Frequently Asked Questions

The exact physiological cause or causes of tinnitus are not known. However, several sources have been found to be likely triggers and/or exacerbates of tinnitus. These include: Noise Exposure - Exposure to loud sounds/noises may cause damage to inner ear hair cells. This irreversible damage can cause tinnitus and hearing loss; the two often going hand-in-hand. This is why up to 90 percent of tinnitus sufferers have some degree of hearing loss. Wax build-up in the ear canal - Excessive wax build up can compromise hearing and may also cause tinnitus to be perceived as louder. Excessive ear wax should be removed by a physician or trained audiologist. Q-tips are not an ideal way to remove wax from the ear canal because it often pushes the wax down further causing an impaction. Q-tips may also scratch or abrade the ear canal. Certain medications - Some medications are ototoxic, which means that they can be damaging to the ear and may lead to tinnitus, hearing loss and even vertigo. Other medications may produce tinnitus as a side effect without causing damage to the inner ear. Medicinal effects, which can depend on the dosage of the medication and duration of time that it is taken, can be temporary or permanent. It is a good idea, that before commencing any medication, you make your physician aware of your tinnitus, and discuss alternative medications that may be available. Ear or sinus infections - Tinnitus is a common side effect of ear and/or sinus infections. Generally, tinnitus lessens in severity and gradually disappears as the infection clears. Jaw misalignment - Misaligned jaw joints or jaw muscles may cause or exacerbate tinnitus, by causing pressure on the ear structures. Some dentists specialize in treatment of temporomandibular jaw (TMJ) disorders and can provide assistance with treatment. Cardiovascular disease - Approximately 3 percent of tinnitus patients describe a pulsatile tinnitus. This refers to a rhythmic pulsing that is often in sync with the heartbeat. This type of tinnitus may indicate vascular conditions, such as hypertension or atherosclerosis (hardening of the arteries). Certain types of tumors - Far less commonly, people have a benign and slow-growing tumor on their auditory, vestibular, or facial nerves, which may cause tinnitus, hearing loss, facial paralysis, and vertigo and/or loss of balance. Head and neck trauma - Physical trauma to the head and neck can induce tinnitus, which may be accompanied by headaches, hearing loss, memory loss, and/or vertigo. Other disorders - Other disorders may have tinnitus as a side effect, including fibromyalgia, hypo-/hyperthyroidism, and Lyme disease. When a known disorder is the cause of tinnitus, treating the disorder will often alleviate the tinnitus as well.

Although there appears to be a hereditary predisposition for hearing loss and tinnitus due to exposure to loud sounds, a specific tinnitus gene has yet to be identified. However, genes have been identified for several types of hearing loss which may have tinnitus as a side effect, including Meniere’s disease and the growth of tumors on the auditory and/or vestibular nerves (vestibular schwannoma), as well as with disorders such as TMJ disorder.

Factors such as degree of hearing loss and the quality of the tinnitus can affect the severity of the condition from patient to patient. Tinnitus is highly variable and the reaction to it is also variable based on the individual’s level of tolerance, coping strategies and other life factors, including stress level.

Health insurance rules can vary from state to state and from carrier to carrier. It is likely that the initial evaluation will be covered by insurance, however it is also possible that many tinnitus treatments are not covered because they are considered experimental. Other treatments, like hearing aids, are not covered at all because they are expensive, and insurance companies don't have to cover them.

Once the tinnitus signal is generated in the auditory system, another part of the brain (the limbic system) attaches an emotional response to it. Similar to the “feeling” you get when you scratch your fingernails down a blackboard, tinnitus is more than just a perceived sound. Tinnitus can trigger anxiety and stress responses in the body which, in addition to the limbic system, also involves the autonomic nervous system. This is why, for some individuals, tinnitus can be quite debilitating causing difficulty with sleeping, concentrating, reading, relationships, and other everyday activities. Several studies have shown a correlation between tinnitus and depression, as well as with anxiety and stress disorders, with these being more common in individuals who experience tinnitus than those who do not. Additionally, studies have shown that patients who are depressed suffer a greater disability from their tinnitus than non-depressed patients. If depression is a problem for you, it would be wise to seek help from a mental health professional.

