“The way we manage it not only needs to treat an audiological problem, but there’s quite a lot of psychology in there as well,” Hall says. “Trying to change the way that people think about their tinnitus and what significance it has for them.”
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Here are some ways people tried to treat tinnitus in the past: The ancient Egyptians suggested poking reeds into your ears. The Assyrians would chant an incantation. Pliny the Elder, an ancient Roman scholar, favored earthworms boiled in goose grease and stuck into the ear as a treatment for all manner of ear maladies. A Welsh manuscript from the 14th century recommends taking a hot loaf of bread out of the oven, tearing it in half and holding it over your ears. “Bind and thus produce perspiration, and by the help of God you will be cured,” it reads.
Today, the available treatments are less yeasty. They focus on the two avenues Hall suggested: masking the sound, and helping people cope with it.
There is still a lot about tinnitus that is not understood, and there is no cure. There’s nothing doctors can do as of yet to make the sound go away, though researchers are looking into different kinds of brain stimulation as a possibility. But everyone I spoke to was adamant that doctors should not tell patients they just have to live with it.
As with pain, doctors treating tinnitus (usually) only have the patient’s subjective experience to go on. Hall says doctors will typically just talk with the patient about what kinds of sounds they’re hearing, how loud, and how often. To determine the pitch and volume, they may play sound recordings and ask the patient which one matches their tinnitus, but “those kind of objective measures are still more often in the domain of research rather than in the clinic,” she says. Usually, it’s just patient reports. As long as there are no indications of anything more serious, like a brain tumor or the vascular problems that can come with pulsatile tinnitus, it’s not totally necessary to figure out the sound’s origins in order to treat it.
“The concern is how it interferes with people’s daily life, as opposed to putting a label on it, saying ‘Well, this is due to that,” Hoffman says.
For people whose tinnitus comes with hearing loss, getting a hearing aid can often improve their tinnitus as well as their hearing. Doctors may recommend cognitive-behavioral therapy to reduce the distress that tinnitus can cause. Or they may recommend sound therapy, which distracts the brain from the noise it’s creating by masking it with other sounds. This can be as simple as playing background music, or as elaborate as a hearing aid that can also pipe white noise into the ear.
The American Tinnitus Association has a story its members like to tell, about how its co-founders, Jack Vernon and Charles Unice, came up with the idea for sound therapy. According to West (and to a story in the spring 2011 issue of the ATA’s magazine Tinnitus Today), Unice, who suffered from tinnitus himself, came to Portland from California in 1971 to visit Vernon. While they were out for lunch, they passed Portland’s Lovejoy Fountain. Unice stopped in his tracks and declared that while he stood by the fountain, he couldn’t hear his tinnitus. And thus the two men realized that if noise is the problem, the solution is … more noise.