Who gets tinnitus?

Tinnitus is ear ringing. The most effective treatments for tinnitus involve noise-canceling headphones, cognitive behavioral therapy, background music and lifestyle changes.
Tinnitus is ear ringing. The most effective treatments for tinnitus involve noise-canceling headphones, cognitive behavioral therapy, background music and lifestyle changes.

Tinnitus (pronounced either “TIN-uh-tus” or “tin-NY-tus”) is a sound in the ears, like ringing, buzzing, whistling, or even roaring. It can come and go or can be continuous. It can also range in pitch from low to high.

With over 45 million Americans experiencing tinnitus, it is a common health condition, especially in men over 40. It is also common in veterans who were exposed to bomb blasts that damaged their brain’s auditory function.

What is tinnitus?

It is not clear why the brain hears sounds that do not exist. There are two forms of tinnitus — subjective and objective. With subjective tinnitus only you can hear the sounds. With objective tinnitus, which is rare, others can also hear the sounds. 

Tinnitus usually starts in the inner ear, often from damage to the hair cells in the cochlea.

The subjective variety occurs in over 99% of cases. It usually starts in the inner ear, often from damage to the hair cells in the cochlea. Some tinnitus is chronic (ongoing) while some people experience acute episodes of tinnitus.

Pulsatile tinnitus is where you can hear your heartbeat inside the ear, usually at night when it is quiet.

Tinnitus is not a disease, but rather a symptom of some other underlying health condition such as:

The condition can occur anywhere from the outer ear, the inner ear, or even in the brain where it tries to compensate for hearing loss {Harvard Health Publishing: “Tinnitus: Ringing in the ears and what to do about it.”}. It is common in veterans who were exposed to bomb blasts that damaged their brain’s auditory function.

Tinnitus can also be a side effect of taking an ototoxic prescription. Over 200 medications can cause ringing in the ears when beginning or ending a prescription. 

Other causes of tinnitus may include:

  • Hearing loss due to age
  • Excessive noise
  • Middle ear obstruction
  • Build-up of earwax
  • Congestion
  • Dirt or foreign objects in the ear canal
  • Head or neck trauma
  • Scuba diving or snorkeling
  • Extreme elevation changes while flying
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Certain antibiotics
  • Certain cancer medications
  • Diuretics

Of people experiencing tinnitus, 40%  have a lower tolerance or dislike for environmental sounds.

Diagnosis for tinnitus

Your doctor can examine you for problems with medications or hypertension or can refer you to a specialist for further testing. Tests for tinnitus can include:

  • An audiogram to measure hearing across frequencies
  • A tympanogram to measure the eardrum’s flexibility
  • An otoacoustic emission test to measure hair cell functionality
  • An auditory brainstem response test to measure how sound signals travel to the brain
  • An electrocochleography test to measure how sound signals travel to the hearing nerve

Treatments for tinnitus

Chronic tinnitus has no cure, but treatment is available to minimize the noise. It also often gets better on its own with time.

The first step is to evaluate your overall health and treat any underlying problems. Evaluate your diet, your exercise routine, and sleep pattern. If you are experiencing depression or anxiety you might consider seeking treatment for those first.

Avoid loud noises by using ear protectors.

Sometimes a hearing aid that is correctly adjusted to cancel ambient sounds can help you hear better, which in turn makes the tinnitus less noticeable.

You can seek cognitive behavioral therapy (CBT) to better understand what it is that is happening in the brain and how to make the sound less noticeable.

You can also try sound therapy using background music or an ear-level masker.

Other things you can try to reduce the impact include:

  • Check your blood pressure, and get it under control if it is too high.
  • Start a daily exercise routine.
  • Get plenty of sleep.
  • Reduce stress.
  • Stop smoking.
  • Use aspirin or other anti-inflammatory drugs sparingly.
  • Try to ignore the sound by directing your attention to other things.
  • Practice meditation or yoga
  • Cut back on caffeine and alcohol.

You can also try going to sleep with a fan or a humidifier running.


 

Possible complications and side effects

Tinnitus can have a distressing impact on a person’s well-being. It can lead to:

Some drugs can make tinnitus worse. They include certain antibiotics, antimalarial drugs, and certain cancer drugs.

You should seek medical attention if you notice any of the following:

  • Severe hearing loss
  • Vertigo
  • Vomiting or Nausea
  • Sounds limited to one ear 
  • Difficulty with coordination
  • Numbness on one side of the face or body 

What are the main causes of tinnitus?

Tinnitus describes hearing sounds that come from within the body. It’s commonly referred to as “ringing in the ears,” but there are many different sounds that you may hear if you have tinnitus.

These sounds do not come from an external source and are most times subjective, or only heard by the person. You may hear these sounds in just one ear or both.

Mild tinnitus is quite common, as many people experience ringing in their ears at some point. If you’re in a noisy place, like a concert or sports event, you may notice the ringing afterward. However, there are those who experience frequent or constant tinnitus and find it impacts the quality of their everyday lives.

