“Tinnitus and migraines are like the chicken and the egg. Which came first? I always try to get the patient to seek control of the migraine first and then usually the tinnitus will subside.” - Drew Sutton, MD, Board-Certified Otolaryngologist
At some point or another, you may have experienced a migraine. A migraine is characterized as a particularly painful headache, and it comes with the chance of developing other symptoms alongside a throbbing head. Nausea, sensitivity to light, sensitivity to sound, and even blurred vision can accompany a migraine.
One symptom that seems to be linked with migraines is tinnitus. Tinnitus is characterized by the perception of a ringing in the ears without any outside sound stimuli. This phantom sound has the ability to make an already unpleasant experience even more unpleasant.
Below is a closer look at tinnitus and migraines and how they may be linked, and the ways you can try and combat them.
What Is Tinnitus?
Tinnitus is traditionally characterized by a phantom ringing in the ears, but in reality, tinnitus can sound very different from person to person.
For some, tinnitus may consist of high-pitched noise, while it can sound like a whooshing sound for others. The diverse sounds perceived are large, but they are all characterized as phantom sounds not readily heard by those around you.
In addition to tone, the frequency of tinnitus can also differ. An example of this is with a form of tinnitus known as pulsatile tinnitus that occurs in rhythmic pulses, while another tinnitus is always present and constant. Some tinnitus may come along with another ailment, such as hearing loss, while tinnitus can come from seemingly out of the blue.
There are two main categories of tinnitus, and these include subjective tinnitus and objective tinnitus. Each type has its own unique cause and presentation. Below is a more detailed look at the types of tinnitus and potential causes.
Subjective Tinnitus
Subjective tinnitus is thought of as the most common form of tinnitus. Subjective tinnitus is only perceivable by the individual and does not appear to have any outwardly apparent physical causes.
Due to a general lack of physical stimuli, subjective tinnitus is thought to have a basis within the brain, specifically within the auditory cortex.
Subjective tinnitus can occur seemingly without other conditions, but subjective tinnitus and hearing loss often occur together. This is thought to happen due to a mechanism similar to phantom limb pain.
It is believed that when hearing loss occurs, the auditory cortex tries to increase its sensitivity to auditory signals. In the case of tinnitus, it is thought that the sensitivity is turned up so much that the brain begins interpreting the lack of auditory signal as a specific tone, leading to tinnitus.
Objective Tinnitus
Unlike subjective tinnitus, objective tinnitus tends to cause the signals being sent from the ear to the brain. Where subjective can be thought of as mainly neurological based, objective can be thought of tinnitus caused by physical stimuli affecting the ear.
One form of objective tinnitus is called pulsatile tinnitus, and it results in a rhythmic pulsing of sound. Typically the pulsing rhythm is caused by more turbulent blood flow near the sensory organs of the ear. The ears pick up this turbulence as sound, which then leads to pulsatile tinnitus.
Another form of objective tinnitus could be as a result of muscle spasms within or surrounding the ear. In the ear, there are tiny muscles, and there is also a number that surrounds the ear. Muscle spasms can interact with the sensory aspects of the ear, which can send unintended sound signals to the brain.
Tinnitus Treatments
While there are several different kinds of tinnitus, they all result in a pestering sound. Some tinnitus can be treated once the underlying cause is resolved, but frequently tinnitus is untreatable and leaves individuals feeling frustrated, annoyed, and wanting relief.
There are several tinnitus treatments available, and many of them focus on reducing tinnitus’s effects on your overall well-being. Therapy and other techniques have been shown to help those with tinnitus.
One of the most popular methods of tinnitus treatment is therapy. Both cognitive behavioral therapy and tinnitus retraining therapy can be utilized. Both methods try to better your relationship with your tinnitus by learning how to effectively deal with it and how to train your body to not view it in a negative light.
These methodologies can be very helpful for those with severe degrees of tinnitus that simply cannot carry on with their day-to-day due to the immense distraction of the tinnitus.
Another technique that many people utilize to get some short-term tinnitus relief is to utilize sound masking. Sound masking has many uses, but it is mainly utilized to mask unwanted environmental sounds.
Sound masking is most notable with white noise, and many parents now utilize white noise machines with their children to allow them an easier time taking naps when other things may be happening in the house.
For tinnitus, sound masking can be an effective way to drown out the tinnitus and allow you to get some relief. One common issue amongst those with tinnitus is that it can be difficult to fall asleep. Utilizing sound masking could be just the thing you need for quick tinnitus relief and allow you to get to sleep.
Migraines
Migraines pose the potential to throw off your entire day. With immense head pain, it can be difficult to focus on anything else. A migraine is hard enough, but several people suffer from more complex migraines, including myriad other accompanying symptoms.
Some of the more common standard migraine symptoms include sensitivity to light, sensitivity to sounds, and tinnitus. For complex migraines, people may experience stroke-like symptoms and an odd sensation called an aura. Below is a closer look at some of the common migraine types. There are nine distinct types of migraines, but below is a closer look at some of the more common forms.
Common Migraine
A common migraine is the most prevalent form of migraine. It is accompanied by normal migraine symptoms such as feeling tired, sensitivity to different senses, and pain originating from the head.
The general recommendations for a common migraine include taking an over-the-counter pain reliever and going into a dark, quiet room to rest.
Migraine with Aura
Migraines with aura are different in that people essentially feel a migraine coming on well before the migraine pain actually sets in. There are four different phases of migraine.
Those that have migraines with aura are those that experience the preceding phases of a migraine. These preceding symptoms can be as far out as a couple of hours and include the possibility of visual disturbances, difficulty concentrating, feeling off, and tinnitus.
Relationship Between Migraines and Tinnitus
The link between tinnitus and migraines is unique, and the relationship is well studied, but there is still much to be learned about it. Migraines and tinnitus have a close relationship with a large comorbidity rate between the two, which means that many people will experience both simultaneously.
Many researchers have tried to deduce the underlying mechanism behind the two being so closely related with high comorbidity. Is it tinnitus that brings on the headache, or does the headache increase sensitivity to preexisting tinnitus?
A 2015 study with 489 comorbid participants found that headaches seem to precede bothersome tinnitus rather than the other way around. This finding indicates that a migraine can worsen the perception of tinnitus at some level and lead to more severe tinnitus.
While this finding is elucidating, it is also known that tinnitus symptoms could be an aspect of migraine aura. This conflict illustrates the complex nature between tinnitus and migraines.
Best Way To Treat
The best way to treat tinnitus and migraines is to mitigate the migraine as much as possible. Having a migraine can be painful and can increase your sensitivity to many stimuli, including tinnitus, which can worsen the tinnitus.
Taking over-the-counter pain medication is a great first-line treatment, and if that doesn’t work or your migraine becomes too much to handle, you may need to seek medical expertise. Migraines, in some cases, can be extremely complex and a medical provider will be better equipped to tackle your migraine.
Conclusion
In summary, tinnitus and migraines are unique problems, but they appear to connect within the body. While the extent and underlying mechanism between the two are not well understood, the comorbidity of the two conditions is apparent.
Understanding the ins and outs of tinnitus and migraines can allow you to understand their unique relationship better and give you insight into potential ways you can effectively deal with or treat them. Taking steps to improve either can help your overall wellbeing.
Sources:
Migraine Headaches: Causes, Treatment & Symptoms | Cleveland Clinic
Earwax Buildup and Tinnitus
Medications for Tinnitus
Why Does Pulsatile Tinnitus Come and Go
