Acupuncture
for the Treatment of Tinnitus
Tinnitus,
the perception of noise or ringing in the ears, is a prevalent problem in the
United States, affecting approximately 45 million Americans each year.1,2 Though
tinnitus is not considered a disease on its own, it is a significant symptom
stemming from some kind of underlying condition.3 Root causes of
tinnitus range from age-related hearing loss to ear injury or circulatory
disorder.1 Further, tinnitus can appear in those with structural
lesions or those with conditions such as Meniere’s disease and multiple
sclerosis.3 Pulsatile and non-pulsatile tinnitus are two ways to
classify the problem, though many subtypes are frequently identified in the
literature (somatic, neurological, objective, subjective). Pulsatile tinnitus
involves the sensation of a rhythmic sound that resembles a heartbeat,
swooshing or whooshing not externally sourced.4,5 This form of
tinnitus is often caused by sounds such as personal pulse, vascular problems or
changes in the ear canal.5 By comparison, non-pulsatile tinnitus is
attributed to problems with the nerves involved with hearing and may be experienced
in one or both ears.5 This form of tinnitus is oftentimes described
as originating inside the head.5
Determining
the cause of tinnitus, regardless of type, is of key importance in the terms of
treatment. Clearly, if the underlying problem can be addressed and rectified or
improved, the associated symptoms may be alleviated or improved as well.
However, finding effective treatments for tinnitus have been challenging to
date.3
Acupuncture,
originating in ancient China, has been used for thousands of years to treat a
variety of conditions. Due to its efficacious outcomes in treating multiple
maladies, it seems appropriate to examine its usefulness when applied to those
suffering from tinnitus. Research surrounding this topic is abundant, yet simultaneously
inconsistent with many studies demonstrating efficacy and some presenting its lack of usefulness.
In
a review of 40 research studies, the efficacy of acupuncture as a treatment for
tinnitus was examined.6 Eight different types of acupuncture were
analyzed, some of which were tested in conjunction with additional
interventions such as supplementary medicine.6 A total of 3657 subjects were included across
the 40 studies.6 Researchers concluded that all eight methods of
acupuncture were effective in the treatment of neurological tinnitus (tinnitus
caused by disease such as Meniere's disease).6
Similarly,
a 2019 study was performed to determine
the usefulness of acupuncture as a treatment choice for patients suffering from
tinnitus.7 One hundred seven tinnitus patients were examined over
the course of 17-24 acupuncture treatments.7 Researchers concluded
that patients experienced improvement in their tinnitus condition following the
course of treatment.7
A
clinical observation study was performed to determine the difference in outcome
between acupuncture combined with the intake of an herbal formula compared with
the intake of the same herbal formula alone.8 Sixty patients were
randomized into two groups - a combined therapy group and an herbal formula
only group and treatment was administered according to a specific regimen for a
total of six weeks.8 Tinnitus severity score and tinnitus handicap
inventory were used to determine clinical effects of the treatments over the
course of the study.8 Results showed an efficacy rate of 93.3% in
the combined therapy group when compared to the 67.9% efficacy rate in the
herbal formula only group.8 Researchers concluded that acupuncture
used in conjunction with an herbal formula provided improvement for tinnitus
patients.8
A randomized clinical trial of 50 participants
tested the effectiveness of acupuncture on tinnitus when compared to no
treatment.9 Subjects were divided into equal groups and were
evaluated for five weeks.9 Results showed a statistically
significant effect between groups, leading researchers to conclude the efficacy
of acupuncture to reduce tinnitus intensity and improve the quality of life of
the tinnitus patients.9
In
a systematic review of literature, tinnitus
and the effect of acupuncture as a treatment modality was studied.10
