TLDR
- Who: Oto (JoinOto), a health tech company offering evidence-based tinnitus coaching and a CBT-based app.
- What changed: NUOPTIMA built topical authority through keyword clustering, structured content, and a high-quality backlink campaign targeting tinnitus sufferers searching for answers online.
- The number: 2.5x increase in keywords ranking positions 1 to 3, from 69 to 176, recorded June to November 2023.
5.2k
Organic Traffic
457k
Total Impressions
11.8k
Total Clicks
About Oto and the Challenge
Oto (JoinOto) is a health tech company specializing in tinnitus coaching. The company was founded by military doctors and is backed by award-winning audiologist Anna Pugh and ENT consultant Jameel Muzaffar. Its app delivers evidence-based programs built around cognitive behavioral therapy (CBT), mindfulness, and soundscapes, targeting people who are newly diagnosed or have lived with tinnitus for years. Oto also collaborates with Cambridge University and Lindus Health on teletherapy research.
The challenge was visibility. Tinnitus sufferers search for answers across a wide range of symptom and treatment queries. Oto's site was not capturing that demand at scale, and its keyword footprint and backlink profile were both underdeveloped relative to the opportunity.
Team
JoinOto Team
Edmund Farrar
Founder
Lili Miller
Content Director
Lola Rose Donohoe
Junior Developer
What We Did
The engagement ran from June 2023. Work covered four areas: keyword strategy and topical authority, content production and structure, backlink acquisition, and technical SEO.
Keyword Clustering and Topical Authority
We started with deep keyword research: interviews with the Oto team, competitor analysis, and a review of how tinnitus sufferers actually search across the symptom and treatment journey. From that we built keyword clusters around primary topics, then worked through them methodically, starting with clusters that offered the easiest traffic gains and building toward more competitive terms as topical authority grew.
One example cluster targeted the link between the common cold and tinnitus. The table below shows keywords where Oto's site ranked on the first page of Google as a result of this cluster work:
| Keyword | Current position | Volume |
| ringing in ears with cold | 1 | 250 |
| tinnitus after cold | 1 | 200 |
| ear ringing after cold | 1 | 150 |
| ear ringing from cold | 1 | 100 |
| ear ringing with cold | 1 | 100 |
| ringing in ear after cold | 1 | 90 |
| ears ringing after cold | 1 | 80 |
| ears ringing head cold | 1 | 80 |
| cold ears ringing | 1 | 80 |
| cold with ringing in ears | 1 | 60 |
| ears ringing cold | 1 | 60 |
| ringing in ear cold | 1 | 60 |
| ringing in ears after a cold | 1 | 60 |
| ringing in ear with cold | 1 | 50 |
Content Structure
Every content piece was built to a consistent template designed to both answer user queries and signal expertise to search engines. The table below shows the core elements we applied across Oto's content:
| Feature | Description |
| Author Details | Named team members listed as authors to build credibility and topical authority. |
| Headings | Clear, descriptive headings guiding readers through each article. |
| Bullet Points | Used for easy-to-digest information and to surface key points quickly. |
| Tables | Structured data presentation for complex or comparative information. |
| Images | Relevant visuals to complement and reinforce written content. |
| Call to Actions | Directing readers toward contacting Oto, reading more, or joining a webinar. |
| Conclusions | Summarizing key points and reinforcing the main message of each piece. |
Backlink Strategy
Our off-page SEO work focused on quality over volume. We created original content for third-party publishing domains, each piece written to be genuinely useful to that site's audience, with contextual links placed naturally back to Oto's domain. Over six months, this brought referring domains up 38% and total inbound links to 1.2k.
Technical SEO
We ran a comprehensive technical SEO audit at the start of the engagement, then re-ran it after each fix was applied. The priority list was constantly updated so the development team always worked on the changes with the most ranking impact. Where Oto's team lacked capacity, our developers stepped in directly.
Results
All figures below cover June to November 2023.
5.2k
Organic Traffic
4.8k
Total Ranking Keywords
99
Pages Ranking in the Top 100
Organic Traffic
- Organic traffic grew 40% between June and November 2023, bringing average estimated monthly traffic to 5.2k.
Organic Keywords
- Keywords ranking in positions 1 to 3 went from 69 to 176, a 2.5x increase over the same period.
Backlink Results
- Quality referring domains grew 38% over six months.
- Total inbound links reached 1.2k.
Key takeaways
- Topical authority compounds. Ranking for easy-volume symptom clusters first (like "ringing in ears with cold") built the domain credibility needed to compete for harder tinnitus terms later. If you are in a health or wellness category with a wide symptom universe, clustering by topic and attacking clusters sequentially is more effective than scattering keywords. Our SEO services are built around this methodology.
- Backlink quality matters more than speed. A 38% increase in referring domains over six months from contextually relevant placements moved the needle more than a high-volume, low-quality link push would. That is because each link was placed inside content genuinely relevant to both the publisher and Oto. See how we approach link building for health and wellness clients.
- Technical SEO needs a constant feedback loop, not a one-time audit. Re-running the site audit after every fix and reprioritizing the task list kept the development team focused on the highest-impact changes at all times, rather than working down a stale list.
If you want to grow organic traffic in a competitive health or wellness category, book a call with NUOPTIMA to talk through what a similar program could look like for your site.