Tinnitus
Your health expert: Mr Anil Banerjee, Ear, Nose and Throat Consultant
Content editor review by Liz Woolf, May 2021
Next review due June 2024
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, usually mildly. 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 within minutes or hours. 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. As with adults, tinnitus is more common in children with 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.
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Diagnosis of tinnitus
The aim of diagnosis is to find the underlying cause of your tinnitus.
Your GP will ask about your symptoms and medical and family history. They may ask you about possible causes. So, they may ask how often you have been exposed to noisy environments or 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 auriscope. And they may refer you to an audiologist to do hearing tests.
There are a lot of possible causes of tinnitus. So there are many different tests that a doctor may carry out to help find out what’s causing it. You may need to 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, you will probably need to play a big part in managing your own condition. Your doctor may suggest some simple things to try that could help manage the tinnitus. The following suggestions could 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 the perception of tinnitus. There isn’t strong evidence for this. But you could try leaving a window open or having a fan or the radio on to see if this works for you.
- Recorded sounds such as rain, the sea or birdsong may help. Again, there isn’t strong evidence but it could be worth trying. You can buy CDs with nature sounds, download sound effects from websites or use an app on your phone.
- Loud noise can make your tinnitus worse and may damage your hearing. Avoid very loud sounds such as listening to music on high volume or using power tools without ear-defenders.
- If you are taking medicines known to cause tinnitus, your doctor will advise you to stop taking them.
- For some people, certain substances can make the tinnitus worse. For example, caffeine, alcohol, sugar, artificial sweeteners, food colouring or tobacco. It may be worth cutting these out in turn to see if that helps.
- Exercise will help to improve your overall health and well-being and will also help you to sleep.
- 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 (see our section on helpful websites).
Remember that if you have tinnitus, the first thing you should do is contact your GP.
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 is sometimes called sound therapy. There are two main types. 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. Some people find that sound generators interfere with their hearing when in use.
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. If this is the case, your doctor may refer you for 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. For many, there is little or no scientific evidence that they work. But there is no harm associated with most of them and some people find they help.
Your doctor may suggest that you try hypnosis, acupuncture or herbal remedies. These can help you relax and relieve the stress or anxiety that tinnitus may cause.
Acupuncture involves putting very fine needles into your skin at specific points. Some herbal remedies can have side-effects or interfere with other medicines. Do check with your doctor before starting to take them.
There is a range of other complementary therapies that may work for you.
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.
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.
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 is likely to 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 (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. See our treatment and self-help sections for some suggestions.
Sometimes tinnitus is temporary, particularly after being exposed to very loud noise for a short time. If you develop it long term, you’re unlikely to get rid of it completely. But many people find that they notice it less as time goes on. See our self-help section for suggestions of how to manage it.
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. See our section on symptoms for more information.
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. See our treatment and self-help sections for more information.
Depression
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT) is a type of talking therapy. It helps you change how you think, feel and behave.
Hearing loss
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This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals and deemed accurate on the date of review. Photos are only for illustrative purposes and do not reflect every presentation of a condition.
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