Ear ringing, also known as tinnitus, is a common symptom reported by many fibromyalgia patients. However, the connection between fibromyalgia and tinnitus is not fully understood. In this article, we’ll explore the current research on the link between fibromyalgia and ear ringing, look at the potential causes, and provide tips for managing tinnitus symptoms.
What is Fibromyalgia?
Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, sleep problems, and cognitive difficulties. Other common symptoms include headaches, depression, anxiety, Raynaud’s phenomenon, and irritable bowel syndrome.
Fibromyalgia affects 2-8% of the population, with women being disproportionately impacted. The exact causes of fibromyalgia are unknown, but research suggests it results from central nervous system dysfunction leading to central sensitization and an amplified response to stimuli that would not normally be painful.
There are no lab tests to definitively diagnose fibromyalgia. Diagnosis is based on a patient’s medical history, reported symptoms, and physical exam. Sometimes other conditions are ruled out first. Many fibromyalgia patients struggle for years to get a proper diagnosis.
The Link Between Fibromyalgia and Tinnitus
Several studies have found a higher prevalence of tinnitus among those with fibromyalgia compared to the general population:
- A 2007 study found that 41% of fibromyalgia patients reported tinnitus compared to 15% of healthy controls.
- A 2012 study reported a 3-fold increased risk of tinnitus for people with fibromyalgia.
- A 2018 study found a 39% prevalence of tinnitus in fibromyalgia patients.
However, the correlation does not prove causation. More research is still needed to determine if there is a direct link between the two conditions.
Potential Causes
While a definite connection has not been established, researchers have proposed some possible explanations for the association between fibromyalgia and tinnitus:
- Central sensitization – Research indicates both fibromyalgia and tinnitus involve central sensitization, or increased sensitivity in the central nervous system. This theory suggests the central sensitization present in fibromyalgia may make patients more prone to developing tinnitus as well.
- Inflammation – Some studies show fibromyalgia patients have elevated inflammatory markers. Inflammation may play a role in tinnitus for some people.
- Small fiber neuropathy – There is evidence of peripheral small fiber neuropathy in some fibromyalgia patients. Small fiber neuropathy affecting the inner ear may lead to tinnitus symptoms.
- Oxidative stress – Imbalances in antioxidant levels and oxidative stress may be a factor in both fibromyalgia and tinnitus.
- Brain hyperactivity – Neuroimaging studies suggest people with fibromyalgia and tinnitus share some patterns of hyperactivity in certain areas of the brain.
More research is needed to confirm if any of these theories explain the higher prevalence of tinnitus in fibromyalgia patients.
Characteristics of Tinnitus in Fibromyalgia
In addition to being more common, tinnitus in fibromyalgia patients also appears to have some unique characteristics compared to regular tinnitus:
- Tends to be bilateral, affecting both ears.
- Often described as a more distressing, severe ringing.
- Higher prevalence of hyperacusis (increased sensitivity to certain sound frequencies).
- Higher likelihood of pulsatile tinnitus (hearing a rhythmic pulsing sound).
Interestingly, a few studies have also found an association between fibromyalgia and hearing loss or deafness. However, the reasons for this connection remain unclear.
Managing Tinnitus
Currently there is no cure for most cases of tinnitus. However, there are treatments that can help make tinnitus more manageable and less bothersome:
- Cognitive behavioral therapy (CBT) – CBT helps patients learn coping techniques to better manage reactions to tinnitus.
- Tinnitus retraining therapy (TRT) – TRT uses sound therapy and counseling to retrain the brain to tune out and be less bothered by tinnitus.
- Medications – No medications are FDA-approved specifically for tinnitus, but some antidepressants, anti-anxiety drugs, and other medications may provide relief for some people.
- Sound therapy – Listening to soothing background sounds can help mask tinnitus or make it less noticeable.
- Stress management – Stress reduction strategies like meditation, yoga, or tai chi may help alleviate tinnitus symptoms.
- Healthy lifestyle – Diet, exercise, sleep hygiene and limiting alcohol and caffeine intake can help manage tinnitus.
- Alternative therapies – Some options include acupuncture, massage, chiropractic adjustments, and nutritional supplements like zinc, ginkgo biloba, and melatonin.
Since fibromyalgia patients often have multiple symptoms to manage, a multidisciplinary treatment approach is recommended. This may involve seeing various specialists like audiologists, ENT doctors, neurologists, and psychologists.
Conclusion
In summary, many studies confirm there is an association between fibromyalgia and increased risk of tinnitus. Potential explanations include central sensitization, inflammation, small fiber neuropathy, oxidative stress, and brain hyperactivity. Tinnitus in fibromyalgia patients also appears to have some unique characteristics like being bilateral and more distressing.
While more research is needed, the current evidence suggests tinnitus and hyperacusis should be considered common comorbidities in fibromyalgia patients. There are various therapies that can help make tinnitus more manageable, especially when used in combination. As with fibromyalgia itself, a multimodal treatment approach is likely to be most effective for alleviating troubling ear noises.