Tinnitus

Tinnitus is the term used for noises or sounds which are heard in one or both ears or in the head which do not come from an external source. They are often described as a high-pitched ringing but can also be described as a buzzing, hissing, pulsing, whistling, roaring, or various other sounds. Tinnitus can be very mild in loudness and only noticeable in a quiet room or it can become extremely loud and annoying to the point where the sufferer hears nothing else. It can be present all of the time or occur intermittently.

Mechanisms of Tinnitus
When the brain first hears tinnitus it attempts to classify the sound from its stored data of sounds with which it is familiar. When no 'match' can be made from previous experience, the brain focuses on the sound to such an extent that the sound is effectively magnified and the brain gives it a level of importance it does not deserve.
This happens in the same way as when you are alone in your house at night and you hear the sound of a blind knocking against a window sill, or the floor boards expanding or contracting. Your senses go into a state of high alert, and the sounds are given unnecessary significance. This is because the limbic system within the brain is interpreting the sounds as signals of possible danger.
In the same way, whenever you are aware of your tinnitus, your brain automatically interprets the sounds as a sign that something is terribly wrong, or as a danger signal. If this continues, your mind becomes obsessed with the sound, continually focusing on it and thus maintaining your body and mind in a state of high alert.
If this fearful pattern of thought is left unchecked, the negative response to the sound is reinforced. This 'programming' of the brain must be corrected so that you learn to manage your tinnitus rather than letting it manage you.

Psychological assessment
Tinnitus has been demonstrated to be an important stressor and is often associated with anxiety and, in particular, depression. Without doubt, there is an association between tinnitus annoyance and a poor psychological state. Anxiety and depression play an important role in the tinnitus process and often the characteristics of tinnitus do not predict the distress provoked by it.
A comprehensive assessment is essential before the implementation of a therapy. Apart from medical and audiological parameters, perceptual, attentional, emotional and behavioral aspects have to be equally considered. Topics of psychological assessment include characteristics of tinnitus (loudness, localization, pitch of sound) and the progression of tinnitus (onset, duration, intensity, increasing and decreasing factors). Beyond that, cognitive-emotional evaluation and coping (e.g., catastrophic thinking, helplessness, anger, sadness, etc.), psychological impairments related to tinnitus (depression, irritability, sleeping problems and so on), effects of tinnitus on life (e.g., work, social interactions), sources of stress apart from tinnitus (e.g., live events, daily hassles), operant factors (e.g., avoidance behavior), comorbidity (e.g., mental disorders, hearing loss), treatment history and treatment expectations.

Causes Of Tinnitus
1: Most tinnitus comes from damage to the microscopic endings of the hearing nerve in the inner ear.
2: Hearing loss. Too much exposure to loud noise can cause tinnitus.
3: Long-term use of certain medications. Aspirin used in large doses, quinine, antibiotics and anti-inflammatory drugs can affect inner ear cells. Trauma-related damage to your inner ear.
4: Temporomandibular joint problems. These are “jaw joint” disorders, and they may result in clicking or grating noises when you move the jaw.
5: Stiffening of the bones in the middle ear.
6: A hole in or a rupture of the eardrum.
7: Ear infection. If an infection reduces your ability to hear outside noises, you’re more likely to hear the noises related to tinnitus.
8: Ear wax. Buildup of excess wax in your ear can reduce your ability to hear or inflammation of the eardrum membrane, the middle ear, or the inner ear.
9: Allergies, tumors, and problems in the heart and blood vessels, jaws, and neck can cause tinnitus. High blood cholesterol clogs arteries that supply oxygen to the nerves of the inner ear. If you are older, advancing age is generally accompanied by a certain amount of hearing nerve impairment and tinnitus.
10: Diet can affect tinnitus. Specific foods may trigger tinnitus. Foods include red wine, grain-based spirits, cheese, and chocolate quinine/tonic water, high fat, high sodium can all make tinnitus worse in some people.
11: Stress is not a direct cause of tinnitus, but it will generally make an already existing case worse. Ringing in the ears also sometimes accompanies vertigo (dizziness).
12: High blood pressure. Hypertension and factors that increase blood pressure, such as stress, alcohol and caffeine, can make tinnitus more noticeable.
13: Meniere's disease. Tinnitus can be an early indicator of Meniere's disease, an inner ear disorder that may be caused by abnormal inner ear fluid pressure.
14: Exposure to loud noise. Loud noises, such as those from heavy equipment, chain saws and firearms, are common sources of noise-related hearing loss. Portable music devices, such as MP3 players or iPods, also can cause noise-related hearing loss if played loudly for long periods. Tinnitus caused by short-term exposure, such as attending a loud concert, usually goes away; long-term exposure to loud sound can cause permanent damage.

