Tinnitus Treatment in Ayurveda: A Comprehensive Overview

Tinnitus is a prevalent audiological condition characterized by the perception of sound in the absence of an external stimulus. Often described as ringing, buzzing, hissing, or whistling in the ears, tinnitus can significantly impact an individual’s quality of life. In this article, we will delve into the definition, causes, symptoms, treatments, home remedies, and prevention strategies for tinnitus.

What is tinnitus?

Tinnitus manifests as the perception of sound without any external source. It can be subjective, audible only to the affected individual, or objective, where the sound can be heard by others as well. Subjective tinnitus is more common and often associated with hearing loss or inner ear disorders. Objective tinnitus typically stems from vascular abnormalities or muscular disorders in the head and neck region.

Tinnitus Causes

Tinnitus can have various underlying causes, including:

1. Hearing Loss: Age-related hearing loss (presbycusis) or noise-induced hearing loss can trigger tinnitus. Damage to the auditory nerve or hair cells in the inner ear can lead to abnormal electrical signals interpreted as sound by the brain.
2. Exposure to Loud Noise: Prolonged exposure to loud noises, such as industrial machinery, firearms, or loud music, can damage the delicate structures of the inner ear, leading to tinnitus.
3. Earwax Buildup: Accumulation of earwax can block the ear canal, causing irritation and tinnitus. Removal of the earwax often resolves the symptoms.
4. Medical Conditions: Certain medical conditions like Meniere’s disease, temporomandibular joint (TMJ) disorders, cardiovascular diseases, and neurological disorders can contribute to tinnitus.
5. Medications: Some medications, including certain antibiotics, cancer drugs, diuretics, and antidepressants, may have tinnitus as a side effect.

Symptoms of tinnitus

The hallmark symptom of tinnitus is the perception of sound in the absence of an external source. The sound can vary in pitch, intensity, and duration. Other associated symptoms may include:

• Hearing Loss: Tinnitus is often accompanied by varying degrees of hearing loss, especially in cases of noise-induced or age-related hearing loss.
• Hyperacusis: Increased sensitivity to normal environmental sounds can occur in conjunction with tinnitus.
• Vertigo or Dizziness: In conditions like Meniere’s disease, tinnitus may be accompanied by episodes of vertigo or dizziness.

Tinnitus Treatments

Treatment strategies for tinnitus aim to alleviate symptoms and address underlying causes. They include:

1. Management of Underlying Conditions: Treating underlying medical conditions such as hypertension, diabetes, or cardiovascular diseases may help alleviate tinnitus symptoms.
2. Hearing Aids: For individuals with concomitant hearing loss, hearing aids can amplify external sounds, reducing the perception of tinnitus.
3. Sound Therapy: Background sounds or white noise can help mask the perception of tinnitus, providing relief to sufferers. Devices such as white noise machines or smartphone apps are commonly used for sound therapy.
4. Cognitive Behavioral Therapy (CBT): CBT techniques help individuals reframe their perception of tinnitus, reducing associated distress and improving coping mechanisms.
5. Medications: In some cases, medications such as antidepressants, antianxiety drugs, or even anticonvulsants may be prescribed to alleviate tinnitus symptoms.

Home Remedies for tinnitus

In addition to conventional treatments, several home remedies may offer relief from tinnitus:

1. Noise Management: Avoiding exposure to loud noises and using ear protection in noisy environments can prevent further damage to the auditory system.
2. Stress Reduction Techniques: Stress and anxiety can exacerbate tinnitus symptoms. Relaxation techniques such as deep breathing, yoga, or meditation may help alleviate stress and improve tinnitus perception.
3. Healthy Lifestyle Choices: Maintaining a healthy lifestyle through regular exercise, balanced nutrition, adequate sleep, and limiting caffeine and alcohol intake can promote overall well-being and potentially reduce tinnitus severity.
4. Ear Hygiene: Keeping the ears clean and free of excess earwax buildup can prevent irritation and potential worsening of tinnitus symptoms.

Prevention of tinnitus

While not all cases of tinnitus are preventable, certain measures can reduce the risk of developing tinnitus:

1. Protect Your Hearing: Limit exposure to loud noises by using ear protection devices such as earplugs or earmuffs in noisy environments.
2. Monitor Medication Side Effects: Be aware of potential side effects of medications, especially those known to cause ototoxicity or tinnitus, and consult a healthcare professional if you experience any auditory symptoms.
3. Maintain Cardiovascular Health: Adopting a heart-healthy lifestyle through regular exercise, a balanced diet, maintaining healthy blood pressure and cholesterol levels, and avoiding smoking can reduce the risk of vascular-related tinnitus.

