Strategies, Tips, Tools and Techniques
By Glenn Schweitzer
Tinnitus, the medical term for the perception of non-existent noise, often described as ringing in the ear, is a common symptom among vestibular patients and a difficult one to address. It’s also much more prevalent than most people realize. According to the US Centers for Disease Control, nearly 15% of Americans experience tinnitus.1
Tinnitus can vary from intermittent to pulsatile to constant. Regardless of the duration, tinnitus can quickly ruin your quality of life.
Even moderate levels of tinnitus can affect a person’s ability to work and socialize.2 Anxiety and stress levels go through the roof and it becomes harder to fall asleep, which in turn makes the anxiety worse. It’s a vicious cycle, and a hard one to break.
But there is hope. Through a mental process known as habituation, the process of decreasing your response to a stimulus through repeated exposure, you can find lasting relief and get to a place where the tinnitus stops bothering you entirely. There are also many things you can do to find relief from tinnitus during an acute episode.
It is important to have your tinnitus evaluated by an ENT or audiologist to help determine if there is an underlying cause that should be treated separately. If hearing loss is a factor, hearing aids and medication can sometimes directly improve your tinnitus.
In addition to standard medical treatment, here are some coping strategies that can help you manage your tinnitus.
Tinnitus Coping Techniques
Practice changing your reaction
When tinnitus is bothersome, most people fight to ignore the sound, but that can often be a losing battle. Most of the time, you will not be able to think your way out of this kind of intensely negative emotional experience.
It’s much more effective to focus on your tinnitus and intentionally change your reaction to it.
Try to practice the following technique anytime you experience a spike in your tinnitus, realize that it’s bothering you more than usual, or catch yourself obsessively noticing or checking it.
- Stop what you’re doing, sit down, and get comfortable.
- Close your eyes, take several deep breaths, and relax your muscles as much as possible with each exhale.
- Focus on your tinnitus and think about the hours leading up to this moment. Recognize that before now it wasn’t bothering you this intensely. Become aware of how long the “good period” without tinnitus was leading up to this difficult moment.
- Remind yourself that the difficult moment will pass. When it’s bad, we always think, “What if it stays like this forever?” But it rarely does. Every difficult moment you’ve experienced before now passed eventually. Your tinnitus will calm down.
- Choose a different coping tool and use it immediately, before you go back to whatever it was you were doing previously. Coping tools that are helpful include anything that masks the sound of your tinnitus, relaxes you mentally or physically, or distracts you from the sound. The goal is to break the negative thought patterns by doing something proactive.
If you still have some of your hearing, sound masking is one of the easiest and most effective coping tools available to tinnitus sufferers. It’s a simple concept: background noise can offer temporary relief by drowning out the sound of your tinnitus.
Any background noise that you find relaxing or enjoyable can work. Nature sounds, music, podcasts, radio, TV, or other forms of “white noise” (a constant ambient sound) are all great options. Even a desk fan can work in a pinch.
My sound masking device of choice is a Bluetooth speaker connected to my phone. With this setup, I’m not restricted to a limited selection of sounds like I would be with a sound or white noise machine.
You can listen to music, podcasts, and an endless list of sounds within the hundreds of sound therapy apps available in the app store, many of which are free.
Pro Tip: Download several sound therapy apps and take time to explore all of the different options. Once you know what works for you, make a list of your favorite sounds so you have multiple options to choose from when you find yourself in a difficult moment.
For people with hearing loss, hearing aids can provide some relief by amplifying background noise to drown out the sound of your tinnitus.3
Breathing techniques are a great way to cope with tinnitus because the can help reduce anxiety and stress by triggering the “relaxation response.”4 The next time you are having a difficult tinnitus moment, here is a powerful breathing techniques you can try:
4-7-8 Breathing Exercise (as popularized by Dr. Andrew Weil): Breathe in quietly through the nose for 4 seconds, hold the breath for 7 seconds, and exhale audibly through the mouth for 8 seconds. Repeat for a total of 4 breaths.5
Most tinnitus suffers know that distracting themselves from the sound is an effective way to cope. Any activity that grabs your attention is going to help you forget about the sound, if only for a short while. Distraction can work well, but you can make it even more effective by combining different distractions, and involving as many of your senses as you can.
For example, instead of walking on the treadmill, go for a walk outside while you listen to music. Instead of taking a shower, take a hot bath while you listen to a podcast. Generally speaking, the more senses you can involve in an act of distraction, the more effective the coping experience.
Meditation (mindfulness6 and other techniques) can be a powerful tool to find relief from tinnitus. Meditation is the practice of focusing your attention on a single point of awareness. The idea behind meditation therapy is to retrain the brain to accept your tinnitus.7
Certain types of meditation can help facilitate the habituation process and lead to lasting relief.8
(Author’s Note: Meditation is a crucial component of my ongoing management of Meniere’s disease, which is the underlying cause of my tinnitus. Meditation can be a powerful coping tool many different types of vestibular disorders that are exacerbated by stress and anxiety.)
