Can your hearing repair itself?

I always have earplugs in my purse. I use them for Zumba, movie theatres, clubs, any time I am in loud noise for more than 20 minutes I try to use them. I’m not as perfect about it as I would like to be. It definitely has reduced some of the noise in my ears. Plus, I know it is also helping to prevent further damage.

I have heard that high blood pressure possibly can cause noise in the ears. If you have high blood pressure, controlling it might help.

If you’re still young, it will partially repair itself. If you’re over 30, not so much. Earplugs make no difference there; they only keep it from getting worse.

Many guys I’ve worked with in machine shops try going without earplugs. Most are permanently hard of hearing. There’s no coming back from that. I listen to lots of loud music myself (especially Progressive and Trance), but won’t even think of entering my workplace without earplugs. My hearing tests have been consistent for >25 years despite the music because I never damaged my ears in the first place. Prevention is the only fix.

Noise damage is permanent and cumulative, so even if someone is only exposed to noise in their teens and twenties, it is still relevant. What was known about tinnitus in the 1960s was very little (hence the use of the term “nerve damage” which is incorrect), and even when I was in grad school in the 1990s we didn’t have much specific knowledge, because there is no way to see the inner workings of a live auditory system. Only with newer imaging techniques, like PET Scans and fMRI, can we get some insight into what is happening.

When evaluating a patient with tinnitus, we will ask them to describe the frequency, duration and perceived location of the sound. Tinnitus treatments these days regard it as a symptom akin to pain, and some places will use a scale from 1–10 to ask how bothersome it is to the patient. What you describe about your tinnitus and the other case history and test results help us to determine if your difficulties are most likely due to noise exposure, or if perhaps there is another factor contributing to your symptoms.

What recent research is suggesting about tinnitus in most cases (especially noise exposure) is that it is a by-product of hearing loss, similar to a phantom limb phenomenon – when someone loses an arm, but they still feel their fingers. When someone’s inner ear hair cells are damaged and no longer triggering the nerve as they used to (which is a sensory loss, rather than a nerve loss), the nerve fibers are still there and healthy and expecting to be busy, only there is no incoming sound stimulation so they are firing and creating their own noises.

For many people, correcting for the hearing loss is adequate to suppress the tinnitus. For others it is not enough, so some of the manufacturers have tinnitus maskers integrated into the hearing aids. For someone whose hearing loss started many years ago, they may not even notice the tinnitus much anymore… either because they’re so used to it, and/or because the nerve has atrophied from lack of sound stimulation from the inner ear. We now have diagnostic techniques to more clearly identify which components of the auditory system are working well and which aren’t, but in most cases, that is splitting hairs and the patients want to focus on relieving the symptoms.

Hearing aids are a rehabilitative process. You are learning to hear with assistance, like wearing eyeglasses or using a cane or orthotics. Those with good hearing don’t even notice most of the sounds around them because they expect those sounds to be there – they’ve been hearing them since before they were born. The ears are aware of our environment all around us, behind us, beyond what we can see, and through the walls that confine our vision. Our ears being constantly “on” is how we can sleep soundly at night, because unexpected sounds will awaken us. We all have heard that visually impaired people hear better – no; they only pay more attention to what they’re hearing and the learn to use auditory information consciously, when for those with decent sight the correlation of auditory and visual cues means we don’t have to think about it.

Wearing the hearing instruments during all one’s waking hours is the best way to retrain your brain to respond to the sounds around you more like someone who hears all those sounds naturally. This is why patient motivation is the key factor in success with hearing instruments. With the technology we have today, many of my patients notice how much easier it is to follow conversations and how natural it seems during the 1-hour hearing aid demonstration visit. It is best if a family member or close friend accompanies the patient to that visit so the patient can notice the difference in the sound of a familiar voice. We ask them to say things that the patient can’t anticipate the answer to.

You might want to check whether you have a University Medical Center near you, if it is affiliated with an Audiology Doctorate program as you may get some savings if you work with doctoral students who are being supervised. This way you can get state-of-the-art services, too. You can go to the website for the American Tinnitus Association for additional information. Let me know if you have any further questions!

Thanks. I suppose its odd I mean I am aware of no actual hearing loss. I don’t ever struggle to hear people talking or sounds on any frequency I have noticed. Though if i am not hearing them how would I know?. But yeh there is always a constant high pitched noise. I am 30 so I suppose the damage might well be permanent. Its a shame though, loud music is one of my favourite things. I guess the things you like best are always the most harmful after all.

@noodle_poodle – I say they to my patients all the time, when they claim that they don’t miss a thing: “How can you know what you’re missing if you’re missing it?”

Tinnitus is often the first sign of noise damage and can occur before we see changes on the audiogram. Other factors can cause tinnitus, such as medical conditions and medications. Some people are more prone to get tinnitus than others – do your parents, siblings, or other relatives have it? You may have some hearing loss, but because you are young, you are able to compensate for it more easily than someone in their 50s and older. If you have health insurance, you might want to get it tested at least to have a baseline.

I have had tinnitus for as long as I can remember. I remember being put down for my afternoon nap and listening to it as I watched the floaters in my eyes move across the ceiling – it was my normal, so I presumed that everyone has it. I was in college before I learned that it is not normal. I suspect high fevers and aspirin use in childhood, but I’ll never know for sure. Certainly, all the concerts I went to in the ‘80s didn’t help.

