Tinnitus: common causes and what can help

Woman resting her head in the evening, noticing ringing in her ears

Have you ever noticed a ringing, buzzing or humming in your ears when the room is quiet? You are far from alone. Tinnitus is common, and while it can be frustrating, a lot can help. This article is general information, not medical advice. If you are worried about your symptoms, please speak to a doctor.

What is tinnitus?

The NIDCD (the US National Institute on Deafness and Other Communication Disorders) describes tinnitus as the perception of sound that has no external source, so other people cannot hear it. Besides ringing, the NHS says it can sound like buzzing, whooshing, humming, hissing, throbbing, or even music. It may affect one ear, both ears or your head, and may come and go.

The NIDCD says surveys estimate that 10 to 25% of adults have tinnitus, and that children can have it too. NHS inform, Scotland’s national health information service, says around 1 in 10 people have persistent tinnitus.

Reassuringly, the NHS says tinnitus is not usually a sign of anything serious and may get better by itself.

Common causes and links

The exact cause is not always clear, but health organisations link tinnitus to several common factors.

Hearing loss

The NIDCD says most people who have tinnitus have some degree of hearing loss, often caused by ageing or loud noise. Mayo Clinic explains that damaged hair cells in the inner ear may “leak” random signals to the brain.

Noise exposure

NHS inform says most people have tinnitus for a short time after loud noise, such as a concert, and that repeated exposure can damage the inner ear.

Ear wax and ear infections

According to the NIDCD, a blockage of the ear canal by ear wax, or by fluid from an ear infection, can trigger tinnitus. These causes are often treatable.

Some medicines

The NHS says tinnitus can be a side effect of some medicines, including certain chemotherapy medicines, antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin. The NIDCD adds that this is more likely at high doses. Never stop or change a medicine without talking to your doctor first.

Stress and fatigue

ASHA lists stress and fatigue among the factors associated with tinnitus, and the NHS and Mayo Clinic both note that stress can make it worse.

Other conditions

The NHS also mentions Ménière’s disease, diabetes, thyroid disorders and multiple sclerosis, and the NIDCD lists head or neck injuries, jaw joint problems and high blood pressure. Mayo Clinic describes tinnitus as a symptom of more than 200 different health conditions, rather than a disease in itself.

When to see a doctor urgently

Most tinnitus is not an emergency, but some signs need prompt medical attention:

Tinnitus that beats in time with your pulse. The NHS advises asking for an urgent GP appointment. The NIDCD says imaging tests may be needed when tinnitus pulsates.
Tinnitus with sudden hearing loss, facial weakness or a spinning sensation (vertigo), or after a head injury. The NHS says to go to an emergency department.
Tinnitus with dizziness, or numbness or weakness in the face, arm or leg. Mayo Clinic advises seeing a healthcare professional as soon as possible.
Tinnitus in one ear only. Worth having checked: Mayo Clinic notes that acoustic neuroma, a non-cancerous growth on the hearing nerve, can cause continuous, high-pitched ringing in one ear.

The NHS also recommends seeing a doctor, less urgently, if your tinnitus is regular or constant, is getting worse, or is affecting your sleep, concentration or mood.

What can help

The NIDCD says there is currently no cure for tinnitus, but there are ways to reduce symptoms. Treating a cause such as ear wax can remove or greatly reduce it. Otherwise, the aim is to make tinnitus less noticeable.

Sound therapy

ASHA notes that tinnitus may be more noticeable in quiet places. The NHS advises against total silence and suggests listening to soft music or sounds. The NIDCD describes options from bedside or smartphone sound generators to small wearable devices that produce soft, pleasant sounds.

Hearing aids when there is hearing loss

The NIDCD calls hearing aids one of the main treatment options for people with tinnitus who have hearing loss: by making outside sounds easier to hear, they make tinnitus less noticeable. ASHA adds that some hearing aids have a built-in tinnitus masker.

CBT-based approaches

Cognitive behavioural therapy (CBT) helps you change the way you think about and respond to tinnitus. The NIDCD says studies have shown it can improve wellbeing in people with tinnitus, and the NHS lists CBT among the talking therapies that may be offered. Tinnitus retraining therapy, which combines counselling with sound therapy, is another option. The American Tinnitus Association notes these need active participation, often over 3 to 12 months.

Relaxation and sleep

The NHS suggests:

trying deep breathing or yoga to help you relax
sticking to a bedtime routine and cutting down on caffeine
keeping busy with hobbies rather than focusing on the tinnitus
joining a support group

Protecting your hearing

Mayo Clinic recommends wearing hearing protection around loud sounds, turning down headphone volume and limiting alcohol, caffeine and nicotine, which can worsen tinnitus.

A word of caution: the NIDCD notes that supplements advertised as cures have not been proven to work.

How a hearing assessment helps

Because tinnitus and hearing loss so often go together, a hearing test is a useful first step. ASHA says an audiologist can test your hearing, assess your tinnitus and discuss management options. They may ask what the sound is like, what makes it better or worse and how it affects your sleep, and may measure its pitch and loudness.

At Harmony, our hearing tests give you a clear picture of your hearing. Our tinnitus management service offers an assessment and practical support. Where hearing loss is part of the picture, we can talk you through options, including Starkey hearing aids. Where a medical opinion is needed, we work alongside ENT surgeons.

You do not have to face it alone

Understanding tinnitus is often the first step towards feeling more in control. If ringing or buzzing is bothering you, book an appointment with Harmony. We will listen, explain your results in plain language and help you find a way forward that suits you.