Isn't It OK to Use Headphones Even at Low Volume?

[Michael Leigh]

Hi @Rick Austin

I believe the debate on whether it is safe for a person with tinnitus to use headphones, at low volume will go on for a long time and certainly after I have shuffled off this mortal coil. Tinnitus has been around for thousands of years and I don't see a cure for it any time soon. I am not being pessimistic just a realist. Nineteen out of twenty medical conditions cannot be cured and at this moment tinnitus is one of them. It comes in different levels of severity and no two people experience it the same. Many things can cause it: underlying medical condition, injury to the head, reaction to medication and the most common exposure to loud noise.

Due to tinnitus being so complex, it wouldn't be right to say a person with noise induced tinnitus is suffering more than someone that has tinnitus caused by an underlying medical condition or a head injury and vice versa. Last week someone called me from overseas and clearly in a lot of distress with her tinnitus. It was brought on by a road traffic accident a few years ago. She had habituated but unfortunately, a recent second head injury has caused an increase in the noise and now she has multiple sounds to deal with and finds it extremely difficult to cope.

The ENT doctors that I have met over the years are adamant; that someone with tinnitus shouldn't listen to any type of audio through headphones no matter how low the volume is set as there's a risk of making the condition worse. Some ENT doctors have said the opposite. Providing the volume is kept low through headphones no harm will be done to the auditory system.

I have said many times in this forum and others. ENT doctors are physicians not tinnitus experts. They know about the anatomy of the ear and are able to treat it medically or surgically and I believe they do this well and I have a lot of respect for their expertise. I have read many posts in this forum from people with "noise induced" tinnitus that have used headphones and kept the volume low and realised it has increased and will not return to baseline. I have also read some people with "noise induced" tinnitus that are not adversely affected by headphone use. I believe when a person has "noise induced" tinnitus it is different from other types of tinnitus. This is not to imply that it more severe just different. In many cases hyperacusis is present, which is not always noticeable in people with tinnitus that was not caused by "noise trauma" to the auditory system. However, there are exceptions.

Even after a person habituates with tinnitus resulting from noise trauma, I believe one should to be careful. Although the "wound" has healed a scar remains. The cochlea in the inner ear is more sensitive to sound. Over the years many people have contacted me by email and at tinnitus forums. Saying after they have habituated and returned to using headphones and keeping the volume low, they noticed their tinnitus increased in volume over time. Fortunately with treatment many people can go on to live their life without tinnitus causing too much problems. However, there is a dark and sinister side to this condition that is not often talked about. When it is severe it can be very debilitating and unfortunately ruin a person's life. That is the cold hard truth and I'm sorry to sound so sobering.

I am only referring to people that have tinnitus that resulted from noise trauma and not other types of tinnitus. I will always advise anyone that has noise induced tinnitus, and has asked the question, as you have done opening this thread: Is it ok to use headphones at low volume? In my opinion, it is not safe for you to do so as there's always the risk of your tinnitus increasing and if that happens it is unlikely it will return to baseline.

I wish you well
Michael

 

[Jazzer]

"Science" involves observations. Here is one, the second post in this thread

Here is another observation


Michael states that people he talked to provided more observations consistent with the hypothesis that it is not completely safe to use headphones, no matter how quiet one sets the volume to.
Our first observation involved setting the volume at 5%. You are right, 5% must have been too loud, if it lead to damage. So there is no such thing as "low volume" for someone who already has tinnitus.

@Bill Bauer - you are so right !!
There is no such thing as low volume, for somebody that already has Tinnitus.
Noise is damaging- full stop !!

 

[Jazzer]

Hi @Rick Austin

I believe the debate on whether it is safe for a person with tinnitus to use headphones, at low volume will go on for a long time and certainly after I have shuffled off this mortal coil. Tinnitus has been around for thousands of years and I don't see a cure for it any time soon. I am not being pessimistic just a realist. Nineteen out of twenty medical conditions cannot be cured and at this moment tinnitus is one of them. It comes in different levels of severity and no two people experience it the same. Many things can cause it: underlying medical condition, injury to the head, reaction to medication and the most common exposure to loud noise.

Due to tinnitus being so complex, it wouldn't be right to say a person with noise induced tinnitus is suffering more than someone that has tinnitus caused by an underlying medical condition or a head injury and vice versa. Last week someone called me from overseas and clearly in a lot of distress with her tinnitus. It was brought on by a road traffic accident a few years ago. She had habituated but unfortunately, a recent second head injury has caused an increase in the noise and now she has multiple sounds to deal with and it finds it extremely difficult to cope.

