Tinnitus: Ringing in the ears and what to do about it - Harvard Health (2022)

Constant noise in the head— such as ringing in the ears—rarely indicates a serious health problem, but it sure can be annoying. Here's how to minimize it.

Tinnitus: Ringing in the ears and what to do about it - Harvard Health (1)

Tinnitus (pronounced tih-NITE-us or TIN-ih-tus) is sound in the head with no external source. For many, it's a ringing sound, while for others, it's whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating.

Almost everyone has had tinnitus for a short time after being exposed to extremely loud noise. For example, attending a loud concert can trigger short-lived tinnitus. Some medications (especially aspirin and other nonsteroidal anti-inflammatory drugs taken in high doses) can cause tinnitus that goes away when the drug is discontinued. When it lasts more than six months, it's known as chronic tinnitus. As many as 50 to 60 million people in the United States suffer from this condition; it's especially common in people over age 55 and strongly associated with hearing loss. Many people worry that tinnitus is a sign that they are going deaf or have another serious medical problem, but it rarely is.

Most tinnitus is subjective, meaning that only you can hear the noise. But sometimes it's objective, meaning that someone else can hear it, too. For example, if you have a heart murmur, you may hear a whooshing sound with every heartbeat; your clinician can also hear that sound through a stethoscope. Some people hear their heartbeat inside the ear — a phenomenon called pulsatile tinnitus. It's more likely to happen in older people, because blood flow tends to be more turbulent in arteries whose walls have stiffened with age. Pulsatile tinnitus may be more noticeable at night, when you're lying in bed and there are fewer external sounds to mask the tinnitus. If you notice any new pulsatile tinnitus, you should consult a clinician, because in rare cases it is a sign of a tumor or blood vessel damage.

The course of chronic tinnitus is unpredictable. Sometimes the symptoms remain the same, and sometimes they get worse. In about 10% of cases, the condition interferes with everyday life so much that professional help is needed.

While there'sno cure for chronic tinnitus, it often becomes less noticeable and more manageable over time. You can help ease the symptoms by educating yourself about the condition — for example, understanding that it's not dangerous. There are also several ways to help tune out the noise and minimize its impact.

Auditory pathways and tinnitus

Tinnitus: Ringing in the ears and what to do about it - Harvard Health (2)

(Video) Tinnitus: Ringing in the Brain | Josef Rauschecker | TEDxCharlottesville

Sound waves travel through the ear canal to the middle and inner ear, where hair cells in part of the cochlea help transform sound waves into electrical signals that then travel to the brain's auditory cortex via the auditory nerve. When hair cells are damaged — by loud noise or ototoxic drugs, for example — the circuits in the brain don't receive the signals they're expecting. This stimulates abnormal activity in the neurons, which results in the illusion of sound, or tinnitus.

What's going on?

Most people who seek medical help for tinnitus experience it as subjective, constant sound like constant ringing in the ears or a buzzing sound in the ear, and most have some degree of hearing loss. Things that cause hearing loss (and tinnitus) include loud noise, medications that damage the nerves in the ear (ototoxic drugs), impactedearwax, middle ear problems (such as infections and vascular tumors), and aging. Tinnitus can also be a symptom ofMeniere'sdisease, a disorder of the balance mechanism in the inner ear.

Tinnitus can arise anywhere along the auditory pathway, from the outer ear through the middle and inner ear to the brain's auditory cortex, where it's thought to be encoded (in a sense, imprinted). One of the most common causes of tinnitus is damage to the hair cells in the cochlea (see "Auditory pathways and tinnitus"). These cells help transform sound waves into nerve signals. If the auditory pathways or circuits in the brain don't receive the signals they're expecting from the cochlea, the brain in effect "turns up the gain" on those pathways in an effort to detect the signal — in much the same way that you turn up the volume on a car radio when you're trying to find a station's signal. The resulting electrical noise takes the form of tinnitus — a sound that is high-pitched if hearing loss is in the high-frequency range and low-pitched if it's in the low-frequency range. This kind of tinnitus resembles phantom limb pain in an amputee — the brain is producing abnormal nerve signals to compensate for missing input.

