Acupuncture for Tinnitus: Evidence, Realistic Goals and Warning Signs

Acupuncture for tinnitus is best thought of as a way to make the ringing easier to live with, not as a cure. The research on it is mixed. Some reviews report that people rate their tinnitus as less of a burden after a course of treatment, but the trials are small and many have design flaws, and the main American guideline for doctors, from the American Academy of Otolaryngology–Head and Neck Surgery Foundation, makes no recommendation for or against it. This article explains what that means in practice: how tinnitus is diagnosed, which treatments have the strongest support, where acupuncture can sensibly fit, how to measure whether it is helping, and which symptoms need a doctor first.

It is written by Netra Integrative Health Clinic in South Plainfield, New Jersey, for adults whose tinnitus has already been checked by a doctor or hearing specialist, or who are about to be, and who want an honest picture before they book.

The short answer

If you want the position in a few lines, here it is. Acupuncture cannot repair a damaged inner ear, and no study has shown that it switches tinnitus off. Some trials suggest it can reduce how much tinnitus bothers people, and that is the outcome most worth aiming for. The treatments with the best evidence are different ones: a hearing evaluation, hearing aids when there is hearing loss, sound therapy and cognitive behavioral therapy (CBT). Acupuncture can be added alongside those, especially when tinnitus comes with poor sleep, stress, or tension in the jaw and neck.

That is a modest promise, and we would rather make a modest promise and keep it. Many people who come to us have already been told there is nothing more to do. There usually is something to try, as long as everyone is clear about what is being measured.

What tinnitus is, and why the cause comes first

The National Institute on Deafness and Other Communication Disorders (NIDCD) defines tinnitus as hearing a sound that has no outside source. Most people call it ringing, but it can also sound like buzzing, hissing, roaring or clicking. The NIDCD tinnitus page cites surveys suggesting that 10 to 25% of adults have it, and children can have it too.

Tinnitus is a symptom, not a disease. Mayo Clinic describes it as a symptom of more than 200 different health conditions, and in many people no single cause is ever found. The common causes include:

• Hearing loss, from age or from loud noise, which damages the hair cells of the inner ear.
• Medicines, including NSAIDs, some antibiotics, cancer drugs, diuretics and some antidepressants, especially at high doses.
• Problems in the ear itself, such as earwax buildup, ear infections, eustachian tube problems or otosclerosis.
• Jaw joint problems, which both NIDCD and Mayo Clinic list as a cause.
• Head or neck injuries.
• Blood vessel conditions, such as high blood pressure or atherosclerosis, which are more often behind tinnitus that pulses.
• Less common conditions, including Ménière's disease, vestibular migraine, a benign nerve tumor called an acoustic neuroma (vestibular schwannoma), and chronic illnesses such as diabetes, thyroid disease and anemia.

Some of these causes can be treated directly. NIDCD notes that dealing with a physical cause, such as earwax or a jaw problem, can remove the tinnitus or reduce it a great deal. That is why acupuncture should never be the first step. If your ear is blocked with wax, needles will not help, and a nurse with an ear irrigation kit will.

Three types worth knowing

• Subjective tinnitus is the common kind, heard only by you.
• Objective tinnitus is rare. A clinician can sometimes hear it with a stethoscope, and it often has a specific, treatable cause.
• Pulsatile tinnitus beats in time with your heart. NIDCD says imaging is especially likely in this case, because the cause is often a blood vessel problem that can be found and treated.

How tinnitus is checked

NIDCD describes a three-step route. Your primary care doctor looks for earwax or infection and reviews your medicines. An ear, nose and throat doctor (otolaryngologist) examines your head, neck and ears and may order an MRI, CT scan or ultrasound. An audiologist measures your hearing and assesses the tinnitus itself.

The American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) guideline adds a useful rule of thumb. It calls for a prompt, full hearing test when tinnitus is in one ear only, when it has lasted six months or more in both ears, or when you have noticed trouble hearing. It also says imaging should be kept for specific situations: tinnitus that pulses, tinnitus in one ear, uneven hearing loss between the ears, or abnormal findings on a neurological exam. If any of those apply to you and you have not been checked, start there.

