Tinnitus is the perception of sound in the ear or head that does not arise from the external environment, from within the body (e.g., vascular sounds), or from auditory hallucinations related to mental illness. Up to 18% of the general population in industrialised countries are mildly affected by chronic tinnitus and, for 0.5%, tinnitus has a severe effect on their ability to lead a normal life (Coles 1984).
The condition can occur as an isolated idiopathic symptom, or in association with any type of hearing loss - age-related hearing loss, noise-induced hearing loss, MeniÃ¨re's disease, or an acoustic neuroma. It can also occur in people with normal hearing thresholds due to aspirin or quinine toxicity. Tinnitus is also associated with depression, but it is not always clear whether it is a cause of the depression or a manifestation of the condition (Sullivan 1988). It can also occur with chronic otitis media, head injury and barotraumas.
Tinnitus can have an insidious onset, with a long delay before clinical presentation. It can persist for many years, particularly when associated with a sensorineural hearing loss. Tinnitus can cause insomnia, an inability to concentrate, and depression (Zoger 2001). Treatment is aimed at reducing the loudness and intrusiveness of the tinnitus, and minimising its impact on daily life.
- Coles RR. Epidemiology of tinnitus: (1) prevalence. J Laryngol Otol 1984; 9: 7-15.
- Sullivan MD et al. Disabling tinnitus: association with affective disorder. Gen Hosp Psychiatry 1988; 10: 285-91.
- Zoger S et al. Psychiatric disorders in tinnitus patients without severe hearing impairment: 24 month follow-up of patients at an audiological clinic. Audiology 2001; 40: 133-40.
How acupuncture can help
A systematic review in 2000 concluded that research had not demonstrated acupuncture to be efficacious as a treatment for tinnitus (Park 2000); however, some of the studies used inadequate acupuncture, some used sham controls of questionable validity and most were a cross-over design that it is generally considered inappropriate for acupuncture evaluation (Jackson, 2006). Controlled trials conducted more recently than this review (Tan 2007, Okada 2006, Azevedo 2007, Jackson 2006) have all found acupuncture to provide effective relief from tinnitus, with one finding it more effective than western medicine (Tan 2007). However, they were very small, and larger, high-quality studies are required to confirm these findings. (See Table below)
Acupuncture may help relieve tinnitus by:
- acting on the cochlea, specifically on the contractile activity of outer hair cells (Azevedo 2007);
- acting on the function of the efferent olivocochlear system to suppress otoacoustic emissions (Azevedo 2007);
- altering the brain's chemistry, increasing neuropeptide Y levels (Lee 2009; Cheng 2009), and reducing serotonin levels (Zhou 2008);
- reducing inflammation, by promoting release of vascular and immunomodulatory actors (Kavoussi 2007, Zijlstra 2003);
- increasing local microcirculation (Komori 2009), which aids dispersal of swelling.