Acupuncture Therapy for Ear Ringing (Tinnitus)
Ear ringing, also known as tinnitus, is a condition where a person hears sounds without an external source. The sound in the ears are usually described as ringing, buzzing, hissing, or humming. Ear ringing indicates a functional disturbance in the ear region and is associated with a wide array of causes, such as exposure to loud noise, ear infections, certain medications, and aging. If you experience constant ear ringing accompanied by hearing decline, you should seek medical help as soon as possible.
Acupuncture is a key component of traditional Chinese medicine (TCM). Physicians insert fine needles into specific points on the body surface and apply stimulating techniques to regulate the flow of qi (vital energy) within the body, aiming to achieve therapeutic or preventative purposes. For ear ringing, acupuncture therapy helps to promote blood and qi activities, eliminate local tension or pathological changes inside the ears, and enhance the connection between the ears and internal organs. These actions bring positive effects to reduce the loudness and severity of ear ringing.
There is no universal acupuncture remedy suitable for all ear ringing sufferers. Appropriate point selection and stimulating techniques should be chosen based on the diagnosed disharmony patterns. Clinically, TCM physicians classify ear ringing into two major types:
| Excess type | Deficient type | |
|---|---|---|
| Ringing sound | Sudden onset, loud and noisy, continuous ringing, sounds that become louder when covering ear, often feels a sense of fullness or stuffiness in the ears | Gradual onset or lingering ear ringing, soft and gentle sound, that are likely to be alleviated when covering ear. It worsens at night or when feeling fatigued |
| Accompanied signs | A red face, irritability, thirst, headache, constipation and yellow tongue coating | Pale face, dizziness, night frequency, lumbar soreness, knee weakness or general weakness, loose bowel, abdominal distention, a pale tongue with little coating |
| Invovled systems | Liver, gallbladder, or lung | Kidney, spleen or heart |
| Stimulating techniques | Reducing techniques along the relevant meridians | Tonifying techniques along the relevant meridians, moxa heat may also apply |
| Sample disharnony patterns | Liver and gallbladder fire flaring, phlegm-fire obstruction, qi stagnation and blood stasis, wind evil attacking upward | Kidney essence deficiency, middle qi sinking, liver yin deficiency, liver blood deficiency, ear orifices not nourished |
Nevertheless, physicians will follow below when selecting acupoints for ear ringing cases:
- One or two major points around the ears, such as ting gong (Si19, open mouth), ting hui (Gb2, open mouth), er men (Sj21, open mouth), shuai gu (Gb8), yi feng (Sj17), and jiao sun (Sj20), as these points usually create a strong needling sensation, and so can achieve better relief results.
- Acupoints on the head and neck, that can release the local muscular tension as well as promote blood and qi circulation toward the ears.
- Since ear ringing is associated internal disharmonies, assistant acupoints will be selected according to individual presentations, for example: excess type usually selects wai guan (Sj5), hou xi (Si3), lie que (Lu 7), and zhong zhu (Sj3); while deficient type usually selects san yin jiao (Sp6), tai xi (Ki3), zhao hai (Ki6), and tai chong (Lr3).
For some stubborn symptoms, extra acupoints are selected:
- Insomnia: an mian
- Dizziness: bai hui (Gv 20), tou wei (St8)
- Headache: tai yang (Ex-Hn3), feng chi (Gb20)
- Low appetite: zhong wan (Cv12), zu san li (St36)
- Emission: shen shu (Bl23), qi hai (Cv6)
- Irregular menstruation: tian shu (St25), san yin jiao (Sp6).
During manipulation, the direction and depth of needle insertion should be concerned, which helps make the needling sensation transmit to the inner ear. Achieving sufficient intensity of needing sensation, also known as obtaining qi (de qi), is crucial for the therapeutic effect, and is the goal of all acupuncture remedies.
Below are some acupuncture protocols for ear ringing:
Case 1: Persistent ear ringing for two years, sound like cicadas and worsen when feeling fatigue, other accompanied signs include lumbar soreness, knee weakness, irritability, insomnia, thready and rapid pulse.
TCM diagnosis: yin deficiency and yang hyperactive
Point selected and techniques: ting hui (Gb2, open mouth), yi feng (Sj17), jiao sun (Sj20), zhong zhu (Sj3), tai chong (Lr3), apply on alternative side with reducing technique; tai xi (Ki3), shen shu (Bl23) & gan shu (Bl18), apply on alternative side with tonifying techniques.
Interpretation: The ears are surrounded by Triple Burner (Sj) and Gallbladder (Gb) meridians, stimulating acupoints like Sj3, Sj17, Sj20, Gb2 aim to promote qi flowing along these meridians. Lr3 point is the source point of liver meridian, stimulating it helps clear fire in the liver. Since kidney essence deficiency is a major cause for the ear ringing, the selected Bl23 and Bl18 are the back transport points of the two organs and Ki3 is the source point of kidney meridian, which can invigorate kidney and liver, boost extra essence sending upward to nourish the ears orifices and relieve ear ringing.
Case 2: a young girl with an intermittent ringing in left ear. She has an impulsive temper, the ringing sound is aggravated when experienced emotional distress or anger, even affected hearing. Sometimes, she has poor sleep, dry stools and irregular menstruation. Her tongue has a white thin coating, and the pulse is thready and taut.
TCM diagnosis: liver stagnation and fire hyperactive
Point selected and techniques: feng chi (Gb20), ting hui (Gb2, open mouth), yi feng (Sj17), zhong zhu (Sj3), apply with reducing techniques daily for 7 days.
Interpretation: stimulating the points surrounding the ears help unblock the meridians and promote qi flowing in the regions, and clear the localized pathogenic factors; Sj3 belongs to the triple burner meridian and is specialized in purging heat and promoting hearing. The four acupoints work together to relieve ear ringing.
Case 3: Sudden ear ringing and deafness, accompanied with dizziness, distention in forehead, a red face, throat dryness, a bitter taste in mouth, irritability, insomnia, chest oppression, constipation, and scanty urine.
TCM diagnosis: liver fire irritating ears
Therapeutic principles: purge liver fire and clear ear orifices.
Point selected and techniques: er men (Sj21, open mouth), ting hui (Gb2, open mouth), tai yang (Ex-Hn3), bai hui (Gv20), yi feng (Sj17), zhong zhu (Sj3), and tai chong (Lr3), apply with reducing techniques, and needle retention for 30 minutes each time.
Interpretation: stimulating the acupoints around ears can promote qi flowing in the relevant meridians; the Ex-Hn3 and Gv20 enhance the ascending of pure yang to the head region, unblock the ear orifices and relieve hearing problems; the Lr3 helps purge fire in the liver.
For ear ringing cases, duration of acupuncture treatment often depends on the patient’s response. Acute ear ringing usually requires two to three times a week, while chronic cases are treated once a week, with ten sessions as one course. During this period, patients have better maintain healthy lifestyle habits, eat a proper diet and keep the treated area warm to promote recovery.
Generally, acupuncture treatment is most effective in the early stages of ear ringing, during the acute phase, and for young patients without hearing loss. It must also be tailored to individual treatment, or treatment based on syndrome differentiation. Chronic ear ringing often has a longer the treatment duration, such as 3 to 4 months or at least 2 to 3 courses, compliance and patience are inevitable for desirable outcomes.
Acupuncture therapy not only can shorten the treatment course of ear ringing, but also alleviates insomnia, irritability, anxiety, and other problems caused by the symptom, improving the overall condition of the patients. Acupuncture along with Chinese herbal medicine or other auxiliary therapies can achieve the best results for ear ringing management.
