Tinnitus

Your health expert: Dr Mohamed Hariri, Consultant in Audio-Vestibular Medicine,
Content editor review by Liz Woolf, October 2023
Next review due October 2026

Tinnitus means hearing sound that isn’t caused by an outside source. People describe it as ringing, hissing, clicking or buzzing in their ears. Many different conditions can cause tinnitus. But sometimes there is no obvious cause. About one in six people have tinnitus occasionally. Around one in 50 people have severe tinnitus.

About tinnitus

Many of us have had ringing in the ears after hearing a loud bang or being at a concert with very loud music. This is temporary tinnitus and generally goes away soon afterwards. But tinnitus can also be a longer-term condition.

There are two types of tinnitus. Subjective tinnitus means that only you can hear the sound. This is by far the commonest type of tinnitus. It is usually caused by a problem with your inner ear or the nerves involved with hearing.

Objective tinnitus means that your doctor can also hear the sound you’re hearing. They’ll listen through a stethoscope placed near your ear. Only one in 100 cases of tinnitus is this type. It is usually caused by a physical problem that produces sound in or near the ear (for example, a pulse in a blood vessel). Your doctor may call this pulsatile tinnitus.

Anyone can develop tinnitus. It’s more common as we get older. But it can start at any age, including in childhood. Tinnitus is more common in adults and children who have hearing problems.

Symptoms of tinnitus

Tinnitus is when you hear sound that isn’t caused by an outside source. It can be whistling, buzzing, ringing, hissing, humming or roaring. You may have it in one or both ears.

Tinnitus may be continuous or it may come and go. Objective tinnitus (that your doctor can also hear) is usually a humming, clicking or beating sound. It may be in time with your heartbeat.

You may notice tinnitus more when it’s quiet, so it can seem worse when you’re in bed. It may also be worse when you are feeling stressed.

Sometimes, people with tinnitus have other symptoms such as:

dizziness
problems with balance
jaw pain
facial weakness
sensitivity to loud noise

Severe tinnitus can be very distressing, and some people develop depression. If you think you have tinnitus, contact your GP.

Worried about hearing loss?

Get a picture of your current health and potential future health risks with one of our health assessments.

To book or to make an enquiry, call us on 0370 218 8122^∧

Find out more about health assessments

Causes of tinnitus

Hearing loss is the most common cause of tinnitus but it may be caused by any of these conditions:

age-related hearing loss
noise-induced hearing loss, caused by exposure to loud sounds
a build-up of earwax in your ear
reactions to medicines such as aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), certain antibiotics, diuretics, beta-blockers and chemotherapy
Ménière’s disease – a rare ear condition that causes vertigo, hearing loss, tinnitus and a feeling of pressure in the ear
otosclerosis – a rare condition affecting a bone inside your ear
head or neck injuries
ear infections
diabetes or thyroid problems
psychological problems such as anxiety or depression
problems with your nervous system (for example, multiple sclerosis)
non-cancerous growths such as acoustic neuroma

Objective tinnitus (where your doctor can also hear the sounds) may be caused by:

problems with your veins or circulation
problems with your jaw joint and surrounding muscles

Tinnitus can also be related to other conditions though these are less common. Because it has so many possible causes, it’s important to contact your GP if you have tinnitus. They can make sure it is properly investigated.

Diagnosis of tinnitus

Your GP will try to find the underlying cause of your tinnitus. They will ask about your symptoms, and your medical and family history. They may ask about possible causes – for example, how often you’ve been exposed to noisy environments. They may also check if you’ve taken certain medicines.

Your GP may examine your head and neck. They will also look inside your ears with an instrument called an otoscope. This is to check for earwax build up, infection or other abnormalities. They may ask you to see an audiologist for hearing tests.

There are a lot of possible causes of tinnitus. This means you may need many different tests to find out what’s causing it. You may have:

further hearing tests
blood tests
a CT scan (like an X-ray but producing a detailed series of cross-sections of your body)
an MRI scan (using magnets, radio waves and computers to produce a detailed image of the inside of your body)
a psychological assessment – because tinnitus can often lead to anxiety or depression

Self-help

If you have tinnitus, the first thing you should do is contact your GP. They will advise you on how to best manage your condition. Your doctor may suggest some simple things to try. Here are some suggestions that could help you manage tinnitus and improve your quality of life.

Relaxation could help, so your doctor may advise you on some relaxation techniques.
A low level of background noise may help to reduce awareness of your tinnitus. Try leaving a window open or having a fan or the radio on.
Recorded sounds such as rain, the sea or birdsong may help. You can buy CDs with nature sounds, download sound effects from websites or use an app on your phone.
Loud noise can make tinnitus worse and further damage your hearing. Avoid very loud sounds such as listening to music on high volume or using power tools without ear-defenders.
You may need to stop taking medicines known to cause tinnitus – your doctor will advise you.
For some people, certain substances can make tinnitus worse. Some doctors advise reducing salt, caffeine, alcohol, sugar, artificial sweeteners or food colouring.
Exercise helps to improve overall health and well-being, and can also help you to sleep.