Complications :-
• Fatigue
• Stress
• Sleep problems
• Trouble concentrating
• Memory problems
• Depression
• Anxiety and irritability

Symptoms :-
Tinnitus involves the annoying sensation of hearing sound when no external sound is present. Tinnitus symptoms include these types of phantom noises in your ears:
• Ringing
• Buzzing
• Roaring
• Clicking
• Hissing
The phantom noise may vary in pitch from a low roar to a high squeal, and you may hear it in one or both ears. In some cases, the sound can be so loud it can interfere with your ability to concentrate or hear actual sound. Tinnitus may be present all the time, or it may come and go.
There are two kinds of tinnitus.
• Subjective tinnitus is tinnitus only you can hear. This is the most common type of tinnitus. It can be caused by ear problems in your outer, middle or inner ear. It also can be caused by problems with the hearing (auditory) nerves or the part of your brain that interprets nerve signals as sound (auditory pathways).
• Objective tinnitus is tinnitus your doctor can hear when he or she does an examination. This rare type of tinnitus may be caused by a blood vessel problem, an inner ear bone condition or muscle contractions.

How Tinnitus Affects People :-
People with tinnitus may display the following behaviour in the early stages:
• frequent mood swings
• depression
• anxiety attacks
• tension
• irritability
• frustration
• poor concentration
• sleep problems
extreme distress, especially in the early stages, is common. However, the tinnitus does not cause these problems directly. It is your emotional response that causes the problems. Modifying your emotional response eliminates the majority of these problems.

Exercises Beneficial for Tinnitus :-
1. Breathing Relaxation Exercise:
• Breathe slowly and deeply, Hold your breath a moment.
• Relax, and then let your breath out.
• Wait a moment, then breathe slowly and deeply again, and so on.
2. Muscle Relaxation Exercise:
• Sit in a chair or lay on a bed. Find a comfortable position.
• Breathe slowly.
• Tighten your fist. Feel the tightness in your hand and wrist.
• Breathe out. As you do, relax your hand and wrist. Feel the difference.
• Repeat this with other parts of your body, Try it with your other hand, each arm, leg, foot, your back, neck, face and jaw.
You can do these exercises regularly, when and where you have the time and space. You will improve with practice. You should start to feel the benefits quickly.

3. Meditation exercise
Sit comfortably in a chair.
Relax the muscles around your eyes and soften your gaze.
Allow yourself to feel sensations in the body:
Feet on the floor
Legs resting comfortably on the chair
Arms resting
Hands soft and relaxed
Tightness in your shoulders
Tension in the face
Now allow yourself to experience your breathing.
Feel the gentle movements of the body as you breathe.
Pay attention to your breath:
Entering your nose
Passing through your throat
Filling your lungs
Causing the abdomen to swell
Feeling the swell against the back of the chair
Now invite other areas of the body in…take your attention to any area where you may have pain or tension. Let any tight muscles soften and relax. Become aware of your feelings or mood and what thoughts might be passing through your mind. Be aware of all of these sensations together with your breathing.
Now start to move gently – any small movement that you can manage, maybe moving fingers up and down, circling the feet or simply moving them side to side. Be aware of being back in the room again, but feeling more settled and at peace.

4. Pranayama for Tinnitus
Relaxation via breathing exercises might make better tinnitus, as stated by Andrew Weil, M.D. The more calmed you are, the more effortlessly blood circulates and the lesser your stress levels. Yoga breathing exercises are described as pranayama. To do a basic pranayama exercise, sit up straight with your legs crisscrossed on the floor. Inhale via your nose and enlarge your stomach. Exhale and observe your stomach depress similar to a balloon. Take several breaths into your abdomen and then your subsequent breathing, breathe into your lungs too in order that your rib cage enlarges. Breathe out totally via your nose in order that your rib cage and stomach breakdown. Lastly, breathe in to fill up your stomach, lungs and upper chest; breathe out totally.

5.General Physical Action
Daily workout makes better circulation and is advantageous for remedying tinnitus, as stated by Dr. Weil. The Centers for Disease Control and Prevention suggest that kids obtain 60 minutes of reasonable to demanding physical action daily, varying from brisk walking to running. Grownups and seniors must do 150 minutes every week of reasonable aerobic movement like brisk walking for overall fitness. Whatever kind of aerobic action you perform, it must be founded on what you take pleasure in and can uphold steadily.

6. Resisted Opening
The resisted opening exercise is a jaw exercise to make better relaxation and movement within the jaw joints for TMJ respite. To do this exercise, put you palm beneath your chin with your mouth shut. Press your jaw against your palm to gradually open your mouth. Utilize your palm to apply weightless resistance as you open your mouth as far as at ease. Shut your mouth to finish the exercise.

7. Midline Exercise
The midline exercise needs certain focus but will aid you to make a habit of opening your jaw consistently. To do this TMJ exercise, stand in front of a mirror with your mouth shut. Watch how your top and bottom teeth line up. Gradually open your mouth and remain your bottom teeth aligned with your top teeth. The jaw might desire gliding in one route or the other if there is tension or muscle inequity. Do not allow the jaw to move sideways. Shut your mouth.

