Bad news and good news for tinnitus sufferers | Hacker News Reader

Bad news and good news for tinnitus sufferers

nautil.us

51 pointsdnetesn44 comments

I think the title's a bit clickbait. Basically it's saying there's been a paper published that says:

>Tinnitus and chronic pain [are similar]. It is now becoming increasingly clear that higher cognitive and affective brain systems are centrally involved in the pathology of both disorders.

and the article says:

>In both, there is impairment in the frontal lobe

>In tinnitus and chronic pain, these structures appear to become dysfunctional, turning “up” pain and auditory signals, leading to pain or tinnitus noise.

So not really good or bad news so much as another theory. There may be an element of that but tinnitus can start instantly after a loud noise so I'd imagine it's something lower level going wrong in that case at any rate.

>I think the title's a bit clickbait

In this case, the article's content is far more interesting than the title suggests, contrary to the usual pattern.

I have mild tinnitus, it's not really bothering me but is noticeable in quiet environments. I find it interesting that I can exacerbate it by pulling on my jaw or clenching my jaw. If I'm feeling a bit under the weather, it is also exacerbated by moving my eyes. So at least in my case, there's a definite connection to muscles around the ear.

There appears to be at least some support for this in the literature, e.g. http://www.scielo.br/scielo.php?pid=S1808-86942012000600004&...

I can confirm that for mine as well. If I move my jaw forward, I can hear a very clear high pitched noise, relatively loud too. Even when my regular tinnitus is barely or not at all audible. Stretching the neck and jaw muscles can sometimes help or at the very least modify the sound. Also, colds and such seem to have a very direct effect on it as well.

At least for me, it does not seem to be related to stress as such.

Funny, btw., I'm 39 and up until last week or so I was certain that the high pitched noise happened to everyone if they moved their jaw forward. I've had that for as long as I can remember, way before I ever had my first tinnitus episode, and never even thought that that may not be normal :)

weird... I don't have tinnitus, that I know of, but if I put earbuds in that provide a lot of sound dampening and clench my jaw muscles, it makes a pretty noticeable roaring sound, kind of sounds like the inside of an airplane.

I think that is just the sound of your muscles tensing. I hear it too when I clench my jaw muscles, at the same time I hear a louder version of my tinnitus. So at least for me they are distinct sounds.

I think that's the sound of your Eustachian tubes being open.

That's an interesting theory.

Same, also getting drunk makes it worse for me.

Yep even just one beer will make it worse for me the next day.

Also running, the harder I run the worse it is.

Same here. If I clench my jaw or push it forward it gets much louder and more noticeable, especially on one side.

I was reading up on the physics of how hearing works at the molecular level and the movements involved are very small of the order of the width of an atom so shoving elsewhere on the head might be able to affect things in the ear on that scale. The mechanism kind of works by running a sort of string (tip link) between two hairs linked to an ion channel so when a wave moves the hairs the string pulls the channel open enough to let K+ ions through. The whole thing looks Heath Robinson enough to go wrong fairly easily. http://www.cochlea.eu/en/hair-cells

It's similar for me. I'm not sure if the tinnitus is the result of too many loud concerts / events, or constant jaw tension (TMJ). I've had it for about 5 years now, but it's generally pretty mild. I do notice I won't hear anything in the mornings sometimes so I suspect it's psychological, or tension related.

Two purchases have had a huge impact on my quality of life related to the tinnitus:

1. A pill case with some musicians earplugs on my keychain. Never feel like I need to decline an invite to a noisy place: https://www.amazon.com/Water-proof-Air-tight-Aluminum-Keycha...

2. The Bose qc20 noise cancelling earbuds - they don't go inside the canal, so they don't irritate or exacerbate the tinnitus, and for me at least the noise cancelling effect counteracts the tinnitus frequency.

Same! In my case, i only started noticing tinnitus after a month or so of lots of stretching and exercises to relieve neck/shoulder pain, and i can even make it go away temporarily by tapping the back of my head.

Tinnitus is definitely muscle related for lots of us I suppose.

Certain causes of tinnitus cannot be treated, but some can. So be sure your doctor tries to understand the cause of your tinnitus.

For example, one (of many) causes of tinnitus is otosclerosis--the "stirrup" bone in your ear grows extra bone and becomes unable to vibrate properly. The primary symptom of this problem is somewhat muffled hearing, but it is often accompanied by tinnitus.

This condition comes on extremely slowly, so you may not notice the hearing loss. I finally noticed it in myself once when I put my head down on a pillow and suddenly couldn't hear the TV.

There is a good medical solutions to it though--"stapes mobilization surgery". Low risk, better hearing, and tinnitus gone.

So if you have tinnitus and somewhat muffled hearing, see a doctor and mention otosclerosis. It is definitely worth getting checked out. It can really improve your life.

Whew, I thought this was going to be about the results of Auris Medical's new tinnitus drug, AM-101. The results are due to come out within the next month or so. The drug is injected into the ear, so it wouldn't effect tinnitus that originates in the brain. I've had tinnitus for about 10 years now, and it sucks that doctors know so little about it. However, there seem to be a lot of companies popping up recently that are trying to attack the problem, so I'm excited.

Another company, Otonomy, is also working on a tinnitus drug that's injected into the ear (see http://www.ncbi.nlm.nih.gov/pubmed/19847455). It's an NMDA receptor antagonist (just like AM-101), so it doesn't seem like it would work for tinnitus that originates in the brain.