Bothersome or not: the question that shapes the plan

Most people with tinnitus are not seriously troubled by it. According to the AAO-HNSF guideline fact sheet, about 20% of adults who experience tinnitus need clinical help. For the rest it is a background noise they notice in a quiet room and then forget.

The guideline asks clinicians to separate two groups. Nonbothersome tinnitus does not change daily life much. Bothersome tinnitus causes distress, interferes with sleep or concentration, or lowers quality of life. It also separates recent tinnitus from persistent tinnitus, which it defines as lasting six months or longer. Treatment decisions follow from those two questions.

The burden can be heavy. Mayo Clinic lists fatigue, stress, sleep problems, trouble concentrating, memory problems, anxiety, irritability and headaches as possible complications. The AAO-HNSF fact sheet reports depression in 48% to 60% of people with tinnitus in the studies it reviewed. Mayo makes an encouraging point here: treating the sleep, mood and stress problems can help even when the sound itself does not change. That is also where acupuncture is most often aimed.

Acupuncture for tinnitus: what the studies found

The evidence comes in three layers: what the main guideline says, what the systematic reviews found, and why those reviews disagree.

The guideline: no recommendation either way

The 2014 AAO-HNSF clinical practice guideline is the main American guidance for clinicians who look after people with tinnitus, from ear surgeons to audiologists and family doctors. On acupuncture, its statement is that no recommendation can be made for patients with persistent, bothersome tinnitus. The panel did not find enough good evidence of benefit or of harm to come down on either side.

That is different from a recommendation against. The same guideline does recommend against several other popular options, as you will see below. Acupuncture sits in the middle: not shown to work, not shown to be useless, and safe enough that patients and clinicians can choose to try it.

The reviews: some benefit reported, low confidence

A systematic review and meta-analysis by Liu and colleagues, published in 2016 in the European Archives of Oto-Rhino-Laryngology, pooled randomized trials from English and Chinese databases. Its abstract on PubMed reports that the combined data seemed to show some advantages for acupuncture over conventional therapies. It also reports two warning signs: nearly all the Chinese studies were positive while most of the English studies were negative, and many trials, especially the Chinese ones, had methodological flaws. The authors concluded that acupuncture may offer subjective benefit to some patients with tinnitus, but that the risk of bias prevents a firm conclusion.

Our tinnitus condition page also discusses a 2023 meta-analysis that reported lower tinnitus handicap scores with acupuncture. Its evidence was graded low quality as well. More recent reviews keep reaching the same place: some positive signals, too few large, well-blinded trials to be sure.

Why the studies disagree

A few problems run through this research, and they are worth understanding because they shape how we run a trial of treatment with you.

• Tinnitus is measured by asking people. There is no blood test or scan for how loud your tinnitus is. Studies rely on questionnaires, and those answers move with expectation, attention and mood.
• Blinding is hard. Patients usually know whether they had needles. When a trial cannot hide which group is which, positive results become less certain.
• The trials are small and varied. Points, session numbers and patient groups differ from study to study, which makes it hard to pool them fairly.
• Tinnitus has many causes. A trial that mixes noise damage, age-related hearing loss and jaw-related tinnitus may hide a benefit in one group or overstate it in another.

The fair reading is that acupuncture for tinnitus is an option to test in an individual, with a clear measure, for a defined period. It is not a treatment with proven, predictable results.

The treatments with stronger evidence

Before or alongside acupuncture, make sure you have been offered the treatments the guideline supports. NIDCD notes there is currently no cure, but these approaches help many people.

• Hearing aids. If you have hearing loss, the guideline recommends a hearing aid evaluation. Making outside sounds easier to hear can make the tinnitus less noticeable.
• Sound therapy. Tabletop sound machines, phone apps, wearable sound generators and combination hearing aids add a soft background sound that makes the tinnitus less intrusive. The guideline says clinicians may offer it.
• Cognitive behavioral therapy. CBT does not aim to remove the sound. It changes how you respond to it, which reduces distress and helps sleep. The guideline recommends it for persistent, bothersome tinnitus.
• Education and counseling, including tinnitus retraining therapy, which NIDCD lists among the behavioral options.
• Treating a cause, such as removing earwax, treating an infection, adjusting a medicine (only through your prescriber) or treating a jaw joint problem.

