Tinnitus: Ringing in Your Ear Really Comes From Your Brain

Jan. 10, 2024 – Uncontrolled ringing, buzzing, or whooshing in your ear can seriously interfere with your quality of life. Just ask Jeff Grace, who has tinnitus. 

“Tinnitus can be frightening, painful, irksome, isolating, stressful, overwhelming, depressing, distracting, and annoying,” said Grace, a 41-year-old California native who works as aa fitness trainer and coach. 

Grace, who’s had tinnitus for nearly 5 years, said the condition affects his general well-being and is mentally draining. 

“My ears are always filled with a high-pitched ringing noise that doesn’t seem to go away. It follows me around all day long, almost like a constant background hum. It can occasionally be more obvious, particularly in calmer settings, which makes it difficult to focus or relish peaceful periods,” he said, adding that he’s tried many ways to manage his tinnitus. 

“Steering clear of anything that might aggravate my tinnitus is ineffective. If the trigger is a loud noise, it’s not always feasible to avoid that.” 

Tinnitus can also sound like roaring, hissing, humming, clicking, or squealing, and can vary in volume and pitch. It may be constant or happen every once in a while. You may also hear more sound when you move parts of your body. 

According to the American Tinnitus Association, more than 25 million Americans have some form of the disorder, and about for about 5 million people, it’s chronic. 

New Research, New Hope 

A new study from Harvard University’s Massachusetts Eye and Ear offers groundbreaking insight into the role the brain plays in tinnitus – and its surprising significance.

A research team led by Stéphane F. Maison, PhD, an audiologist at Massachusetts Eye and Ear and an associate professor at Harvard Medical School, found that chronic tinnitus was not only linked to a loss of the auditory nerve, but also hyperactivity in the brainstem. 

In their study, published in the journal Nature, people in the study showed normal results on a conventional hearing test, despite tinnitus symptoms. “But we know that does not tell the whole story,” Maison said.

Why is this? 

“If you were in a car accident and lost your leg, you might experience phantom pain – the sensation that your leg is still there and causing discomfort,” he said. “This happens because your brain is trying to compensate for the loss, and in doing so, it becomes hyperactive, so you feel something that is not really there.”

The same idea applies to tinnitus, he said. “We can use the same idea – the brain of a person with hearing loss is trying to ‘hear’ something that is not there, which can result in perceived sound.” 

The good news: The team’s research may be able to provide a specific way to diagnose tinnitus. “There’s no test for tinnitus as a chronic condition, so what we are also trying to do is improve testing so it can be useful in a clinical setting and be useful in terms of treating these patients in the future.”

This means that a patient who is diagnosed with a condition that is linked to tinnitus now may not need to deal with the symptom indefinitely. 

“The hope is to regrow auditory fibers that have been lost through drug therapy,” Maison said. “The consequence of that could be that by ‘retraining’ the brain through treatment, we can reduce tinnitus.”

What are the Causes of Tinnitus? 

According to data from Yale Medicine, this damage can come from something as minor as earwax buildup, or it can result from a disease or disorder, such as: 

Neurological issues, including a head injury Cardiac diseaseAn infection in your ear or sinusesAn inner ear disorderEar and sinus infections/pressureHigh cholesterolThyroid conditionsHormone shiftsFibromyalgiaTemporomandibular joint disorderA side effect or reaction to prescription drugs

Circulatory problems can also cause tinnitus. A vascular condition that lessens blood flow in your body, for example, can cause a rhythmic sound called pulsatile tinnitus. Austrian researchers also point to aging as a key risk factor for tinnitus.

Many patients find that stress makes their tinnitus worse and, like Grace, find that loud sounds make it worse. 

How Is Tinnitus Triggered? 

Any of the conditions that tinnitus is linked to can damage the body’s auditory system. 

“Nobody knows exactly where tinnitus originates in the brain,” said Tina Huang, MD, a neurotologist and assistant professor of otolaryngology at the University of Minnesota Medical School in Minneapolis. “We do know, however, that tinnitus is triggered by hearing loss.”

According to data from Harvard Medical School, sound waves flow to your middle and inner ear. This is where hair cells turn those waves into electrical signals, which then move to your brain’s auditory cortex. If something damages the hair cells, though, your brain doesn’t receive these signals. Instead, abnormal activity happens within your neurons, and you have an auditory illusion: tinnitus.

What Current Treatments for Tinnitus Can Help?

“A doctor can sometimes treat tinnitus with a course of steroids,” says Huang. “Counseling can be very helpful to help patients feel less bothered by it as well.” 

Grace has gotten relief this way. 

“Cognitive behavioral therapy was a treatment that I found to be effective,” he said. “This kind of counseling alters your perspective and how you respond to tinnitus. I learned some coping mechanisms from my therapist to deal with the stress, anxiety, and depression brought on by my tinnitus.”

Exercising and getting enough sleep have also helped him to keep tinnitus triggers like stress and anxiety at bay, he said. 

These treatment options may also be useful: 

Maskers, which are small devices that can lessen the sound you hearHearing aidsCochlear implants, if hearing loss along with tinnitus is very severeRest and relaxation. As Huang sums it up: “Mindfulness can also be helpful, as well as getting enough sleep, to decrease the stress that may make tinnitus worse.”
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