Most tinnitus is "sensorineural," meaning that it's due to hearing loss at the cochlea or cochlear nerve level. But tinnitus may originate in other places. Our bodies normally produce sounds (called somatic sounds) that we usually don't notice because we are listening to external sounds. Anything that blocks normal hearing can bring somatic sounds to our attention. For example, you may get head noise when earwax blocks the outer ear.

Some drugs that can cause or worsen tinnitus

Aspirinand other nonsteroidal anti-inflammatory drugs,including ibuprofen (Motrin) and naproxen (Aleve, Naprosyn)

Certain antibiotics,including ciprofloxacin (Cipro), doxycycline (Vibramycin, others), gentamicin (Garamycin), erythromycin (Ery-Tab, others), tetracycline (Sumycin), tobramycin (Nebcin), and vancomycin (Vancocin)

Antimalarial drugssuch as chloroquine and quinine

(Video) What Makes Your Ears Ring?

Certain anticonvulsants,including carbamazepine (Tegretol, others) and valproic acid (Depakote, others)

Certain cancer drugs,including cisplatin (Platinol) and vincristine (Oncovin, Vincasar)

Loop diuretics (when given intravenously in high doses), including bumetanide (Bumex), furosemide (Lasix), and torsemide (Demadex)

Tricyclic antidepressantssuch as amitriptyline (Elavil, others), clomipramine (Anafranil), and imipramine (Tofranil)

Evaluate and treat underlying problems

If you develop tinnitus, it's important to see your clinician. She or he will take a medical history, give you a physical examination, and do a series of tests to try to find the source of the problem. She or he will also ask you to describe the noise you're hearing (including its pitch and sound quality, and whether it's constant or periodic, steady or pulsatile) and the times and places in which you hear it. Your clinician will review your medical history, your current and past exposure to noise, and any medications or supplements you're taking. Tinnitus can be a side effect of many medications, especially when taken at higher doses (see "Some drugs that can cause or worsen tinnitus").

Musculoskeletal factors — jaw clenching,tooth grinding, prior injury, or muscle tension in the neck — sometimes make tinnitus more noticeable, so your clinician may ask you to tighten muscles or move the jaw or neck in certain ways to see if the sound changes. If tight muscles are part of the problem, massage therapy may help relieve it.

Tinnitus that's continuous, steady, and high-pitched (the most common type) generally indicates a problem in the auditory system and requires hearing tests conducted by an audiologist. Pulsatile tinnitus calls for a medical evaluation, especially if the noise is frequent or constant. MRI or CT imaging may be needed to check for a tumor or blood vessel abnormality.

Your general health can affect the severity and impact of tinnitus, so this is also a good time to take stock of your diet, physical activity, sleep, and stress level — and take steps to improve them. You may also be able to reduce the impact of tinnitus by treating depression, anxiety, insomnia, and pain with medications or psychotherapy.

(Video) Can tinnitus cause loss of hearing ? | Most Rated Health FAQ Channel

If you're often exposed to loud noises at work or at home, it's important to reduce the risk of hearing loss (or further hearing loss) by using protectors such as earplugs or earmuff-like or custom-fitted devices.

Selected resources

American Academy of Audiology
www.audiology.org

American Tinnitus Association
www.ata.org

National Institute on Deafness and Other Communication Disorders
www.nidcd.nih.gov

Managing tinnitus

In addition to treating associated problems (such as depression or insomnia), there are several strategies that can help make tinnitus less bothersome. No single approach works for everyone, and you may need to try various combinations of techniques before you find what works for you. If you have age-related hearing loss, a hearing aid can often make tinnitus less noticeable by amplifying outside sounds.

There is no FDA-approved drug treatment for tinnitus, and controlled trials have not found any drug, supplement, or herb to be any more effective than a placebo. That includes ginkgo biloba, which is sometimes promoted for this purpose. Some patients believe that acupuncture helps, but it too has been found to be no better than a placebo.

