Tinnitus (ringing in the ears)

Understanding the symptoms, risk factors, causes and treatments is important to managing tinnitus.

Overview

What is tinnitus?

Tinnitus is an awareness of sound in the ears or head which is not from an external source. There are many different types of tinnitus sounds. Common descriptions are that it is a hiss, whistle, whirr, ring or buzz. Occasionally, it can be segments of music. The pitch can be high or low and the level can vary over time.

Tinnitus is the perception of noise or ringing in the ears. A common problem, tinnitus affects about 15 to 20 percent of people. Tinnitus isn’t a condition itself — it’s a symptom of an underlying condition, such as age-related hearing loss, ear injury or a circulatory system disorder.

Although bothersome, tinnitus usually isn’t a sign of something serious. Although it can worsen with age, for many people, tinnitus can improve with treatment. Treating an identified underlying cause sometimes helps. Other treatments reduce or mask the noise, making tinnitus less noticeable.

Ever heard ringing and not from your phone? An estimated 25 million Americans have already experienced a ringing sound in their ears, or Tinnitus. Common triggers include: acute/excessive noise, impaired blood circulation, stress, or misalignment of the cervical spine or jaw joint – or general hearing loss. The reason for its occurrence varies based on individual lifestyles.

No matter what the cause, you can get help now! If you are 55 or over, you’re in an especially good position to get assistance.

Tinnitus can occur in one ear (left or right) or both. The noises originate in the head and ear canal rather than outside the body. There are about 200 health disorders that could cause tinnitus sounds. One of the most frequent reasons for ear ringing is hearing loss. The damage could be caused by age related factors, noise factors or both. Speaking with a Advanced Hearing expert can help you understand if you have hearing loss that may have gone unnoticed.

The sounds experienced by people vary in volume, intensity and type. Some noises sound like high-pitched ringing while others sound like an airplane engine. Other types of noises are similar to the sounds of wind blowing, a rainstorm, or a tea kettle whistling. People experience intermittent or constant sounds. Whatever type of sound experienced, the noise disrupts a person’s life. A person may never have relief from constant ear noise.

About forty percent of the population will experience unpleasant ear ringing at some point in their lifetime. Ten to twenty percent will experience chronic tinnitus (a duration of over three months). Symptoms most commonly occur in people over the age of 40. However, people of all ages are susceptible to some form of disruptive and persistent ear ringing.

Carefully read the information below so that you can identify the symptoms, causes, and available treatments. Please call Advanced Hearing to speak with an expert about your questions. We will explain tinnitus in further depth, discuss your symptoms, and, if you like, set an appointment for you with a hearing specialist. Call us today!

Definition of tinnitus

The main tinnitus symptom is hearing different noises when none are present in the external environment. These noises vary but many sound like leaves rustling in the wind, waves crashing, or plow trucks pushing snow over concrete. The noises may come and go or be present all the time, affecting one ear or both. Due to the constant noises, people may have sleep difficulties, poor concentration, headaches, and tension in the neck.

How common is tinnitus?

In its mildest form, tinnitus is extremely common and many people experience occasional sounds in their ears, for example after being in a noisy place such as a concert. An estimated 10% of the UK adult population experience tinnitus frequently. Around 5% find it affects their quality of life.

Symptoms

Tinnitus involves the sensation of hearing sound when no external sound is present. Tinnitus symptoms may include these types of phantom noises in your ears:

  • Ringing
  • Buzzing
  • Roaring
  • Clicking
  • Hissing
  • Humming

The phantom noise may vary in pitch from a low roar to a high squeal, and you may hear it in one or both ears. In some cases, the sound can be so loud it can interfere with your ability to concentrate or hear external sound. Tinnitus may be present all the time, or it may come and go.

There are two kinds of tinnitus.

