Tinnitus is the perception of phantom noise in the ear. It is characterized by the perception of noise in the ear, without any external source of the noise. The noise and the intensity of the tinnitus noise vary for each tinnitus patient.
Tinnitus can be temporary or permanent and it can be mild or intense. Other accompanying symptoms like headache, vertigo or loss of balance, difficulty sleeping, and reduced concentration.
Tinnitus is often considered as a symptom rather than a disease. The presence of tinnitus is often a sign that something is wrong with either your ears or other parts of the body related to or close to the ear.
Common causes of tinnitus are exposure to loud noise, ototoxic medications, autoimmune inner ear disease, earwax blockage, aging, head injury or trauma, and ear disease. Strain to the head and neck muscles and temporomandibular joint disorder (TMJ) can also cause tinnitus.
No two tinnitus cases are the same; this means that even if the cause of the tinnitus in two tinnitus patients is the same, their symptoms can not be the same, neither can the tinnitus’s effects on their lives be the same.
This notwithstanding, tinnitus has been grouped into various types for proper understanding. Let's take a look at them.
Types of Tinnitus
1. Subjective Tinnitus
Subjective tinnitus is the most common type of tinnitus. The tinnitus patients can only hear the tinnitus noise. The major cause of subjective tinnitus is exposure to loud noise, and it can be temporary or permanent depending on the severity of the damage done to the ears.
2. Objective Tinnitus
This is a very rare type of tinnitus. Unlike subjective tinnitus, objective tinnitus is not only heard by the tinnitus patient; it can be heard by an audiologist using a stethoscope.
Vascular deformities or involuntary muscle contractions usually cause objective tinnitus.
Since the cause of objective tinnitus is usually known, it is the only type of tinnitus that can be cured. When the underlying condition causing the ringing is treated, the tinnitus will stop.
3. Neurological Tinnitus
Neurological tinnitus is often caused by a problem with the brain's auditory functions. The brain's auditory function can be affected by certain disorders such as Meniere’s disease. This affects the proper functioning of the brain in interpreting sound signals being sent from the inner ear.
A problem with the sensory system causes this type of tinnitus. It can be triggered or worsened by moving certain parts of the body. In most cases, the cause of somatic tinnitus is outside the ears.
5. Pulsatile Tinnitus
Pulsatile tinnitus is a type of tinnitus that aligns or is in sync with the tinnitus patient’s pulse or heartbeat. It is often caused by turbulence or increased blood flow in blood vessels close to the ear. The turbulence can be caused by various factors, such as the clogging of blood vessels.
6. Musical Tinnitus
Musical tinnitus is also known as auditory imagery or musical hallucinations. Instead of hearing random noises in the ear, people with musical tinnitus hear a melody or a tune in their ears. Musical tinnitus is common in people with hearing loss.
7. Low-Frequency Tinnitus
Low-frequency tinnitus is one of the most confusing types of tinnitus. This is because people with this type of tinnitus are usually unable to tell if the sound they hear in their ears is being generated internally or externally.
This post will extensively examine low-frequency tinnitus, what causes it, and possible treatments for it. Let's get started.
What is Low-frequency Tinnitus
As already stated, people with low-frequency tinnitus are often unsure of the exact origin of the noise. The noise associated with low-frequency tinnitus corresponds to the two lowest octaves on a piano. An octave is an interval between one musical pitch and another with double its frequency.
Low-frequency tinnitus sound is often perceived as a deep droning, murmuring, humming, or rumbling noise. Because of the way its sounds and the uncertainty of the source of the noise, it is one of the tinnitus with the strongest effect on tinnitus patients. Low-frequency tinnitus is not just annoying; some tinnitus patients have described it as a noise that can drive someone crazy or even make one question his sanity.
The noise associated with low-frequency tinnitus is often a low-pitched hum. This has made it easy for people who have another phenomenon known as The Hum to believe that they have tinnitus.
What is The Hum?
The Hum refers to a persistent and invasive low-frequency humming, droning, or rumbling noise that has been widely reported amongst people dwelling in urban areas. The Hum is not audible to all people, and it has been likened to the sound of a large truck idling in a nearby park.
Hums have been reported in the United Kingdom, the United States, New Mexico, Canada, and New Zealand. Because the majority of cases of the hum have been reported in urban areas, many people believe that hum is a form of noise pollution that is screened from most people by the general city soundscape.
The actual cause of the hum is not yet known, but it has been attributed to certain factors like mechanical sources such as industrial plants, biological auditory effects, and manifestations of tinnitus. The Hum is accompanied by symptoms such as headaches, insomnia, and dizziness.