The most effective approaches are behavioral strategies and sound-generating devices, often used in combination. They include the following:

(Video) What does it mean when you hear a ringing in your ear ? | Best Health FAQ Channel

Cognitive behavioral therapy (CBT).CBT uses techniques such as cognitive restructuring and relaxation to change the way patients think about and respond to tinnitus. Patients usually keep a diary and perform "homework" to help build their coping skills. Therapy is generally short-term — for example, weekly sessions for two to six months. CBT may not make the sound less loud, but it can make it significantly less bothersome and improve quality of life.

Tinnitus retraining therapy (TRT).This technique is based on the assumption that tinnitus results from abnormal neuronal activity (see "What's going on?"). The aim is to habituate the auditory system to the tinnitus signals, making them less noticeable or less bothersome. The main components of TRT are individual counseling (to explain the auditory system, how tinnitus develops, and how TRT can help) and sound therapy. A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient's tinnitus. Depending on the severity of the symptoms, treatment may last one to two years.

When TRT was developed in the 1980s by neuroscientist Dr. Pawel Jastreboff, it was designed to be administered according to a strict protocol. Today, the term TRT is being used to describe modified versions of this therapy, and the variations make accurate assessment of its effectiveness difficult. Individual studies have reported improvements in as many as 80% of patients with high-pitched tinnitus.

Masking.Masking devices, worn like hearing aids, generate low-level white noise (a high-pitched hiss, for example) that can reduce the perception of tinnitus and sometimes also produce residual inhibition — less noticeable tinnitus for a short time after the masker is turned off. A specialized device isn't always necessary for masking; often, playing music or having a radio, fan, or white-noise machine on in the background is enough. Although there's not enough evidence from randomized trials to draw any conclusions about the effectiveness of masking, hearing experts often recommend a trial of simple masking strategies (such as setting a radio at low volume between stations) before they turn to more expensive options.

Biofeedback andstress management.Tinnitus is stressful, and stress can worsen tinnitus. Biofeedback is a relaxation technique that helps control stress by changing bodily responses. Electrodes attached to the skin feed information about physiological processes such as pulse, skin temperature, and muscle tension into a computer, which displays the output on a monitor. Patients learn how to alter these processes and reduce the body's stress response by changing their thoughts and feelings. Mindfulness-based stress reduction techniques may also help.

Not all insurance companies cover tinnitus treatments in the same way, so be sure to check your coverage. If you're willing to enroll in a research study, you may be able to receive a cutting-edge treatment free. (For more information, go towww.clinicaltrials.gov, and enter the search term "tinnitus.")

Image: Casarsa_Guru/Getty Images

FAQs

How do I get rid of ringing of tinnitus? ›

Treatment
  1. Earwax removal. Removing an earwax blockage can decrease tinnitus symptoms.
  2. Treating a blood vessel condition. Underlying blood vessel conditions may require medication, surgery or another treatment to address the problem.
  3. Hearing aids. ...
  4. Changing your medication.
4 Feb 2021

Is there any cure for tinnitus ringing in the ears? ›

The Reason Why There Is No Cure for Tinnitus

The damage can be caused by noise exposure, ototoxic medications, or the existence of other health conditions. The damage results in instability of the sensorineural auditory pathway which produces a phantom signal that the brain interprets as sound.

What is the root cause of tinnitus? ›

Tinnitus is usually caused by an underlying condition, such as age-related hearing loss, an ear injury or a problem with the circulatory system. For many people, tinnitus improves with treatment of the underlying cause or with other treatments that reduce or mask the noise, making tinnitus less noticeable.

Why do doctors not take tinnitus seriously? ›

Many doctors simply never become aware of any actual treatments available for tinnitus sufferers. Another issue is that doctors often feel uncomfortable addressing the psychological and emotional impacts of a problem like tinnitus.

What is the best medication for tinnitus? ›

Medications for Tinnitus

For some, treatment with low doses of anti-anxiety drugs -- such as Valium or antidepressants such as Elavil -- help reduce tinnitus. The use of a steroid placed into the middle ear along with an anti-anxiety medicine called alprazolam has been shown to be effective for some people.

