Lead audiologist David Johnstone.jpgTinnitus is the name for hearing noises that are not caused by sounds coming from the outside world. It is common and not usually a sign of anything serious. It might get better by itself and there are treatments that can help.

David Johnstone, lead audiologist at NCIC, spoke about the condition during Tinnitus Awareness Week, which runs until February 7. He said: “Tinnitus is the perception of hearing sounds when no external sound is present.

“Tinnitus is very common and is reported in all ages even young children, approximately 30 per cent of the population will experience some episodes of tinnitus which will likely be short lived and not intrusive but around 13 per cent of people experience tinnitus more persistently, it is most commonly heard in people with hearing loss but can be heard in normal hearing patients.

“Tinnitus sufferers can describe the sounds they hear in varying ways such as ringing, buzzing, whistling, roaring and less commonly as a pulsing or whooshing.

“Most tinnitus is subjective (only the patient can hear it) but there can be cases where it is objective (where a clinician can hear it during examination) this is most likely to be a pulsing sound and can be associated with problems in blood vessels or muscle contractions in and around the middle ear.”

Are there any common causes of tinnitus?

David said: “While we do not know the exact answer to what causes tinnitus, we know that it is not a disease or an illness. It is generally agreed that tinnitus results from some type of change, either mental or physical, not always related to hearing.

“When we hear, sound travels into the ear and then the hearing nerves take the signals to the brain. The brain is then responsible for putting it all together and making sense of the sound. Because the ears don’t know what’s important and what’s not, they send a lot of information to the brain. This is too much information for us to process, so the brain filters out a lot of unnecessary ‘activity’ and background sound, such as clocks ticking or traffic noise.

“If there is a change in the system, for example, a hearing loss or ear infection, the amount of information being sent to the brain changes. The brain then responds to this change in levels by trying to get more information from the ear, and the extra information you may get is the sound we call tinnitus. The tinnitus is therefore actually brain activity and not the ear itself! It is generally accepted that it isn’t only a change in the ear that can result in tinnitus, but it could be due to a change in our stress levels, for example, with tinnitus being noticed after periods of significant stress, a change in life circumstances or general wellbeing.

“People often say that they are aware of noises in the ears when they have a cold, an ear infection or wax blocking the ear. Sometimes people become aware of tinnitus following a really stressful event and once they’re aware of it, seem to notice it more and more, but this usually fades once these things have passed. However, some people continue to notice the tinnitus, for example after an infection has cleared up.

Fortunately, tinnitus is rarely an indication of a serious disorder and a doctor will be able to check this for you.”

What should you do if you think you have tinnitus?

David said: “Don't worry! The first person to talk to is your GP. Your GP may need to refer you to an Ear, Nose and Throat (ENT) Surgeon, who will rule out any medical factors, assess your hearing and probably give you some information about what tinnitus is and how best to manage it.”

Is it preventable or treatable?

David said: “I guess the biggest issue around prevention is to look after your ears with regard to noise damage, prolonged exposure to high intensity noise can cause permanent damage to the sensory hair cells in our inner ear leading to hearing loss and therefore more risk of developing tinnitus. Always use the recommended PPE if you work in a noisy environment, even when we listen to music for enjoyment it should be played at moderate levels.

“There is no "cure" for tinnitus but there are treatments available this is usually accessed by referral from an ENT consultant to the Audiology department or to a counselling service such as First steps. 

“Most NHS Audiology departments have hearing therapists or specially trained audiologists who are available to offer more support, they can fit hearing aids if required and/or therapy devices that use White/Pink noise to help the patient habituate to the sounds they hear so they become less intrusive. Counselling services can provide Tinnitus sufferers with CBT (cognitive Behavioural therapy) or advice on mindfulness and relaxation as it has been proven that stress reduction and relaxation can decrease the perception of intrusive Tinnitus.

“Whichever place you are referred to they will most likely stress that you mustn't worry and to keep doing the things you enjoy.”

Are there any tips you could give someone to help manage it at home that may make it easier to live with?

David said: “If you start living your life differently to accommodate the tinnitus, it’s just going to seem more of a problem. You may need to do things differently, for example introducing some background music at home to try and increase the ambient noise levels around you to act as a distraction in particular in the evenings as Tinnitus can be perceived to be louder at night-time and when trying to sleep as there is less environmental sound to be heard. There are lots of apps available to download that offer soothing sounds and relaxation techniques that are very good at helping people manage their tinnitus at home.”

There are local Tinnitus support groups organised by Cumbria Hearing Loss Equipment service although Covid will affect these. They are funded by Cumbria County Council. E-mail Cumbria@bid.org.uk for more information.

There are also good resources online such as:-

BTA British Tinnitus Association


RNID Royal National Institute for deaf people



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