Studies have been conducted to understand the hum fully, but these studies have not yet reached a conclusive result. There is still skepticism regarding whether The Hum is a physical sound or not.
A study showed that the low throbbing background noise caused by the hum always peaks between 30 to 40Hz, and it is usually heard early in the morning when there is a cool light breeze. Other studies have pegged the frequency between 32Hz and 80Hz with modulation starting from 0.5 to 2Hz.
Even though some studies have tried to prove that the hum is the same as low-frequency tinnitus, we do not believe it is. This is because many people who hear The Hum have been able to get rid of it by changing location. Some people said they stopped hearing the hum when they left their house and moved to another house in the same city.
If a person can move away from the humming in his ear by merely going to another house, then it's most likely not tinnitus. It has an external source, which has not yet been identified.
The Hum is a low-frequency sound, and low-frequency sounds can travel miles due to the high energy content; this makes it hard for people to identify the exact source of the noise. People who live close to industrial areas, factories, or railroad diesel locomotives often complain of hearing the hum.
Some audiologists believe that most people’s hum problems are based on the physical world around them and focus too keenly on innocuous background sounds. The use of psychology and relaxation techniques can minimize the effects of the hum.
Causes of Low-Frequency Tinnitus
As stated earlier, every type of tinnitus is a symptom that something is wrong. Even though the exact source of low-frequency tinnitus and its cause cannot be ascertained, below are some known causes.
1. Venous Hum
A venous hum is a humming noise caused by the vibration of vein walls. This vibration is caused by the flow of blood being drained from the brain through the internal jugular veins. The humming noise is often heard in the upper chest near the clavicle.
Blood flows to the brain through the internal carotid and vertebral arteries, but for some unknown reason, when the blood is flowing to and from the brain, it can cause a humming noise. This humming noise is heard through the entire cardiac cycle and can also be heard in the ear as low-frequency tinnitus.
Asides from the discomfort and annoyance that venous hum causes, it is harmless and causes no serious health issues.
2. High Blood Pressure
High blood pressure can cause low-frequency tinnitus. The force of blood pushing against the blood vessels of your body is known as blood pressure. When blood pressure is low or high, it can affect the viscosity of your blood. Viscosity refers to the measurement of stickiness and thickness of your blood, and it determines how easily blood flows through blood vessels.
Blood pressure is considered to be high when the systolic pressure (the pressure when your heart beats) is above 130 and the diastolic pressure (the pressure when your heart rests between the beats) is higher than 80.
When your blood pressure is high, the blood’s viscosity is increased; this reduces the blood flow through the capillaries. When this happens, the capillaries that supply blood to your inner ear’s structure can no longer supply the right amount of blood to the ears. Over time this can result in hearing problems, including tinnitus.
Asides from the fact that the change in blood pressure can cause low-frequency ringing in the ear, the medications used to treat high blood pressure can also cause tinnitus.
Some high blood pressure drugs are ototoxic. This means that the side effects can affect hearing and cause tinnitus. Examples of ototoxic high blood pressure medications are high doses of loop diuretics and high doses of aspirin.
3. Poor Blood Circulation
There is a link between the health of your heart and your hearing. Heart diseases like atherosclerosis can narrow or stiffen arteries in the body.
When diseases plague arteries, they can get blocked with plaque and also spasm and rupture.
When arteries are narrowed or clogged with plaque, the flow of blood through them is affected. This results in Inadequate flow of blood to the inner ears.
The survival and the proper functioning of the hair cells in the inner ear heavily depend on adequate blood supply because oxygen is transported to them through the blood.
The hair cells located in the cochlea in the inner ear are responsible for converting noise sent from the middle ear to electrical impulses, which it sends to the brain, where it is interpreted as sound.
When these hair cells are deprived of oxygen due to poor blood circulation, they can get damaged. This damage can cause phantom noises (tinnitus) to be perceived in the ear. If the hair cells are destroyed, it can result in hearing loss.
Hair cells in the inner ear cannot be regenerated, so any hearing problem (tinnitus or hearing loss) caused by damage to hair cells is permanent.
4. Anxiety and Stress
This may sound strange, but anxiety and stress can cause and also worsen tinnitus. Studies have proven that people who have post-traumatic stress disorder are more susceptible to developing tinnitus.
Not only do stress and anxiety cause tinnitus, but they also cause high blood pressure, and as you already know, high blood pressure can cause low-frequency tinnitus.