What is the best natural treatment for tinnitus? ›

Lifestyle changes for tinnitus
  • Treating dysfunctions and obstructions. According to the American Tinnitus Association, most cases of tinnitus are caused by hearing loss. ...
  • Exercise. Exercise can have a big impact on your overall health and well-being. ...
  • Mindfulness-based stress reduction. ...
  • DIY mindfulness meditation.

Is there a cure for tinnitus 2022? ›

Currently, there is no cure for tinnitus. In other words, there is treatment but no scientifically-proven approach to completely eliminate tinnitus. However, tinnitus can be improved for many individuals if the treatments are sensibly selected and properly carried out.

What is the latest treatment for tinnitus? ›

"Earlier trials have found white noise, goal-based counselling, goal-oriented games and other technology-based therapies are effective for some people some of the time," says Dr Searchfield. "This is quicker and more effective, taking 12 weeks rather than 12 months for more individuals to gain some control."

Are there any FDA approved treatments for tinnitus? ›

There are currently no FDA-approved drugs specifically for tinnitus.

What are the 2 types of tinnitus? ›

Tinnitus is generally broken down into two types: subjective and objective. Subjective tinnitus is very common and is defined as a sound that is audible only to the person with tinnitus. Subjective tinnitus is a purely electrochemical phenomenon and cannot be heard by an outside observer no matter how hard they try.

When should I see a neurologist for tinnitus? ›

if your tinnitus continues beyond a week, becomes bothersome, starts to interfere with your sleep and/or your concentration, or makes you depressed or anxious, seek medical attention from a trained healthcare professional.

What neurological conditions cause tinnitus? ›

Neurologic causes include head injury, whiplash, multiple sclerosis, vestibular schwannoma (commonly called an acoustic neuroma), and other cerebellopontine-angle tumors.

What happens if you dont treat tinnitus? ›

Like many other conditions that affect the hearing, tinnitus can also affect your quality of life. Many people who have tinnitus claim that they find it hard to think, sleep, concentrate, or enjoy silence. Untreated tinnitus can wreak even more havoc on your life, leading to irritability, insomnia, and even depression.

Can tinnitus be a brain problem? ›

Tinnitus could be the result of the brain's neural circuits trying to adapt to the loss of sensory hair cells by turning up the sensitivity to sound. This would explain why some people with tinnitus are oversensitive to loud noise.

Is tinnitus considered brain damage? ›

Myth #2: Tinnitus means your brain is dying

One study showed that roughly 76 percent of veterans with a traumatic brain injury also experienced tinnitus. So while tinnitus does not impact your brain, it could be an indicator of some other issue that is affecting your brain.

What meds worsen tinnitus? ›

Medications that can cause tinnitus
  • Aspirin and other NSAIDs. ...
  • Benzodiazepines. ...
  • Tricyclic antidepressants. ...
  • Certain antibiotics. ...
  • Isotretinoin (Accutane) ...
  • Loop diuretics. ...
  • Beta blockers. ...
  • ACE inhibitors and angiotensin receptor blockers.
22 Apr 2022

What spice gets rid of tinnitus? ›

So, it's a bit of a game changer that tinnitus symptoms could be alleviated by the powerful compounds within turmeric. Studies have shown that turmeric extracts have a positive anti-inflammatory response in ear conditions.

What tea helps with tinnitus? ›

Ginger Spice Iced Tea

There is some research which shows that ginger may be able to help relieve pressure levels in the ear that may possibly trigger tinnitus.

What herb cures tinnitus? ›

Despite this, Ginkgo biloba is the most commonly used herbal supplement for tinnitus (Hall 2011).

What can an audiologist do for tinnitus? ›

Audiologists are qualified to provide tinnitus counseling and management, to help soothe the ringing in your ears. Some other ways audiologists treat tinnitus include vitamin therapy, biofeedback, hypnosis, electrical stimulation, relaxation therapy, and tinnitus masking hearing aids.

