NHS Tinnitus Treatment Advice
If you visit https://www.nhs.uk/conditions/tinnitus/, you will find a small amount of fairly generic but reasonable advice regarding tinnitus. There is the usual advice to seek an urgent medical opinion if your tinnitus came about through a head injury, is associated with dizziness, or beats in time with your pulse. It also suggests seeing your GP if it is disturbing you, getting worse, or is always there.
There are routine do’s and don’ts to help you, such as trying some deep breathing, sleep improvement techniques, and considering joining a support group. You can also follow links to some national charities where there is further advice and support available.
The main treatment recommendations are different therapeutic approaches to tinnitus rehabilitation.
- Classical directive counselling, i.e. telling you what’s going on and what you can do about it
- Cognitive Behavioural Therapy (CBT), a psychological approach that looks at the reasons for your tinnitus perception and distress and looks at ways to change it
- Tinnitus Retraining Therapy: originally, this was a very prescriptive and dogmatic approach. Now usually called Modified TRT, it is used in some form in most NHS departments
You will additionally find a brief discussion on the causes of tinnitus. Most of these can be discussed with your GP or ENT consultant. Crucially, it also mentions hearing loss, which is often one of the precursors to tinnitus, if not sometimes the driving force.
Across the UK, it is fair to say that tinnitus treatment is something of a post-code lottery for NHS patients. There are centres of excellence and areas where there is no one with a special interest or training. Unfortunately, there isn’t a national tariff for tinnitus treatment, so it is up to each audiology department to decide if they can fund treatment and to what extent.
We know for a great many patients that accurately correcting their hearing loss can significantly help reduce their awareness of tinnitus. This is because there is simply more information travelling up the auditory nerve from outside sources, so internal noise seems quieter by comparison. All audiology departments will offer hearing aids, although some may require a certain degree of hearing loss (>35 dBHL average) or may only fit one ear.
Generally, for tinnitus patients, the more light and open the fitting is in the ear, the better. This is so that internal noises are not trapped inside the head, known as the occlusion effect. In most cases, NHS hearing aids have a range from 200 Hz to around 8,000 Hz, which is fine for amplifying speech alone. Where someone has a very low or very high frequency of hearing loss, modern private hearing aids can offer an extended range from 100 Hz to around 9,600 Hz, enabling more relevant masking of ambient sound to travel up to the brain as well as a more natural tone to speech and music.
In some areas, hearing aids with tinnitus therapy sounds are also available. These normally employ a variation of white noise that can be shaped for differences in pitch and volume. This sound enrichment can be very valuable in helping both to control and feel in control of your tinnitus, but it needs an experienced audiologist to set it up to be used safely and effectively.
More modern hearing aids also have the ability to stream much higher-quality sounds directly from a mobile phone tinnitus application. These can be highly individualised by the wearer and changed whenever necessary with the application. The most recent private devices are beginning to more closely resemble small music ear buds than traditional hearing aids and are becoming increasingly efficient at features such as noise cancellation and speech enhancement.
For a full tinnitus assessment and free trial, book an appointment with one of our experts at Tinnitus Centres