Some things the guideline advises against. It says clinicians should not routinely prescribe antidepressants, anticonvulsants, anti-anxiety drugs or ear injections mainly to treat the tinnitus itself, although NIDCD notes that a doctor may prescribe them for the mood or sleep problems that come with it. It also advises against ginkgo biloba, melatonin, zinc and other dietary supplements for tinnitus, and against transcranial magnetic stimulation as a routine treatment. NIDCD adds that vitamins, herbal extracts and supplements are often advertised as cures and that none has been proven to work.

We mention this because patients often arrive having spent a lot on supplements. If something has not helped after a fair trial, it is reasonable to stop it, with your doctor's agreement if it was prescribed.

Where acupuncture fits

We see acupuncture as one part of a plan, most useful in four situations.

• Tinnitus that has wrecked your sleep. Many patients find sessions relaxing, and better sleep makes the sound easier to tolerate the next day.
• Tinnitus tangled up with stress or anxiety. The two feed each other. A calmer nervous system notices the sound less.
• Tinnitus with jaw or neck tension. Jaw joint problems are a recognized cause. People who clench or grind their teeth, or who have stiff neck muscles, may notice their tinnitus changes with that tension. Treatment for these areas is part of the plan, alongside your dentist or doctor. Our articles on acupuncture for TMJ and acupuncture for neck pain cover those problems in more detail.
• Tinnitus after the usual options. Some patients have tried hearing aids, sound therapy and CBT and still struggle. Acupuncture is a reasonable addition to test, not a replacement for what is already helping.

It is less likely to help, in our view, when tinnitus comes from a structural problem that needs medical treatment, or when someone hopes for complete silence. We will tell you if we think your situation falls into that group.

Possible ways acupuncture acts on tinnitus

Nobody has fully worked out how acupuncture produces its effects, as the National Center for Complementary and Integrative Health (NCCIH) acknowledges. Its acupuncture overview describes three possible routes: effects on the nervous system, local effects in the tissue around the needles, and nonspecific effects such as expectation and the attention of treatment. For a symptom measured by how much it bothers you, the nonspecific effects are likely to play a large part. We do not think that makes the benefit less real for the person who sleeps better, but it is one reason to measure carefully.

Chinese medicine has its own way of describing tinnitus. It sorts cases into patterns, for example a sudden, loud ringing linked to stress and anger, or a soft, constant hiss that comes with age and fatigue, and chooses points and herbs to match. Ayurveda describes ringing in the ears through the Vata dosha, the principle of movement and dryness, and recommends routines and oils that settle it. We use these frameworks to choose treatment. They are not proven explanations of what happens inside the ear, and we present them that way.

Keeping score: a simple tinnitus record

Because tinnitus is measured by what you report, a simple record kept before and during treatment is the most honest way to judge it. We ask patients to rate a few things once a day:

• Loudness, from 0 to 10.
• How much it bothered you, from 0 to 10. This number often changes before loudness does.
• Sleep: how long it took to fall asleep and whether tinnitus woke you.
• How much of the day you noticed it: most of the day, some of the day or rarely.
• Possible triggers: noise exposure, caffeine, alcohol, poor sleep, a stressful day, jaw clenching, a cold.

Two weeks of entries before the first needle gives you something to compare against later. If your audiologist has given you a standard questionnaire, such as the Tinnitus Handicap Inventory, bring your score. Many of the trials used it, and repeating it later gives you a number to compare.

Look for a change in distress and sleep first. A sound that is just as loud but bothers you half as much is a real improvement, and it is the kind of change the research is most likely to support.

How long a course of treatment takes

We do not set a standard count in advance. The length of your history, the likely cause and your own response all change it. Most plans here follow a similar outline:

• Opening weeks: treatment once or twice weekly.
• Review: after the first short course, we compare your record with your baseline and discuss what has and has not changed.
• Continue and space out: if distress, sleep or loudness has clearly improved, sessions are gradually spaced further apart.
• Stop: if nothing has changed after a fair trial, we say so. Continuing a treatment that is not helping wastes your time.

Tinnitus of recent onset, especially after an infection or a noisy event, often settles by itself over weeks, so improvement in that period is hard to credit to any one treatment. Long-standing tinnitus tends to change more slowly. For the general rules on planning a course, read how many acupuncture sessions people usually need.

Ayurvedic and herbal care for tinnitus

Some patients combine acupuncture with Ayurvedic medicine or individually prescribed herbal medicine. In Ayurveda, care for ringing in the ears focuses on calming Vata: a steady daily routine, regular meals, warm oil massage, gentle yoga and breathing practices, and meditation. Herbs may be prescribed for the individual.

Be clear about the evidence here. Our condition page notes that we found no trials of Ayurvedic treatment for tinnitus. Ginkgo, the herb most often promoted for tinnitus, probably does not reduce it, and the AAO-HNSF guideline advises against using ginkgo or other supplements to treat it. What Ayurvedic routines can offer is help with the sleep, stress and restlessness that make tinnitus harder to bear.

Any herbal prescription from our clinic is chosen for you and checked against your medicines, including blood thinners, blood pressure medicines and antidepressants. Mayo Clinic notes that some herbal supplements can themselves be linked to tinnitus, which is one more reason to tell us about everything you take.

About your practitioner

Dr. Saikumar Gandapodi, DAOM, Dipl. OM, AP, L.Ac., founded Netra Integrative Health Clinic and is the clinician you will see at every visit. He does the consultation, the treatment and the reviews himself, in person in South Plainfield, so your tinnitus record is read by the person who knows your history.

Much of his work is with complex and advanced conditions, and with patients who have already tried several treatments without results elsewhere. Tinnitus often belongs in that group: people arrive after hearing tests, scans, supplements and well-meant advice, still lying awake with the noise. He looks at the whole picture, including sleep, stress, jaw and neck tension, digestion and medicines. No outcome can be promised for any one person, and he will tell you at the first visit what he thinks is realistic.

Training and credentials

He earned his doctorate in acupuncture and Oriental medicine (DAOM) at Five Branches University, after a master's in Traditional Oriental Medicine at Pacific College of Health and Science. The Dipl. OM after his name is national board certification in Oriental Medicine. He is licensed in New Jersey and New York as an acupuncturist and herbalist (L.Ac.), and Florida board-certifies him as an Acupuncture Physician and Doctor of Oriental Medicine (AP). His Ayurvedic training is classical, he is a Yoga Therapy graduate, and he completed advanced clinical training in India.

Where his expertise lies

In one assessment he draws on three systems: Chinese medicine, Ayurveda and Yoga Therapy. Complex and long-running conditions are his main focus, together with orthopedic problems, fertility and internal medicine. The condition pages on this website, the tinnitus page among them, are written and clinically reviewed by him. His profile is on the team page.

The first appointment

Plan on an hour for the initial consultation. Needling usually waits for the next visit, because the hour is spent understanding your tinnitus and checking that the medical groundwork has been done.

Dr. Gandapodi will ask when the sound began, whether it is in one ear or both, what it sounds like, whether it pulses, what makes it louder or quieter, and how it affects your sleep, work and mood. He will ask about noise exposure, ear infections, dental and jaw problems, neck injuries, headaches and dizziness. As part of the Chinese medicine assessment he will look at your tongue and feel your pulse at both wrists.

Please bring:

• Your ID and insurance card.
• Results from your latest full set of blood tests (emailing them before the visit is fine).
• Every prescription, over-the-counter medicine and supplement you take, and how much.
• Your latest hearing test (audiogram) and any notes from an ENT doctor or audiologist.
• Reports from any MRI or CT scan.
• Your tinnitus record, or any questionnaire scores you have.

If you have not yet had a hearing test and your tinnitus is in one ear, has lasted six months or more, or comes with hearing difficulty, we will ask you to arrange one. By the end of the hour you will have a suggested schedule and know when progress will first be reviewed. Our new patients page covers paperwork and arrival.

During a tinnitus session

Each treatment visit takes half an hour. You lie on a padded table, and points are chosen for you. They may be on the head around the ears, on the neck and shoulders, and on the hands, arms, lower legs and feet. If jaw tension is part of the picture, points around the jaw may be included.

The needles are hair-thin, come sealed and sterile, and are thrown away after one use. You may feel a quick prick as each one goes in, and then a heavy, warm or tingling sensation around it. Sharp pain is not expected; say so and that needle will be moved or taken out. You then rest quietly. Many people find this the quietest part of their week, and some notice their tinnitus less while lying still. Our acupuncture treatment page explains the method in general.

If a quiet room makes your tinnitus feel louder, tell us, and bring earbuds with the sound app or recording you already use. Gentle background sound while you rest follows the same idea as the sound therapy many audiologists recommend.

Afterwards people tend to feel quiet and loose; occasionally someone feels sleepy or notices a tender spot. Avoid loud noise for the rest of the day and keep up your sound machine or other sound therapy at night.

Insurance and payment

Most health plans list Dr. Gandapodi as an in-network provider. Medicare and Medicaid are not among them, since the clinic does not take part in either program, but most Medicare Advantage plans with an acupuncture benefit are accepted. Note that Original Medicare covers acupuncture only for chronic low back pain, according to Medicare.gov, so it does not cover acupuncture for tinnitus.

Plans set their own limits on diagnoses and visit numbers, so we check yours for you at no charge: fill in the insurance verification form and expect an answer within three to five business days. Only the acupuncture is billed to a health plan. Ayurvedic care, Chinese herbal medicine, Panchakarma and Transdermal Medication Therapy are self-pay. See our insurance page, or our guide to acupuncture coverage in New Jersey.

If your tinnitus began after a car accident, see a doctor first (see the safety section below). Once you have been checked, acupuncture for accident-related symptoms can be billed to the personal injury protection (PIP) part of your auto policy. Mention the accident when booking and keep the claim number handy.

Health savings, flexible spending and health reimbursement accounts can pay for acupuncture, and if your administrator wants a Letter of Medical Necessity we can provide one (HSA and FSA details). CareCredit is welcome too. Seniors receive a discount, and our financial assistance program helps patients who need it; call the front desk to talk it through.

Safety and red-flag symptoms

In licensed hands, with sterile disposable needles, acupuncture carries little risk. NCCIH notes that serious complications are rare and have been linked mostly to nonsterile needles or poorly delivered treatment, and that the FDA regulates acupuncture needles as medical devices. The usual after-effects are small: a bruise, a spot of blood, a little soreness. Tell us if you take a blood thinner, have a bleeding disorder or a pacemaker, are pregnant, or tend to faint around needles.

Sudden hearing loss is an emergency

If you lose hearing in one or both ears suddenly, all at once or over a few days, with or without new ringing, see a doctor immediately. NIDCD calls sudden deafness a medical emergency. Steroids are the usual treatment and work best when started as soon as possible; NIDCD notes that treatment delayed beyond two to four weeks is less likely to reverse permanent hearing loss. People often lose time by assuming the problem is earwax, allergies or a sinus infection. Do not wait for an acupuncture appointment.

Other warning signs

Mayo Clinic advises the following, and we agree:

• Emergency care if tinnitus begins after a car accident, a sports injury or another blow to the head.
• Prompt medical care if tinnitus comes with sudden hearing loss, dizziness, or numbness or weakness in the face, arm or leg. Facial weakness or numbness with trouble speaking can be a stroke; call 911.
• Prompt care if tinnitus is causing anxiety, depression or serious sleep problems.
• A doctor's appointment if tinnitus starts after a cold and has not cleared within a week.

In addition, see your doctor if your tinnitus pulses with your heartbeat, is only in one ear, or comes with hearing that is worse on one side. These are the situations in which the AAO-HNSF guideline says further tests may be needed.

If tinnitus has left you feeling hopeless or having thoughts of harming yourself, call or text 988, the Suicide and Crisis Lifeline, or call 911 in an emergency. Tinnitus-related distress is common and treatable, and you do not have to manage it alone.