The ENT doctors that I have met over the years are adamant; that someone with tinnitus shouldn't listen to any type of audio through headphones no matter how low the volume is set as there's a risk of making the condition worse. Some ENT doctors have said the opposite. Providing the volume is kept low through headphones no harm will be done to the auditory system.

I have said many times in this forum and others. ENT doctors are physicians not tinnitus experts. They know about the anatomy of the ear and are able to treat it medically or surgically and I believe they do this well and I have a lot of respect for their expertise. I have read many posts in this forum from people with "noise induced" tinnitus that have used headphones and kept the volume low and realised it has increased and will not return to baseline. I have also read some people with "noise induced" tinnitus that are not adversely affected by headphone use. I believe when a person has "noise induced" tinnitus it is different from other types of tinnitus. This is not to imply that it more severe just different. In many cases hyperacusis is present, which is not always noticeable in people with tinnitus that was not caused by "noise trauma" to the auditory system. However, there are exceptions.

Even after a person habituates with tinnitus resulting from noise trauma, I believe one should to be careful. Although the "wound" has healed a scar remains. The cochlea in the inner ear is more sensitive to sound. Over the years many people have contacted me by email and at tinnitus forums. Saying after they have habituated and returned to using headphones and keeping the volume low, they noticed their tinnitus increased in volume over time. Fortunately with treatment many people can go on to live their life without tinnitus causing too much problems. However, there is a dark and sinister side to this condition that is not often talked about. When it is severe it can be very debilitating and unfortunately ruin a person's life. That is the cold hard truth and I'm sorry to sound so sobering.

I am only referring to people that have tinnitus that resulted from noise trauma and not other types of tinnitus. I will always advise anyone that has noise induced tinnitus, and has asked the question, as you have done opening this thread: Is it ok to use headphones at low volume? In my opinion, it is not safe for you to do so as there's always the risk of your tinnitus increasing and if that happens it is unlikely it will return to baseline.

I wish you well
Michael

I agree with all of the above.

I have Noise Induced Tinnitus.
It is hell-on-earth.
However, I am a member of a beautiful loving family. They deserve a winner, not a loser.
I encourage myself.
"Easy Dave - be a winner - reclaim your life."
Determination plays a big part.

 

[Sam Bridge]

I hope someone reading this asks their doctors whether a loud phone or clanking plates can change T for the worse. If you do that, please let us know the answer that you got from your doctor.

Unless you live under a rock you will be exposed to noises like that every day, i know i am and it doesn't have any negative effects.

 

[Greg Sacramento]

Several studies including the Illinois study show thru MRI scanning that there's a complete difference with accepting sound depending on severity. That is because mild, moderate and severe tinnitus is pinpointed to different parts of the brain. Those with severe T can tolerate certain sounds better than those with mild T. Other sounds are less tolerable for those with severe T than those with mild T. This is all discussed in the Illinois study.

 

[glynis]

My view still stands.
Earphones playing white noise etc for short lengths of time for those people whom can not afford white noise generators or hearing aids in my view can help give them a break regardless of their tinnitus cause.
Its only my view and will back it up if I find any documentation etc .
Love glynis

 

[Michael Leigh]

Several studies including the Illinois study show thru MRI scanning that there's a complete difference with accepting sound depending on severity. That is because mild, moderate and severe tinnitus is pinpointed to different parts of the brain. Those with severe T can tolerate certain sounds better than those with mild T. Other sounds are less tolerable for those with severe T than those with mild T. This is all discussed in the Illinois study.

Thank you for the information. A person will have to decide for themselves whether it is safe to use headphones at low volume or not. In the case of tinnitus caused by "noise trauma" I do not believe it is safe to use them at any level. for there is always a risk of the tinnitus being made worse.

Michael

 

[Sam Bridge]

My view still stands.
Earphones playing white noise etc for short lengths of time for those people whom can not afford white noise generators or hearing aids in my view can help give them a break regardless of their tinnitus cause.
Its only my view and will back it up if I find any documentation etc .
Love glynis

Could just use a phone app and the phones speaker, thats what i do if i need masking at home.

