Why has no one found a cure for my tinnitus? The pandemic, stress and noises in my ears.
It seems quite a pertinent time to write this article. There are articles suggesting that some people are noticing hearing loss and tinnitus as a side effect of having a severe version of the virus and on a personal level I have noticed more people being referred for counselling then at the same time last year. Stress and anxiety related to living through a pandemic and how it has affected people’s lives is likely another strong trigger for this spike in tinnitus distress.
Some of the doyens of tinnitus wrote a wonderful article this time last year on exactly this topic of why no cure (https://www.frontiersin.org/articles/10.3389/fnins.2019.00802/full); and the same issues are still relevant a year later.
Quite simply if tinnitus can now perhaps be a side effect of in some severe cases of Covid 19, we can now add another trigger factor or cause of tinnitus. With some many different causes of tinnitus and research showing that that drugs don’t work on tinnitus, it suggests that the origin of where the tinnitus begins on the hearing pathway may be different for each sub type. This makes it difficult to find a pill to make it better, you need to find one that will work on them all (which hasn’t happened yet) or try and separate the different triggers and where they cause the problem and then design an intervention for each.
Great, let’s do that you say! But it’s not that easy. Firstly in comparison to other conditions, research into tinnitus isn’t well funded. Secondly, the ear is a complex mechanism and unlike the eye where we can look in and almost see how it works all the way to the brain; we can’t do this with the inner ear, we are limited to only some scanning technique’s, using animal and computer modelling as we can’t view the whole pathway to the brain easily. This makes finding where the subtype’s origins begin very difficult, that’s before you can even look for a drug. One piece of research which still needs a bit of investigating but kind of makes sense is even suggesting that normal working daily bodily rhythms can also change tinnitus levels !
Secondly we know for long term tinnitus that it isn’t the ear that maintains the sound or increases the loudness. Like for chronic pain the gating mechanism in our brain has become faulty and is letting too much tinnitus information in. What does that mean? Basically it is like someone has dropped a metal bar on your foot and broken your toe. Despite the toe being broken and there being no change to it, the pain reduces slightly after a few hours, and you only then feel the same level of pain if you move it the wrong way. In tinnitus and chronic pain suffers the level of pain going to your conscious brain hasn’t reduced (gated back) like it should have done and you are getting that same level of initial pain all the time. To understand this better you can click on this link about Understanding Pain (recommended by the British Pain Society)
Well that just stinks, I hear you say. What everyone is saying: Go home and get used to it and there isn’t a cure, is true! How am I going to manage?
But that isn’t quite true. The gating mechanism I described above, is our way in, into helping you manage your tinnitus, and those people that have tinnitus , like me have used it to our advantage to make the tinnitus not take over our lives.
The below link is a good way to explain how we work to break the tinnitus cycle
Understanding how pain management works video (breaking the cycle)
Breaking the tinnitus cycle – how it works
Understanding your tinnitus, understanding your negative thought processes, understanding how easily tinnitus attaches itself to stress and pain, understanding the benefits of sound enrichment in your environment and lastly the use of some form of relaxation are all the ways we use to attack tinnitus and chronic pain.
Anyone with a chronic pain or tinnitus would love someone to take their tinnitus away and not have to do the work themselves to get rid of the tinnitus. Or wishing it whatever triggered it had never happened are dangerous thoughts as they keep you stuck where you are presently. But to have your tinnitus not affect you this is what you have to do to go forward to a better place.
Understand your tinnitus?
Yes can fluctuate or in some just stay the same monotone level, some people have more than one sound (we don’t know why and generally the cause of this is not sinister). This is quite a normal pattern for tinnitus.
If we are in pain or stressed, not feeling well, even some people foods that stimulate like chilli, coffee can make tinnitus louder. These stressors often make the tinnitus louder for a time only, and then the tinnitus will generally go back down to normal levels.
Your ear needs something else to listen to! You are only hearing the tinnitus and your brain is concentrating on that, so give it something else. Put music on, the TV or radio, or use a min indoor fountain, distract your ear and brain. BUT not louder, than the tinnitus. You want it just underneath. Otherwise your brain never learns that the tinnitus is the less important sound. Put simply if put loud music on in the house to not hear the planes overhead, you walk out the door the noise of them will slap you in the face. However, if you have music on in the house so you can still hear the planes, you walk out the front door the plane noise is louder but it doesn’t slap you in the face and distress you.
Negative thoughts! We often blame tinnitus for everything. But as a tinnitus counsellor, when I break it down with people, it’s amazing how often they give their tinnitus more power than they should. How many times have people said to me, tinnitus wakes me up and I can’t sleep anymore! Does it really wake you up? If your tinnitus wakes you up, but one of the other things you do 85% of the time when that happens is go to the toilet, than what has really woken you up? This is a negative thought; you are blaming the tinnitus when the original cause is actually a bodily function, but this thought then starts a negative cycle. You wake (probably because your body needs the toilet) but immediately you listen to see if the tinnitus is there, yep it is you get upset, and then you can’t sleep.
Lastly, modern life is incredibly stressful and to overly stimulating. So unless we know how to put on the breaks our stress levels rises and then the amount of give room that we have between being able to cope and new stressful event is much smaller. Learning to relax, meditate is really important. If we do this consistently that give room increases and so we are much better able to cope with new stressful events, and in turn that means we are better able to manage the tinnitus and that then in the long term also helps us to react to it less.
In my next blog. I will describe things a bit further. The above is a very simple explanation of why tinnitus management works and the reasons for it. Tinnitus doesn’t always isolate itself in a bubble and some people will needs lots of help from a tinnitus counsellor and other therapists and clinicians to help them address their tinnitus along with the other issues in their lives. Louise Hart
If you want further immediate support than ring the Tinnitus Helpline on 0800 018 0527 https://www.tinnitus.org.uk/
Of further information https://www.paintoolkit.org/pain-tools on more suggestions for management techniques.