More than 50 million Americans suffer from tinnitus, or ringing in the ears. Experts say it's the most common service-related disability among U.S. military veterans. Yet many people remain unsure what can be done about it.
74-year-old Michael Stern has lived with the problem for a decade, ever since he woke up from an operation with painful noise in his ears. "It feels as if your head is going to explode," he told CBS News.
Now the nation's largest group of ear, nose and throat specialists, the American Academy of Otolaryngology - Head and Neck Surgery, has come out with new guidelines for treating the condition, based on the latest research.
The group says many cases are minor or go away on their own, but about 20 percent of patients need some type of medical intervention.
That should start with a "targeted history and physical exam," says Dr. Sujana Chandresekhar, a co-author of the new treatment guidelines. "You need to do a hearing test when it is appropriate, you need to counsel the patient that there are plenty of choices for them of ways to manage their problems."
The Academy recommends against routine scans and MRIs to diagnose the condition. It says patients who also suffer from hearing loss may benefit from a hearing aid evaluation.
The use of medications such as antidepressants and anticonvulsants are not recommended.
The panel also recommended against dietary supplements such as Ginkgo biloba, melatonin and zinc, or the use of a technique called transcranial magnetic stimulation, which involves the use of magnetic fields to stimulate nerve cells in the brain.
The guidelines are neutral on the effects of acupuncture for treating tinnitus, neither recommending nor warning against this popular form of alternative medicine.
While it falls short of a cure, doctors say patients with persistent, bothersome tinnitus may benefit from learning about strategies for managing their condition, and from cognitive behavioral therapy to help them cope.
Michael Stern still has trouble with the noise in his head, but therapy has helped him learn to shift his focus to other things.
"It's always bad," he said, "but the most important thing is just to... to go out and try lead as normal a life as possible."