You could also contact an organisation providing information and support for people with tinnitus. You may find ideas that help you. Some organisations run support groups where you can share suggestions and experiences. For more information, see our section on helpful websites.

Treatment of tinnitus

There are no treatments that have been shown to directly cure tinnitus. Your doctor or specialist may prescribe a treatment to address an underlying cause, such as impacted ear wax. But in many cases, they are more likely to suggest treatment to help you manage the tinnitus.

For most people, tinnitus improves slowly over time. This is because you learn to get used to your tinnitus so it doesn’t have such an impact on your life. Doctors call this ‘habituation’. Some of the following treatments can help with habituation.

Sound generators

If you have good hearing, your doctor may suggest a sound generator. These used to be called masking devices and the technique is sometimes called sound therapy. The generators work in a similar way to some of the self-help suggestions such as having the radio or TV on in the background.

There are two main types of sound generator. One is a portable machine that produces calming sounds. The other fits to your ear like a hearing aid and produces a constant low-level noise or tone. This is sometimes called white noise and works by covering up the tinnitus. It may also help your brain get used to the tinnitus.

Maskers work best in people with normal or nearly normal hearing. Some people find that sound generators interfere with their hearing when in use. Others say their hearing is improved because the tinnitus is less obvious.

Hearing aids

If you have tinnitus because of a problem with your hearing, your doctor may suggest a hearing aid. This makes external sounds louder, so you’re less aware of the tinnitus. Hearing aids help to relieve around half of all cases of tinnitus related to hearing loss.

Cognitive behavioural therapy (CBT)

Tinnitus can cause anxiety, disrupt your life or stop you doing the things you enjoy. Your doctor may suggest cognitive behavioural therapy (CBT). The aim of CBT is to help you think differently about the condition and achieve a more positive attitude. It doesn’t help reduce the loudness of the sound you hear.

But CBT can help you to cope with your symptoms, deal with any negative feelings and change how you think about tinnitus. So it may help to improve your quality of life.

Surgery

For most people, surgery can’t help with tinnitus. But in a small number of cases, tinnitus is caused by a physical problem such as a growth near your ear. In these situations, surgery may help.

Complementary therapies

Complementary therapies are treatments that are not included in conventional medical treatment. Some people find that hypnosis, acupuncture or herbal remedies help their tinnitus. There is little or no scientific evidence that these approaches work. But there is no harm associated with most of them and some people find they help.

Acupuncture involves putting very fine needles into your skin at specific points. Make sure you use a qualified practitioner. Some herbal remedies can have side-effects or interfere with other medicines. Do check with your doctor before starting to take them.

Some people with tinnitus say that cutting out caffeine, alcohol or added salt helps reduce their tinnitus. This is only a small proportion of people affected overall, but it may be worth a try. If you want to see if this helps, cut out one thing at a time for at least six to eight weeks.

Medicines

Depression or anxiety may make your tinnitus worse. Treating these conditions may help to ease your symptoms and help you manage them better. So your doctor may prescribe an antidepressant if they think that will help.

Living with tinnitus

Tinnitus affects people in different ways. This is partly to do with how serious it is. For some people, it can be very distressing – particularly if it is very bad. Fortunately, most cases are relatively mild. Even mild tinnitus can be distressing at first, but most people find they cope better as time goes on.

Tinnitus can have a social and a psychological impact on you. If you find it difficult to hear or concentrate, you may interact less with friends and family.

Often people have difficulty sleeping, particularly when they first develop tinnitus. It is also relatively common for people with tinnitus to have anxiety or depression.

Do try and stay positive. It’s unlikely that your tinnitus can be cured. But there are things that can help, so it’s essential to see your GP. It may help to talk to other people who are affected. You can find support groups online (for more information, see our section on helpful websites).

There are lots of things you can do to help with tinnitus. It’s unlikely to be completely cured. But there are measures that can reduce its impact on you.

For some suggestions, see our sections on treatment and self-help.

Sometimes tinnitus is temporary, particularly after being exposed to very loud noise for a short time. If you develop long-term tinnitus, you’re unlikely to get rid of it completely. But many people find that they notice it less as time goes on.

For suggestions on how to manage tinnitus, see our section on self-help.

Tinnitus is a sound that you hear that doesn’t come from an outside source. It varies in how it sounds so people describe it in very different ways. You may have it in one or both ears. There are sometimes other symptoms such as dizziness.

For more information, see our section on symptoms.

Whether or not you can get rid of tinnitus completely depends on the cause. So, it’s worth seeing your GP. Often people find they become used to it so that it doesn’t bother them so much. Doctors call this habituation. There are treatments that can help.

For more information, see our sections on treatment and self-help.

Tinnitus can be a buzzing, hissing, humming, roaring or whistling sound. Sometimes it’s a pulse or clicking – this may be objective tinnitus, which means your doctor can also hear it.