I had to make a new account just to post this. A few years ago I noticed tinnitus develop in one of my ears along with associated hearing loss following a very stressful period of time. After some research I went to a specialist neurosurgeon / neuroscientist who tested me for all sorts of viruses and conditions and also performed a special DMSA chelation urinalysis which let me know that I have lead poisoning. I am now working with special diet and lifestyle changes in order to attempt to draw as much of it out as I can. I am also working with a dentist who specializes in removing metal amalgam fillings which are one source of possible lead (as well as mercury) exposure. I did have some mercury in my urine profile as well but not in the danger zone like lead.

I've read several article on Tinnitus now and there is never a mention of possible heavy metal contamination. It is surprising to me because it seems like an environmental issue which has been largely swept under the rug for generations now. I hope it gets better and more information and awareness is brought forth.

> Martin’s resignation in the face of tinnitus isn’t rare, perhaps because tinnitus remains poorly understood.

No. It's because you go to the doctor and you literally get sent home without being helped in any way whatsoever. Well, he looks into your ear and maybe you get some useless medication. Just save the money and time and deal with it, that's all you can do as of today.

I found the docs useless. I found earplugs helped a bit - they can prevent further damage and allow the body to recover.

I had been using various forms of white noise for years to help reduce external annoyances while I was working and trying to concentrate. That has led to what appears to be an early form of tinnitus. It doesn't cause me pain yet, sometimes it's really annoying and I no longer hear actual silence when I should. I've found relief by using gun shooting ear protection, as funny as that sounds. 34 to 37 db level protection. The ear protectors are dirt cheap to buy on Amazon and moderately comfortable. They would probably look stupid to wear in an office setting, but I work out of a home office, so no concerns there. A few hours here and there of wearing them and the tinnitus (or whatever it is at this point) is meaningfully reduced.

I've found some help visiting an Osteopath, but that's because mine seems to be at least somewhat related to the neck/jaw muscles or around that area. He showed me some relaxing and general exercises that do help a bit. But in the end he agreed that basically for now, you just need to find a way to deal with it.

How does that contradict the quote?

Maybe your doc sends you home with no help precisely because it is poorly understood and so they don't know how to help you?

Because the article makes it sound like Martin is an idiot who has a choice, he could at least try to understand it better, when really, Martin has no option other than resignating and sucking it up unless he's a brilliant doctor and neurologist and dedicates his entire life to this problem. The 'perhaps' is also completely out of place. How about some honesty: The doctors are completely clueless and can't do anything, therefore, Martin resignated.

That was not my reading at all; like greenshackle, I did not see any contradiction between what you quoted, and the point you made.

Yeah, I got the exact same experience at my doctor. I tell them it's not single sound but several and the frequencies are changing all the time. Completely ignoring that assistent then spends a few minutes figuring out the sound frequency (me trying to compare a hissing sound in my ears to a single tune...). Afterwards doctor looks into both ears for a few second and then tells me it's nothing obvious, so there is nothing that can be done about it, but I can get some cortisol for 3 days in case it helps (didn't).

In the UK I got sent to ENT clinic, then a cat scan to make sure it wasn't anything serious.

Then, the doc told me they couldn't do anything, but if it distressed me there was counselling available to help you learn how to deal with it.

So while your experience may have sucked, they can do something, they just can't cure it.

I had the same result (in the UK), except didn't get told anything about counselling.

My doctor told me "You have no disease. You have a symptom of a disease." Which he honestly intended as good news. Then he sent me on my way with the guidance to relax and learn to live with it.

I remembered why, after seeing this guy once years before for another ent problem, I never went back to him.

I've created a few iOS apps for tinnitus, if anyone is interested. The apps provide masking therapy or notch filter therapy. There does not seem to be a scientific way to predetermine what therapy, if any, will be therapeutic to you, so it helps to try a few different things. https://itunes.apple.com/us/app/serene-ears/id790457760?mt=8... https://itunes.apple.com/us/app/nix-tinnitus-player/id842249...

So what are the good and bad news? I didn't find it by skimming.

Kind of stumped me. Good - they've got a new theory, bad - still no treatment?

Bad news (there is no cure):

  “We both found the same brain structure involved in the
  cortex,” he says. “Both tinnitus and chronic pain are
  chronic conditions—there is no cure.”

Good news (there may be treatment):

  Rauschecker says, some believe there may be “an
  underlying brain condition that gives you tinnitus and
  depression.” For this reason, Rasuchecker feels that
  dopamine and serotonin are hot candidates for drug
  therapies.

  A study in March, citing Rauschecker’s paper on chronic
  pain and tinnitus, demonstrates “that the meta-
  cognitive ability to acknowledge and let go of arising
  sensory events engages a unique, self-facilitated pain
  modulatory system.” In others words, meditation can
  help reduce chronic pain, and perhaps tinnitus.

Bad: It's chronic (not really news). It's related to depression.

Good: It's already treatable with serotonin and might become more easily treatable because there seem to be an underlying neurological cause and hearing damage is not sufficient in itself.

Search for iodine therapy. Even if you are not iodine deficient according to diagnostic tests, iodine can help a lot with tinnitus.

I have it, too. It's worse when I didn't get enough sleep (which is most of the time).

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