Navigating the healthcare system can be difficult — especially when dealing with a distracting, upsetting, and unnerving condition like tinnitus. To help patients realize the best possible treatment for their tinnitus, ATA has developed a Tinnitus Patient Navigator that identifies the optimal step-by-step process for finding medical support.
Please note: this outlines a general process and is designed to apply to the broadest array of tinnitus cases. While most patients would be well served following the progressive approach below, each patient’s tinnitus experience is unique and may require a different treatment workflow.
Tinnitus Health-Care Providers
If you, or someone you know has tinnitus that is causing a problem, this is a great place to find help.
You can seek help from a wide variety of health-care providers, including but not limited to, audiologists, otolaryngologists, psychologists, licensed clinical social workers, dentists, and physical therapists. Below is a description of provider training and possible ways they can help. Each provider listed below is required to be licensed by the state in which they provide services. Licensure can be verified by checking the licensing board in your state.
All providers on the list support the mission of ATA, but may not necessarily specialize in the evaluation and management of tinnitus. Please note that tinnitus treatment is not within the scope of practice of hearing aid dispensers in every state.
AUDIOLOGIST: A healthcare professional trained to identify, diagnose, and manage or treat disorders of the auditory (e.g., hearing loss and tinnitus) and vestibular systems (e.g., dizziness). As part of a treatment program, audiologists may recommend hearing aids to make day-to-day listening easier, improve awareness, and help with tinnitus. Some audiologists may also have additional training in the specialized evaluation and management of tinnitus and provide services such as Tinnitus Retraining Therapy, Tinnitus Activities Treatment, Progressive Tinnitus Management, etc. (https://www.ata.org/managing-your-tinnitus/treatment-options/behavioral-therapies).
Audiologists hold either a master's’ (M.A. or M.S.) or doctorate (Au.D. or Ph.D.) degree in audiology. Audiologists work predominantly in private practices, otolaryngology practices, academic medical centers and hospitals.
DENTIST: A medical doctor trained to diagnose, treat and prevent oral diseases, promote oral health, and create treatment plans to maintain or restore the oral health of their patients. Dentists also diagnose Temporomandibular Joint Treatment (TMJ). If you are suffering from frequent headaches, jaw aches, and/or aching facial pain, it could be Temporomandibular Joint Disorder, also known as TMJ or TMD. Associations between tinnitus and TMJ/TMD have been reported, so if there are symptoms of TMJ or TMD and treatment is pursued, there may be some relief from tinnitus. Dentists hold either a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DDM).
HEARING AID DISPENSER: A person licensed by the state to measure hearing and fit and sell hearing aids. Hearing aids have been shown to mitigate the intrusiveness of tinnitus. A hearing aid dispenser does not have a college degree related to audiology, but may have a college degree in an unrelated field of study. Hearing aid dispensers may be certified (Board Certified Hearing Instrument Specialist, BC-HIS). Hearing aid dispensers work in private offices and big box stores.
LICENSED CLINICAL SOCIAL WORKER (a.k.a. LCSW): A professional trained to provide mental health services for the prevention, diagnosis, and treatment of mental, behavioral, and emotional disorders. The goal is to enhance and maintain physical, psychological and social function. Some LCSWs are trained to provide cognitive behavioral therapy, which is an option recommended by the American Academy of Otolaryngology - Head and Neck Surgery Clinical Practice Guidelines for Tinnitus. LCSWs hold a master’s degree in social work. LCSWs work in private practices, community health centers and hospitals.
NEUROLOGIST: A medical doctor who specializes in the evaluation and treatment of disorders that affect the brain, spinal cord, and nerves. If you have headaches associated with your tinnitus or sensitivity to sound, you may benefit from a consultation with a neurologist. Neurologists work in private practices, academic medical centers and hospitals.
NEUROTOLOGIST: A medical doctor who has trained in the field of otolaryngology-head and neck surgery and evaluates and manages neurological disorders of the ear. See Otolaryngologist.
