Tinnitus is when you hear a persistent ringing or another sound in your ear that is not caused by an outside source. Some of the potential causes are hearing loss, an ear canal blockage, and certain medications.

An estimated 10 to 15 percent of adults experience tinnitus.

Tinnitus retraining therapy (TRT) is a potential treatment option for moderate or severe tinnitus. It involves a combination of counseling and sound therapy to train your brain to ignore the sound in your ear.

Some studies have found that TRT is an effective treatment for most people, but there’s still limited evidence that it’s more effective than other treatments.

Read on to learn how TRT works, what to expect, and how effective it is.

Tinnitus can range from barely noticeable to severely impacting your quality of life.

A few forms of tinnitus, such as when it is due to ear impaction or occurs as a side effect of medication, can be cured by cleaning out the ears or stopping the medication. But most types of tinnitus caused by hearing loss cannot be cured, according to 2019 research.

Some medical treatments can help you manage your symptoms, though.

TRT, for example, is a promising treatment where you undergo a combination of counseling and sound therapy to help you gradually habituate to the sound of your tinnitus. Habituation is when you get used to a sound so that you no longer focus on it.

You experience habituation often in your daily life. For example, you may find a fan bothersome when you first turn it on, but the sound becomes less noticeable after a while.

Counseling

Before you start TRT, you’ll undergo an interview and medical examination with a doctor to evaluate your symptoms and hearing status. You may need a different treatment if a medication or underlying medical condition is causing your symptoms.

After these examinations, you undergo counseling with a hearing specialist called an audiologist. Counseling aims to change how you perceive your tinnitus and begin the habitation process. Each session typically lasts about 1 to 2 hours.

During this phase, your counselor will review the results of your initial evaluation. They’ll also teach you how your auditory system works to demystify the issue and change negative thinking patterns about your tinnitus.

The counselor will also recommend strategies to help you begin the process of habituation, focusing on changing your negative emotional reaction and hypersensitivity to the sound.

Sound therapy

The sound therapy component of TRT uses sounds to mask your tinnitus. During this part of your therapy, you’ll wear a device behind your ear that plays masking or white noise with a sound intensity slightly below that of your perceived tinnitus.

The goal of sound therapy is to help your brain get used to the tinnitus sound by decreasing the contrast between the tinnitus and external sound.

It’s important to note that insurance often does not cover these devices.

It takes 12 to 18 months for people to reach habituation with TRT. The first improvements tend to appear after 3 months.

More than 100 studies have examined the effectiveness of TRT, and most have found significant improvements in about 80 percent of people.

Modifications and improvements have been developed over time, improving TRT’s effectiveness. Yet the exact way that TRT improves tinnitus still isn’t fully understood.

Evidence remains inconclusive on the question of whether TRT is superior to other treatments, according to 2021 research.

Researchers noted that this uncertainty is due to a lack of randomized controls in studies. They have also noticed a large placebo effect.

Plus, tinnitus seems to naturally decline over time in many people, even without treatment. And some people learn to habituate by themselves, without structured therapy, or come up with their own ways to mask the tinnitus sounds, such as using a sound machine or a fan while sleeping.

A 2016 study found no evidence of a difference between tinnitus masking, TRT, and tinnitus education and counseling in reducing tinnitus severity.

In a 2019 study, researchers compared TRT to standard care counseling for improving tinnitus-related quality of life. The researchers found that about half of the total people showed significant reductions in symptoms, but there was little difference between the two groups.

A 2021 review of studies found there’s not enough evidence to draw conclusions about the treatment of tinnitus in children due to a high risk of bias in current studies.

TRT is considered a safe treatment that doesn’t have any known side effects. You can share any concerns you may have with your primary care doctor or audiologist before starting treatment.

Tinnitus is very common. For some people, it can significantly affect their quality of life. If you’re experiencing tinnitus — especially if it is severely affecting you — you may choose to contact a doctor for evaluation and treatment.

It’s also a good idea to see your doctor if:

  • You hear a sound like a heartbeat.
  • Your tinnitus is only in one ear.
  • Tinnitus comes on suddenly.
  • The tinnitus sound is so bothersome that you can’t focus.
  • You also have dizziness, vertigo, or hearing loss.

Tinnitus doesn’t have a cure yet, but treatment can help you manage your symptoms. Here are some of the most common tinnitus treatment options.

Lifestyle changes

Making some lifestyle changes may help manage your symptoms. Some changes you can make include:

Hearing aids

Tinnitus is often a symptom of hearing loss. A hearing aid can make external sounds louder and can potentially make tinnitus less noticeable. Additionally, many hearing aids have tinnitus masking programs.

Sound masking devices

Sound masking devices can play white noise or sounds that drown out the tinnitus. These devices can be played from a device directly in your ear, an external sound machine, or even from your phone.

One small study from 2017 found that broadband sounds, including white noise, were generally more effective than nature sounds at masking tinnitus.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) aims to identify negatives patterns of thoughts and behaviors, and modify them.

Research from 2021 has found that CBT doesn’t reduce the subjective loudness of tinnitus but can still increase the well-being of affected people.

Medications

Many medications have been investigated for treating tinnitus, but none have been proven to be effective for all people.

Healthcare professionals may often prescribe antidepressants, but several randomized studies and a review of studies found that they weren’t associated with an improved outlook for tinnitus. They may help people who also have major depression or sleep disorders.

Anticonvulsants also haven’t consistently been shown to be effective, but they do provide some relief for some people.

TRT is a promising form of tinnitus treatment that involves counseling and sound therapy to help reduce symptoms. Research suggests that TRT can lead to a significant improvement in about 80 percent of people, but there still isn’t significant evidence to show that it’s more effective than other treatment options.

If you’re significantly bothered by your tinnitus, it’s a good idea to contact a doctor. Some types of tinnitus do not have a cure, but many people experience significant relief after undergoing treatment. A doctor can also help you discover if there’s an underlying medical condition contributing to your tinnitus.