A person with tinnitus often hears “ringing in the ears,” but they may also hear hissing, clicking, or whistling sounds. It can be temporary, or it can be chronic and persistent.
An estimated 50 million Americans are affected by Tinnitus. It typically happens after age 50 but it can also be felt by children and adolescents.
Specific causes include exposure to prolonged or chronic noise, injuries to the head and neck, and ear infections. Occasionally, it may indicate a serious underlying health problem.
Tinnitus has no cure but there are ways to handle it. With time , most people with persistent tinnitus adapt to the vibration, but 1 in 5 can find it disturbing or debilitating.
In others, this may lead to insomnia, concentration difficulties , poor performance at work or school, irritability, anxiety , and depression.
Important facts about tinnitus
Here are some key points about tinnitus. More detail is in the main article.
- Around 50 million Americans experience some form of tinnitus.
- Most tinnitus is due to damage to the cochlea, or inner ear.
- Certain medications can cause or worsen tinnitus, for example, aspirin, particularly in large doses.
- People with tinnitus may be over-sensitive to loud noise.
- Most people learn to live with tinnitus, but help is available for those who find this difficult.
What is tinnitus?
Tinnitus happens when we hear a sound that doesn’t come from any source outside the body. It is not a disease, but a symptom of a problem that underlies it.
The noise is typically subjective, meaning it can be heard only by the person who has tinnitus.
The most common form is a high-pitched, steady ringing. This may be annoying but it usually does not indicate a serious condition.
This may be objective in fewer than 1 percent of situations. That means other people will hear the noise. Cardiovascular or musculoskeletal motions in the person’s body may cause this form of noise. This can reflect a sign of a medical emergency.
Tinnitus is a low- or high-pitched, non-auditory, internal sound that can be irregular or persistent in one or both ears.
The varied sounds are described as whistling, chirping, clicking, screaming, hissing, static, roaring, buzzing, pulsing, whooshing, or musical.
Sound volume will fluctuate. Sometimes, it is most apparent at night or during quiet periods. Some hearing loss may occur.
The first step is to treat any underlying cause of tinnitus.
This may involve:
- prompt care for an ear infection
- discontinuing any ototoxic medications
- treating any temporomandibular joint (TMJ) problems, which affect the joint betwen the jaw bone and the cheek bone
Most forms of tinnitus don’t get healed. Most people get used to it and learn to fine-tune it. Ignoring it instead of focusing on it will bring relief.
If this does not work, medication may benefit the patient for the effects of tinnitus, insomnia , anxiety, hearing difficulties, social isolation, and depression. Dealing with these issues can improve a person’s quality of life considerably.
Here are a few other things that a person can do to manage tinnitus and its consequences.
Sound therapy utilizes ambient noise to mask the perception of tinnitus by the patient. Low-level background music, white noise or specialized ear maskers can be of assistance.
The person should consider the option of sound pleasant. Masking devices offer immediate relief, and when the sound therapy is switched off tinnitus awareness returns.
Hearing aids are a common type of treatment for hearing. Because of the tinnitus, they amplify external sounds and turn attention to certain noises.
Tinnitus retraining therapy (TRT) involves retraining the auditory system to accept the abnormal tinnitus sounds as natural rather than disruptive.
This requires support from a qualified specialist and wearing an appliance that produces white noise at low levels. Continuous therapy sessions will help the tinnitus cope.
The effectiveness of this therapy is proportionate to the extent of the tinnitus, and the general mental health of the patient.
Follow-up findings show that TRT offers relief to around 80 percent of tinnitus patients.
Cognitive behavioral therapy ( CBT) can help relieve depression in people with tinnitus, although the sound does not seem to be reduced.
One way to avoid tinnitus, and likely hearing loss, is to minimize excessive noise exposure.
To avoid damage to the hearing from developing or worsening:
- use hearing protection, such as ear mufflers and earplugs, in noisy environments
- play personal listening devices at a moderate volume
Improving wellness will not stop tinnitus but overall well-being can help to limit its intensity and provide physical and emotional benefits.
Exercise, healthy eating, good sleeping habits, avoiding smoking and excessive alcohol, recreational and social activities, as well as the techniques of stress management and relaxation will all help to achieve optimum wellness.
Unfortunately, there is no way to reverse once the damage is done.
Anyone experiencing tinnitus should see a doctor for an exam and examination to determine the root cause.
A medical assessment may rule out any rare but life-threatening causes of tinnitus. It may be necessary to refer to an otolaryngologist, or an ear, nose , and throat specialist.
Questions a doctor might ask include:
How or when did it start?
- Are the noises constant, intermittent, or pulsating?
- Is there any hearing loss or dizziness?
- Is there any pain or jaw clicking?
- Have you had a recent illness or injury?
- Has there been any exposure to loud noise, such as a rock concert or explosives?
Tests may include:
- a complete examination of the ear, head, neck, and torso
- hearing tests
- laboratory blood tests
- imaging studies
Tinnitus is most commonly caused by damage and loss of the tiny sensory hair cells in the inner ear cochlea.
This appears to happen when people age, and it can also result in overly loud noise from prolonged exposure. Loss of hearing may correlate with tinnitus.
Evidence shows that the auditory deprivation of certain levels of sound results in improvements in the way the brain processes sound.
When the brain receives less external stimuli at a particular frequency, it begins to adapt and change. Tinnitus may be the way the brain replaces the missing sound frequencies which it no longer receives from its own auditory system.
Some medications like aspirin , ibuprofen, certain antibiotics, and diuretics can be “ototoxic.” They cause damage to the inner ear, resulting in tinnitus.
Other possible causes are:
- head and neck injuries
- ear infections
- a foreign object or earwax touching the eardrum
- eustachian tube (middle ear) problems
- temporomandibular joint (TMJ) disorders
- stiffening of the middle ear bones
- traumatic brain injury
- cardiovascular diseases
When tinnitus is caused by a foreign body or earwax, removing the object or wax often causes the tinnitus to go away.
Tinnitus that sounds like a heartbeat may be more serious. It may be due to an irregular growth in the ear area, like a tumor or an irregular connection between a vein and an artery.
It needs a medical evaluation at the earliest opportunity.
Teens, loud music, and possible future hearing problems
One study found that over half of the 170 teenagers had previous year experienced tinnitus. Research has proposed that “potentially risky leisure habits,” such as listening to loud music on personal devices, could trigger tinnitus.
The authors, however, found that those who were susceptible to tinnitus appeared to keep their music volume down, indicating that they may have a secret vulnerability to potential hearing loss.
We suggest screening for tinnitus and low tolerance from an early age for excessive noise, as these could be early indicators of future hearing loss.
In the general population, tinnitus is a common problem especially among those with certain risk factors.
- noise exposure from work, headphones, concerts, explosives, and so on
- gender, as men are affected more than women
- hearing loss
- age, as older individuals are more susceptible