OTOLARYNGOLOGIST (a.k.a. ENT): A medical doctor who specializes in the evaluation and treatment of disorders of the ears, nose and throat and related structures of the head and neck. An otolaryngologist can rule out physical causes of tinnitus such as excessive ear wax, problems with the middle ear (e.g., fluid, stiffened bones), or benign tumors on the auditory nerve. Otolaryngologists work in private practices, academic medical centers, community health centers and hospitals.
PHYSICAL THERAPIST (a.k.a. PT): A healthcare professional trained to diagnose and treat individuals who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. If you notice changes in your tinnitus associated with head and/or neck movement, or have been experiencing pain in your head or neck, your tinnitus might be associated and a physical therapist might be able to provide relief. PTs hold a masters (MPT, MSPT) or doctorate (DPT) in physical therapy. Physical therapists work in hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. See http://www.apta.org/AboutPTs/.
PSYCHIATRIST: A medical doctor (an M.D. or D.O.) trained to evaluate, diagnose and treat people who are affected by temporary or chronic mental health problems. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems and can prescribe medication. If you have symptoms of depression and/or anxiety, a psychiatrist can diagnose and treat these conditions, which may result in mitigation of your tinnitus. See https://www.psychiatry.org/patients-families/what-is-psychiatry.
PSYCHOLOGIST: A healthcare professional trained to help people cope more effectively with life issues and mental health problems. Psychologists also are trained in Cognitive Behavioral Therapy, Mindful Meditation, and Acceptance and Commitment Therapy, methods that have been helpful for reducing the impact of tinnitus on sleep, concentration and mood. Psychologists hold either a masters (M.A. or M.S.) or doctorate (Psy.D., Ph.D. or Ed.D). Psychologists work in private practices, community health centers, hospitals and schools. See http://www.apa.org/helpcenter/about-psychologists.aspx.
ATA also has a free online directory of hearing health professionals, who have self-identified as tinnitus specialists. Be informed about existing treatment options
When you begin to notice burdensome tinnitus symptoms...
Tinnitus can be a very frightening condition, especially if it develops rapidly, without warning, or without a clear triggering event. However, it is important for patients with tinnitus to stay calm and not panic about their condition. Tinnitus is very, very rarely indicative of an underlying emergency or life-threatening medical situation. In some cases, tinnitus may be an acute symptom that goes away after a few days or weeks.
Please note: if your tinnitus symptoms were triggered by a traumatic physical event (head/neck damage, concussive trauma, etc.) you should immediately seek medical care to address any emergency medical conditions.
Visit your primary care provider (PCP) and audiologist
If your tinnitus continues beyond a week, becomes bothersome, starts to interfere withyour sleep and/or your concentration, or makes you depressed or anxious, seek medical attention from a trained healthcare professional. Your PCP should be able to diagnose/rule out certain causes of tinnitus, such as obstructions in the ear canal or temporomandibular joint dysfunction (TMJ), and provide a referral to the appropriate specialist. If no underlying medical issues are found, see an audiologist for a hearing assessment and evaluation of tinnitus treatment options.
It is also vital that tinnitus patients educate themselves about tinnitus and tinnitus management so that they can be their own advocates in the healthcare process. (In some situations, the patient may have to educate the provider about all the options currently available.) ATA encourages patients to independently research their condition in preparation for their appointments and arrive with specific questions for their provider:
- Do you follow the best practice guideline for tinnitus management, as developed by the American Academy of Otolaryngology?
- What tests do you require or suggest? What are the tests designed to reveal?
- What is your diagnosis?
- Have you ruled out any physical causes of tinnitus: TMJ, head/neck trauma, obstruction in the ear canal, tumors, etc.
- Are you familiar with the full range of tinnitus management options currently available?
- What tinnitus management option is best for my situation? Do you offer this service?
- What tinnitus treatments do you use in your practice?
- What is your treatment plan for me? Can you provide this service or will you refer me to another provider?
- How much will treatment cost? How many visits do you think I’ll need? Will my treatment be covered by my insurance?
- Do you have any additional information for me to review?
- Are you a professional member of the American Tinnitus Association?