I still enjoy going to concerts, but I always wear my Musician’s Earplugs, I have all three filters and change them based on what levels the sound is. You can get sound level meter apps for smartphones, too. You may have 60 or more years ahead of you, but these are the only ears you’ve got – take good care of them!

@hearkat As an aside, I think Tinnitus may be stress-related. I tend to have a high-pitched whining most of the time, but it’s intensity varies with how relaxed I am. Like my hearing tests, it’s been constant for my entire life, unaffected by my years in machine shops or around jet engines and steam turbine generators. Either that, or I damaged my ears before I was a teen and somehow managed to never damage them further, but given some of the places I’ve been, I doubt that.

In college, thanks to my very large speakers, screaming guitar amp, blaring headphones I was accepted into a hearing study about people with tinnitus (ringing in the ears). They did have hearing aids that give off a very gentle white noise that for lack of a better term, neutralized the ringing in my ears. I found that to be very cool! So if you need to relieve this ringing there are these devices that can help mask the ringing.

That was 32 years ago for me and I have to say the ringing is all but gone. I still play music and jam loudly but it’s not hours a day like it was in my teens and 20’s. Just be mindful of your ears and I too carry around ear plugs to wear at live shows.

@hearkat I found your explanation and comparison to phantom leg pain very interesting. With phantom leg pain sometimes a mirror can trick the brain. It would be great if someone figured out a trick for tinnitus. Mine isn’t ringing, but I have noise.

When people say ringing, what type of ring? Like a bell?

The UT Dallas researchers are working with a device developed by MicroTransponder, a biotechnology firm affiliated with the University. MicroTransponder currently is testing a vagus nerve stimulation therapy on human patients in Europe in hopes of reducing or eliminating the symptoms of tinnitus, the debilitating disorder often described as “ringing in the ears.”

@jerv Tinnitus is a common co-morbid of ASD and AS. It does seem to come & go with stress and anxiety for those that aren’t acute/chronic sufferers

@jerv – Stress and elevated blood pressure to exacerbate tinnitus. There is a ton of research going into tinnitus these days because it is the number one disability of veterans in the US and the baby boomers are now dealing with the consequences of noise damage. There may not be a lot that will be available in my lifetime, but hopefully those in their 20s and 30s will benefit from the research being done today.

I’m not surprised to hear that @SpatzieLover says there is a high correlation of tinnitus complaints among people on the autism spectrum. One thing about tinnitus, though, is that many people have hit but the majority aren’t bothered by it – there is a great variability in how the individual is able to ignore unwanted stimuli – whether it’s a tag in their shirt or a sound in their ears. Thus I suspect it may not be that it occurs more in the ASD population, but rather that a greater proportion of those on the spectrum find it disturbing.

Tinnitus is any sound perceived in the ears/head that does not have a source. For many, including myself, it is a constant high-pitched ringing – like the sound after you turned of the old TV sets or in the old alarm systems at the department stores. However, many people hear different sounds: hissing, crickets, frogs, sizzling, roaring like the ocean, and the hum of a motor or some of the more common descriptors I’ve heard, @JLeslie.

Also @JLeslie, I heard a little about the mirror experiment for the phantom pain, but I am not recalling if that was for amputees. That is the phantom limb phenomenon that I was referring to – for example, when someone loses an arm but can still ‘feel’ their fingers, because the nerves are expecting tactile and proprioceptive input from the body part that is no longer there. The auditory nerve is expecting sensory input from the cochlea and it isn’t getting it.

Complicating the whole issue further is that our auditory system is not just passively reacting to input – it does actually make sounds that we can elicit and measure – that is how newborns’ hearing is tested. But since the auditory system is so complex and microscopic, we can’t really study it in live subjects. There is a Temporal Bone Registry for those who want to donate them after their death for research, but we can only learn so much from dead tissues.

@hearkat Yes, it is for amputees. The mirror supposedly helps a percentage of amputees who feel pain in the missing limb. They place the mirror in a way that when they look in the mirror it appears they have both legs. This tricks the brain and relieves the pain. I am not sure what the statistics are for how significantly it helps and how many people it helps.

I guess technically I have tinnitus from how you defined it. I never was very sure since people always talk about ringing. Most of the time I can ignore it. Sometimes suddenly I realize I have the noise. It isn’t that it just started, it’s like becoming aware of a whitenoise. At times is it much louder. I have slight hearing loss in both ears, my left more than my right, which I knew before getting tested. The doctor said it is unusual for my hearing loss to be different in each ear. The hearing loss doesn’t really affect me daily. The only time it is difficult is when. Phone doesn’t get loud enough, things like that. It’s rare that happens though.

I went to a Eric Burdon concert, and stood about 8 feet away from him, and this massive speaker that was probably bigger than him. Great concert, but I couldn’t hear a thing for 3 days. My hearing did eventually return, but I do have tinnitus, probably partially from that show.

@filmfann I have a significant event that I guess made my tinnitus here to stay. Previously, it used to come and go, and mostly be gone. Since a race at Sebring years ago where I didn’t protect my ears all day for two days I have been permanently worse. It’s always there now. It isn’t as bad as the first 6 months after that race though.

@filmfann – Recent findings suggest that the temporary threshold shift that occurs with exposure to loud noise is to be due to the system reflexively trying to shield itself to minimize permanent damage, not that there is damage that is then repaired.