Does Everyone with Tinnitus Need a Hearing Aid? The Answer Is NO

by Dr. Jennifer Gans

 

One of the most common—and most misunderstood—messages people with tinnitus hear is this:

“You have tinnitus, so you need a hearing aid.”

Hearing aids can be helpful for people with tinnitus who also have measurable hearing loss. But for those people with tinnitus who have very mild hearing loss or no measurable hearing loss they are quite often unnecessary and expensive.

Understanding when hearing aids help—and when they don’t—can spare people unnecessary expense, frustration, and disappointment.

Tinnitus Is Not a Hearing Aid Problem
It’s a Brain Processing Issue

Tinnitus is not a disease of the ear. It is a benign internal signal generated by the auditory system and interpreted by the brain. What determines whether tinnitus becomes bothersome is not the sound itself—but how the brain responds to it. Click on this link to learn important information about tinnitus.

Many people have tinnitus and are barely aware of it. Others find it intrusive, distressing, and life-altering. The difference lies in the brain’s reaction to tinnitus and:

- Threat perception and vigilance

- Attention and salience

- Emotional and autonomic nervous system activation (anxiety)

This is why two people with identical hearing tests can have vastly different tinnitus experiences.

When Hearing Aids Can Help Tinnitus

Hearing aids may be beneficial when there is measurable hearing loss, especially in the speech frequencies. We know that the first perception of tinnitus is caused by the brain ‘searching for a sound that it is no longer able to perceive’. Hearing aids amplify sound and in essence, gives the brain returned access to sound. Tinnitus can sometimes feel less bothersome because the brain does not have to work as hard to pick up a missing sound signal.

Most modern hearing aids have a ‘sound generator’ function. Through the hearing aid, a myriad of sounds can be played directly into the ear. These sounds can be used as sound enhancement providing a myriad of neutral, customizable sounds like white noise, pink noise, or nature sounds (ocean waves), which work to distract the brain from tinnitus, relaxing the mind through providing auditory enrichment.

But for people with normal or near-normal hearing, purchasing a hearing aid for just the sound enhancement feature can be an unnecessary expense. Sound enrichment can be free or nearly free by filling the environment with sound through any device (smartphone, noise-machine, stereo, and the like).

Importantly, hearing aids do not treat tinnitus directly—they change the auditory environment in which tinnitus is perceived.

When Hearing Aids Are Not Necessary—And Unhelpful
Many people with tinnitus:

- Have normal or near-normal hearing

- Have a focus on tinnitus driven by mis-information

- Experience stress, anxiety, trauma, or hypervigilance

- Experience tinnitus that does not change with sound enrichment

- Continue to feel distressed even when hearing is amplified

In these cases, hearing aids alone often fail to help and sometimes worsen frustration when expectations are not met.

Why Tinnitus Arises

The brain has a built-in cancellation system designed to filter out irrelevant internal sensations—like the feeling of clothes on your skin or the sound of your own breathing. In bothersome tinnitus, this system fails. The brain mistakenly tags the sound as:

- Important

- Threatening

- Worth monitoring

Once tinnitus enters the brain’s priority lane, amplification alone cannot remove it from awareness. But accurate education emphasizing the benign nature of tinnitus and anxiety reduction can. Click this link to learn more about the critical role of tinnitus education.

What Actually Helps Most People with Tinnitus

Research and clinical experience consistently show that the most effective tinnitus interventions target the brain, not just the ear:

- Accurate tinnitus education

- Anxiety and stress reduction

- Mindfulness-based attention retraining

- Reducing tinnitus-related checking and monitoring behaviors

When the brain learns that tinnitus is safe, predictable, and irrelevant, the sound often fades into the background—with or without hearing aids.

The Bottom Line

Some people with tinnitus benefit from hearing aids when there is measurable hearing loss.

Everyone with tinnitus has hearing loss. But not everyone with tinnitus has measurable or significant hearing loss warranting a hearing aid.

A hearing aid is a tool, not a cure—and it is only appropriate when it addresses the underlying driver of a person’s tinnitus distress.