Cookie policy notice

By continuing to use this site you agree to our cookies policy below:
Since 26 May 2011, the law now states that cookies on websites can ony be used with your specific consent. Cookies allow us to ensure that you enjoy the best browsing experience.

This site is intended for health professionals only

At the heart of general practice since 1960

Guideline of the month: managing tinnitus

The key guideline for March

The guideline

The British Tinnitus Association (BTA) has, for the first time, produced guidance for GPs to help with the management of tinnitus. It follows discussions with patients and GPs, with the latter saying they would like more support to help them manage the condition.

Key points for GPs

  • Patients should be referred if their tinnitus is: pulsatile; unilateral; associated with vertigo; coexistent with asymmetric hearing loss; causing psychological distress; or associated with significant neurological symptoms.
  • Tinnitus can result in a blocked feeling in the ears but antibiotics rarely help.
  • Neither conventional nor complementary therapies have been shown to help. A positive approach and encouraging patient self-help are more effective.
  • Consider a hearing aid if there is associated hearing loss. Reducing the effort a patient exerts to listen can reduce the level of tinnitus.
  • Recommend that patients avoid silence, as low-level background noise, such as a fan or gentle music, can reduce the starkness of the tinnitus.

Practical issues

There are some 750,000 tinnitus-related GP consultations in England each year but audiology is often not available in primary care and referral pathways vary between areas. A BTA survey found 88% of patients wait up to four months to see a specialist. In addition, mental health support is sometimes indicated for psychological symptoms.

Expert comment

Dr Steve Brown, a GPSI in ENT in Beaconsfield, says: ‘The red-flag list is useful. If unilateral hearing loss is suspected using a tuning fork and doing Weber’s test is simple and often helpful. If audiology assessment is not possible in primary care, some private hearing aid providers will do it free. Where fullness in the ear is described with sensorineural hearing loss, tympanometry helps exclude a middle-ear effusion. Once red flags have been excluded, I try to get patients to focus on the natural history of gradual improvement. The BTA website is useful (tinnitus.org.uk).

The guideline

Baguley D, McFerran D. Tinnitus guidance for GPs. Sheffield: BTA; 2017. 

Rate this article  (3.33 average user rating)

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Readers' comments (1)

  • The link at the foot of the article does not work, here is the link to the guide:
    https://www.tinnitus.org.uk/guidance-for-gps
    and here is the downloadable guide link: https://www.tinnitus.org.uk/Handlers/Download.ashx?IDMF=905a25d0-a32e-4d77-a969-8ca19d30a50d

    Unsuitable or offensive? Report this comment

  • Thank you for letting us know. That link is fixed now.

Have your say

IMPORTANT: On Wednesday 7 December 2016, we implemented a new log in system, and if you have not updated your details you may experience difficulties logging in. Update your details here. Only GMC-registered doctors are able to comment on this site.