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09.04.2014

My ears are ringing and my head hurts, tinnitus causes and treatments - For You

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If you subscribe to any of our print newsletters and have never activated your online account, please activate your account below for online access. For years, experts recommended low-fat diets as a way to lower cholesterol and heart disease risk.
When you are caring for someone who is ill, elderly, or disabled, it's important to consider how you'll handle those times when you can't be with your loved one in person. Some people don't have a health care power of attorney or living will because they don't realize how important these documents are.
When you think of risk factors for hearing loss, over-the-counter pain relievers probably aren't among them.
A study found that one in 10 people who take protective aspirin may not really qualify, because the risk of heart attacks and strokes wasn't great enough to justify the risk of unwanted bleeding associated with aspirin. When shopping for shoes, you want to have more than fashion in mind — you'll also want to consider function and keeping your feet in good shape. Age-related changes in vision aren’t great enough to keep older people from driving at night. Constant noise in the head -- such as ringing in the ears -- rarely indicates a serious health problem, but it sure can be annoying.
Tinnitus (pronounced tih-NITE-us or TIN-ih-tus) is sound in the head with no external source. While there's no cure for chronic tinnitus, it often becomes less noticeable and more manageable over time. Sound waves travel through the ear canal to the middle and inner ear, where hair cells in part of the cochlea help transform sound waves into electrical signals that then travel to the brain's auditory cortex via the auditory nerve. Most people who seek medical help for tinnitus experience it as subjective, constant sound, and most have some degree of hearing loss.
Tinnitus can arise anywhere along the auditory pathway, from the outer ear through the middle and inner ear to the brain's auditory cortex, where it's thought to be encoded (in a sense, imprinted). Tinnitus that's continuous, steady, and high-pitched (the most common type) generally indicates a problem in the auditory system and requires hearing tests conducted by an audiologist. Your general health can affect the severity and impact of tinnitus, so this is also a good time to take stock of your diet, physical activity, sleep, and stress level — and take steps to improve them.


In addition to treating associated problems (such as depression or insomnia), there are several strategies that can help make tinnitus less bothersome. There is no FDA-approved drug treatment for tinnitus, and controlled trials have not found any drug, supplement, or herb to be any more effective than a placebo. The most effective approaches are behavioral strategies and sound-generating devices, often used in combination.
For many, it's a ringing sound, while for others, it's whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking.
When hair cells are damaged — by loud noise or ototoxic drugs, for example — the circuits in the brain don't receive the signals they're expecting.
Things that cause hearing loss (and tinnitus) include loud noise, medications that damage the nerves in the ear (ototoxic drugs), impacted earwax, middle ear problems (such as infections and vascular tumors), and aging. One of the most common causes of tinnitus is damage to the hair cells in the cochlea (see "Auditory pathways and tinnitus").
She or he will take a medical history, give you a physical examination, and do a series of tests to try to find the source of the problem. Pulsatile tinnitus calls for a thorough evaluation by an otolaryngologist (commonly called an ear, nose, and throat specialist, or ENT) or neurotologist, especially if the noise is frequent or constant.
You may also be able to reduce the impact of tinnitus by treating depression, anxiety, insomnia, and pain with medications or psychotherapy. No single approach works for everyone, and you may need to try various combinations of techniques before you find what works for you. CBT uses techniques such as cognitive restructuring and relaxation to change the way patients think about and respond to tinnitus. Masking devices, worn like hearing aids, generate low-level white noise (a high-pitched hiss, for example) that can reduce the perception of tinnitus and sometimes also produce residual inhibition — less noticeable tinnitus for a short time after the masker is turned off. Other treatments that have been studied for tinnitus include transcutaneous electrical stimulation of parts of the inner ear by way of electrodes placed on the skin or acupuncture needles, and stimulation of the brain using a powerful magnetic field (a technique called repetitive transcranial magnetic stimulation, or rTMS).
Some medications (especially aspirin and other nonsteroidal anti-inflammatory drugs taken in high doses) can cause tinnitus that goes away when the drug is discontinued.
In about 10% of cases, the condition interferes with everyday life so much that medical help and psychotherapy are needed.


Our bodies normally produce sounds (called somatic sounds) that we usually don't notice because we are listening to external sounds. She or he will also ask you to describe the noise you're hearing (including its pitch and sound quality, and whether it's constant or periodic, steady or pulsatile) and the times and places in which you hear it.
Today, the term TRT is being used to describe modified versions of this therapy, and the variations make accurate assessment of its effectiveness difficult. Your clinician will review your medical history, your current and past exposure to noise, and any medications or supplements you're taking. The main components of TRT are individual counseling (to explain the auditory system, how tinnitus develops, and how TRT can help) and sound therapy. Electrodes attached to the skin feed information about physiological processes such as pulse, skin temperature, and muscle tension into a computer, which displays the output on a monitor.
As many as 50 to 60 million people in the United States suffer from this condition; it's especially common in people over age 55 and strongly associated with hearing loss. Pulsatile tinnitus may be more noticeable at night, when you're lying in bed, because more blood is reaching your head, and there are fewer external sounds to mask the tinnitus. The resulting electrical noise takes the form of tinnitus — a sound that is high-pitched if hearing loss is in the high-frequency range and low-pitched if it's in the low-frequency range. A 2010 review of six studies by the Cochrane Collaboration (an international group of health authorities who evaluate randomized trials) found that after CBT, the sound was no less loud, but it was significantly less bothersome, and patients' quality of life improved.
A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient's tinnitus. In a Cochrane review of the one randomized trial that followed Jastreboff's protocol and met the organization's standards, TRT was much more effective in reducing tinnitus severity and disability than a technique called masking (see below). Patients learn how to alter these processes and reduce the body's stress response by changing their thoughts and feelings. Many people worry that tinnitus is a sign that they are going deaf or have another serious medical problem, but it rarely is.



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