@Darwinfisch
If you were to use white noise generators as I do, then you would understand that the sound coming from them is smooth and not coarse unlike white noise emitted from headphones or earbuds, which can irritate the auditory system. Please read my post below or skip to the end and read my "PS" comments.
The views on whether a person with tinnitus should listen to music through headphones are controversial. Some people show no adverse affects while others do even when the volume level is kept low.
We are all different so the only way a one can know is to experiment for themselves if they want to. In my opinion, when the tinnitus was caused by exposure to loud noise/music and it has become intrusive - by this I mean a person having to seek help at ENT, then they shouldn't listen to music through headphones no matter how low the volume is set.
Most music has syncopation throughout its frequency range, so it's constantly changing in pitch, rhythm and timbre. The beat of the music and volume can also change while listening. This evokes pleasure and can stir our emotions. This happens whether we listen to music loud or soft, although certain types of music does sound better played at a higher volume than others, and vice versa.
Once the Cochlea in the inner ear becomes affected by noise exposure, it is much more sensitive to sound. This is one of the reasons hyperacusis (sensitivity to sound) is often experienced with noise-induced tinnitus. The wearing of WNGs (white noise generators) as part of TRT treatment can often cure the condition or reduce its symptoms. Someone that already has a sensitive auditory system due to noise-induced tinnitus and listens to music through headphones at a low volume, risks irritating the Cochlea further, which can make the tinnitus louder and more intrusive.
In my opinion, it can be misleading when some health professionals tell tinnitus patients, listening to music through headphones is fine as long as long as the volume is kept low. These health professionals mean well and know a lot about the anatomy of the ear and therefore, it is not my intention to try and undermine their abilities or expertise. However, It must be said, that many of them have never experienced intrusive tinnitus and therefore don't know much about it. I have spoken to people and corresponded with them by email and at Internet forums, complaining their tinnitus has become worse after listening to music through headphones even though the volume was kept low. My advice to anyone that has tinnitus that was caused by exposure to loud noise is not to listen to music through headphones, as the auditory system is more sensitive.
White noise generators.
Some may question the use white noise generators and in-ear types that emit white noise directly into the ear. White noise generators don't usually irritate the auditory system due to the volume being kept low and its frequency range remains constant, so there is no syncopation within it unlike music. The white noise generator fits behind the ear. Attached to this is a small plastic tube that wraps round the ear and enters the ear canal. At the end of this tube is a small aperture where the white noise exits into the ear. In-ear white noise generators also have a small aperture where the white noise exits.
I believe someone that has noise induced tinnitus and uses earbuds to listen to music, is putting themselves at even greater risk of making the tinnitus worse.
Michael
PS: Behind the ear (BTE) white noise generators, have a "thin tube" that wraps around the ear and is inserted in the ear canal. At the end of this tube there is an opening - a very "small" hole which the white noise emits and is sent towards the eardrum and inner ear. Similarly, in-ear white noise generators also have a small opening which the white noise is emitted. Headphones and earbuds are different. They use a large speaker or diaphragm in comparison to deliver sound. Playing white noise through them cannot easily be fine tuned as the WNG and can cause irritation to the ear and auditory system. Therefore, it' possible to make the tinnitus worse.
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