What is tinnitus?
Tinnitus is when you hear unexplained sounds in your ears even though there’s no actual noise externally. It's commonly known as ringing in the ears. If you notice buzzing or ringing in your ears, you may have tinnitus.
But what are the main causes of tinnitus, and how does it go away? Here’s everything you need to know about tinnitus.
Tinnitus is the medical term for occasional ringing in the ears. You may hear it in one or both ears. You may hear a loud or soft, low- or high-pitched sound like ringing, clicking, roaring, hissing, whistling, or buzzing.
It's one of the most common health conditions in America. Up to 15% of Americans, representing more than 50 million people, have tinnitus. Of these, 20 million have long-term or chronic tinnitus, and 2 million have severe or debilitating tinnitus symptoms.
What are the types of tinnitus?
There are two types of tinnitus:
Subjective tinnitus. If you have subjective tinnitus, only you can hear the sounds in your ears or head. This type accounts for 99% of all tinnitus cases.
Objective tinnitus. In this type, you and the people around you can hear the sounds in your ear. Problems in your blood flow, nerves, muscles, bones, or connective tissue can create these sounds. It's very rare, accounting for less than 1% of all tinnitus cases.
What are the main causes of tinnitus?
Tinnitus is not a disease. It's a symptom caused by an underlying condition. It occurs when the sensory hair cells in your ears get damaged due to increased pressure or injury.
Tinnitus causes include the following:
When your ear gets damaged, you can get hearing loss and tinnitus. Hearing loss can be age-related. Aging weakens your ears and affects hearing. Loud noises can also induce hearing loss. Loud sounds of heavy machinery, at work, at events or concerts, or during accidents can cause ear trauma and affect your hearing.
The ringing or buzzing might be your brain’s way to compensate for the sounds that you can’t hear due to hearing loss. For example, if you can’t hear high-frequency sounds, you may hear those sounds during tinnitus.
Blockage in your ear canal
Ear wax buildup, dirt, or foreign objects can block your ear canal. This can increase pressure in your inner ear, which can affect or irritate your eardrum and cause tinnitus.
Head or neck injury
Injury or trauma to the head or neck can affect your muscles, nerves, or circulation, which can cause tinnitus.
Temporomandibular joint problem
Your temporomandibular joint is present near your ear and connects your lower jaw to the skull. If the muscles, bones, or connective tissue in this joint get damaged by injury, you may develop tinnitus.
Changes in air or water pressure
Sudden or extreme changes in air or water pressure can damage your ear and cause tinnitus. This is called barotrauma. It can occur while snorkeling, scuba diving, or flying.
Brain injury or trauma can damage the areas that process your hearing. This can cause tinnitus symptoms.
Ototoxic medicines are toxic to the ear. They affect your hearing and balance. Tinnitus is a side effect of ototoxic medicines. Ototoxic medicines include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin
- Some antibiotics
- Certain cancer drugs
- Water pills or diuretics
Other health problems
Tinnitus is a symptom of underlying health problems. Balance disorders like Ménière's disease and otosclerosis affect the inner ear and can cause tinnitus. Thyroid problems, anemia or a lack of healthy red blood cells, high blood pressure, and blockage in your arteries can cause tinnitus. Tumors, autoimmune disorders like Lyme disease and fibromyalgia, depression, anxiety, or stress can also cause it.
What are tinnitus symptoms?
Tinnitus symptoms include hearing sounds like ringing, buzzing, hissing, roaring, or pulsing. Some may hear whooshing, throbbing, screeching, humming, music, or singing.
You may hear the sounds in one or both ears. It may feel like the sounds are in your head. These sounds often come and go. But some people may hear them all the time. You may also have difficulty hearing, concentrating, or sleeping.
Look out for these sound patterns:
Tonal tinnitus. The sounds may be almost continuous or overlap with a fluctuating volume. This is known as tonal tinnitus and can’t be heard by people around you.
Pulsatile tinnitus. If the sounds match your heartbeat, it can be because of a blood flow problem. This is called pulsatile tinnitus and can be heard by people around you.
Musical tinnitus. You may hear a tune or a song on a continuous loop. This is called musical tinnitus or musical ear syndrome.
How is tinnitus diagnosed?
If you notice tinnitus symptoms, you’ll need to visit an audiologist or ear doctor. They’ll check your medical history and whether you’re taking any ototoxic medicines. They’ll perform the following tests for tinnitus diagnosis:
Audiometric tests. Tinnitus is often caused by hearing loss. So, your doctor will use audiometric tests to check your hearing. They may use speech recognition tests or play sounds at different frequencies and volumes.
They may use a tympanogram to check for problems in your middle and inner ear. They may also use acoustic reflex testing to see how your ear muscles react to loud noises. They may do otoacoustic emission testing to look for problems in your inner ear cells using small, sensitive microphones.
Tinnitus sound matching. Your doctor will make you hear common tinnitus sounds to identify your tinnitus symptoms.
Minimum masking level. This test helps identify the volume at which an external noise masks your tinnitus symptoms.
Loudness discomfort level. This test checks your sensitivity to loud external sounds. It helps the doctor decide on the right treatment for you.
Other tests. Your doctor may use tinnitus questionnaires to understand your symptoms. They may perform tests to check for underlying diseases. They may order an MRI to check for injury or trauma.
How is tinnitus treated?
Tinnitus is treated by addressing the underlying cause. If your tinnitus is due to ototoxic drugs, your doctor will stop or change them. If your ear is blocked, the doctor will remove the blockage to treat your tinnitus.
Other tinnitus treatments include:
- Tinnitus counseling for coping
- Cognitive behavioral therapy to reduce anxiety
- Tinnitus retraining therapy or sound therapy to shift your focus from the tinnitus
- Hearing aids or ear implants for hearing loss and tinnitus
- Sound generators or electronic devices that make soft, calming sounds to cover up the tinnitus
- Acoustic neural stimulation, which uses sound waves to change your brain’s nerve pathways and shifts your focus from tinnitus
- Medicines, antidepressants, and anti-anxiety drugs
Visit your doctor if you have constant or worsening tinnitus. If it affects your daily functions like sleep or concentration, seek treatment immediately.
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American Tinnitus Association: "Causes," "Measuring Tinnitus," "Symptoms," "Understanding the Facts."
Harvard Health Publishing: "Tinnitus: Ringing in the ears and what to do about it."
National Institute on Deafness and Other Communication: "Tinnitus."
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