  • Subjective tinnitus is tinnitus only you can hear. This is the most common type of tinnitus. It can be caused by ear problems in your outer, middle or inner ear. It can also be caused by problems with the hearing (auditory) nerves or the part of your brain that interprets nerve signals as sound (auditory pathways).
  • Objective tinnitus is tinnitus your doctor can hear when he or she does an examination. This rare type of tinnitus may be caused by a blood vessel problem, a middle ear bone condition or muscle contractions.

When to see a doctor

If you have tinnitus that bothers you, see your doctor.

Make an appointment to see your doctor if:

  • You develop tinnitus after an upper respiratory infection, such as a cold, and your tinnitus doesn’t improve within a week

See your doctor as soon as possible if:

  • You have tinnitus that occurs suddenly or without an apparent cause
  • You have hearing loss or dizziness with the tinnitus

Ear noise sounds like:

Reasons for its emergence

The reasons for the emergence of tinnitus have only been partially explained. One of the possible causes is the effect of noise or certain medicaments on the auditory nerve. In healthy ears, the nerves spontaneously produce electrical impulses, so-called spontaneous activity. This changes when the noise meets the ear. Through this encrypted information is sent to the ear. If the auditory nerve is damaged it has the effect of spontaneous activity. This can reduce or change in time. It is assumed that a deviation of spontaneous activity results in subjective ear ringing. Tinnitus can also, however, take place in the brain.

In this case it is a so-called central tinnitus, a defective transmission of information, which occurs on the transmission path between the hair cells in the ear and the brain. One of the major causes of ear ringing continues to be diagnosed as stress. Stress induces a great number of physical reactions. The body excretes more of the hormone cortisol, which results in a constriction of the blood vessels reducing blood circulation. This reduction has a particular effect on the small blood vessels, the capillaries, and can lead to closure of the blood vessels in the inner ear. It is not yet known precisely how the reactions triggered by stress cause ear ringing.

Preventing Tinnitus

The causes of tinnitus are many. But there is good news! The risk of occurrence can be reduced and there are preventative measures to take to avoid this illness. Fundamentally one must avoid the danger of damaging the ear through loud noises. Wear enough protection for your hearing against loud noises. Furthermore, one should reduce stress as much as possible. To this end, manage your time and allow for periods of relaxation and exercise. Recognize stress in your life, find healthy ways to cope with stress, have a support network, and eat balanced and healthy meals. These choices can lead to more energy and a more efficient everyday life. One should most certainly go to an ENT specialist with acute ear noise for a short-term therapy – usually through the use of medicaments – to avoid long-term problems.

hear.com is your expert in hearing aids. We have a nation-wide network of hearing aid providers, so we are certain to have a partner in your area! Your satisfaction is our greatest motivation. We can provide you with information on tinnitus as well as other diseases such as Meniere’s disease and hypoacusis. We also introduce you to top hearing aid manufacturers and their products.

Causes

A number of health conditions can cause or worsen tinnitus. In many cases, an exact cause is never found.

A common cause of tinnitus is inner ear hair cell damage. Tiny, delicate hairs in your inner ear move in relation to the pressure of sound waves. This triggers cells to release an electrical signal through a nerve from your ear (auditory nerve) to your brain. Your brain interprets these signals as sound. If the hairs inside your inner ear are bent or broken, they can “leak” random electrical impulses to your brain, causing tinnitus.

Other causes of tinnitus include other ear problems, chronic health conditions, and injuries or conditions that affect the nerves in your ear or the hearing center in your brain.

Common causes of tinnitus

In many people, tinnitus is caused by one of these conditions:

  • Age-related hearing loss. For many people, hearing worsens with age, usually starting around age 60. Hearing loss can cause tinnitus. The medical term for this type of hearing loss is presbycusis.
  • Exposure to loud noise. Loud noises, such as those from heavy equipment, chain saws and firearms, are common sources of noise-related hearing loss. Portable music devices, such as MP3 players or iPods, also can cause noise-related hearing loss if played loudly for long periods. Tinnitus caused by short-term exposure, such as attending a loud concert, usually goes away; both short- and long-term exposure to loud sound can cause permanent damage.
  • Earwax blockage. Earwax protects your ear canal by trapping dirt and slowing the growth of bacteria. When too much earwax accumulates, it becomes too hard to wash away naturally, causing hearing loss or irritation of the eardrum, which can lead to tinnitus.
  • Ear bone changes. Stiffening of the bones in your middle ear (otosclerosis) may affect your hearing and cause tinnitus. This condition, caused by abnormal bone growth, tends to run in families.

