Tinnitus is a symptom of several medical conditions. It is characterised by various high pitched or whooshing noises that only you can hear. This is because the noise is generated from inside the body as a result of possible dysfunctions of the ear or nervous system.1
Tinnitus also causes a host of other distressing symptoms, which can make it difficult to cope with. It is therefore important to talk to your doctor if you are experiencing tinnitus so you can receive a diagnosis and get the appropriate treatment.1
While there is no technical cure for tinnitus, there are several options to manage the severity of your condition.2
Causes of tinnitus
Tinnitus either has a neurological (sensory tinnitus) or physical/structural (somatic tinnitus) cause.
Tinnitus is commonly the result of an ear infection such as:
- Otitis media (middle ear infection)
- Labyrinthitis (inner ear infection)
- Mastoiditis (inflammation of the tissue and bone behind the ear)
Other causatory conditions include:
- Hearing loss
- Ménière’s disease (an inner ear dysfunction)
- Brain or spinal tumour (usually non-cancerous, abnormal growths of tissue)
Tinnitus may also be a result of some neurological conditions, for example:
Physical damage to the structures within the ear may also be the cause of your tinnitus. These can include:
- An impacted cerumen (extreme buildup of ear wax in the ear canal)4
- Otosclerosis (abnormal reshaping of bone in the middle ear)5
- Temporomandibular joint disorder (TMJ; painful jaw movements)3
- Head or neck injury3
Signs and symptoms of tinnitus
Tinnitus is characterised by hearing noise that is not the result of anything in the surrounding environment. Tinnitus can be temporary, where the symptoms come and go, or chronic, where the symptoms last for months or years.
Tinnitus can sound differently to different people, such as:
- Inaudible music or voices
There are also different manifestations of tinnitus, including:
- Subjective tinnitus (sound that can only be heard by you)
- Objective tinnitus (sound that can be heard by others when their ear is pressed against you or a doctor uses a stethoscope)
- Pulsatile tinnitus (sound that mimics blood pumping through the ear)
- Steady tinnitus (sound that is one prolonged tone)1
Constant tinnitus noise can make certain things like relaxing and sleeping difficult - some even report feeling anxious, stressed, depressed and/or extremely tired as a result. You may also find it hard to concentrate on tasks or hear external noises (like talking or music) if the tinnitus sound is particularly loud.
Tinnitus can also occur in combination with feelings of dizziness, imbalance or vertigo.1
Management and treatment for tinnitus
There is no guaranteed cure for tinnitus and treating and managing it often focuses on alleviating its associated symptoms to improve your quality of life.
- Prescription medication to treat depression and/or anxiety
- Melatonin supplements to relieve sleeplessness and improve energy levels
- Supplements such as vitamin B, zinc and magnesium to support the function of the auditory nerves
- Hearing aids or cochlear implants for hearing loss/deafness2
Clinicians often use a technique called tinnitus retraining therapy (TRT) to directly deal with the phantom noises caused by tinnitus.2
Cognitive behavioural therapy (CBT) is one crucial part of TRT, where patients are counselled to essentially ignore the sound of their tinnitus. This can reduce the stress and frustration associated with tinnitus and help patients lead a less impacted life. CBT does, however, have different levels of effectiveness between patients.6
TRT also includes things you can do at home to aid sleep and concentration, such as using background/white noise to mask the sound of the tinnitus (without further harming your ears with loud noise).2
A small number of tinnitus cases can be corrected with surgery, when the cause is a physical obstruction or abnormality in the ear.2
Diagnosis of tinnitus
Tinnitus is diagnosed through a consultation with your doctor, where you will:
- Be asked to give your medical history
- Be asked to describe the noise and any other symptoms you are experiencing
- Have your hearing assessed
- Be assessed for possible causes and/conditions causing tinnitus2
How common is tinnitus?
Tinnitus is estimated to affect around 10% of adults worldwide. It affects all ages and genders equally.3
Who is at risk of tinnitus?
Adults tend to suffer with worse/more debilitating tinnitus symptoms. You may also be at risk of tinnitus if you:
- Listen to loud noise or music daily/long term
- Are overweight
- Drink excess alcohol
- Have arthritis
- Have high blood pressure
- Take certain prescription pain, antibiotic or chemotherapeutic drugs3
Can tinnitus be prevented?
Tinnitus can be difficult to prevent if it is a symptom of a progressive or lifelong condition. However, doctors advise minimising your exposure to risk factors that can damage your ears, for example, strong medications (if possible) and frequent loud noise exposure, to potentially reduce your chance of experiencing tinnitus.3
Does tinnitus go away on its own?
Tinnitus can disappear on its own and is reported to gradually stop after the age of 70 in some sufferers. However, in some cases, tinnitus may intermittently come and go or become a lifelong symptom.3
When should I see a doctor?
You should see your doctor if your tinnitus makes it hard to go about your daily life, interferes with your sleep or is generally distressing. It is also important to see your doctor to get any underlying health problem investigated and diagnosed so you can receive any available treatment.3
Tinnitus is a symptom of many different conditions that affect the ears or nervous system. Sounds heard in tinnitus range in pitch (high or low), volume (loud or quiet) and frequency (constant or intermittent).
All manifestations of tinnitus should be taken seriously, so it is important to visit your doctor if you have any concerns. If tinnitus is significantly impacting your physical and mental health, receiving a diagnosis and treatment can also make a difference to your quality of life.
- Han BI, Lee HW, Kim TY, Lim JS, Shin KS. Tinnitus: characteristics, causes, mechanisms, and treatments. J Clin Neurol [Internet]. 2009 Mar [cited 2023 May 25];5(1):11–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686891/
- Swain SK, Nayak S, Ravan JR, Sahu MC. Tinnitus and its current treatment–Still an enigma in medicine. Journal of the Formosan Medical Association [Internet]. 2016 Mar 1 [cited 2023 May 25];115(3):139–44. Available from: https://www.sciencedirect.com/science/article/pii/S0929664615003848
- Baguley D, McFerran D, Hall D. Tinnitus. The Lancet [Internet]. 2013 Nov 9 [cited 2023 May 25];382(9904):1600–7. Available from: https://www.sciencedirect.com/science/article/pii/S0140673613601427
- Schwartz SR, Magit AE, Rosenfeld RM, Ballachanda BB, Hackell JM, Krouse HJ, et al. Clinical practice guideline (Update): earwax(Cerumen impaction). Otolaryngol--head neck surg [Internet]. 2017 Jan [cited 2023 May 25];156(S1). Available from: https://onlinelibrary.wiley.com/doi/10.1177/0194599816671491
- Cureoglu S, Baylan MY, Paparella MM. Cochlear otosclerosis. Curr Opin Otolaryngol Head Neck Surg [Internet]. 2010 Oct [cited 2023 May 25];18(5):357–62. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075959/
- Jun HJ, Park MK. Cognitive behavioral therapy for tinnitus: evidence and efficacy. Korean J Audiol [Internet]. 2013 Dec [cited 2023 May 25];17(3):101–4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3936550/