 

[Greg Sacramento]

Just a moderator, not a judge. Besides the linked article, read the other blue link articles at the bottom of the page and to the side under Related Questions. I didn't bother. I'm only giving a source. Remember, I just the moderator.

https://www.quora.com/Does-listening-to-music-on-headphones-at-a-low-volume-harm-ears

 

[glynis]

@Greg Sacramento ,
Hi Greg ,
I was reading the same article today so thank you for putting it up.
Love glynis

 

[Michael Leigh]

@Greg Sacramento

Whilst the link you have put up is informative. For a person with tinnitus caused by noise trauma it doesn't mean much. I'm fairly sure using headphones at low volume will not cause: harm to the ears. I'm saying there's a risk of the tinnitus becoming louder for someone with "noise induced tinnitus" that chooses to use headphones, even at low volume. It is quite possible for someone with noise induced tinnitus, to use headphones at low volume and their tinnitus increases but there will be no hearing impairment. The only negative therefore is the increase in the tinnitus which they might find distressing. That is my point. It's not that using headphones at low volume will cause hearing damage for someone that has "noise induced" tinnitus - I'm sure it wont. It is the fact that there's a real possibility of the tinnitus becoming louder and will not return to baseline. It is also true, some people with noise induced tinnitus are not affected by headphone use.

Michael

 

[Tinker Bell]

I would imagine that the pattern of inner ear hair damage might be different for acoustic trauma patients and patients who got T due to ototoxicity. The former lose the hairs that correspond to higher frequencies. I am not sure why that would be the case for the latter.

Ototoxic damage begins with higher frequencies, just like acoustic trauma. This is well established and the reason why cancer patients receiving ototoxic medications have their hearing frequently tested above 8k to check for any loss.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138949/

 

[glynis]

I will be doing my own investigation regarding my views and any infornation I will make sure to let you guys know
Love glynis

 

[Greg Sacramento]

@Michael Leigh Honestly I didn't read the articles other than comments on the original link. Something about wearing headphones when crossing the street can kill you. I laughed. I couldn't read the other blue links relating to 'already having tinnitus' because I can't remember my google ID. I don't need to type in my google ID for other searches.

 

[GregCA]

The ENT doctors that I have met over the years are adamant; that someone with tinnitus shouldn't listen to any type of audio through headphones no matter how low the volume is set as there's a risk of making the condition worse.

But...

Most doctors don't know anything about tinntius Bill. They know about the anatomy of the ear and how to treat it medically or surgically.

This is the reason why there are so many tinnitus forums on the Internet because there are medical professionals giving advice about a condtion that they know very little about. I say again, they know about the anatomy of the ear and can treat it medically and surgically and this they do well. However, when it comes to tinnitus many know little about it.

Granted, he or she knows about the anatomy of the ear and how to treat it medically or surgically but they are not tinnitus experts. Most know very little about the condition.

ENT doctors are physicians and know all about the anatomy of the ear and I have a lot of respect for them and their expertise. They can treat the ear medically or surgically. However, most of them know very little about tinnitus.

ENT doctors know about the anatomy of the ear. They are able to treat it medically or surgically and most do this well. However, the majority of them no nothing about tinnitus because they have never experienced it.

You are quite right @Bill Bauer most doctors particularly those that work in ENT know very little about tinnitus.

Whilst the majority of them know about the anatomy of the ear and can treat it medically or surgically, they know almost nothing about tinnitus.

I'm confused... do they know what they're talking about or not?

 

[IAmCalifornia]

Am I the only 1 who is thinking, how can an ENT be THE medical authority on the ear and not know jack about tinnitus?! Or an audiologist who's only purpose to push hearing aids and scam TRT in your face, otherwise a useless and made up profession. We're f**ked! Like serious can ENTs only clean wax and test your hearing and that is it?!? They can't even tell you, "hey this is why your tinnitus is happening, you have bad hearing" or "hey this is why your tinnitus is happening, you might have TMJ" or "hey this is why your tinnitus is happening, you took ototoxic pills".

Seriously we are F***ED!!!!

 

[Tinker Bell]

But...









I'm confused... do they know what they're talking about or not?

They only know what they're talking about when it agrees with your opinion.

 

[linearb]

Michael Leigh frequently encourages people to see audiologists and not ENTs, so there's no cognitive dissonance in what I see from him here... Compared to me, he's a remarkably consistent poster as far as sticking to his basic ideas.

ENTs aren't perfect, and may give bad info, but I'd trust a bad ENT over some random internet post any day... I mean, look at that guy @linearb for example, he talks way too much and changes his mind every six posts

Tinnitus is super complicated and personal; if a doctor gives you advice that turns out to be bad, it's not your fault, but it's also not their fault that they are not omnescient. Medicine is a service industry. You pay the best doctor you can afford, they give you the best advice they have, and if it's wrong, well, life is complicated.

Hearing tests including evoked emissions tests VERY VERY RARELY cause any significant problems. The metrics they produce are not foolproof or magic, but right now they are the best tool we've got to put some hard, objective numbers on hearing function. Modern medicine needs to be able to do that to function. Medical advice without metrics may as well come from an alchemist or priest.

Most diagnostic inquiries into tinnitus are geared towards identifying the rare, but potentially fatal or potentially fixable physical causes. That's it. If you don't turn out to have a tumor or vascular abnormality there's not much modern medicine can do for you.

 

[Bill Bauer]

But...

I'm confused... do they know what they're talking about or not?

In general, doctors and ENTs have little to offer to T patients. Michael has been struggling with T for years and was able to find some doctors who where slightly more knowledgeable than others.

 

[Bill Bauer]

Am I the only 1 who is thinking, how can an ENT be THE medical authority on the ear and not know jack about tinnitus?!

The doctors are being taught that it is an incurable disease. There hasn't been any scientific studies of what makes T worse (if anything) and what promotes healing. As a result, the doctors don't know how to treat T, and what to advise you regarding adjusting your lifestyle.

 

[glynis]

I can say for sure that the ENT Specialist I recently went to see was all up on tinnitus and menieres and I have seen him many times over the 12-14 years with menieres.
Checked my ears ,hearing test and did microsuction,camera up my nose,Allergy blood test,asked if I would like CBT as TRT was not now on offer.
Arraged to be seen by audiology.
Asked did I have trouble sleeping and advised on all that and we had a great chat about it.
I told him about everything I was involved in regarding tinnitus.
We talked about my hearing loss due to menieres and the impact that had on my tinnitus and spent well over 45 minutes together.
I can not fault the care I had from him .
He was happy to discharge me now the menieres symptoms are controlled or got to burn out but my hearing will continue to reduce due to the menieres.
My main tinnitus treatment permanently are my duel purpose hearing aids and betahistine and meds to help me sleep.
We hear so many people complain about the treatment we get so I feel you should hear of the great support I got at The Royal Stoke Hospital.
Love glynis

 

[Jazzer]

Several studies including the Illinois study show thru MRI scanning that there's a complete difference with accepting sound depending on severity. That is because mild, moderate and severe tinnitus is pinpointed to different parts of the brain. Those with severe T can tolerate certain sounds better than those with mild T. Other sounds are less tolerable for those with severe T than those with mild T. This is all discussed in the Illinois study.

Where can we find information on this study Greg?

 

[Red]

@Rick Austin
@glynis

Glynis use very specific wording in her posts that I think should be paid attention to. This is a very specific usage for headphones and is probably not what most people are thinking of when someone asks, "Can I still use headphones if I have tinnitus?" Glynis sees it as okay for people who cannot afford white noise generators but what is not said is whether or not other types of noise would be considered safe.

Rick Austin is asking about it in regards to music and in regards to music I believe the answer should be no.

@linearb

Talks about basic physics and how with headphones, we are more susceptible to unexpected bursts of sound. This is the problem with going about using headphones with anything but @glynis 's approach. White noise typically has a constant and predictable level of volume. However, when you are listening to music or voices, your volume is attuned to the base level of these noises. There will be peaks and drops in volume that you can never predict.

Adding in hyperacusis makes it more complex, as if you are like me, there are certain sounds that really gnaw on the ears, no matter the volume.

If you are using a streaming service, examples include YouTube or Pandora, then you need to worry about advertisements which can be higher in volume than the music you are listening to. You also need to make sure that your equipment is properly configured with each use so that you don't accidentally blast yourself.

Even before tinnitus I had sensitive ears and I was always protective of them. So when I say that my volume was at 5% I do mean that that was the volume it was at. The problem is that you can only be so lucky even if you do everything right. I have had multiple worsenings thanks to headphones, even while being cautious. Even doing everything perfectly, the sounds of headphones just hurt my ears now.

So we know that science is a fact but there are still so many facts that we have yet to discover. We can admit that tinnitus is a mystery and perhaps we don't fully understand how sound pressure can affect tinnitus. So, I do not care much about science saying that headphone usage is okay. Because that science does not take tinnitus into account. As far as treating and understanding tinnitus goes, we may as well be working with humors.

I know what works for me and I believe that other people here should figure out what works best for them. For me, that is discontinuing the use of headphones.

 

[Red]

well this is all bad news since listening to music like that is very important to me. Also important, is that i have to try and mix/master the music i make, and my laptop isn't good enough, so i need headphones. i guess i can try to stop recreationally.

I also hope that one day we will without a doubt understand tinnitus, it's causes, etc. it ain't good when everyone disagrees about a condition like this

I think you should discontinue them. I never preferred laptops but can you get some speakers for them? Does the stress and anxiety from risking headphones really make a more enjoyable listening experience than speakers?

I hope someone reading this asks their doctors whether a loud phone or clanking plates can change T for the worse. If you do that, please let us know the answer that you got from your doctor.