Does CBD oil work for tinnitus? ›

While research suggests that CBD has promising qualities, like alleviating pain and helping with anxiety, there's no scientific evidence that CBD or any other cannabis product can help with tinnitus. That said, CBD may help you deal with the side effects of constant ringing in your ears, like sleep troubles and stress.

Does CBD gummies help with tinnitus? ›

CBD gummies are thought to help with tinnitus by reducing inflammation and relieving pain. CBD is an anti-inflammatory compound that can help to reduce the swelling in the ears that is associated with tinnitus. CBD is also a pain reliever, and it can help to reduce the pain that is associated with tinnitus.

Is there a shot for tinnitus? ›

Steroid Injections.

Fluctuation of hearing and resulting tinnitus can be treated with a series of injections of Dexamethasone (a potent steroid) with an 85 percent chance of reduction in tinnitus symptoms.

What is the difference between ringing in the ears and tinnitus? ›

Definition. Tinnitus is the medical term for "hearing" noises in your ears. It occurs when there is no outside source of the sounds. Tinnitus is often called "ringing in the ears." It may also sound like blowing, roaring, buzzing, hissing, humming, whistling, or sizzling.

What does severe tinnitus sound like? ›

People experience tinnitus as hearing many different and sometimes variably changing and intertwining sounds. People hear ringing, hissing, roaring, crickets, screeching, sirens, whooshing, static, pulsing, ocean waves, buzzing, clicking, dial tones, and even music.

Is tinnitus linked to dementia? ›

After adjusting for sociodemographic characteristics and medical co-morbidities, patients with early-onset dementia had a 67% higher likelihood of having prior tinnitus (OR = 1.628; 95% CI = 1.321–2.006).

Can a brain scan show tinnitus? ›

An MRI scan may reveal a growth or tumor near the ear or the eighth cranial nerve that could be causing tinnitus. Imaging tests can also help doctors evaluate pulsatile tinnitus. They can show changes in the blood vessels near the ears and determine whether an underlying medical condition is causing symptoms.

When is tinnitus serious? ›

Even though tinnitus is often benign, there are some specific symptoms that should alert people to seek medical evaluation: pulsatile tinnitus of any kind. tinnitus in one ear only. bothersome tinnitus that cannot be ignored.

What health issues cause tinnitus? ›

Medical causes of tinnitus

Anemia, allergies, impacted earwax, diabetes and an underactive thyroid gland (hypothyroidism) are all common medical conditions that can be associated with tinnitus and sometimes hearing loss.

Can neck problems cause tinnitus? ›

Can tinnitus and ringing in ears be caused by neck problems? The answer is yes. Clinically speaking it is called cervical tinnitus. In practice, these are whistles and ringing perceived in the ear in conjunction with the emergence of cervical pain and neck problems.

Does tinnitus mean nerve damage? ›

The vestibulo-cochlear nerve, or eighth cranial nerve, carries signals from the inner ear to the brain. Tinnitus can result from damage to this nerve.

What part of the brain does tinnitus affect? ›

Tinnitus is linked to abnormal changes at one or more levels along the auditory pathway [5-7]. Human brain imaging studies have identified altered tinnitus-related activity in auditory areas, including the inferior colliculus [8] and auditory cortex [9-11].

Will magnesium help tinnitus? ›

Magnesium is a mineral absolutely necessary for robust human health. It is a cofactor in over 300 enzyme systems that regulate biochemical reactions in the body. It has also been found to prevent hearing loss during noise exposure and is helpful in lowering tinnitus sounds due to hearing loss.

Is tinnitus in your ears or brain? ›

Ringing in the ears, also called tinnitus, can be a debilitating problem for the millions of people who suffer in the U.S. Some who are affected by tinnitus, however, do not suffer any major symptoms. Recent studies show that a person's experience with tinnitus originates with the brain, not the ears.

Can tinnitus affect your memory? ›

These studies generally show that tinnitus does affect the way that people process information but the methods that were used did not rule out other factors, which could affect performance on the tests of attention and memory used.

