Tinnitus

Katy Waterman | Published 14 March 2024 | Updated 08 April 2024 | 8 mins read

A woman appears to be in pain, touching her ear.

What is tinnitus?

Tinnitus is a condition in which you can hear sounds even though there’s no external noise.

It can range from a quiet background hum to a loud, irritating whistling or ringing sound. It can arise suddenly or develop gradually over time. Some potential triggers include exposure to loud noises, age-related hearing loss, and certain medical conditions as well as injuries, trauma, or surgery to the head or ear. Regardless of how it starts, tinnitus can significantly impact your daily life.

Symptoms

Tinnitus symptoms can differ from one person to another. The primary symptom of tinnitus is the perception of sound with no external source, such as a ringing, buzzing, hissing, or roaring in your ears. But, the specifics of what you hear can vary widely.

Tinnitus symptoms can vary by:

Sound variations – noises can range from a subtle hissing or waves crashing to louder roaring, buzzing, whistling, or ringing sounds. The specific sound differs from person to person.
Volume fluctuations – the volume of these sounds can fluctuate, changing intensity over the day. For some people, it is a constant sound that stays at the same volume all the time. For others it may have intermittent changes and be louder at night, for example.
Duration – tinnitus symptoms may be continuous or episodic, with the noises coming and going at different times.

In addition to these primary symptoms, tinnitus can also be accompanied by some secondary symptoms including:

Hearing changes – some people with tinnitus might notice a decline in their overall hearing ability.
Sensitivity to sounds – sometimes, tinnitus can lead to hyperacusis, a heightened sensitivity to everyday sounds, making daily life seem louder or more bothersome than before.

However, not everyone with tinnitus will experience these secondary symptoms.

What does tinnitus sound like?

Tinnitus sounds different for everyone but can generally be categorised into the following sound types.

Ringing	A high-pitched ringing that can sound faint and delicate or deep and resonant like a ringing phone.
Buzzing	It can sound like bees buzzing near your ear or as if your phone is vibrating on a hard surface.
Hissing	Can sound like water simmering on the stove, or like the sound of air escaping from a tyre.
Roaring	This can sound like a distant aeroplane or as if you are by the sea listening to the waves crash on the sand.
Pulsating	Can sound like a rhythmic beat like a drum or metronome. It may be in sync with your heartbeat.
Clicking	Can be irregular and unpredictable. Sounds like a sharp tapping sound or like the click of a camera shutter.
Musical	This can sound like singing or as if there is music playing when there is none.

Main types of tinnitus

There are many different types of tinnitus however the three main types are most common – subjective, objective, and pulsatile.

Subjective tinnitus

This type of tinnitus is the most common type where only the person experiencing it can hear the sounds. This type of tinnitus often results from irregularities in the communication between the auditory nerves and the brain, or underlying issues within the ear.

Objective tinnitus

Objective tinnitus is much rarer than subjective tinnitus. It’s a type of tinnitus that sometimes allows those in close proximity to the sufferer to also hear the tinnitus sounds. It is often caused by vascular or muscular issues.

Pulsatile tinnitus

Pulsatile tinnitus is a type of tinnitus where the sufferer will hear sounds synchronised with the rhythm of their heartbeat. It is often linked to the constriction in blood flow around the head, neck, or ears.

It could also be a potential indicator of an underlying medical condition, making it crucial to get help and guidance from a healthcare professional.

Causes

There are a wide variety of factors that can cause tinnitus so uncovering the origin can be a complex problem to solve.

