The AudioNotch Tinnitus Treatment Blog

Does Tinnitus Go Away?

Written by AudioNotch Team on August 01, 2014

This is definitely a question that’s at the forefront of someone’s mind if they’ve just recently acquired the symptom of tinnitus.

First things first – if you develop tinnitus: seek the evaluation of a doctor. Some medical causes of tinnitus are reversible and some can be harbingers of serious illness (in rare cases, brain tumours like acoustic neuromas).

So: what does medical science say about the natural history of tinnitus (that is, the common progression of this symptom)?

Natural course

Noise-induced tinnitus can be acute or chronic. Acute tinnitus can last from a few minutes to a few weeks after noise exposure.24 In some cases, tinnitus has a gradual onset and several years can pass before an intermittent, low-intensity tinnitus becomes bothersome.25 Spontaneous remission by natural habituation is experienced by more than three-quarters of sufferers. Habituation occurs within the CNS, whereas adaptation involves a peripheral sensory organ.8 For those in whom the condition worsens, the tinnitus intensity increases over time but its pitch tends to remain stable.22 If tinnitus persists for more than 2 years, it is considered permanent and irreversible.26 However, chronicity is not associated with a favorable response to treatment.27

So, according to this resource, if you have tinnitus for two years, it’s probably permanent and irreversible. However, more than 75% of people with tinnitus “get used to it” – meaning they habituate to the sound and it no longer bothers them. If this source is to be believed, then spontaneous remission doesn’t occur after two years.

However, what about some conflicting data?

In one study Rubinstein et al. (3) found substantial longitudinal fluctuations in tinnitus and a high occurrence of spontaneous remission. The patients were studied at ages 70, 75 and 79 years. Results showed that tinnitus had increased in severity in 25 % of the women, and decreased in 58%, leaving 17% unchanged. For the men, tinnitus increased in 8% and decreased in 39%, with a larger proportion unchanged (53%). Of course, this study can be questioned as it relied on self-report and that other measures (such as maskability) could show a different result. However, the reliability of tinnitus matching is not impressive (4). It can be very hard for patients to remember how bad their tinnitus was a few years back and the anchor points may change over time so that a distress rating of 8 (on a 10-point scale) might mean a different thing five years later.

3. Rubinstein B, Österberg T, Rosenhall U. Longitudinal fluctuations in tinnitus as reported by an elderly population. J Audiol Med 1992;1:149-155.

Thus, other data has showed that there are substantial changes in the subjective experience of tinnitus severity over time. One thing with the quote above is that it’s not clear if the definition of “spontaneous remission” means that tinnitus volume declined or if it disappeared completely.

In conclusion, the available evidence on rates of tinnitus remission (the sound going away entirely OR getting quieter over time) is not very good. There are anecdotes available for everything on-line but it’s impossible to verify them. It’s one of the questions about tinnitus we don’t have a good answer to right now.