Is tinnitus usually in one or both ears? ›

Most people experience tinnitus in both ears, called bilateral tinnitus. Less commonly it develops in only one ear, called unilateral tinnitus. Tinnitus may be a sign of injury or dysfunction of the inner ear, and is often associated with age- or noise-related permanent hearing loss.

Does tinnitus mean Alzheimer's? ›

After adjusting for confounding factors like diabetes, head injuries, and income, the researchers determined that patients with tinnitus were 1.54 times more likely to develop Alzheimer's and 1.56 times more likely to develop Parkinson's.

Does tinnitus lead to stroke? ›

Thus, tinnitus could precede the occurrence of stroke not only as an intermediate role in the association between vascular disease and stroke, but also as an independent risk factor for stroke.

Does tinnitus mean brain tumor? ›

Symptoms that may indicate a possible cranial base tumor include: Headaches or dizziness. Tinnitus (ringing in the ear) Difficulty breathing.

What are the 4 types of tinnitus? ›

Tinnitus sounds different to everyone, so it makes sense that there are four different types: subjective, objective, neurological, and somatic.

How my tinnitus went away? ›

Tinnitus that is caused by ear infections, a build-up of earwax or perforated eardrums will go away but only if you seek treatment to deal with the underlying cause. This may be taking antibiotics to clear up infections or having your ears syringed to remove excess wax.

Does tinnitus worsen with age? ›

[1] The prevalence of chronic tinnitus increases with age, peaking at 14.3% in people 60–69 years of age.

Does tinnitus mean something serious? ›

Tinnitus is the name for hearing noises that are not caused by sounds coming from the outside world. It's common and not usually a sign of anything serious. It might get better by itself and there are treatments that can help.

What is the difference between tinnitus and ringing in the ears? ›

Definition. Tinnitus is the medical term for "hearing" noises in your ears. It occurs when there is no outside source of the sounds. Tinnitus is often called "ringing in the ears." It may also sound like blowing, roaring, buzzing, hissing, humming, whistling, or sizzling.

Is tinnitus a brain or ear disorder? ›

In most cases, tinnitus is a sensorineural reaction in the brain to damage in the auditory system. While tinnitus is often associated with hearing loss, there are roughly 200 different health disorders that can generate tinnitus as a symptom.

What does an MRI show for tinnitus? ›

An MRI scan may reveal a growth or tumor near the ear or the eighth cranial nerve that could be causing tinnitus. Imaging tests can also help doctors evaluate pulsatile tinnitus. They can show changes in the blood vessels near the ears and determine whether an underlying medical condition is causing symptoms.

Can tinnitus improve itself? ›

In many cases, tinnitus dissipates on its own regardless of the cause. However, that doesn't mean you should wait weeks, months, or even years for your tinnitus to disappear. If your tinnitus continues for more than a couple of weeks and negatively affects your quality of life, consult an audiologist.

Does anxiety cause tinnitus? ›

Anxiety activates the fight or flight system, which puts a lot of pressure on nerves, and increases blood flow, body heat, and more. This pressure and stress are very likely to travel up into your inner ear and lead to the tinnitus experience.

When is tinnitus considered permanent? ›

If you experience your tinnitus in short bursts, maybe only a few minutes each, there's a good chance that it will fade over time. However, if it has been going on for months or even years, then it's likely that the condition is permanent.

Videos

1. How to maintain healthy ears and hearing!
(Next Generation Acoustics)
2. "Progress in the Treatment of Hearing Disorders" - Michigan Medicine at Peninsula Community Library
(oldmission)
3. Tinnitus Ringing in the ears and what to do about it
(ringing in the ears treatment)
4. Caffeine and Tinnitus: Is There a Link?
(American Journal of Medicine)
5. Perimenopause Tinnitus? Yep, it's a thing
(Shock Talk With David and Mary Shockley)
6. Reducing Your Brain's Tinnitus with Dr. Keith Darrow, PhD
(Ben Thompson, AuD - Treble Health)

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