Exposure to loud noise – prolonged exposure to loud noises such as concerts, industrial machinery, or firearms can damage the delicate structures inside your ears. Always wear ear protection in loud environments.
Age-related tinnitus – The natural wear and tear on our ears as we age can result in age-related hearing loss which can include the development of tinnitus.
Ear wax build up – Sometimes we can experience earwax buildup which can obstruct your ear canal and cause tinnitus symptoms.
Medications – some medications such as non-steroidal anti-inflammatory drugs, antibiotics, and some antidepressants can cause tinnitus as a side effect.
Perforated eardrum – a tear or hole in your eardrum which can cause ear infections and sudden hearing loss. Tinnitus is a symptom of this.
Cholesteatoma – an abnormal collection of skin cells deep inside your ear. They’re rare but, if left untreated, they can damage the delicate structures inside your ear which can result in tinnitus, hearing, and balance issues.
Cancer – Some cancers and cancer treatments may cause tinnitus.
Multiple Sclerosis (MS) – People with MS can sometimes experience problems including tinnitus, increased sensitivity to sound and loss of hearing.
Meniere’s disease – A condition where excess fluid builds up in the inner ear resulting in a range of issues including balance problems, vertigo and tinnitus.
Ear infections – infections in your ears and sinuses can disrupt your auditory system resulting in temporary bouts of tinnitus.

Side effects

Tinnitus can impact your daily life and lower your quality of life which is why it’s important to treat the underlying cause as soon as possible. Some tinnitus sufferers may struggle to get a full night’s rest, feel isolated, or struggle to concentrate on tasks.

Common side effects of tinnitus include:

Anger
Concentration problems
Isolation
Depression, anxiety, and feelings of hopelessness
Sensitivity to places with constant talking or loud music
Sleep disorders, insomnia
Some people can ignore their tinnitus most of the time, but leaving it untreated can have a negative impact on your life if it’s experienced over extended periods of time.

Diagnosis

Making sure you seek a proper diagnosis for your tinnitus is essential. Whether it has developed recently or is a long-standing issue, contacting your GP is the first step you should take towards understanding and treating your tinnitus.

Here’s a step-by-step guide on the diagnosis process:

Consult your GP – your doctor will be able to provide an assessment and diagnosis.
Symptom evaluation – your GP will review your symptoms, inquiring about:
- The affected ear(s)
- Sound continuity
- Impact on your hearing
Medical history – your medical history will be discussed.
Ear examination – your doctor will use an otoscope to examine the inside of your ears, checking for issues like earwax buildup or infections.
Further investigation – if only one ear is affected without any apparent causes, your GP may refer you for further investigations to try and find potential underlying causes.

Learn more about tinnitus consultation

Treatment

While there’s no definitive cure for tinnitus, there are effective ways to manage the symptoms.

Some common treatment options include:

Earwax removal – If your tinnitus is linked to a buildup of earwax, your GP will recommend earwax removal.
Medication adjustments – If it’s deemed that your tinnitus is being caused by a medication you’re on, your GP may suggest an adjustment to your dose.
White noise – Using white noise can help to mask the sound of tinnitus – think using fans, music, or tv shows to help block out the sounds.
Hearing aids – For those with intermittent tinnitus or who don’t constantly notice it, hearing aids equipped with tinnitus sound adjustments can be beneficial.
Therapy – Tinnitus can be distressing and impact your daily life. Undergoing therapies like Tinnitus Retraining Therapy (TRT) or Cognitive Behavioral Therapy (CBT) can help you alter your perception and response to it
Natural remedies – There’s no medical evidence to suggest that natural remedies can help your tinnitus but some people find that zinc or magnesium supplements or using melatonin can be beneficial for them.

Takeaway

Tinnitus is a common issue that many people suffer with. It can develop independently, for example as a result of damage to the inner ear, or as a symptom of another underlying health condition such as Ménière’s disease. It sounds different to every person, ranging from a high-pitched ringing sound to a deep roaring noise. And there are many different types of tinnitus. Treating tinnitus is important to preserve your quality of life for as long as possible.

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FAQs

Tinnitus can come and go. In fact, it is often temporary and goes away within 16 to 48 hours. However, if it continues for days or weeks, or if it has gotten louder, you should talk to your GP or hearing care expert.

It’s rare that tinnitus is associated with a serious medical problem. It is usually not severe enough to interfere with daily life. But, some people find that it affects their mood and their ability to sleep or concentrate.

There are some studies that suggest that tinnitus may be inherited. If a family member has tinnitus, you might have an increased likelihood of developing it. There are also a number of inherited conditions which can increase your likelihood of developing tinnitus. This is why it’s important to regularly have your hearing checked.