Bone Conduction Headphones for Tinnitus

How do we hear sounds?

Before getting into the details of hearing through bone conduction and the use of bone conduction headphones for tinnitus, let’s first review how we as humans hear sounds:

ear anatomy
  1. Sound waves, which are vibrations, enter the outer ear and travel through the ear canal to the middle ear, where the eardrum is located
  2. The sound waves hitting the eardrum cause the eardrum to vibrate. This in turn sends vibrations to three tiny bones in the middle ear called the malleus, incus, and stapes
  3. The three bones of the middle ear then increase the vibrations further and send them to the cochlea (the spiral-shaped structure filled with fluid) in the inner ear
  4. Vibrations cause the fluid inside the cochlea to move, which creates a traveling wave against the basilar membrane (an elastic outer covering that runs from the beginning to the end of the cochlea)
  5. Hair cells (sensory cells on the basilar membrane) are then set in motion. Those near the wide end of the cochlea detect higher-pitched sounds, while those towards the center detect lower-pitched sounds
  6. Movement of the hair cells triggers the opening of nearby pores that causes chemicals to rush into the cells and create an electrical signal
  7. The auditory nerve carries the electrical signal to the brain, which processes it as a sound that we recognize and understand

How do we hear sounds through bone conduction?

tinnitus friendly headphones

While we normally hear sound through vibrations against the eardrum, in bone conduction, sound waves vibrate on the bones of the head and jaw, bypassing the eardrum and transmitting the sound directly to the inner ear.

Bone conduction headphones do not cover the ears, and therefore, allow the wearer to still hear the sound of their environment and the sound of their own voice.

Many report the following practical uses for bone conduction headphones:

  • Can maintain awareness of surroundings (eg, listening for traffic)
  • Can still hear while having a conversation
  • Avoids damaging, high sound levels of standard headphones
  • Can be worn with hearing aids
  • Since they don’t rely on the eardrum, make good headphone options for individuals with hearing loss (which usually results from damage to the eardrum)
  • Can be used as a method for masking tinnitus

How might bone conduction headphones help with tinnitus?

One method of tinnitus treatment is to use sound masking devices that produce music, white noise, pink noise, or ambient sounds to distract from or cover tinnitus sounds.

Bone conduction headphones can be used as tinnitus maskers for those who find tinnitus relief with environmental/ambient sounds, music, or speech (eg, podcasts).

Furthermore, many tinnitus sufferers report that, since standard headphones generally block external noise, wearing them can make tinnitus sounds seem louder. Standard in-ear headphones can also worsen hearing loss and tinnitus. Using bone conduction headphones on the other hand, would likely remedy these issues as they leave the ears free and unblocked.

As every person’s experience with and causality of tinnitus is different, it is always a good idea to speak with your healthcare provider who is treating you for tinnitus about using bone conduction headphones.

Other common questions about bone conduction headphones

How do bone conduction headphones work with earplugs?

Orange ear plugs for wearing with bone conduction headphones

The key attraction to bone conduction headphones is that they let you listen to music while still being able to hear your surroundings (since they are not worn in the ear or over the ear and therefore do not block your ear canal).

But when you read about bone conduction headphones, you may see people talking about how they can be used with earplugs (or if you purchase a pair of Aftershokz headphones, you’ll find that they also come with a pair of foam earplugs).

Wearing ear plugs with bone conduction headphones give you the option to block out the ambient noise around you. This is a great option to have when you want to listen to your music, white noise, podcasts, etc. but are also:

  • Sleeping and do not want to be disturbed
  • Looking for a moment of peace, without disturbance
  • In the office and want to block out the distracting voices around you
  • In a place where there are extremely loud noises and want to protect your ears
  • Traveling and want to block out the sounds around you

Furthermore, the Aftershokz bone conduction headphones have a specific EQ setting for when you want to listen with ear plugs in.

On these headphones, when you press the “+” and “-” buttons at the same time with the headphones on, you’ll hear a voice that says “Equalization changed.” This reduces the vibration in the headphones to allow for listening with ear plugs in.

It should be noted that foam ear plugs should be changed regularly—mostly for hygienic reasons but also because the foam material does not maintain its shape for forever. Aftershokz sends its customers a specific brand, but any foam ear plugs do the job.

Can others hear your music with bone conduction headphones?

Other people cannot hear what you’re playing through your bone conduction headphones. One user reports that when not worn placed against the temples, the audio can be heard slightly. However, when worn properly, others cannot hear what is playing through them.

  1. National Institute on Deafness and Other Communication Disorders (NIDCD). How Do We Hear? Updated January 2018. Accessed June 2020.
  2. Manning C, et al. The Effect of Sensorineural Hearing Loss and Tinnitus on Speech Recognition Over Air and Bone Conduction Military Communications Headsets. Hearing Research. 2017;349:67-75.
  3. Dauman R. Bone conduction: An Explanation for this Phenomenon Comprising Complex Mechanisms. Eur Ann Otorhinolaryngol Head Neck Dis. 2013;130(4):209-213.
  4. U.S. Department of Veterans Affairs. How to Manage Your Tinnitus: A Step-by-step Workbook. Accessed June 2020.

Images courtesy of Visual Hunt and Amazon.

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