Other causes of tinnitus

Some causes of tinnitus are less common, including:

  • Meniere’s disease. Tinnitus can be an early indicator of Meniere’s disease, an inner ear disorder that may be caused by abnormal inner ear fluid pressure.
  • TMJ disorders. Problems with the temporomandibular joint, the joint on each side of your head in front of your ears, where your lower jawbone meets your skull, can cause tinnitus.
  • Head injuries or neck injuries. Head or neck trauma can affect the inner ear, hearing nerves or brain function linked to hearing. Such injuries generally cause tinnitus in only one ear.
  • Acoustic neuroma. This noncancerous (benign) tumor develops on the cranial nerve that runs from your brain to your inner ear and controls balance and hearing. Also called vestibular schwannoma, this condition generally causes tinnitus in only one ear.
  • Eustachian tube dysfunction. In this condition, the tube in your ear connecting the middle ear to your upper throat remains expanded all the time, which can make your ear feel full. Loss of a significant amount of weight, pregnancy and radiation therapy can sometimes cause this type of dysfunction.
  • Muscle spasms in the inner ear. Muscles in the inner ear can tense up (spasm), which can result in tinnitus, hearing loss and a feeling of fullness in the ear. This sometimes happens for no explainable reason, but can also be caused by neurologic diseases, including multiple sclerosis.

Blood vessel disorders linked to tinnitus

In rare cases, tinnitus is caused by a blood vessel disorder. This type of tinnitus is called pulsatile tinnitus. Causes include:

  • Atherosclerosis. With age and buildup of cholesterol and other deposits, major blood vessels close to your middle and inner ear lose some of their elasticity — the ability to flex or expand slightly with each heartbeat. That causes blood flow to become more forceful, making it easier for your ear to detect the beats. You can generally hear this type of tinnitus in both ears.
  • Head and neck tumors. A tumor that presses on blood vessels in your head or neck (vascular neoplasm) can cause tinnitus and other symptoms.
  • High blood pressure. Hypertension and factors that increase blood pressure, such as stress, alcohol and caffeine, can make tinnitus more noticeable.
  • Turbulent blood flow. Narrowing or kinking in a neck artery (carotid artery) or vein in your neck (jugular vein) can cause turbulent, irregular blood flow, leading to tinnitus.
  • Malformation of capillaries. A condition called arteriovenous malformation (AVM), abnormal connections between arteries and veins, can result in tinnitus. This type of tinnitus generally occurs in only one ear.

Medications that can cause tinnitus

A number of medications may cause or worsen tinnitus. Generally, the higher the dose of these medications, the worse tinnitus becomes. Often the unwanted noise disappears when you stop using these drugs. Medications known to cause or worsen tinnitus include:

  • Antibiotics, including polymyxin B, erythromycin, vancomycin (Vancocin HCL, Firvanq) and neomycin
  • Cancer medications, including methotrexate (Trexall) and cisplatin
  • Water pills (diuretics), such as bumetanide (Bumex), ethacrynic acid (Edecrin) or furosemide (Lasix)
  • Quinine medications used for malaria or other health conditions
  • Certain antidepressants, which may worsen tinnitus
  • Aspirin taken in uncommonly high doses (usually 12 or more a day

In addition, some herbal supplements can cause tinnitus, as can nicotine and caffeine.