Acupuncture alongside your ENT and audiologist

We offer acupuncture as complementary care. It works alongside your doctor, ENT and audiologist and does not replace them. Keep wearing your hearing aids, keep your sound therapy and CBT if they help, and do not stop or change any prescribed medicine, even one listed as a possible cause of tinnitus, without the doctor who prescribed it. If you agree, your physician or audiologist can receive a brief summary of your treatment from us. ENT doctors, audiologists and other clinicians can send patients through the referring providers page. More about how we work with ear, nerve and brain conditions is on our neurological disorders page.

Frequently asked questions

Can acupuncture cure tinnitus?

No treatment currently cures most tinnitus, and acupuncture is no exception. Some studies suggest it may reduce how much tinnitus bothers people. The main U.S. guideline makes no recommendation for or against it.

Could acupuncture harm my hearing?

There is no reason to expect that when a licensed practitioner uses sterile needles. Needles do not go into the ear canal. Points near the ear are on the skin around it.

Should I see an ENT or audiologist before acupuncture?

Yes, if you have not already. A hearing test and ear exam can find treatable causes, and some kinds of tinnitus need imaging. Sudden hearing loss needs a doctor the same day.

How soon might I notice a change?

That differs from person to person, and nobody can promise a result. Some people notice better sleep or less distress within the first few weeks. Loudness, if it changes, usually changes more slowly. We review progress against your record after a short course.

Will it help if my tinnitus comes from noise damage or age-related hearing loss?

Acupuncture cannot restore damaged hair cells in the inner ear. It may help with the distress and sleep problems that come with the tinnitus. Hearing aids and sound therapy are the first options for tinnitus linked to hearing loss.

My tinnitus gets louder when I clench my jaw or turn my neck. Is that relevant?

Yes. Jaw joint problems and head or neck injuries are recognized causes. Tell your dentist or doctor, and tell us. Treatment of jaw and neck tension can be part of your plan.

Can I keep using my hearing aids and sound therapy?

Please do. Acupuncture is meant to be added to them, not to replace them.

Do ginkgo or other supplements help?

The AAO-HNSF guideline advises against ginkgo, melatonin, zinc and other supplements for treating tinnitus, and NIDCD says none has been proven to work. Any herbal prescription from us is aimed at sleep, stress and general balance, and is checked against your medicines.

What if my tinnitus pulses with my heartbeat?

See your doctor first. Pulsatile tinnitus often has a blood vessel cause that can be found and treated.

Will my insurance pay for acupuncture for tinnitus?

That is set by each plan, and we can check yours free in three to five business days. Original Medicare does not cover it. If your tinnitus followed a car accident, the clinic can bill auto insurance PIP after your medical evaluation.

Can I come after work or at the weekend?

Yes. Weekday appointments run until 8:00 PM (from 10:00 AM), and on Saturdays we see patients from 9:00 AM until 5:00 PM. For a same-day opening, phone us; there are only a few.

Booking an appointment

You will find us in Suite 210 at 5001 Hadley Road, South Plainfield, NJ 07080, an easy trip from Edison, Piscataway, Plainfield, Metuchen, Dunellen and Middlesex; the location page has directions. We do not take walk-ins. Request a time on the online booking page (you will get a text and email confirming it) or phone (908) 402-7301. Using insurance? Send the verification form before your first visit. Begin your tinnitus record today and bring it, with your most recent hearing test, to the consultation. Plans change; if you cannot make it, a call 24 hours ahead lets us offer the slot to someone else.

Written as general education on tinnitus and acupuncture, this article cannot replace advice from your doctor, ENT or audiologist. Sources: the National Institute on Deafness and Other Communication Disorders pages on tinnitus and sudden deafness, the American Academy of Otolaryngology–Head and Neck Surgery Foundation tinnitus guideline fact sheet, the 2016 systematic review by Liu and colleagues in the European Archives of Oto-Rhino-Laryngology, Mayo Clinic, the National Center for Complementary and Integrative Health and Medicare.gov, all linked or named above.