Acupuncture for Tinnitus: How I Approach It, Plus a Qigong Exercise
Updated: 6 days ago
Over the years, plenty of people have asked me about acupuncture for tinnitus. The honest answer is that tinnitus comes in several types, the research is mixed, and it's hard to manage with any approach.
Tinnitus is not an easy thing to treat, and that goes for every treatment, not just acupuncture. It's common, too: the authors of a 2014 US clinical practice guideline estimate it affects 10 to 15% of adults.
Below I'll go through what the research says, how I approach tinnitus in clinic, what I look for in an assessment, and a simple exercise you can try at home.
Why is tinnitus so hard to treat?
Because we don't fully understand the mechanism of tinnitus from a biomedical point of view. If you're living with tinnitus you've probably done some research already, and you'll have noticed there isn't much around in terms of really reliable results. That isn't unique to acupuncture. It's true of most treatments on offer.
That's also why I'd rather give you an honest picture than a promise. So let's start with what the research reports.
What does the research say about acupuncture and tinnitus?
The research is mixed: many reviews report a benefit, but the underlying trials are generally low quality, so the evidence is far from settled. A 2022 overview in Frontiers in Neurology by Xianpeng Xu and colleagues pooled 14 systematic reviews. Eleven of the 14 reported that acupuncture was effective, and three found no firm conclusion or no significant benefit.
The overview also looked at how certain the evidence is. Of 54 outcomes assessed, none were rated high certainty, and risk of bias was the most common reason for marking them down. The authors called acupuncture a potentially positive treatment but asked for larger, multi-centre trials before drawing firm conclusions.
An earlier 2020 review of six systematic reviews in Longhua Chinese Medicine, by Donelli and colleagues, found a similar split. Two judged acupuncture unlikely to help, two said the evidence was too limited, and two judged it effective. Its authors noted that some benefit may exist in particular subtypes of tinnitus.
The US guideline I mentioned makes no recommendation for or against acupuncture. It does recommend cognitive behavioural therapy for people whose tinnitus is persistent and distressing. In my view that fits with the role of the stress response, which I come back to below.
That's what the research reports. It pools different types of tinnitus and different acupuncture methods, so it can't tell us which types might respond or how you'll respond. In clinic my approach is individualised, which is different to the standardised protocols used in most trials.
What do I look for in a tinnitus assessment?
Tinnitus comes in several types, so every case is unique and needs an assessment. Three patterns I pay attention to are:
Recent onset. How long you've had it shapes how I plan and review treatment.
Changeable. It fluctuates in intensity, or moves from one ear to the other. A changing pattern gives me more to go on when I'm assessing.
Linked to something. It came on after a flu, an infection or a bout of sinus congestion, and has stayed.
The other pattern is tinnitus that has built up gradually over years. It tends to be constant, dull and in the background, and it may come with some hearing loss. The research doesn't tell us whether recent or long-standing tinnitus responds differently to acupuncture, so I don't predict based on type. For long-standing tinnitus I plan a longer block of sessions with regular reviews, and continuing is always your decision.
How do I approach tinnitus in clinic?
With acupuncture I always look at the tinnitus in the context of you, so every case is unique and needs an assessment. For most people, my focus is regulating the nervous system, because in my view your stress response is closely tied to how much the tinnitus bothers you. Beyond that, what I focus on depends on the pattern:
Recent tinnitus with sinus congestion or an infection: my focus is lymphatic drainage, sinus drainage and circulation through the head.
Tinnitus with headaches or migraines: my focus is the neck, and blood flow into the head and around the ears.
If you have tinnitus alongside neck tension or headaches, I also check the trigger points in the neck and shoulders. Trigger point references describe the sternocleidomastoid muscle as one that can refer symptoms to the ear, including tinnitus.
How many sessions should you try?
To see how acupuncture sits with your tinnitus, I do an assessment and suggest a series of at least 6 sessions, then we review. Some people notice changes, some don't, and it's better judged over a block than on one or two visits. To give the review something concrete, we track things like how loud, how frequent and how bothersome the tinnitus is, plus your sleep, tension and stress. See how long acupuncture takes to work and how often to come for more.
How do you do "beating the heavenly drum"?
It's a traditional Chinese health and longevity practice for the ears, and it takes about a minute. It's called beating the heavenly drum.
Cup your hands over your ears, with your fingers resting at the base of your skull at the back of your head.
Flick your index finger over your middle finger so it taps the skull. With your hands properly covering your ears, it sounds like the beat of a drum.
Drum repeatedly, 50 to 100 times.
Try it at least once in the evening before you go to bed, since tinnitus often feels more noticeable then. You can also do it a couple of times through the day, such as in the morning. I'd give it a few weeks and see how you find it. It's a traditional practice, so think of it as something to try rather than a proven treatment.
FAQs: Acupuncture for Tinnitus
Can acupuncture help tinnitus?
I can't promise that. Tinnitus is hard to manage with any approach, and the research on acupuncture is mixed and mostly low quality. In clinic I assess your pattern, suggest a block of sessions and review how you respond.
Does the type of tinnitus matter?
It matters for how I assess and plan. I look at whether it's recent, whether it fluctuates and whether it started after a flu, infection or sinus congestion, or has built up over years. The research doesn't tell us which types respond, so I don't predict based on type.
How many acupuncture sessions should I try for tinnitus?
I like to start with an assessment and a series of at least 6 sessions to see how you respond, then plan from there. We track loudness, frequency, how bothersome it is, sleep, tension and stress so the review has something concrete to look at.
Does stress make tinnitus worse?
In my view your stress response is closely tied to how much tinnitus bothers you, which is why regulating the nervous system is a big part of how I work with it.
What happens in a first appointment?
An initial session involves a consult, assessments and treatment. I explain everything you need to know and what to expect, and we come up with a plan to suit your goals.
Ready to try acupuncture for your tinnitus?
If you'd like a whole-body approach to your tinnitus, you're welcome to come and see me. An initial session involves a consult, assessments and treatment, and I'll assess your pattern and put together a plan with you. The qigong exercise above is there to try either way.
If you'd like to try acupuncture in Sydney's eastern suburbs, come and see me at Acupuncture Grove in Bondi Junction. You can book online here or reach out with a question.
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Gavin Martin-Rentz is an AHPRA-registered acupuncturist and Chinese medicine practitioner at Acupuncture Grove, Bondi Junction, Sydney, with over 10 years in practice.
Acupuncture Grove services Bondi Junction, Bondi Beach, Coogee, Clovelly, Bronte, Waverley, Randwick, Maroubra, Double Bay, Watsons Bay, Vaucluse and surrounding Sydney suburbs.
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