Six randomized controlled studies were examined and results showed positive
effect in two unblinded studies and no significant effect in four blinded
studies.10 Researchers concluded: “The belief that acupuncture is a
specifically effective treatment for chronic tinnitus is not based on the
evidence of rigorous randomized controlled trials. Further research on this
subject seems to be warranted but should be conducted according to the highest
methodological standards.”10
An additional study demonstrated the ineffective nature of
acupuncture on tinnitus patients.11 The randomized, single-blind,
placebo-controlled study followed 50 patients suffering from the condition and
divided participants into a manual acupuncture group, an electrical acupuncture
group and a placebo group.11 Researchers studied frequency of
tinnitus, tinnitus intensity, and reduction of life quality among patients over
the course of the study.11 Patients were evaluated before treatment,
following six sessions of treatment and one month following the completion of
treatment.11 Results demonstrated no statistically significant
effect of either form of acupuncture.11 Despite the lack of statistically
significant improvements, researchers noted relative advantages of electrical
acupuncture when compared to the other two groups.11
From
the preponderance of the evidence, it appears that acupuncture holds a distinct
amount of possibility in terms of an effective treatment modality for those
suffering from tinnitus. There are several factors to acknowledge in regard to
the studies reviewed, including small sample sizes and relatively brief
treatment periods. However, it is important to note that though the evidence
for the efficacy of acupuncture as a treatment option is perhaps not
overwhelming, it does not include extensive risk. Therefore, it likely would be
wise to consider acupuncture as a treatment option for those suffering from
tinnitus, particularly if other therapies have not yielded results or have
created negative side effects.
1.Mayo
Clinic. Tinnitus. Available at:
https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156.
Accessibility verified November 24, 2019.
2.American
Tinnitus Association. Understanding the Facts: Demographics. Available at: https://www.ata.org/understanding-facts/demographics.
Accessibility verified November 24, 2019.
3.Naderinabi
B, Soltanipour S, Nemati S, Saberi A, Parastesh S. Acupuncture for chronic
nonpulsatile tinnitus: A randomized clinical trial. Caspian J Intern Med. 2018;9(1):38–45.
doi:10.22088/cjim.9.1.38
4.Department
of Radiology and Biomedical Imaging. Pulsatile Tinnitus Clinic. Available at:
https://radiology.ucsf.edu/pulsatile-tinnitus. Accessibility verified November
24, 2019.
5.My
Health Alberta. Ringing in the ears (tinnitus). Available at:
https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=tinit.
Accessibility verified November 24, 2019.
6.
Pang P, Shi Y, Xu H, et al. Acupuncture methods put to the test for a tinnitus
study: A Bayesian analysis. Complementary Therapies in Medicine. 2019;
42:205-213.
7.
Lin TY, Yang SW, Lee YS, et al. Analysis of Factors Influencing the Efficiency
of Acupuncture in Tinnitus Patients. Evid Based Complement Alternat Med.
2019;2019:1318639. Published 2019 May 26. doi:10.1155/2019/1318639.
8.
Chen S, Tan X, Fei L, Xiang X. Clinical observation on idiopathic tinnitus
treated with acupuncture, buzhong yiqi tang and cizhu wan. Zhongguo Zhen Jiu.
2018;38(4):369-73. doi: 10.13703/j.0255-2930.2018.04.007.
9.
Doi MY, Tano SS, Schultz AR, Borges R, Marchiori LL. Effectiveness of acupuncture
therapy as treatment for tinnitus: a randomized controlled trial. Braz J
Otorhinolaryngol. 2016;82(4):458-65. doi: 10.1016/j.bjorl.2016.04.002.
10.
Park J, White AR, Ernst E. Efficacy of Acupuncture as a Treatment for Tinnitus:
A Systematic Review. Arch Otolaryngol Head Neck Surg. 2000;126(4):489–492.
doi:https://doi.org/10.1001/archotol.126.4.489.
11.Wang
K, Bugge J, Bugge S. A randomised, placebo-controlled trial of manual and
electrical acupuncture for the treatment of tinnitus. Complement Ther
Med. 2010;18(6):249-55. doi: 10.1016/j.ctim.2010.09.005.
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