How to Protect Your Ears From Tinnitus Because the Damage May Have Already Begun

Since the start of the pandemic, I’ve stayed fit and (relatively) sane, taking daily walks around my neighborhood listening to my favorite crime podcasts and K-pop songs. However, one day in the spring of 2020, I began to hear ringing in my right ear. I developed tinnitus : the perception of sounds in the absence of external sources.

I knew it was the volume level on my headphones that was to blame – I often couldn’t hear the occasional car driving through the bends of mountain roads in my area. (I set volume limits on my previous iPhone, but didn’t check to see if those settings would migrate to my new one. They didn’t.) But worse than noise was the knowledge that I did it to myself inadvertently, especially since I have witnessed how my mother has fought this disease in the past.

I’m lucky. Three months after completely abandoning the headphones, the constant high pitch with a touch of vibrato disappeared one day as quickly as it appeared. However, two-thirds of the estimated 45 million Americans – 14 percent of the population – who experience tinnitus at some point in their lives have it for at least one year. Some people experience it for decades.

Tinnitus has a reputation for being a curse that you just have to learn to live with. “Not true,” says Dr. Melissa Wyckoff , founder and director of audiology at Peachtree Hearing in Atlanta and a member of the board of directors of the American Tinnitus Association (ATA).

“The biggest misconception is that nothing can be done, that this is a life sentence and no one can help you,” she said. “There is no magic pill … but there are so many things we can do to help [you] cope.”

Tinnitus cannot be cured, but its causes and characteristics can be cured – and it may go away. Most importantly, most cases can be prevented with good listening hygiene. Here’s what to do if one day your ears starts ringing, and also how to prevent it from happening to you and your loved ones in the first place.

What are the causes of tinnitus?

Let’s be clear about one thing first: you can pronounce it as TIN-uh-tus or as ti-NIGH-tus according to the ATA . (For the record, I’m the TIN-uh-tus team.) However, whatever you say it, tinnitus is more of a symptom than a condition in and of itself. 80 percent of tinnitus cases are associated with hearing loss, but more than 200 other conditions may be relevant, including:

• Blockage of the middle ear ( for example , from wax or foreign objects)
• Head and / or neck injury
• Sinus pressure (including while snorkeling, flying, or scuba diving)
• TMJ (also known as trismus)
• Medications (including some NSAIDs , chemotherapy, and antibiotics)
• Autoimmune diseases (especially Lyme disease and fibromyalgia)
• Blood vessel disease (such as high blood pressure, usually associated with a pulse )
• Metabolic disorders such as thyroid disease.
• Psychiatric disorders (eg, depression, anxiety)
• Vestibular or inner ear disorders (eg, Meniere’s disease)
• Some tumors

From time to time, Wikoff sees people with tinnitus who have a serious medical condition. “Ears are a window to so much more in your body,” she said. In fact, my mother’s tinnitus was caused by a fast-growing benign brain tumor near her ear canal. Once she removed it, her tinnitus went away.

However, for most people, hearing loss is a central factor. We tend to think of hearing loss as a problem in older people, and it is true that age-related hearing loss (also known as presbycusis ) affects 30 percent of adults aged 65 and over and 40-50% of people 75 and over. However, age-related hearing loss is often the result of years of prolonged exposure to noise, and the increased use of on-ear and in-ear headphones in the iAge puts all of us at risk of developing this damage earlier.

Think of hearing loss as solar damage or CTE : Repetitive exposure to loud noise creates temporary damage called temporary threshold displacement (TTS) that accumulates over time and ultimately leads to permanent damage or permanent threshold displacement (PTS) . Every time you leave a loud concert, finish mowing the lawn, or hit pause on your favorite workout playlist at the gym and your ears feel full of cotton wool, you are essentially giving them mild concussions, which time can lead to. irreversible hearing loss.

Sounds (pun?) It is illogical that hearing loss makes you hear things that no one else hears, as in the case of tinnitus. The reason is that our brain recognizes when we have lost the ability to hear certain frequencies and creates those sounds to compensate. Because we tend to lose the ability to hear higher frequencies at first, most tinnitus sounds – you can hear some patterns here – are high. Moreover, it is not just ringing: the noise in the ears can also sound like whistling, buzzing, clicking or roaring.

While most of the causes of tinnitus are not life-threatening, many, including hearing loss, are chronic conditions that get worse without treatment. So, if you don’t know why you have tinnitus, see a therapist. Your ears are trying to tell you something.

How to treat tinnitus

While there is currently no cure for tinnitus, there are many ways to mitigate its effects on your daily life, and there are even several treatments that can stop the tinnitus. Treatment falls into three main categories: devices or applications that provide sound therapy , mental health and lifestyle therapies , and multidisciplinary approaches that use both.

Sound therapy devices

Sometimes the solution is simple – buy a hearing aid. If your tinnitus pitch matches the pitch (s) you can no longer hear, hearing aids tuned to those frequencies can drown out or significantly reduce the noise. Wyckoff says 80 to 90 percent of her patients experience some relief with hearing aids.

External and / or in-the-ear masking devices, some of which may be attached to hearing aids, can also help by masking or drowning out tinnitus with sounds such as white noise.

Psychotherapy and lifestyle changes

Like any annoying external noise, tinnitus can interfere with sleep and concentration. It can also worsen anxiety and depression, according to an ATA survey of 1,100 people with tinnitus in 2014 . Studies have estimated that people with tinnitus are more than twice as likely to suffer from depression as the national average.