Tinnitus is considered chronic if it lasts for six months or more and doesn’t go away, even worsening over time. It can be stressful to deal with as tinnitus can affect your concentration or cause depression or insomnia. However, there are ways that you can manage it.

QUESTION

What is tinnitus? See Answer

Symptoms of tinnitus

Sounds in the ear

The main sign of tinnitus is hearing internal sound in your ears. Some people with tinnitus hear ringing in one or both ears. However, there is a whole range of sounds that you may hear if you’re experiencing tinnitus. For example, common sounds that people hear are:

  • Hissing
  • Whistling
  • Buzzing
  • Humming
  • Grinding
  • Segments of music
  • Whirring
  • Pulsing
  • Whooshing

Hearing loss

Along with sounds, another sign of tinnitus is overall hearing loss. This can happen to anyone, but studies show that hearing loss associated with tinnitus is more common in people over 40, and more men are affected than women.

Types of tinnitus

There are two types of tinnitus: pulsatile and nonpulsatile.

Pulsatile tinnitus (objective)

Pulsatile tinnitus is objective, meaning that your doctor may be able to hear the sound that you hear by using a stethoscope. People with this type often hear a whooshing or thumping sound that is in time with their heartbeat. This type is known to be associated with vascular issues, muscle movements in the ear, or other structural issues around the face and neck.

Nonpulsatile tinnitus (subjective)

This type of tinnitus is only heard by the person hearing it and can’t be detected by a doctor when using a stethoscope. It is usually associated with the nerves involved with hearing. When there is damage to the pathway from your ears to your brain, you may hear the illusion of sound. The sounds that people with non-pulsatile tinnitus hear seem to come from within the head.

Causes of tinnitus

Tinnitus is a condition that isn’t a disease itself but is a symptom or sign of another underlying issue. There is no exact cause for either type of tinnitus, but there are many conditions that are associated with them. These conditions are related to either mental or physical changes in the body.

It should be noted that there are nearly 200 different conditions that can cause tinnitus. Some of the more common causes of tinnitus include:

Hearing loss

Most people who experience tinnitus have it as a symptom of hearing loss. This can be due to aging or prolonged exposure to loud noise. This happens when the hairs in the inner ear become damaged.

Blockage

If something blocks your ear canal, this can result in pressure building up in your inner ear. This pressure can change the way the eardrum works. Blockage can occur from earwax, inner ear hair, or foreign objects or substances. Ear infections can also cause blockage.

Trauma to the head or neck

Trauma or injury to the head or neck can cause a change in blood flow or issues with nerves and muscle tissues. These changes can cause either type of tinnitus, either objective or subjective. People with these injuries often say that the volume of their tinnitus is loud and frequent.

People with traumatic brain injury (TBI) caused by a concussion may experience tinnitus. This happens when damage is done to the brain’s auditory processing areas.

Medications

Acute tinnitus can be a side effect of some medications. There are currently more than 200 medications, both prescription and non-prescription, that list tinnitus as a side effect. This includes common drugs like antibiotics and aspirin.

Ménière’s disease

Ménière’s disease is a rare condition that causes hearing loss and vertigo. This inner ear disease can also cause tinnitus.

Diagnosis and tests for tinnitus

If you’re constantly hearing sounds in your ears that don’t go away, you should contact your doctor. They can check your inner ear for damage or blockage, or see if you have an ear infection. Your doctor can also perform a hearing test or refer you to a specialist.

If you have pulsatile tinnitus, your doctor may run some imaging tests to get a better look. Tests like a magnetic resonance imaging (MRI) scan or computerized tomography (CT) scan can check for problems like tumors or blood vessel abnormalities.

Treatments for tinnitus

There is currently no cure for tinnitus or single treatment that works for everyone. If your tinnitus comes and goes and does not affect your daily life, you probably don’t need medical treatment.

If your doctor finds an underlying cause, like an ear infection or earwax, they can treat it. If your doctor can’t find a cause, they may recommend some different ways for you to cope, including:

  • Sound therapy
  • Cognitive behavioral therapy (CBT)
  • Counseling
  • Tinnitus retraining therapy (TRT)

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Medically Reviewed on 3/1/2022
References
SOURCES:

American Academy of Otolaryngology–Head and Neck Surgery: "How Can I Lessen the Impact of Tinnitus?

American Academy of Otolaryngology–Head and Neck Surgery: "Tinnitus.

American Tinnitus Association: "Understanding the Facts.

American Tinnitus Association: "Causes."

British Tinnitus Association: "What causes tinnitus?"

Harvard Health Publishing: "Tinnitus: Ringing in the ears and what to do about it.

Harvard Health Publishing: "Tinnitus: Ringing in the ears and what to do about it."

Hearing Link: "What is tinnitus?"

Michigan Medicine: "Ringing in the Ears (Tinnitus).

National Institute of Deafness and Other Communication Disorders: "Tinnitus.

NHS Inform: "Tinnitus."

Vestibular Disorders Association: "Tinnitus