When you are stressed, your body produces hormones that can increase blood pressure. This increase in the flow of blood can cause the sound of the blood flowing through the body to be audible to the ears.
The relationship between tinnitus and stress is said to be circular. This is because stress and anxiety can cause tinnitus, and tinnitus can worsen stress and anxiety. Anxiety causes you to pay more attention to the tinnitus noise, and this can cause it to have more severe effects on your life.
Shifting your focus from the tinnitus noise and getting proper treatment for post-traumatic stress disorder can decrease the tinnitus noise perception.
Low-Frequency Tinnitus Treatment
There is no known cure for tinnitus. In most cases, what is prescribed as a tinnitus treatment doesn't treat tinnitus; rather, it treats the underlying health condition responsible for the tinnitus. When the underlying cause is identified and treated, the tinnitus will subside and eventually disappear.
The major challenge encountered when treating low-frequency tinnitus is that the ringing’s actual cause is not known. Most people with low-frequency tinnitus do not know if the sound is from an external or an internal source. Some have also mistaken the hum for tinnitus.
In cases where the exact cause of low-frequency tinnitus is unknown, standard tinnitus treatment and therapies are often prescribed to alleviate the symptoms.
Below are treatments or therapies that can help relieve low-frequency tinnitus symptoms.
1. Tinnitus Retraining Therapy (TRT)
Tinnitus retraining therapy is a habituation therapy that is aimed at retraining how the brain, auditory system, and central nervous system receive, process, and interpret sound. An audiologist conducts this.
The therapy consists of two sections; the first section entails a series of counseling sessions. The counseling is aimed at helping the tinnitus devise ways to ignore the tinnitus noise the same way background noise is ignored.
The second aspect of the therapy entails the use of sound therapy to weaken or drown out the tinnitus noise. A device that generates low-level noise is inserted into the ear of the tinnitus patient. The noise the device generates has the same volume and pitch as the tinnitus noise.
Tinnitus retraining therapy lasts for about 12 to 14 months, and currently, it is recognized as the most effective treatment for tinnitus. Tinnitus patients begin to experience relief six months into the therapy.
2. Cognitive Behavioral Therapy
Cognitive-behavioral therapy is psychotherapeutic or psycho-social therapy that is aimed at helping people handle negative thoughts to improve their mental health.
Cognitive-behavioral therapy is an effective way to treat low-frequency tinnitus, especially if it is caused by stress and anxiety.
CBT helps tinnitus patients identify and change disturbing and destructive thought patterns that negatively affect their emotions and behaviors.
With this therapy, tinnitus patients are taught to focus less on the tinnitus noise and its effects on their lives.
Changing how they think about the tinnitus disturbance takes away their attention from the tinnitus noise, making it less obvious and reducing the anxiety and stress it causes.
3. Tinnitus Masking
Tinnitus masking is the application of an external sound that affects the tinnitus noise. In some cases, low-frequency tinnitus becomes obvious at night or in quiet environments; the use of tinnitus maskers in such cases can relieve the tinnitus symptoms.
Tinnitus maskers are devices that generate white noise, which is used to introduce natural and artificial noise into a tinnitus patient’s environment; a known problem like hypertension causes the tinnitus, thereby masking the tinnitus noise and making it less obvious.
Tinnitus maskers can be worn above the ear or placed in the tinnitus patient’s room or environment. In the absence of tinnitus maskers, tinnitus patients can use air conditioners, humidifiers, and fans to generate white noise to mask the tinnitus.
4. Lifestyle Changes
Making some lifestyle changes can reduce the severity of low-frequency tinnitus. This is very effective if the tinnitus is caused by a known problem like hypertension.
Some lifestyle changes you can make include; regular exercise, eating a healthy diet, weight loss, mindful stress reduction therapies, reducing salt intake, quitting smoking and drinking, reducing caffeine intake, and seeking counseling for stress and anxiety.
Low-frequency tinnitus is one of the most annoying types of tinnitus, but with the right medical attention and guidance, you will be able to get relief from the symptoms.
While undergoing treatment for your tinnitus, ensure that you pay attention to your mental and emotional health. Avoid activities or circumstances that can heighten your stress and anxiety. Engage in relaxing activities like yoga and meditation.
If you treat any health condition with a medication that you suspect is worsening your tinnitus, inform your doctor immediately. An alternative medicine will be prescribed.
Have you had low-frequency tinnitus? What did it sound like? What treatment or therapy did you use? Share your experience with us.