Headphones go on first — always. Then I attach the TENS pads. The order matters because once you start placing electrodes, you don't want to be fumbling with headphone cables. Do not turn on the TENS unit yet — that happens right before you start the session.
Headphones: Over-ear headphones work best — they don't create pressure in the ear canal the way earbuds do. Noise-cancelling helps because it lets you keep the volume low while blocking ambient distractions, but it's not required. Any over-ear headphones you already own are fine. Wired or wireless both work.
TENS unit: Widely available at Walmart, CVS, Walgreens, and Amazon starting around $25. Any basic unit with adjustable frequency and pulse width works. You don't need anything fancy.
This took me the longest to figure out. I'll share what I know so you don't have to guess.
Protocol A (8kHz): This is where I started and where most people should start. 8kHz sits in the upper range of common tinnitus pitches. The 0.3s on/0.3s off timing comes directly from the Shore Lab protocol that showed results in humans. If your tinnitus sounds like a very high-pitched hiss or whine, this is likely your best match.
Protocol B (4kHz): If your tinnitus is lower-pitched — more of a hum or a ringing in the middle register — Protocol B is worth trying. The slightly longer 0.5s tone bursts give a bit more stimulation per cycle. I switched to this for two weeks and found it less effective for me personally, but tinnitus is individual.
Sham: Silence. No tone plays, but everything else runs normally. This is genuinely useful — run a sham session once a week to test whether what you're experiencing is a real treatment effect or expectation bias. If your ratings improve on sham days at the same rate as active days, that's important information.
Random: The tool picks A, B, or Sham randomly, and you don't know which until after. Good for self-blinding over a longer trial.
Start at 20 and work up gradually. 30 cycles is about 18 seconds of stimulation. Research protocols used 20–40 cycles. 50 is the upper limit — more isn't better, and auditory fatigue is real.
Frequency — use the finder to match your tinnitus pitch. Drag the slider, play the tone, and dial until it's close.
Mode — pulsed plays the tone in bursts (0.2s, 0.3s, or 0.4s on/off). Continuous plays it uninterrupted. Shore Lab used pulsed.
Volume — soft but audible. 0.01–0.10 is the right range. Louder is not more effective.
Repeats — cycles per session. 40 is the default, 50 is the max.
When you're happy with the settings, give it a name and hit Save As Protocol.
Soft but audible. Loud tones are not more effective and will fatigue your ears.
Select where you are placing the TENS pads today — required
One pad each side of the back of the neck, below the skull base, over the upper trapezius. Pads ~2 inches apart.
Avoid: front of neck, throat, carotid
One pad on inner wrist below the crease, one ~2 inches up the forearm. Non-dominant arm first.
Avoid: bony areas or broken skin
0 = no tinnitus, 10 = worst you've ever experienced it.
Turn on the TENS unit and slowly dial up intensity until you feel a clear, steady tingling. Not painful — just present. Once you have that sensation locked in, don't touch the dial again. Click START. Sit still, close your eyes if it helps, and just let it run. The log below will show each cycle as it happens.
Each row shows one cycle. Elapsed = actual time for that cycle. Drift = how far off from the target timing — small values (under 0.05s) are normal.
When it finishes: turn off the TENS first, then remove the pads. Wait a minute or two — I usually just sit quietly — and then rate your tinnitus again. Don't rush to a number. Give yourself a moment to actually listen.
The comparison between your pre and post ratings is where the signal lives. A single session may show a small drop or nothing at all. That's expected. What you're watching for is the multi-week trend. In my experience the first signs appeared around day 10–14 — mornings were quieter, then evenings, and eventually the baseline crept down.
Schedule: Once per day, same time if possible, for at least 4–6 weeks. I do mine in the morning. Leave at least 6 hours between sessions if you do a second one.
Discipline is the protocol. Showing up every day at the same time matters more than any setting you choose. Miss one day and it's fine. Miss a pattern and you lose the signal. Treat it like a habit you don't negotiate with.
Every session is logged here. The pre-rating column is the only one that matters for tracking progress — the trend across weeks is what you're looking for, not day-to-day variation. Two to four weeks of consistency is the minimum before drawing any conclusions.
| Date | Protocol | Cycles | Pre | Post | TENS | Mean Drift |
|---|