Tinnitus

Definition of Tinnitus

‘The perception of sound that results exclusively from activity within the nervous system without any corresponding mechanical, vibratory activity within the cochlea, and not related to external stimulation of any kind’ (Jastreboff and Hazell, 2004  )

This basically means the perceived sound ‘heard’ by the sufferer is not an actual sound heard from the outside environment; or from the usual vibratory mechanism in the inner ear that is a part of the actual hearing function.

There are 2 types of tinnitus – objective and subjective.
Objective tinnitus can be heard by someone else other than the patient. These are usually vibrations of turbulent blood flow that reach the cochlea, detected on clinical examination.
Subjective tinnitus is only ‘heard’ by the patient, and is the most common type.

Causes of Tinnitus

The mechanism as to why the tinnitus sound perception comes about is unknown, but can be linked to some causes such as:
• high blood pressure (hypertension)
• excess catarrh in the middle ear
• viral infections of the inner ear
• neuroma – lesions on the VII cranial nerve
• loud noise damage
The most commonly seen of these are loud noise damage, hypertension, and excess catarrhal in the middle ear.
The mechanism as to how the tinnitus sound perception comes about is thought to be a result of damage to the outer and inner hair cells creating an abnormal, over-activity of the auditory nerve fibre.
The actual noises heard by the patient is the phantom perceived sound from the damaged hair cells sensed in the brain after the damage is done but not actually heard in the true sense. It is like the phantom limb pain that people who have had legs or arms amputated sometimes experience.

The Importance of Tinnitus and Anxiety

Anxiety creates the fight-or-flight response, increasing activity in part of our nervous system called the sympathetic nervous system. This in turn heightens bodily sensitivities and increases alertness, heart rate, muscle contractility and auditory signals perceived as a threat or danger giving them prominence. The body thus fine tunes to the noise for better detection of danger.
This would have been essential as a survival technique to sense danger and give the body extra physical strength to run away from or attack danger.
However, in modern life this reaction from anxiety or stress can damage the body if not worked off on a physical level with exercise, as the heightened body senses are only good in the short term.
With tinnitus, this long term raised sympathetic nervous system activity increases the perceived noise of the tinnitus as it is constantly fine tuning into it. It is a vicious cycle as the patient becomes more aware of it and thus more anxious. Therefore treatment with all causes of tinnitus with natural options includes focusing on reducing this stress and anxiety and their effects on the body.

There is No Cure for Tinnitus

As yet there is no cure for tinnitus and treatment is based on improving it and management of it with orthodox and natural options.

Orthodox Treatment/Management
There are a number of treatments used by conventional medicine to help people cope with the symptoms of tinnitus. These include Cognitive behavioural therapy, antidepressants, support groups, hearing aids, masking devices, and tinnitus retraining therapy.

Medical Herbalists’ Treatment Strategies
A qualified medical herbalist will normally treat the patient ‘holistically’, looking at the whole body to encompass all aspects of individual care. This would include:
• Diet and lifestyle factors
The can play a significant role, affecting how a disease affects your body.
• Previous medical history
Sometimes things that happened a considerable time ago can be related to your current condition or may be affecting how you are currently dealing with an illness.
• Family medical history
• All symptoms and signs that are going on currently for the patient
A detailed look at your current health can allow the herbalist to understand what the most likely underlying causes of the tinnitus are, and any other factors relevant to your health.
• Looking at the individual pattern of how the disease came about
Not only do medical herbalists treat symptoms of the disease itself in the system that it is related, (e.g. tinnitus involves the nervous system), they will also treat other related systems. E.g. for tinnitus from hypertension treatment includes the heart and circulatory system, digestive system, and kidneys as these all play a role in the body’s maintenance of blood pressure.
• Constitution
A person’s constitution is important for seeing how the disease has manifested for them.
For example, a person who feels the cold a lot may have a cold and dry constitution. This could result in stagnation of body fluids, decreased circulation, solidifying of body excretions which could lead to thicker mucus secretions which can lead to excess phlegm/catarrh. This person could manifest their tinnitus from catarrhal cause and this would be treated with warming herbs to move the blood and to clear stagnation of catarrh.
• Treatment is with herbs selected specifically for the individual, diet and lifestyle advice treating the symptoms and the cause.

You know your body best, but it is helpful having someone like a Medical Herbalist monitor you, who can diagnose, and who has knowledge of all body systems and how they relate to one another in certain diseases, and how certain herbs affect this taking into account all aspects of the individual.

Summary and Conclusions

I hope you have found this information insightful. I hope it offers a number of options to help improve your own health and to understand how a Medical Herbalist could work with you to try to improve your situation. We believe that a medical herbalist is one of the medical professionals best placed to offer support for people suffering from Tinnitus.

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JASTREBOFF, P. AND HAZELL, J., 2004. Tinnitus Retraining Therapy. 1st ed. Cambridge: Cambridge University Press.)