“We call it a vicious circle,” says Wyckoff. “All of a sudden, you hear tinnitus, and then it triggers some anxiety, depression, [and] fatigue … and then the tinnitus gets worse, because if we don’t get enough sleep, we can’t fight it. on the same day “.

Several studies have hypothesized that the link between depression and tinnitus is not only psychological, but physiological, due to the connection between the auditory nerve and the limbic system , which affects our emotions, memory, and sleep. Therefore, any lifestyle changes that reduce stress can potentially reduce the effects of tinnitus.

Multidisciplinary treatment

While many patients find relief using only mental health devices or treatments, Wyckoff believes a multidisciplinary approach is needed in the most severe cases of tinnitus.

One such approach, Tinnitus Retraining Therapy (TRT) , uses many of the same mental health devices and methods as traditional treatment standards. However, because it is based on the theory of the limbic system of tinnitus mentioned above, it focuses on neutralizing our relationship to sound, rather than masking or learning to accept it.

When TRT works successfully, people perceive their tinnitus as no different from any other background noise (wind, birds, movement, internal and external chatter) that we filter out in our daily life. Research shows that TRT works the same or slightly better than traditional treatments. Several experimental therapies are also being tested, including non-invasive neuromodulators and electromagnetic stimulation of the brain and vagus nerve.

Which treatment people ultimately choose depends on their budget, schedule, the severity of the tinnitus, and other factors, Wyckoff said. While many people informally report improvement after seeking some form of treatment, especially psychiatric therapy, there are relatively few clinical studies of tinnitus given its prevalence . Organizations such as the American Tinnitus Association are working to change this .

How to avoid tinnitus in the first place

Of course, prevention remains the most effective treatment. This axiom applies not only to people who have never had tinnitus, but also to temporary tinnitus sufferers like myself who can prevent further hearing damage.

Since so many cases of tinnitus are associated with noise exposure, it is important to develop healthy hearing habits using products designed to protect your hearing and use them correctly so that the leak sounds as little as possible.

Parents should teach their children to listen early. In the same way that you limit the screen time, limit the time you use the headphones as much as possible. One metric is the 60-60 rule : 60 minutes a day at 60 percent of the device’s maximum volume. If you cannot restrict the use of headphones (for example, for virtual activities), Wikoff suggests purchasing headphones with a volume limit. For her kindergarten daughter, she uses Puro Sound , a company that makes studio quality headphones with limited volume for kids and adults. (They even make specialized gaming headphones .)

While most smartphones allow you to set volume limits, the headphones that come with these devices sound like sieves. As a result, we increase the volume, thereby increasing the decibel level that sounds in our ear canals. Therefore, it is important to have the headphones that fit snugly in the ears, to them or to them . If you don’t want to ditch your expensive headphones, consider buying customized sleeves , which retail for $ 100-200. Molded to fit over a standard earbud, they block out sound.

If your job requires headphones for hours on end, or if you’re an audiophile with a budget and a desire for the best sound, in -ear headphones are the way to go. The cost can range from $ 250 to $ 1200, depending on whether you have a general or individual fit. Whether you work in music or theater, broadcasting, or other industries where good hearing is a prerequisite, this investment has the potential to protect your livelihood.

In industries like construction or motorsport, the pharmacy foam earplugs provide excellent protection if you insert them correctly. At CDC has an excellent web – site with practical recommendations on showing all the important steps.

Lovers of concerts can use ear plugs for concerts, designed to protect your hearing, not drowning out the sound too much. However, even with them, do not stand near the speakers.

As an adult, test your hearing to establish a baseline

Children are often tested for hearing in elementary school, although the frequency and quality of the test varies from state to state. However, when we enter high school, we are usually on our own.

While the US Preventive Services Task Force earlier this year concluded that there was not enough evidence to develop hearing test recommendations for Americans over 50, Wyckoff notes that we regularly check other body parts related to our senses. “Just like you brush your teeth twice a year [and] check your eyes once a year,” she said, “you should get your hearing tested.”

Some primary care doctors check their hearing during a physical, but many do not. Several inexpensive and free online tests can give you an idea of ​​how your hearing is doing: the $ 8 National Hearing Test (free for AARP members) and a free app called HearScreenUSA .

Most insurance plans cover a referral to an audiologist, and it is recommended that you go at least once after you turn 18 to establish a baseline. Research shows that many older adults underestimate their level of hearing loss, and Wyckoff stresses that the sooner you heal, the less progress will be made.

She recommends that adults over 40 have their hearing tested every 1 to 2 years; other doctors recommend every 3-5. If you notice any of the following signs of hearing loss , it is recommended that you get tested:

• Difficulty understanding people during a conversation and asking them to repeat themselves.
• Increase the volume on your electronic devices more than before
• Hearing problems with consonants
• Hear slurred speech

Don’t stop the music – just be a conscientious consumer

We are all exposed to noise more than ever thanks to our personal devices. The pandemic has exacerbated the problem as many of us wear headphones for hours every day to work or attend classes from home with partners, roommates and children.

So far, I’ve managed to avoid headphones because I live in a relatively quiet house and walk in an area where few neighbors can hear my podcasts and music. Eventually, however, I will find myself in situations where social etiquette and general politeness call for headphones.

Since I already own AirPods, I’ll probably look for custom sleeves. I also want to get my hearing tested to determine the extent of my hearing loss. What I wo n’t do is stop listening to music and podcasts that I love.

“I don’t want no one to listen to music, especially after the year and a half we’ve been through,” says Wyckoff. “Music is what connects us and allows us to escape, [so] we want to find ways to enjoy these things while protecting ourselves.”