I don't understand what is being argued or discussed with you and the other user. My doctor told me to avoid loud venues, including cinema, but to otherwise live life normally. She emphasized to not let tinnitus get in the way. To me, that strongly implies that she believes sounds that you think are harmful she thinks are fine.

 

[glynis]

@Red,
I find your summing up all the information and seeing both sides of each point lovely.
As I have said,If I find information on my views I will put it up on the forum for or against it as so far its more positive but having it in their words might help.
Love glynis

 

[Samir]

There is a relationship between loudness and time. In other words, you can damage your hearing with very loud sounds for a short period of time, or low volume sounds for much longer periods of time. And the truth is that we're all different, so these are just guidelines

Agreed! These are all relative figures, most likely relative to a healthy population.

 

[VRZ78]

well this is all bad news since listening to music like that is very important to me. Also important, is that i have to try and mix/master the music i make, and my laptop isn't good enough, so i need headphones. i guess i can try to stop recreationally.

I also hope that one day we will without a doubt understand tinnitus, it's causes, etc. it ain't good when everyone disagrees about a condition like this

Tinnitus or not it's not advised to use headphone to mix or master... Get a good pair of speaker

 

[Samir]

Noise can be damaging, regardless if it's coming from the headphones, external speakers or elsewhere, if it is intense enough. There is always reason to be cautious when using audio devices, but I think people that already have some kind of damage, noise induced or otherwise, need to be extra cautious.

My tinnitus is most definitely noise induced. I was blasted with a very loud, sudden noise through my headphones. It was one of those in-ear headphones in fact, which must have made the trauma to the ear and brain several times greater. I don't know how loud it was, but I would be very surprised if it was less than 140 dB. Given the intensity of the noise and the fact that I used in-ear headphones. It would have to be in that zone, between 120 dB and 140 dB.

This noise came on suddenly, and I never had the volume knob past the 20% mark, ever. I had a physical volume/gain knob, I am not referring to the volume indicator that you see on a computer monitor. Yet it felt so intense, as if it was outputting maximum power. It was caused by some kind of technical problem with the audio device. I think it was the DAC that had a glitch, and this shocking, nerve-wracking, screeching, high intensity noise was sent out that made me cringe and pull the headphones out of my ears and toss them to the floor. It sounded almost like a feedback loop.

In fact, I have a picture of the sound. I don't think I have posted this before. Have a look!





This sonogram clearly reveals that the highest energy was at about 5.5 kHz! My tinnitus frequency is at about 5.8 kHz when I try to pinpoint it. Go figure! I missed it by 300 Hz. Maybe I should just go by my recording instead of my perception.

I have never put those in-ear headphones or any kind of in-ear headphones or monitors in my ears since, and I never will. Sure I could do that, and I have used the circum-aural ones a couple of times since I started having tinnitus. I have maybe used them on two or three occasions since I started having tinnitus. I rather not use them at all. I don't fear using them, which I did... initially... considering what happened to me, and that I was traumatized by nothing less than the headphones! But I have gotten over that.

I don't think using headphones will damage my hearing and brain more if I did use them at very low, and controlled level. I have gotten rid of the old audio device since. But can I guarantee that another device will not have the same or similar problems and blast me again? Not really, no. You know Murphy's law? If things can go wrong, they will go wrong... eventually, maybe not immidately.

So you ask yourself! Are you prepared to risk your hearing over some music? Have you considered the consequences should something unintentional happen? Do you think it's worth it? Think about it! Then you decide for yourself. I have given you the warning and what can happen if you are unlucky like me.

Let me just add in that my tinnitus has not worsened from listening to some music and white noise over the headphones. The reason I am ditching the headphones is because of personal choice. Not because of increase in spikes or severity. I would like to preserve what hearing I have left. That's all.

 

[Greg Sacramento]

@Jazzer Here is the Illinois study. My discussion post #65 is referenced on pages well into the study. Use arrows to turn pages. Some pages will turn slow.

https://www.ncrar.research.va.gov/Conference/Documents/PPT/Husain.pdf

 

[glynis]

Let me just add in that my tinnitus has not worsened from listening to some music and white noise over the headphones. The reason I am ditching the headphones is because of personal choice. Not because of increase in spikes or severity. I would like to preserve what hearing I have left. That's all.[/QUOTE]

@Samir,
Thank you for your post and views.
As you may have read my views on this thread that playing white noise etc on the lowest setting possible can be a way to help tinnitus if a person can not afford White Noise Generators or hearing aids for short periods of time when struggling.
Love glynis

I will try to back this up with contacting a few professionals