Tinnitus Help in Calgary: Management Options That Have Evidence Behind Them

If you live in Calgary and experience ringing, buzzing, or hissing sounds that no one else can hear, you are not alone. This experience is called tinnitus. It affects many adults, with an estimated 10% to 15% of people reporting it [1]. For some, tinnitus is mild and temporary. For others, it is persistent and bothersome, affecting daily life and well-being.

It is important to have realistic expectations when seeking help for tinnitus. For most people, tinnitus is managed, not "cured." This means the goal is to reduce how much it bothers you and improve your quality of life, rather than making the sound disappear completely. Be cautious of anyone who promises a quick "cure" for tinnitus.

The good news is that there are effective strategies and treatments with evidence behind them that can help you manage your tinnitus. This guide will outline these options.

First Stop: A Hearing Evaluation

If you are experiencing persistent tinnitus, especially if it affects only one ear, or if you also have hearing difficulties, your first step should be a comprehensive hearing evaluation [1].

Why a Hearing Evaluation is Important: Tinnitus can sometimes be a symptom of an underlying condition, including hearing loss. An evaluation helps rule out other causes that might need different medical attention. It also helps an audiologist understand your specific hearing profile and how it might relate to your tinnitus.

Who Performs the Evaluation: A registered audiologist performs a comprehensive hearing evaluation. In Alberta, audiologists are regulated by the Alberta College of Speech-Language Pathologists and Audiologists (ACSLPA) [3]. This means they meet professional standards for education and practice. You can find registered audiologists in Calgary through a clinic directory. Learn more about audiology services in Calgary.

What to Expect: During your initial visit, the audiologist will take a detailed history of your tinnitus and overall health. They will perform a physical examination focusing on your ears and head. This helps identify any conditions that, if managed, might relieve your tinnitus [1]. The audiologist will then conduct a series of hearing tests to assess your hearing ability.

Management Options with Evidence

Once any underlying medical conditions have been ruled out, the focus shifts to managing the tinnitus itself. Here are the options recommended in clinical practice guidelines [1]:

Education and Counselling

Understanding tinnitus is a powerful first step in managing it. Education and counselling are recommended for people with persistent, bothersome tinnitus [1]. This approach helps you learn about what tinnitus is, what might make it worse, and how your brain processes sound.

A healthcare professional, often an audiologist, will provide information and strategies to help you cope. This might include: * Understanding the "fight or flight" response: How stress and anxiety can make tinnitus seem louder or more bothersome. * Habituation: Learning to notice your tinnitus less over time by changing your reaction to it. * Lifestyle adjustments: Identifying and managing factors like stress, sleep, and caffeine intake that can influence tinnitus perception.

Hearing Aids

If your persistent, bothersome tinnitus is accompanied by documented hearing loss, a hearing aid evaluation is recommended [1]. Hearing aids can be very helpful in these cases.

How Hearing Aids Can Help: * Amplify external sounds: By making the sounds around you louder, hearing aids can help mask or cover up your tinnitus, making it less noticeable. * Improve communication: If you have hearing loss, hearing aids improve your ability to hear speech and other important sounds, reducing the effort you put into listening. This can lower stress and fatigue, which might indirectly lessen the impact of tinnitus. * Reconnect you with your environment: Hearing more of the world around you can shift your focus away from the internal sound of tinnitus.

An audiologist can assess whether hearing aids are suitable for you and help you choose the right type and settings.

Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT) is a type of psychological treatment that is recommended in clinical guidelines and may reduce the impact of tinnitus on daily life [1, 2]. It is recommended for individuals with persistent, bothersome tinnitus [1].

What CBT Does: CBT helps you change the way you think about and react to your tinnitus. It aims to reduce the negative impact tinnitus has on your quality of life. Research shows that CBT may reduce the impact of tinnitus on quality of life [2]. For example, on a common scale used to measure tinnitus impact (the Tinnitus Handicap Inventory), people receiving CBT had scores that were about 10.91 points lower than those who did not receive intervention [2]. This is considered a meaningful change.

What CBT Does Not Do: It is important to know that CBT does not change the loudness of your tinnitus [2]. Instead, it helps you manage your emotional response and how much the tinnitus affects your daily activities. It may also lead to a slight reduction in depression that can sometimes occur with tinnitus [2].

CBT for tinnitus is typically delivered by a registered psychologist or other trained mental health professional. It can be provided individually or in a group setting, and sometimes online. A licensed professional can assess whether CBT is a suitable option for you.

Sound Strategies

Sound therapy is an option that clinicians may recommend for patients with persistent, bothersome tinnitus [1]. Sound strategies use external sounds to help manage tinnitus. These are not "cures" but tools to help you cope.

How Sound Strategies Work: * Masking: Introducing a competing sound to cover up or partially hide the tinnitus. This can make the tinnitus less noticeable. * Distraction: Providing an interesting or soothing sound that draws your attention away from the tinnitus. * Relaxation: Using calming sounds to help you relax, especially at bedtime.

Types of Sound Strategies: * White noise generators: Devices that produce a steady, broadband sound. * Environmental sounds: Nature sounds like rain, ocean waves, or forest sounds. * Music: Gentle, instrumental music can be helpful for some. * Tinnitus apps: Many smartphone apps offer a variety of sounds for tinnitus relief. * Fans or humidifiers: Simple household items can provide consistent background noise.

The goal is to find a sound that is pleasant and helps reduce the prominence of your tinnitus without being too loud itself. An audiologist can help you explore sound therapy options.

When to Seek Prompt Medical Care

While most tinnitus is not a sign of a serious medical problem, there are certain situations where you should seek a medical assessment promptly:

• One-sided tinnitus: If your tinnitus is only in one ear.
• Pulsatile tinnitus: If your tinnitus sounds like a rhythmic pulsing or whooshing, often in sync with your heartbeat.
• Tinnitus with sudden hearing loss: If your tinnitus appears at the same time as a sudden change or loss of hearing.
• Tinnitus with focal neurological abnormalities: If your tinnitus is accompanied by symptoms like weakness, numbness, or problems with balance or vision.

These symptoms warrant a timely evaluation by a medical doctor to rule out specific underlying conditions.

The Bottom Line

Living with persistent tinnitus can be challenging, but you do not have to face it alone. In Calgary, there are professionals and evidence-based strategies available to help you manage your symptoms and improve your quality of life. Starting with a comprehensive hearing evaluation by a registered audiologist is a key first step. From there, options like education, hearing aids (if you have hearing loss), and Cognitive Behavioural Therapy are evidence-supported options recommended in clinical guidelines for reducing the impact of tinnitus on your daily life. Remember to be wary of promises of a "cure" and focus on management strategies that are supported by evidence.

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