Acupressure Treatments :
Acupuncturists use needles to access these powerful pressure points, but you can easily balance your qi (energy) and cure tinnitus in the comfort of your own home by gently massaging the following acupressure zones(As In Figure):

1. Acupressure Massage around your ears. Place your fingertips of both hands about 1/8th an inch from your ears. Close your eyes to feel for hallow spots, and fit your fingertips into each of these indentations. Take slow deep breaths as you briskly massage this area, by slowly turning your hand, gliding over the bumps on your skull for two minutes.

2. Acupressure on the Base of your Skull(GB 20) and the acupressure points near and around the top of your head. Press these points about five times each, alternating your position between firm pressure on GB 20, underneath the base of your skull, and pressure into the sore spots on the back of the top of your head. Explore all the points that are covered by wearing a Jewish cap.

3. Hold CV 6, located between your belly button and public bone, taking slow deep breaths, into you go into a deep state of relaxation for 5 to 10 minutes.

4. GV 20 is one of the most potent acupressure points in Chinese medicine; it is called the “Hundred Convergences” because the ancient Chinese believed it was capable of curing 100 diseases. In addition to treating tinnitus, you may also cure neurological and emotional disorders by stimulating Bai Hui.
To locate it, imagine a line running on top of your head, forward to back, between your ears, sort of like a Mohawk. The point that is directly on top of your head in the middle is your Bai Hui.

5. GB 20 is another powerful point for curing illnesses of the head like tinnitus and headaches.
Feng Chi is located at the nape of your neck. To start, place both hands behind your head and use both thumbs to find the soft spot at the base of your skull. Now, gently walk each thumb apart until you find depressions that are adjacent to your large neck muscles. Press each thumb inwards, towards your eyes.

6. SI 19 is used in Chinese medicine to calm the spirit and treat ear problems, including tinnitus and deafness.This is located in the hollow directly in front of each ear. To access, open your mouth, and feel the depression where your jaws meet.

7. GB 2 particularly helpful for treating all ailments related to the ear such as tinnitus and hearing loss. It is located directly below your Ting Gong acupressure point.

8. GB 8 is beneficial for treating damage caused by toxins. This is especially helpful for curing tinnitus caused by long-time use of painkillers, antidepressants, birth control, and quinine. It is located directly above your ear.

Home Remedies
1: Bayberry bark, burdock root, goldenseal, hawthorn leaf and flower and myrrh gum purify the blood and counter act infection.
2: Ginkgo biloba helps to reduce dizziness and improve hearing loss related to reduce blood flow to the ears.
3: Eat fresh pineapple frequently to reduce inflammation.
4: Include in your diet plenty of garlic, kelp and sea vegetable.
5: For ringing in the ears, mix 1 teaspoon of salt and 1 teaspoon of glycerin in 1 pint of warm water. Use a nasal spray bottle to spray each nostril with the solution until it begins to drain into the back of the throat. Spray the throat with the mixture as well. Do this three times a day.
6. Sesame : Sesame seeds have been used by Chinese herbalists for the treatment of tinnitus, blurred vision and dizziness. It is also used in Indian Ayurvedic treatment. You can add it to foods. Other forms of sesame are tahini, the peanut-butter-like spread made from sesame seeds, and halvah, a popular sesame candy.
7. Spinach (Spinacia oleracea) and other foods containing zinc: Zinc deficiency is often associated with tinnitus and certain kinds of hearing loss (sensorineural). So, taking spinach and other foods containing zinc may be beneficial in the treatment of tinnitus. Good sources of zinc include spinach (the best), papaya, collards, brussels sprouts, cucumbers, string beans, endive, cowpeas, prunes and asparagus.
8. Sunflower Seeds :An old Chinese remedy calls for eating sunflower seeds and drinking a tea brewed from their hulls for tinnitus.
9. Fenugreek Seed Tea Drinking a cup of fenugreek seed tea each morning, noon, and night is reported to abolish disturbing ear noises.
10. Castor Oil: Folk remedies for tinnitus include putting three or four drops of castor oil in each ear once a day and inserting a cotton plug.
11. Onion Juice: A folk remedy for tinnitus is using 1 drop of onion juice three times a week until relieved, then once each week or 10 days for maintenance.
12. Passion flower: Passion flower extract regulates neurotransmitters and circulation.
13. Ramson juice : Sometimes, tinnitus is related to constipation. In this case, taking 1 tbsp. of ramson juice daily to clear the large intestine may help.

Avoid eating Coffee, tea, chocolate and cola, alcohol, colourings, artificial colourings and preservatives, MSG, as well as tobacco , some drugs such as aspirin have all been linked to tinnitus, sweets and salted, fried foods.