Tinnitus

What is tinnitus?

If you have ringing or other strange noises in your ears, you might have tinnitus. People with tinnitus hear sounds that aren’t actually being made around them.

There are 2 main types of tinnitus:

• Subjective tinnitus — which only you can hear. This is the most common type.
• Objective tinnitus — which your doctor can also hear when they examine you.

Objective tinnitus can be caused by noise coming from:

• a blood vessel in your head or neck
• your temporomandibular joint (the joint that connects the jaw to your skull)

Up to 1 in 5 people have tinnitus at some point in their life. Tinnitus is more common in older adults.

Tinnitus can come and go, or you might experience it all the time. Some people find their tinnitus is an irritation they can learn to live with. For others, it can be very distressing.

What are the symptoms of tinnitus?

Tinnitus is sometimes known as ‘ringing in the ears’, but if you have the condition you might hear:

• humming sounds
• hissing
• whistling
• clicking
• roaring
• whooshing
• buzzing

The noise can be faint or loud. It can occur in one or both ears. Sometimes the noise may feel like a sensation inside your head.

Some people with tinnitus also have symptoms of hearing loss or vertigo.

Pulsatile tinnitus

In some cases, people describe tinnitus that makes the sound of regular pulsations. This is known as pulsatile tinnitus.

What causes tinnitus?

Tinnitus is more common in people who have some hearing loss or other ear problem. But it can also occur in people who have normal hearing.

Both adults and children can experience tinnitus. Older adults are more likely to experience tinnitus because of age-related hearing loss.

Causes of tinnitus include:

• hearing loss
• a build-up of ear wax
• exposure to loud noises
• ear infections or inflammation
• Ménière’s disease
• tumours
• problems with the inner ear
• some medicines
• head injuries

Sometimes it’s not clear why people develop tinnitus.

When should I see my doctor?

See your doctor if you have tinnitus or hearing loss.

How is tinnitus diagnosed?

Your doctor will ask about your symptoms and do a physical examination, including checking your ears.

Your doctor may check your hearing and refer you to an audiologist for hearing tests.

Depending on your other symptoms, x-rays or scans may be recommended.

How is tinnitus treated?

Treatment will depend on the cause of your tinnitus and how much it is bothering you.

Your doctor may refer you to an ear, nose and throat (ENT) specialist for further tests and treatment.

Even if no underlying cause is found for your tinnitus, there are some treatments that may help if it is bothering you.

Many people get used to tinnitus — they are said to ‘habituate’ so their brain doesn’t notice the tinnitus any more.

Self-care measures

There are some things you can do to help with tinnitus.

• Relax and avoid stress, as stress can make tinnitus worse.
• Talk to your doctor about medicines that can make tinnitus worse, such as non-steroidal anti-inflammatory medicines (NSAIDs) and some antidepressant medicines.

To avoid the tinnitus getting worse, wear ear plugs or headphones if you are:

• using noise-generating equipment (such as a lawn mower)
• in a loud environment, such as a rock concert

Hearing aids

Good quality, properly fitted hearing aids reduce and can even eliminate tinnitus associated with hearing loss.

Hearing aids reduce the strain of listening. They can also distract you from the tinnitus by helping you hear more sounds from the environment around you.

Sound therapy

Sound therapy involves listening to an external sound that helps distract you from your tinnitus. Your doctor or audiologist can advise you on this type of treatment.

Psychological therapy

A type of psychological therapy called ‘cognitive behavioural therapy’ (CBT) can help reduce distress related to tinnitus. Your doctor may refer you to a psychologist for this treatment.

Can tinnitus be prevented?

There several are different causes of tinnitus. Tinnitus that is caused by certain medicines can be prevented. But not all types of tinnitus can be prevented.

Complications of tinnitus

It is well known that tinnitus can be distressing. There is a link between distressing tinnitus and anxiety and depression.

If you are distressed by your tinnitus, talk to your doctor about support and available treatments.