Tinnitus is one of the most common auditory symptoms encountered in clinical practice, often described as a perception of ringing, buzzing, hissing, or other sounds in the absence of an external stimulus. While it is rarely a sign of a serious medical condition, tinnitus can have a significant impact on concentration, sleep, and emotional wellbeing. Understanding its mechanisms and available management options is essential to achieving effective relief.

Understanding Tinnitus

Tinnitus is not a disease in itself but a symptom arising from altered activity within the auditory system. It may originate anywhere along the auditory pathway—from the outer ear to the auditory cortex—but most often results from damage or changes in the cochlea (inner ear). These changes reduce auditory input, leading the brain to increase neural activity in the auditory centres, which is then perceived as sound.

According to research published in the Lancet and Journal of the American Academy of Audiology, tinnitus affects approximately 10–15% of adults, with severity ranging from mild and intermittent to persistent and intrusive.

Common Causes

Tinnitus can develop from a wide range of auditory and non-auditory factors:

• Sensorineural hearing loss – due to ageing (presbycusis) or noise exposure.

• Earwax blockage or middle ear pathology – which alters normal sound conduction.

• Ototoxic medications – including certain antibiotics, chemotherapy agents, and high-dose salicylates.

• Head and neck disorders – such as temporomandibular joint (TMJ) dysfunction or cervical spine tension.

• Vascular and metabolic factors – hypertension, anaemia, thyroid dysfunction, or diabetes.

• Psychological stress – which can amplify perception and distress related to tinnitus.

A comprehensive assessment by an audiologist and, where indicated, an ENT specialist is crucial to rule out underlying medical causes and determine appropriate treatment pathways.

Evidence-Based Management Approaches

There is currently no universal cure for tinnitus; however, a range of scientifically validated management options can significantly reduce its impact and improve quality of life. Modern tinnitus management focuses on habituation—helping the auditory system and brain to decrease the perception and emotional significance of tinnitus over time.

1. Cognitive Behavioural Therapy (CBT)

CBT is the best-supported psychological treatment for tinnitus distress. It doesn’t make the tinnitus sound vanish consistently, but it reliably reduces the negative thoughts and emotional reactions that make tinnitus disabling. Cochrane reviews (the gold standard for clinical evidence) show moderate-certainty evidence that CBT reduces tinnitus-related distress and improves coping for many adults. If tinnitus is affecting mood, sleep or daily functioning, CBT is a mainstay of management.

2. Sound Therapy and Hearing Aids

Sound therapy aims to reduce the contrast between tinnitus and environmental sound, promoting habituation and relaxation.

• Hearing aids can amplify external sounds, reducing the brain’s focus on tinnitus, particularly in individuals with coexisting hearing loss.

• Sound generators or combination devices (hearing aids with built-in sound therapy) can deliver low-level broadband noise, nature sounds, or customised fractal tones to provide consistent auditory stimulation.

Clinical studies indicate that sound therapy is most effective when tailored to the individual’s tinnitus profile and integrated with counselling or behavioural support.

3. Tinnitus Retraining Therapy (TRT) and habituation

TRT combines counselling (to change the emotional response to tinnitus) with long-term low-level sound enrichment. The goal is habituation — the brain learns to “filter out” tinnitus so it no longer grabs attention.

4. Other Management Modalities

• Pharmacological treatments: No medication has been proven to eliminate tinnitus. However, antidepressants, anxiolytics, or sleep aids may be prescribed to address comorbid symptoms such as anxiety or insomnia.

• Neuromodulation techniques: Repetitive transcranial magnetic stimulation (rTMS) and other brain stimulation methods are under investigation. Early results show potential but remain experimental.

• Mindfulness and relaxation-based therapies: Evidence suggests mindfulness meditation and relaxation training can reduce tinnitus-related distress and enhance coping.

Lifestyle and Self-Management Strategies

Lifestyle modifications play an important role in reducing the aggravation of tinnitus and supporting overall auditory health:

• Avoid prolonged noise exposure and use hearing protection when necessary.

• Monitor medication use and consult your GP about potential ototoxic effects.

• Manage stress through relaxation techniques, exercise, and mindfulness-based activities.

• Prioritise sleep by maintaining consistent sleep routines.

• Limit stimulants such as caffeine and alcohol if they appear to worsen symptoms.

• Maintain cardiovascular health through balanced nutrition and regular physical activity, as adequate blood flow supports cochlear function.

These strategies are strongly supported by research from the American Tinnitus Association and British Tinnitus Association as complementary components of holistic tinnitus management.

How Harken Audiology Can Help

At Harken Audiology, tinnitus management is approached through an evidence-based and multidisciplinary framework. Each client undergoes a comprehensive diagnostic evaluation, including audiometric testing and tinnitus profiling, to identify underlying auditory or medical contributors.

Our management plans are individually tailored and may include sound therapy, tinnitus retraining principles, hearing aid fitting, and counselling strategies designed to facilitate habituation and improve quality of life.

Through compassionate, clinically grounded care, we aim to help patients not only manage their tinnitus but regain a sense of control and confidence in their daily lives.