Here is a list of my favorite meditation apps (some are free, some are not):
Brainwave entrainment stimulates the brain to enter a specific state using a pulsing sound. The pulses encourage your brainwaves to align to the frequency of a given beat.9
Here’s how it works: Your mental state changes your brainwaves in a specific way. In fact, there is a predictable and measurable (via EEG) brainwave pattern directly associated with every possible mental state you could ever experience. If you can temporarily change your brainwave pattern with an external stimulus, you will experience a corresponding change in your mental state as result.
In a small clinical study, brainwave entrainment has been shown to be effective at reducing tinnitus disturbance.10
By simply listening to a brainwave entrainment audio track embedded with the frequencies that correspond with deep relaxation, you can trigger a deep relaxation response within minutes.
Warning: If you are prone to having seizures or have had seizures in the past, epileptic, pregnant or wear a pacemaker, do not use brainwave entrainment. Click here to read the full health disclaimer.
Click here to listen to a free brainwave entrainment relaxation audio track.
Physical relaxation techniques
Stress and anxiety tend to work their way into our body as tension, physical aches and pains, and general discomfort. Reducing physical stress not only helps you feel more relaxed, it benefits you mentally and emotionally as well.
The mind-body connection is real, and when the body is relaxed, the mind will follow. Reducing physical stress and tension can have a powerful impact on your tinnitus, especially during spikes. Here are some ways you can achieve this.
- Massage: A professional massage can help relieve tense and knotted muscles throughout the entire body. It can be relaxing, and can have reduce your stress levels. Alternatively, you can use a lacrosse ball or foam roller to perform trigger point massage on yourself.
- Progressive Muscle Relaxation: This simple technique can help you to relax every muscle in your body. Simply sit or lay down comfortably and take a few deep breaths. With each exhale, let your whole body relax, releasing as much tension as you can. Next, work your way through your body, lightly tensing each muscle group one at a time, followed immediately by relaxing that muscle group as much as possible. Start with your feet and toes, then work your way through your legs, buttocks, stomach and lower back, chest and upper back, shoulders and arms, hands and fingers, neck and throat, and then finally your face and head.
- Take a Hot Bath: Soaking in warm to hot water is an easy way to relieve muscle tension. Try taking a hot bath the next time you are struggling with your tinnitus. It may also help to infuse your bath with Epsom salts, which contain magnesium,11 a natural calcium blocker that helps relax muscles.12
- Sauna: The intense heat of a sauna quickly relaxes stiff and sore muscles. Start with just 10-20 minutes in the sauna, which is more than enough time to work up a good sweat. Make sure to stay hydrated; drink plenty of water before you get in and after you get out.
- Acupuncture: There is some research supporting the benefits of acupuncture for tinnitus.13 Many people also find it to be an intensely relaxing experience, which has secondary benefits, as tension can cause tinnitus spikes.
Earplugs and loud noise avoidance
Loud sound exposure is a major risk factor for tinnitus and hearing loss. When you already have tinnitus, it can make it much worse. So the next time your tinnitus is bothering you, try to either avoid loud environments or wear earplugs.
Regular foam or silicone earplugs, or hearing protection earmuffs, work well to protect your hearing. However, if you need to be able to carry on conversations, or want to be able to hear music clearly, high-fidelity (musicians) earplugs are your best option. High-fidelity earplugs lower the decibel level of your environment without distorting or muffling the sound. They can also help you to cope with sound sensitivity issues.
My favorite brands: Eargasm Earplugs and Etymotic Earplugs. (Note: Shop Amazon Smile and select VeDA as your designated charity.)
Exercise isn’t a magic bullet against tinnitus, but it can be an effective way to cope with a tinnitus spike. Exercise doesn’t have to be intense for you to receive benefit from it. A 20 to 30-minute walk is often enough for your brain to start releasing endorphins, which are your body’s “feel good” chemicals. When tinnitus is caused by other medical conditions, exercise can serve the added benefit of improving overall health and wellbeing.
Relax your Jaw Muscles
If your tinnitus is exacerbated by clenching or manipulating your jaw, you can often find some relief by relaxing and massaging the muscles around your jaw.
The problem stems from somatosensory nerves located around the lower jaw that project to a part of the brain called the Dorsal Cochlear Nucleus (DCN).14 Some scientists believe this may be where tinnitus first arises in the brain. There is also other research15 indicating that the DCN is associated with tinnitus in some capacity.
Try the following relaxation and massage techniques the next time you have a difficult tinnitus moment.
NOTE: Temporomandibular Joint Disorder (TMJ) is also a well-documented cause of tinnitus. If you suffer from TMJ, it’s important to find a qualified neuromuscular dentist for evaluation and treatment. In many cases, correcting the underlying TMJ can improve or resolve tinnitus.
About the author: Glenn Schweitzer is a vestibular patient and author of the book, “Rewiring Tinnitus.” This article is based on his personal experience and independent research he conducted to help himself cope with debilitating tinnitus.