Tinnitus – Ayurvedic View

Karna nada is the correlated condition for tinnitus in Ayurveda. This is not an independent disease but a clinical symptom. Vata dosha is the major dosha involved in Karna nada.

Tinnitus Ayurveda Treatment

Karna nada is the delineated condition in Ayurveda for tinnitus. The condition is explained one among the Karna roga (diseases of the ear). It is studied under the Ashtanga Ayurveda (eight branches of Ayurveda), which deals with the Urdhwanga Chikitsa also known as Shalakya Tantra. The diseases of the eyes, ears, nose, throat, scalp diseases, etc. are studied under the Shalakya Tantra.

The etiology is not explained by the authors of Ayurveda. The specific causes of Karna nada are not mentioned but Samanya Karnaroga Nidana (common etiology of ear diseases) can be explained for the condition. Avashyaya (exposure to cold), Jalakrida (swimming), excess talking, excess grief/ stress, improper sleep, excess physical exertion, etc. can be considered as the causes of Karna nada.

The disease is predominant in Vata dosha. The etiology mentioned above vitiates Vata dosha and along with Rasa dhatu, Vata dosha gets lodged in the auditory system or Shabdavaha Srotas. The vitiated Vata dosha in the ears starts producing the sound like a musical instrument and this is termed as Bherimrunagashankha. If the Karna nada is left untreated then it leads to the complication. Karna badhirya (loss of hearing) is a complication of Karna nada.

The line of treatment for Karna nada is like the other three ear diseases viz, Karnashoola, Karnasweda, Karnabaadhirya. Since Vata dosha is the predominant dosha treatment procedure viz, Snehana, Swedana, Nasya, Karnapoorana, Shiroabhyanga, Padabhyanga, Rasayana, and Medhya Chikitsa can be given.

Snehana and Swedana (oleation and fomentation therapies) – here it is both internal and external oleation are administered. The internal oleation or Snehapana can be administered with Indukanta ghritha, Dashamooladya ghritha, etc. External oleation is the oil massage with medicated oils like Narayana taila, Bala taila, etc. on the face and the ears can be done. This is followed by Swedana karma (fomentation).

Then the procedure of Karnapoorana treatment is advised. Nasya (installation of medicated oil or ghee drops in the nostrils)can be given before Karnapoorana.  If there is Kapha dosha vitiation, Vamana can be administered before Karnapoorana. The oils that can be used for Karnapoorana are Bilwa taila, Dipika taila, Dhanvantara taila, etc. Karnapoorana is the installation or pouring of warm medicated oil or ghee into the external auditory canal till it is filled with the medicine and kept for a specific period.

Shiroabhyanga (oil massage over the scalp), Padabhyanga (oil massage over the feet), and Shirodhara (pouring of the medicated oil/milk/ decoction over the forehead in oscillatory movements), Kavala and Gandusha (gargling procedures without movement or with movements) are the additional treatments for Karnanada.

The medicines used in Vataja shoola (pain due to Vataja dosha) can be used in Karnanada (tinnitus).

Medhya Aushadhi (drugs promoting nervous system functions) viz, Brahmi vati, Saraswata Arishta, Ashwagandha choorna, Shatavari choorna, etc. are administered to restore nerve dysfunctioning and strengthen the functioning of the nerve.

Rasayana Chikitsa (rejuvenation therapy) to rejuvenate the tissues and the cells to help reverse the pathology.

Basti (medicated enema therapy) is also the choice of treatment since it is ideal for Vata dosha.

Conclusion

Tinnitus is the perception of the sound involuntarily without any external acoustic or electric stimulus. The auditory system causes infections in the external ear, impacted wax, foreign body in the ear, unpatented eustachian tube, otosclerosis, age-related hearing loss, repeated exposure to noise, trauma, etc. Diseases of the central nervous system, hypoglycemia, etc. are non-otologic causes. Certain ototoxic medications also cause tinnitus. Karna nada is explained in Ayurveda and can be correlated with tinnitus in contemporary science. Vata dosha is the main dosha causing Karnanada and hence treatments Snehana, Swedana, Nasya, Karnapoorana, Shiroabhyanga, Padabhyanga, and Shirodhara are advised. The drugs that promote or strengthen the nervous system and rejuvenate the auditory system can be given.     

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