Why is my tinnitus getting worse and not improving?
A few people have contacted me recently and asked, why is my tinnitus getting worse and not improving? Understandably this is cause for concern because the truth is, that many things can be responsible. It can be disheartening when a person believes they doing all the right things and notice no improvement in their situation. I will be try to answer this question but please keep in mind, tinnitus can be very complex as it comes in many forms and intensities and no two people will experience it the same. If a person also has hyperacusis it often complicates the matter.
Since many things can cause tinnitus I will only be dealing with the most common cause of its onset which is exposure to loud noise. Typically it is listening to audio through headphones at high volume levels or using them for long durations without giving the ears a rest. Going to concerts and nightclubs regularly can be harmful to the ears since high sound levels are often reached at these venues, so it’s something to consider when attending them. It is advisable to wear noise-reducing earplugs and keep away from the front stage or standing near large floor standing speakers for most of the evening.
A rule of thumb at these venues: if you have shout to be heard by a person next to you then this is an indication that the environment you’re in is too loud and I advise that you leave. Not even noise reduction earplugs are one hundred percent safe. If external sound is loud enough it can pass through the skull and reach the inner ear by bone conduction. So even when one habituates they still need to be careful of being in overly loud environments. For those that have been seen at ENT and had tests on their auditory system including an MRI scan. Providing no abnormalities have been found and if medication is not responsible. Then one should be referred to a Hearing Therapist or Audiologist for treatment and management if they are finding it difficult to cope with their tinnitus.
A variety of treatment options are available and I have discussed these in many of my posts and I will place the links at the bottom of the page. Many people with noise-induced tinnitus find the condition improves naturually over time and without treatment. Usually within the first six to twelve months of onset sometimes a little longer, they see improvement and are able to habituate. However, as I’ve said tinnitus can be complex and affect each person differently. If a person is keeping away from loud sounds and not using headphones (even at low volume) then the usual reason it’s getting worse and not improving is due to stress. Once stress and anxiety is reduced then tinnitus will usually respond accordingly and become less intrusive.
I advise talking to your GP, Hearing Therapist or ENT doctor and most likely some form of medication will be prescribed to help lower your stress levels. This is vitally important. The more stressed we become the more intrusive the tinnitus will be and vice versa. Trying to cope with this on your own and not wanting to take medication might seem admirable but not quite practical in the long term, as eventually the sheer magnitude of what you’re up against can become too much for you to cope with without additional help. Counselling with a Hearing Therapist or Audiologist and prove beneficial. By taking away and demystifying the negative thinking that is often associated with tinnitus and hyperacusis. Using sound enrichment is particularly important especially at night using a sound machine by the bedside. More is explained in my articles below.
Relaxation exercises can be very helpful in lowering stress and again you’ll find information in the links below. I advise anyone that is having difficulty coping with stress caused by tinnitus to pursue this route. Thirty minutes of deep relaxation exercises, practised three to five times a week can be most effective in lowering stress an reducing the perception of tinnitus and help the habituation process.
In the case of hyperacuis. Some people habituate to their tinnitus but are still troubled by sensitivity to “certain sounds” when exposed to them. Because they don’t necessarily experience pain they call this “Reactive tinnitus” and this causes their tinnitus spike. This can become quite annoying and troublesome and if not treated it’s quite possible for it to become permanent. I want to a make few things clear as I see them and I’ve mentioned it a few times in this forum. There is no such thing as “Reactive tinnitus” It was a term made up by people in tinnitus forums. This over sensitivity to sound is actually hyperacusis.
There are two ways hypercusis can be treated and I have discussed this at length in my post: Hyperacusis, As I see it, in the link below. The first is naturally without treatment meaning the condition improves over time. One can use sound therapy at home and slowly introduce themselves to normal everyday sounds to help desensitise the auditory system. When necessary “noise reducing” earplugs should be used but I stress they shouldn’t be overused. The second method is having professional treatment with a Hearing Therapist or Audiologist that is trained in the treatment and management of tinnitus and hyperacusis. Sound therapy is used in the form of wearing two white noise generators to desensitise the auditory system and is backed up with regular counselling.
Some clinics practice a new treatment called TDT (Tinnitus Desensitisation Therapy) I believe this is a simplified version of TRT called by another name but with an important element removed, which is regular counselling. Hyperacusis is not only a physical problem but often a psychological one too and for this reason counselling may be needed to address the fear and negative thinking that is often associated with tinnitus and hyperacusis.
For those that believe in Reactive tinnitus message me and I will send you a website link describing it as not used in medical research and is a term used by some tinnitus patients.
I wish you well
This post was written at another forum so links below to my articles are not available, although some are can be accessed in this forum by clicking on my profile page. Tinnitus, A Personal View is not available here as it's very long. Anyone that would like a copy, please send me your email address by private message. Please do not post it in the forum.
Tinnitus, A Personal View