of Meniere's disease. This inner ear disorder can be caused by abnormal pressure build-up in the inner ear fluids. It is sometimes also referred to as endolymphatic hydrops, and may be accompanied by sensations of fullness in the ear and dizziness or vertigo. Often described as a low pitched roaring sound early on. A hearing test and other lab tests can help to establish a diagnosis.
• TMJ disorders. Temporomandibular joint problems. This is the joint that is on both sides of the head in the front of the ears, where the lower jawbone meets the skull and is well known to create tinnitus symptoms in some people. Often a low pitch sound, or clicking, ringing, or popping - accompanied by a feeling of fullness and sometimes pain in the ear.
• Neck injuries or head injuries. Neck or head trauma may affect the hearing nerves, the inner ear, or brain function that is linked with hearing. Generally, these injuries cause tinnitus in one ear only.
• Acoustic neuroma. This type of noncancerous (benign) tumor may develop on the cranial nerve running from the inner ear to the brain. Also referred to as an acoustic/vestibular schwannoma, generally the condition causes tinnitus and hearing loss in one ear only.
• Eustachian tube dysfunction. With this condition, the tube that aerates the middle ear stays expanded at all times, and that can make the ear feel full. This type of dysfunction may be caused by radiation therapy, pregnancy, or losing a lot of weight.
• Muscle spasms inside the ear. The middle ear muscles may tense up (spasm), and that can cause tinnitus, a fullness feeling in the ear, and hearing loss. Sometimes it occurs for no reason, but may also be caused by multiple sclerosis or other neurologic diseases. Fluttering sensations may indicate stapedius muscle contractions. Clicking can suggest contractions of the tensor tympani or nasopharyngeal muscles that control opening of the eustachian tube.
• Somatic or body-based sounds (Head and Upper Cervical). Dental, TMJ, or muscular involvement. Can be caused by whiplash injury. The sternocleidomastoid, masseter, splenius capitus, middle and upper trapezius, and temporalis muscles are often the culprits. Properties suggest a somatic component: intermittency, large fluctuations in loudness, and variability of location. Seeing a dentist or physical therapist may be helpful in reducing the severity of the tinnitus symptoms.
• Metabolic causes. Hyperthyroidism (Grave's Disease). An auto-immune response that over stimulates the thyroid. Tinnitus is usually associated with increased cardiac output and causes a pulsing or rushing noise. Hypothyroidism (Hashimoto's Disease) is an inflammatory condition that also affects the thyroid. The tinnitus is usually a constant sound.
• Perilymphatic fistula. Tends to be high frequency (hissing, crickets) and may be caused by barotrauma, head trauma, valsalva (plugging the nose and forcefully blowing out to make the ears "pop"), and erosion to the bony labyrinth caused by inflammatory or neoplastic processes or following middle ear surgery (stapedectomy). May be diagnosed with a fistula test that produces nystagmus when air pressure is applied into the ear canal.
• ​Other factors. Cervical misalignment, menses/menopause, renal disease, kidney transplants, Lyme disease, and poor circulation.

• Atherosclerosis. Growing older, as well as the buildup of cholesterol and other types of deposits will result in major blood vessels near the inner and middle ear to lose some elasticity - or the capability of being able to expand slightly or flex with every heartbeat. This causes the flow of blood to be more forceful and make it easier for the ear to detect beats. Generally, this form of tinnitus can be heard in both ears.
• Neck and head tumors. A tumor pressing on the blood vessels in your neck (vascular neoplasm) or head may cause tinnitus as well as other types of symptoms.
• High blood pressure. Hypertension as well as other factors which increase blood pressure, like caffeine, alcohol, and stress, can cause tinnitus to become more noticeable.
• The turbulent flow of blood. Kinking or narrowing of a neck artery (or carotid artery) or a vein in the neck (jugular vein) may cause irregular, turbulent blood flow, that can cause tinnitus.
• ​Capillary malformation. Arteriovenous malformation (AVM) is a condition where there are abnormal connections between veins and arteries that may cause tinnitus. Generally, this kind of tinnitus occurs in one ear only.

• Antibiotics, which include neomycin, vancomycin (Firvanq, Vancocin HCL), erythromycin, and polymyxin B.
• Cancer medications, which include cisplatin and methotrexate (Trexall).
• Water pills (diuretics) like furosemide (Lasix), ethacrynic acid (Edecrin), or bumetanide (Bumex).
• Quinine medications that are used for treating malaria and other types of health conditions.
• Some antidepressants might make tinnitus worse.
• ​Taking unusually high doses of aspirin (12 or more per day).

Risk factors

• Exposure to loud noise. Exposure for long periods of time to loud noise may damage the tiny sensory hair cells inside the ear that send sound to the brain. Individuals who work in a noisy environment - like construction or factory workers, soldiers, or musicians -  are at especially high risk.
• Age. As people grow older, the amount of functioning nerve fibers inside the ears decline, which can potentially cause hearing issues that are associated with tinnitus quite often.
• Gender. Men have a higher chance of experiencing tinnitus.
• Smoking. Smokers are at a higher risk for developing tinnitus than non-smokers.
• Cardiovascular problems. Certain conditions that affect the flow of blood, like narrow arteries (atherosclerosis) or high blood pressure can increase the risk for developing tinnitus.

• Irritability and anxiety
• Depression
• Memory problems
• Trouble concentrating
• Sleep problems
• Stress
• Fatigue

• Use hearing protection. Exposure to loud noises over time may damage the nerves inside of your ears, and cause tinnitus and hearing loss. You should wear hearing protection at all times if you use firearms (particularly shotguns or pistols), work within an industry where loud machinery is used, are a musician, or use a chain saw.
• Turn the volume down. Being exposed to amplified music over the long term without wearing any form of ear protection or when music is listened to through headphones at really high volumes, may cause tinnitus and hearing loss.
• ​Take good care of your cardiovascular health. Eating right, exercising on a regular basis, and taking other steps to ensure your blood vessels stay healthy can help to prevent blood vessel disorders that are linked to tinnitus.

What To Do About Your Tinnitus
Tinnitus can be successfully managed and thankfully there are a variety of therapies and tinnitus treatments that you can read about in detail here. These include:

• Cognitive Behavior Therapy (CBT)  - CBT is designed to modify cognitions and behaviors that fuel the reaction to the tinnitus, which can escalate anxiety, insomnia, fear, or stress.
• Tinnitus Retraining Therapy (TRT)  - a blend of sound therapy and a specific course of directive counseling aimed towards desensitization and demystifying.
• The Rohe Method ^®  - a unique treatment designed and trademarked by Dr. Allen Rohe of the Tinnitus & Hearing Center of Arizona, called the  Rohe Method ^® , in which sessions can be conducted online via Skype teleconference, or in his clinic in Tempe, Arizona. With guidance from Dr. Rohe, there have been hundreds of patients that have obtained tremendous relief from the noise in their ears, as well as a  substantial reduction in the anxiety and insomnia that affect so many of his patients.