What is tinnitus?
You may think of tinnitus as the ringing in your ears the day after a loud concert — but might not know exactly what it is. What are the main causes of tinnitus and how does that affect your treatment?
You might wonder what it means if you are experiencing ringing or humming in your ears but haven't been exposed to loud noises recently. What if it’s lasted longer than a few days — will it ever go away? Let’s break it down.
Tinnitus is when you hear ringing or other noises — like roaring or humming — in one or both ears. It can be intermittent, constant, or pulsatile — meaning it pulses like a heartbeat.
Tinnitus is a symptom of an underlying condition, but not a condition in and of itself. It affects 15% to 20% of people all over the world.
Tinnitus can be broken down into two groups:
- Subjective tinnitus — In this more common kind of tinnitus, the ringing can only be heard by the person with tinnitus but not the people around them. It often results from damage to the ear, auditory nerve, or listening center of the brain.
- Objective tinnitus — In this rarer kind of tinnitus, a person experiences a pulsing hum in their ears that someone else can hear either by leaning close or using a stethoscope. It's typically caused by differences in the shape of the carotid artery or jugular vein and therefore change in blood flow within it.
How long does it last?
Everyone experiences tinnitus differently. If it starts after a loud concert or other one-time exposure to loud noise, the tinnitus is likely to go away in a day or two.
Often, people with tinnitus will only hear ringing in their ears for a few seconds to a few minutes at a time — though they may have recurring episodes.
In approximately 1% to 3% of cases, tinnitus can be prolonged and severe enough to negatively affect people’s quality of life. In these situations, it's important to seek professional treatment.
Many causes of tinnitus don't have cures. In case of the causes that do, resolving the underlying condition often gets rid of the ringing in your ears. To get the best idea of when your tinnitus will go away, it’s important to know what's causing it though.
What are the main causes of tinnitus?
There are roughly 200 different disorders that may cause tinnitus. The underlying condition partly determines the qualities, frequency, and severity of your tinnitus.
The common conditions that cause tinnitus include:
- Hearing loss — Hearing loss, whether noise-induced or due to getting older, is the most common cause of tinnitus. Tinnitus may start even before you notice hearing loss, however. The connection between hearing loss and tinnitus partly explains why tinnitus is more common among older people. This form of tinnitus may be permanent, and wearing a hearing aid may reduce the sound of tinnitus — or even eliminate it altogether — by masking it.
- Obstructions in the middle ear — Anything blocking the ear canal can build up pressure in the inner ear and cause tinnitus. Common blockages include excessive earwax, foreign objects, and loose hair from inside the ear. Removing these obstructions can relieve the pressure. You may notice your tinnitus resolving shortly after.
- Head or neck injury — Approximately 17% of tinnitus cases are caused by trauma or injury to the head or neck. These injuries can disturb the blood flow in this area and cause nerve and muscle issues that result in tinnitus. Tinnitus caused by head and neck injuries can also have a louder perceived volume and larger negative impact on your quality of life.
- Traumatic brain injury (TBI) — As many as 53% of people living with a TBI will develop tinnitus. Events that cause TBIs — like whiplash, blunt force, and blasts— can cause head and neck injuries too. Besides TBI, emotional trauma is associated with tinnitus.
Other causes of tinnitus include:
- Certain medications
- Meniere’s disease
- Temporomandibular joint disorder — or TMJ
- Metabolic disorders
- Autoimmune disorders
How do I cope with tinnitus?
Sometimes living with tinnitus isn’t as easy as waiting a day or two after a rock concert for it to disappear. Besides treating the underlying cause, using some of the following tools may help you ease tinnitus symptoms and improve the quality of life of those affected:
Cognitive-behavioral therapy (CBT)
CBT focuses on reframing your reaction to tinnitus rather than getting rid of it altogether. Instead of having an immediate negative reaction upon hearing your tinnitus, CBT teaches you to have more positive or neutral thoughts about it. Although it doesn't alleviate the tinnitus itself, it can improve your overall well-being and mood if you're living with it.
Tinnitus retraining therapy (TRT)
TRT combines educational counseling and sound therapy to improve the quality of life of those with tinnitus. Like CBT, TRT works to reduce the negative reaction related to tinnitus. It also helps you habituate to it, so you're less aware of the tinnitus — keeping it in the background.
Masking is the act of drowning out your tinnitus with external noise like that by using hearing aids. At a high enough level, external sounds can partially or completely cover tinnitus, making acts like focusing or sleeping easier.
Some common noises used for masking include:
- White noise
- Nature sounds
- Electric fans
- Table fountains
When should I seek professional help for tinnitus?
If your tinnitus is frequently irritating or causing you to worry about your health, it is always appropriate to reach out to your healthcare provider. Here are some other signs you should get your tinnitus checked out right away:
- You are only experiencing it in one ear.
- The sound is pulsatile — like a heartbeat.
- It's accompanied by dizziness or balance issues.
- You're also feeling a sudden hearing loss.
- You're not able to sleep through the night.
- Your tinnitus is feeling overwhelming or unmanageable.
Your healthcare provider will work with you to diagnose and treat any underlying causes and give you resources to cope with your symptoms. Whether temporary, intermittent, or chronic, it is possible to manage tinnitus and use therapeutic tools to improve your well-being.
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American Family Physician: "Diagnostic Approach to Tinnitus."
American Tinnitus Association: "Causes," "Sound Therapies."
Audio Engineering Society: "Hearing Measurements During Two Norwegian Music Festivals."
Cleveland Clinic: "Tinnitus."
Indian Journal of Otolaryngology and head and neck surgery: "Pathophysiology and Treatment of Tinnitus: An Elusive Disease."
Journal of Head Trauma Rehabilitation: "Trauma Associated Tinnitus."
Korean Journal of Audiology: "Cognitive Behavioral Therapy for Tinnitus: Evidence and Efficacy."
Trials: "The Tinnitus Retraining Trial (TRTT): study protocol for a randomized controlled trial."
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