If patients have any additional questions or concerns, they should not hesitate to ask their doctor for more information. Communicating your feelings and concerns is the best way to get the information and assurance you need to move forward in your treatment. Also, remember to write down your doctor’s responses so you can review this information later.
Do not trust “no options” diagnoses
An unfortunate truth is that many patients are incorrectly told by doctors that there is nothing to be done for tinnitus. While it is true that there is no definitive cure for the condition, there are several well-proven tools that can significantly lower the burden of tinnitus and improve a patient’s overall quality of life.
The bottom line is this: if you are told that you have no options for managing your tinnitus, or that you have to “go home and live with it,” then you should immediately seek a second opinion from a different hearing health professional.
Consider seeing a behavioral health therapist
Tinnitus symptoms often generate feelings of despair and anxiety in many patients. Current estimates suggest that 48-78% of patients with severe tinnitus also experience depression, anxiety, or some other behavioral disorder. A trained behavioral health therapist may be able to help alleviate some of the negative emotional baggage associated with your tinnitus. There are several behavioral and educational treatment programs specifically for tinnitus management; general psychological therapy may also be beneficial.
Take action and stick to it
Once you and your healthcare provider have collaboratively identified the best management option for your specific situation, you should fully embrace that treatment and take action to realize its full benefits.
It is important to note that patients may not see an immediate improvement upon starting a management program. Many of the best tinnitus management therapies (cognitive behavioral therapy and tinnitus retraining therapy, for instance) require ongoing, active patient participation, over the course of 6-12 months. These programs generate the best outcomes when patients remain optimistic and engaged, and see the treatment through to completion.
Take care of yourself
In addition to active tinnitus management therapies, patients can improve their condition through general wellness and relaxation practices:
- Don’t render judgement on yourself. Patients shouldn’t feel guilty about their condition — you didn’t do anything to deserve this.
- Find ways to increase relaxation. Patients often report that their tinnitus is less burdensome when they are relaxed. Find the activities and behaviors that best help you relax: exercise, yoga, meditation, soothing music, anything that helps you be calm and content.
- Get a good night’s sleep. Sleeping isn’t easy when you have tinnitus, but getting a restful night’s sleep can improve your overall health and may minimize the perceived intensity of tinnitus during waking hours. Many patients use sound machines, radio static, or a fan to mask their tinnitus and help them fall and stay asleep. You may also want to consider how your use of caffeine, alcohol, cigarettes, and other drugs impact your ability to sleep.
Find a support network
You do not need to struggle with tinnitus alone. Patients who find the most success in managing their tinnitus often have strong support networks to help them through their tough spells. Spouses, family, friends, colleagues, and peers can all play a positive support role for tinnitus patients. A strong support group can improve emotional wellness, general feelings of contentment, and optimism; it also minimizes feelings of social isolation and depression.
It is sometimes helpful to speak with other tinnitus patients — people going through the same struggles and participating in the same treatments as you. ATA can direct you to local tinnitus support groups where you can meet with and learn from fellow patients, in a caring, welcoming, and safe atmosphere. ATA can also direct you to Help Network Volunteers who are willing to share their own experiences with tinnitus via one-on-one phone calls or email correspondence
Support ongoing tinnitus research
The process outlined above provides a general framework for making the most of tinnitus management tools, which can lessen the burden of tinnitus and help patients live fuller, happier and more peaceful lives. These services can (and do) help people feel better. But “managing” tinnitus is not the same as “curing” tinnitus. Finding a definitive cure (or cures) to tinnitus is a long term objective for ATA. To reach this final goal, we need more research — studies to improve our understanding of how tinnitus manifests and to explore innovative medical solutions to the problem.
ATA is one of the only national and international organizations that is investing in cutting-edge tinnitus research, in search of a definitive cure for this condition. Each year, we provide seed grants to researchers with innovative projects that help us better understand, treat, and (eventually, we hope) cure tinnitus. These grants are entirely funded by our members and donors — most of whom are tinnitus patients just like you. To show your support for this noble and important work, please consider becoming an ATA member or making a contribution to our organization.