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 “Patient Roadmap,” that identifies the optimal step-by-step process for finding medical support.
Please note: this “Roadmap” 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.
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)
If your tinnitus symptoms continue beyond a week, or become a significant burden, you should seek medical attention from a trained healthcare professional. At the front-line of healthcare services is your primary care provider (PCP), a general practitioner familiar with your medical history, who can diagnose and and treat general health and wellness issues.
Your PCP should be able to diagnose (or eliminate from consideration) certain causes of tinnitus, such as obstructions in the ear canal, temporomandibular joint dysfunction, or sinus pressure. They can also provide recommendations for follow-up care with a healthcare specialist, if indicators suggest a specific etiology (or cause of) tinnitus.
Please note: depending on your health insurance plan, it may be necessary to first get a referral from your primary care provider in order to see any medical specialist.
Find a Hearing Health Professional
Tinnitus typically begins as an audiological (hearing) condition, and so it is generally appropriate to consult medical providers with clinical specialties in hearing health. There are two general types of hearing health providers to consider:
Audiologists (Au.D.) — Audiologists are healthcare specialists, trained in the diagnosis and treatment of hearing loss and other hearing-related disorders. Audiologists can perform an array of hearing tests, interpret test results, fit and adjust hearing aids, and advise on the selection and use of hearing assistance tools. In general, audiologists are the best, first option for the vast majority of tinnitus cases.
Otolaryngologists (E.N.T.) — Otolaryngologists are medical physicians specializing in the integrated systems of the ear, nose, and throat (which is where the acronym E.N.T. comes from). They are trained surgeons, who can manage and treat physical issues within the ear. Generally, otolaryngologists are best suited to treat less common forms of tinnitus, caused by treatable medical maladies in the ear.
An audiologist (Au.D) or otolaryngologist (E.N.T.) may be able to provide a more precise diagnosis for your symptoms and identify the specific causes for your tinnitus, which informs the best treatment option for your condition. An Au.D. or E.N.T. with training and knowledge of tinnitus should be able to discuss an array of tinnitus management options, and help identify the best strategy for your specific medical situation.
Depending on their analysis of your specific case, a hearing health professional may refer you to another specialist — an otologist, neurologist, or behavioral therapist, for example — for further diagnosis or subsequent treatment.
The level of professional tinnitus-specific training varies depending on provider; some healthcare professionals have a deep knowledge of tinnitus management, while many others have little to none. To receive the best-possible healthcare service, patients should seek out audiologists and otolaryngologists with specific capacities in tinnitus management. You may want to call the doctor’s office before scheduling an appointment, to ask if that provider can diagnose and manage tinnitus cases. You may also ask your primary care provider to research and suggest an appropriate specialist for your tinnitus. (ATA also has a free online directory of hearing health professionals, who have self-identified as tinnitus specialists.)
Be informed about existing 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.