Risk factors

Anyone can experience tinnitus, but these factors may increase your risk:

  • Loud noise exposure. Prolonged exposure to loud noise can damage the tiny sensory hair cells in your ear that transmit sound to your brain. People who work in noisy environments — such as factory and construction workers, musicians, and soldiers — are particularly at risk.
  • Age. As you age, the number of functioning nerve fibers in your ears declines, possibly causing hearing problems often associated with tinnitus.
  • Sex. Men are more likely to experience tinnitus.
  • Smoking. Smokers have a higher risk of developing tinnitus.
  • Cardiovascular problems. Conditions that affect your blood flow, such as high blood pressure or narrowed arteries (atherosclerosis), can increase your risk of tinnitus.

Complications

Tinnitus can significantly affect quality of life. Although it affects people differently, if you have tinnitus, you may also experience:

  • Fatigue
  • Stress
  • Sleep problems
  • Trouble concentrating
  • Memory problems
  • Depression
  • Anxiety and irritability

Treating these linked conditions may not affect tinnitus directly, but it can help you feel better.

Prevention

In many cases, tinnitus is the result of something that can’t be prevented. However, some precautions can help prevent certain kinds of tinnitus.

  • Use hearing protection. Over time, exposure to loud sounds can damage the nerves in the ears, causing hearing loss and tinnitus. If you use chain saws, are a musician, work in an industry that uses loud machinery or use firearms (especially pistols or shotguns), always wear over-the-ear hearing protection.
  • Turn down the volume. Long-term exposure to amplified music with no ear protection or listening to music at very high volume through headphones can cause hearing loss and tinnitus.
  • Take care of your cardiovascular health. Regular exercise, eating right and taking other steps to keep your blood vessels healthy can help prevent tinnitus linked to blood vessel disorders.

Tinnitus and hearing difficulties

People with ear ringing often have hearing difficulties which reduce quality of life and health significantly. A hearing test used in a research study of ear noise therapy revealed 95% of tinnitus patients had damaged hearing. 89% of the patients had hearing impairment in both ears. Only 5% had no hearing impairment. However, one cannot conclude that hearing loss or difficulties result in ear ringing. Nonetheless, damaged hearing is considered to be a direct cause for ear ringing symptoms. Around 80% suffering hearing damage for a long period have chronic ear ringing. Hearing aids can be an appropriate means for treating hearing difficulties and at the same time prevent ear ringing. Please request a call with a hear.com expert to learn more about our hearing aids.

Tinnitus and hearing aids

More than fifty percent of tinnitus sufferers also have a loss of hearing. When hearing loss occurs, the brain may lose its ability to process certain sounds and frequencies. Ear ringing may occur as the brain changes in response to hearing loss. Therefore, as hearing aids help restore the brain’s ability to process certain sounds and frequencies, ear ringing may be reduced or alleviated altogether.

The use of hearing aids with so-called tinnitus noisers can effectively relieve tinnitus and hearing loss. The tinnitus noiser counteracts the beeping and whistling by producing a signal that cancels out the distracting noises. It produces a continuous noise that the person perceives as pleasant. It is quieter than tinnitus itself and has a calming effect on the auditory system and consequently the neural pathway to the brain relaying auditory sensations. This enables the brain to re-learn how to focus on noises in the external environment and minimizes or completely eradicates the fixation on the ear noise. The brain has filter systems that categorize sounds as important or not important. After a while, due to the constant signal produced by the noiser, both the noiser and the tinnitus are categorized as not important. An effective reprogramming of the brain is achieved by so-called noise generators, positioned either behind both ears or worn in the ear. This therapy helps the brain become accustomed to sounds and after a certain time, fade them out. The result: tinnitus is not sensed anymore.

Currently, wearing hearing aids for tinnitus is the best solution. Many people with hearing loss find effective relief with these kinds of sound-increasing devices. According to this research: “Clinical evidence shows that the use of hearing aids in tinnitus patients provides two benefits: it makes the patient less aware of the tinnitus and it improves communication by reducing the annoying sensation that sounds and voices are masked by the tinnitus.”

Leading companies in the hearing aid sector have specialized in these devices due to the high number people experiencing ear ringing.

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