Tinnitus

What is tinnitus?

Tinnitus is a problem that causes you hear a noise in one ear or both ears. In most cases, nothing outside of you caused that noise. It’s an internal noise that only you hear in your ear. People commonly describe the noise as a “ringing in the ear.” It also can be roaring, clicking, buzzing, or other sounds. Some people who have tinnitus hear a more complex noise that changes over time. You may hear the noise constantly, or it may come and go.

There are two types of tinnitus.

• Subjective tinnitus happens when you hear a sound that’s not really there. These phantom sounds are caused by certain nerves that aren’t functioning properly or because there is a problem with part of your ear.
• Objective tinnitus is caused by an actual sound that occurs inside or near the ear, such as from nearby blood vessels. Your doctor can hear this sound during an exam. This type of tinnitus rare.

Symptoms of tinnitus

The main symptom of tinnitus is hearing sounds in your ears that aren’t really there. The sound could be ringing. It may also sound like blowing, roaring, clicking, buzzing, hissing, or humming. The noises can be soft or loud. They can be high pitched or low pitched.

What causes tinnitus?

Tinnitus is not a disease. It’s a symptom of an underlying health problem. Most of the time, it’s cause by sensorineural hearing loss (nerve damage in your ear). Sometimes it’s caused by something as simple as earwax blocking the ear canal. Here are some other common causes of tinnitus:

• Exposure to loud noises, which can lead to noise-induced hearing loss over time
• Hearing loss related to aging
• Certain medicines that can damage the inner workings of the ear (for example, taking high doses of aspirin every day)
• Eustachian tube dysfunction (the tube that leads from the middle ear to the back of the throat)
• Inner ear infections, such as otitis media or labyrinthitis
• Meniere’s disease, an inner-ear condition that involves hearing loss and dizziness

Allergies, high blood pressure, low blood pressure, diabetes, tumors, and head injuries can also cause tinnitus. If you have a foreign object in your ear or a build-up of ear wax, you may also experience tinnitus.

In many cases, the cause of tinnitus can’t be identified.

How is tinnitus diagnosed?

Your doctor will take a detailed medical history, including a family history of hearing loss. They will want to know about any medical conditions you may have and any history of infections. Your doctor also needs to know what medicines you’re taking, including herbal products or supplements. They will check your ears. They may give you a hearing test. They may also order other tests to find out what is causing your tinnitus. These could include a head CT scan, a head MRI scan, or blood vessel studies. Your doctor might refer you to an otolaryngologist. This is a doctor that specializes in the ear, nose, and throat (also called an ENT doctor).

Can tinnitus be prevented or avoided?

To prevent tinnitus or keep it from getting worse, avoid long-term exposure to loud noises and activities that put you at risk for hearing loss. If you know you’re going to be around loud noises, take precautions by wearing earplugs or noise-canceling headphones. If you listen to music through headphones, keep the volume low.

If you have tinnitus, avoid things that seem to make it worse. These may include nicotine, alcohol, or caffeine.

Treatment

Treatment will depend on what is causing your tinnitus. If earwax is causing your tinnitus, your doctor will remove it. If a medicine you’re taking is causing the issue, your doctor may recommend you stop taking that medicine. But never stop taking a prescription medicine without talking to your doctor first.

If an underlying condition, such as high blood pressure, is causing your tinnitus, your doctor can create a treatment plan for you to follow. Usually, tinnitus goes away once the condition that is causing it is treated. If diabetes is causing your tinnitus, take your prescribed medicine and follow your doctor’s orders for diet and exercise to manage the condition.

When no specific cause can be identified, your doctor will probably focus on making your tinnitus easier to tolerate. Some possible methods include:

• Hearing aids: For people who have tinnitus and hearing loss, using a hearing aid may be helpful. When you wear a hearing aid, things you need to hear will be louder than the ringing, buzzing, or clicking sound. Hearing aids are available by prescription or over the counter. Talk to your doctor about which is best for you.
• Sound generators (maskers): Wearable sound generators can be placed behind your ear and create white noise (constant background noise) or other sounds. This “masks” the tinnitus and makes it less noticeable. Some people also use bedside sound generators to help them sleep.
• Counseling: Some people who have tinnitus become anxious or depressed because a hearing loss can isolate a person, socially. If you have tinnitus and are struggling, seek help through a counselor and/or a support group to help you cope. Counseling can also be used to help you take the focus off your tinnitus.
• Tinnitus retraining therapy: This method uses a mix of counseling with maskers or other approaches. The goal is to teach your brain to ignore the sounds you hear. This isn’t a quick fix, but many people find it useful with time and practice.
• Relaxing: Stress can make tinnitus worse. Your doctor can suggest relaxation techniques that might help you deal with your stress.
• Medicines: Currently, there are no medicines specifically designed for treating tinnitus. Some medicines, such as certain ones used to treat anxiety, have been shown to relieve tinnitus for some people. Talk to your doctor about whether medicine might relieve your symptoms.

Living with tinnitus

For many people with tinnitus, the condition is just a mild distraction. But for some, tinnitus causes distress and negatively affects their quality of life. It can cause anxiety, depression, sleep disturbances, and poor concentration. To lessen the impact of tinnitus on your life, try the following:

• Avoid loud noises and sounds.
• Control your blood pressure and diabetes.
• Exercise regularly for good circulation.
• Get plenty of sleep and avoid fatigue.

Take the focus off your tinnitus. Use techniques such as sound generators and counseling to push it to the background. Remember that the more you think about tinnitus, the more bothersome it will become.

Questions for your doctor

• The noise in my ears makes it hard for me to sleep. What can I do?
• Is there something causing my tinnitus that we could treat?
• Will I lose my hearing?
• I also get dizzy a lot. Could I have Meniere’s disease?
• Could this be caused by an ear infection?
• Should I avoid listening to music on headphones?
• Is there anything I can do at home to help?

Resources

National Institutes of Health, MedlinePlus: Tinnitus

National Institutes of Health, National Institute on Deafness and Other Communication Disorders: Tinnitus