Remembering that exposure to loud sounds can lead to tinnitus and hearing loss, it is important that individuals protect their ears from these types of sounds. Sounds that exceed 85 dB A can cause inner ear damage with regular and sustained exposure. There is an inverse relationship between the level of sound that can be damaging and the length of exposure to such sounds. In other words, with longer periods of exposure, sounds of lower intensities (again, as low as 85 dB A) are more likely to cause hearing loss. For example, exposure to the noise made by a lawn mower could be damaging to the ears after approximately 6-7 hours, whereas one gun shot is loud enough to cause damage instantly. Additionally, repeated exposure to loud noises can have a cumulative, damaging effect on your hearing. Wearing hearing protection can reduce noise levels by 15 to 20 decibels. For extremely loud situations, using both earplugs and earmuffs together might be necessary. If you are being prescribed a new medication, ask your physician if the medication is ototoxic (toxic to the ear) or associated with tinnitus as a side effect. You may also wish to refer to the Physicians Desk Reference to obtain this information as well.

Besides noise exposure and medication, many people find that alcohol, nicotine, caffeine and certain foods (especially those high in sugar or sodium) can exacerbate their tinnitus. If you have several of these in your diet, you may wish to reduce or eliminate them from your diet for 2 weeks and gradually re-introduce one at a time. This may help you to identify a specific food trigger or exacerbate for your tinnitus. Other known exacerbates include stress and fatigue.

Obviously, if an identifiable cause has been found, appropriate treatment geared toward dealing with that cause may prove beneficial in alleviating the symptom of tinnitus. Other tinnitus treatment strategies have been used as well and are mentioned briefly below: Alternative Treatments -Some people have taken minerals, herbs, homeopathic remedies, or vitamins for their tinnitus and found them to be helpful. Others have turned to acupuncture, magnets, or hypnosis in an attempt to reduce tinnitus. Several of these treatments have been researched and none have been clinically proven to effectively treat tinnitus. Biofeedback - Biofeedback is a relaxation technique designed to help people manage stress in their lives by changing the body’s reaction to it. As mentioned previously, stress can be a trigger/exacerbate of tinnitus. Biofeedback may help individuals to modify their reaction to stress in an effort to prevent exacerbation of tinnitus. It does not, however, address the underlying physiological causes of tinnitus (i.e. hearing loss). Cognitive Therapy - Cognitive therapy is a type of counseling that focuses on changing the individual’s emotional response to the tinnitus. To accomplish this, the counselor helps the patient to identify negative reactions and ways to deal with them. Although counseling is an important aspect of any type of treatment, it, like biofeedback therapy, fails to address the physiological cause of tinnitus. Drug Therapy - There is no specific “tinnitus” drug. However, certain drugs with other primary functions have been prescribed in an effort to relieve tinnitus, including medications used to treat anxiety, depression and seizures as well as antihistamines and anesthetics. However, these medications are often habit-forming and may lead to other unwanted side effects. Hearing Aids - Approximately 90% of patients with tinnitus also have hearing loss. Of these individuals, a significant percentage of them (approximately 70%) notice a reduction in their tinnitus while wearing hearing aids. This is because it brings more ambient sounds into the patient’s audible range thereby providing some masking or coverage of the tinnitus. The benefits of hearing aids may be limited by the frequency response of the hearing aids or in quiet environments because there is no sound to amplify. Sound Therapy - Sound therapy uses sound in an effort to completely or partially cover (mask) the tinnitus. Maskers may be worn at ear level, which looks like a hearing aid, or may be tabletop devices. Sound therapies should always be combined with counseling.

Yes. It is possible to use the Neuromonics device independently of your hearing aid during quiet times, for example, when you are reading or trying to sleep. Your clinician will be able to work out the most appropriate timing with you. You may have an improved ability to use your hearing aid after completing the Neuromonics Tinnitus Treatment, as your loudness sensitivity is likely to improve. Please note that hearing aids are designed to amplify sound that may improve specific kinds of hearing loss. Because hearing aids amplify sound, the amplification may mask tinnitus; however, the masking is not a long-term improvement for tinnitus disturbance. If the tinnitus can be addressed and improved, a new hearing evaluation is recommended to understand if there is a hearing loss that should be treated with hearing aids.

No. The Neuromonics device is a Class II medical device, regulated by the FDA and requires a prescription from a trained clinician. In addition, through research and clinical trials, it has been shown that in order to get the full benefits of the Neuromonics Tinnitus Treatment, a program of support, monitoring, and education is required. The Neuromonics Tinnitus Treatment is designed specifically to target the neurological processes of tinnitus, specifically its auditory, attentional and emotional aspects. The Neuromonics Treatment regimen is customized to each patient’s unique hearing and tinnitus profile and scheduled appointments are required to complete the treatment.

The treatment involves an acoustic signal which targets the neural pathways in the brain to reprogram them to filter out the sound of your tinnitus. The process occurs gradually over a number of months.