What You Need to Know About Tinnitus and How to Manage It

Erica Roth
1 day ago
5 min read

Tinnitus is the medical term for “ringing in the ears,” or the perception of sounds without an external noise or source of the sounds.

According to the American Academy of Otolaryngology-Head and Neck Surgery, more than 50 million people in the United States have experienced tinnitus.

If you have tinnitus, you may hear more than just ringing. People commonly report hearing sounds like:

buzzing
roaring
clicking
whistling
hissing
music
whooshing
throbbing

Tinnitus is not a condition itself, but a symptom of a medical condition or another issue, such as prolonged exposure to loud noises.

You may experience tinnitus in one ear or both ears. People of all ages can develop tinnitus, but it’s more common in older adults.

Keep reading to learn more about the types, causes, and symptoms of tinnitus, and when to see a doctor.

Types of tinnitus

Tinnitus is usually categorized as objective or subjective:

Subjective: This refers to sounds that can only be heard by the person experiencing them, so a doctor cannot hear or examine these sounds. Subjective tinnitus is the most common type.
Objective: This is when another person can hear or identify the noises in your ears. Objective tinnitus is rare.

Sometimes, healthcare professionals further distinguish tinnitus by its rhythm. Pulsatile tinnitus, a form of subjective tinnitus, causes sounds to have the same rhythm as your heartbeat.

What causes tinnitus?

Healthcare professionals and researchers continue to investigate the underlying mechanisms of tinnitus. But several causes have been identified, ranging from external events to underlying medical conditions.

External causes of tinnitus

Tinnitus may be caused by exposure to loud noises or external sounds.

For instance, people who use jackhammers, chainsaws, or other heavy equipment for extended periods are more likely to develop it. This also applies to listening to music through headphones or attending a concert.

On the other hand, some people get tinnitus from sudden, loud noises, such as explosions and gunfire.

Loud noises can damage the inner ear. Your middle ear picks up sound waves. The conduction of those sound waves prompts your inner ear to transmit electrical impulses to your brain.

You can only hear these sounds after your brain accepts the electrical signals and translates them into sound. Sometimes, your inner ear sustains damage, altering how your brain processes sound.

Damage to the tiny bones in your middle ear or your eardrums can also interfere with the proper conduction of sound. Head and neck injuries may damage structures inside the ear.

Medical conditions

Medical conditions that can cause tinnitus include:

ear infections
earwax buildup
age-related hearing loss
ear drum spasms
Meniere’s disease
thyroid disease
high blood pressure
high cholesterol
temporomandibular joint (TMJ) disorders
tumors in the ear or on the auditory nerve
aneurysms
palatal myoclonus

Medications that cause tinnitus

Medication use can also cause tinnitus and hearing damage, which is known as ototoxicity (ear poisoning).

Taking high doses of certain drugs from the following medication classes has been associated with a possible risk of tinnitus:

nonsteroidal anti-inflammatory drugs, such as aspirin
antimalarial drugs
diuretics
antibiotics
anticancer drugs
antidepressants

It’s important to speak with a healthcare professional if you experience tinnitus after starting a new medication. They may be able to alter your treatment plan to reduce symptoms.

When to connect with a doctor

Tinitus is a common condition that affects many people. In most cases, it’ll go away on its own, or it can be managed with lifestyle changes.

However, consider speaking with a primary care doctor if your tinnitus:

doesn’t get better or gradually worsens
is constant or bothers you
rings or beats to the rhythm of your pulse

A primary care doctor can assess your symptoms and, if necessary, refer you to a specialist, such as an audiologist, psychologist, otolaryngologist, or neurologist.

Get immediate medical attention if you experience tinnitus and other symptoms like sudden hearing loss, facial weakness, or vertigo.

How is tinnitus diagnosed?

Diagnosing tinnitus can be tricky because you’re typically the only person who can hear the sounds it creates.

A primary care doctor or an audiologist will first examine your ears. An audiologist may also conduct an audiometric hearing test.

The doctor will transmit sounds to one ear at a time through a set of headphones. You’ll respond by raising your hand or making a similar gesture when you hear each sound.

The doctor may be able to diagnose any hearing loss based on your responses and how loud the sound must be turned up for you to hear it.

A doctor may also use imaging tests, such as CT scans or MRIs, to detect any irregularities or damage in the ear. X-rays don’t always show tumors, blood vessel disorders, or other abnormalities that can affect your hearing.

In some cases, a doctor may not be able to identify what’s causing your tinnitus.

How is tinnitus treated?

Treatment for tinnitus will depend on the underlying cause and severity of your symptoms.

If an underlying health condition is causing your tinnitus, a doctor will develop a treatment plan to address it, which should help manage tinnitus. For instance, they may recommend ear irrigation or microsuction to help clear earwax buildup.

Similarly, if a certain medication is causing tinnitus, the doctor may recommend taking an alternative drug to manage the condition and restore your hearing.

If an underlying cause cannot be identified, then a doctor may recommend a range of tinnitus treatments and remedies. These may include:

using noise-cancelling machines to help dull internal sounds
trying masking devices, which are inserted into your ear and work similarly to a hearing aid
trying therapy, such as cognitive behavioral training and tinnitus retraining therapy
managing stress, such as by exercising, trying biofeedback, and meditating
limiting exposure to loud noises
getting better sleep

In some cases, a doctor may prescribe medications off-label to help manage tinnitus. Off-label means a drug that’s approved by the Food and Drug Administration (FDA) for one purpose is used for a different purpose that hasn’t yet been approved.

Some medications that may be prescribed off-label for tinnitus may include anesthetics, calcium channel blockers, antidepressants, and antihistamines, among others.

However, it’s important to note that no medications have been approved by the FDA to manage tinnitus. Some medications may also cause a wide range of side effects, such as: