Ringing In Ears (Tinnitus): Causes, Diagnosis and Treatment

Tinnitus is a common symptom that affects about 50 million Americans.

Most people describe tinnitus as the perception of ringing in their ears, which can be frustrating.

If the sound is loud or persistent, tinnitus can interfere with your hearing, sleep, and ability to focus.

Tinnitus itself isn’t a disease but a symptom, and it can stem from several medical causes.

There’s no cure for tinnitus, but it can be managed, typically by treating the medical issue that causes it.

If you’re experiencing ringing (or any other sound) in your ears, talk to your health care provider, who can help identify the cause and, hopefully, find a treatment that helps. 

In this article, I’ll explain tinnitus, its symptoms, and its causes.

I’ll explore how tinnitus is diagnosed and how to manage and treat it.

Lastly, I’ll cover tinnitus prevention and when to see a medical provider for ringing in your ears. 

What is Tinnitus (Ringing in Ears)? 

Tinnitus is the perception of a sound in one or both ears when there’s no external sound present.

Many people describe tinnitus as a sound of ringing in their ears; however, tinnitus can also cause buzzing, hissing, humming, or clicking sounds. 

In the case of pulsatile tinnitus, people that experience this symptom often hear rhythmic throbbing, thumping, or whooshing sounds in both ears, which usually sync with the beating of the heart.

About 60% of people who experience pulsatile tinnitus also suffer from anxiety or depression. 

There’s no direct cure for tinnitus.

That’s because it is not a medical condition in and of itself but typically a sign of another medical condition.

For that reason, tinnitus is usually best managed by treating the underlying condition. 

Symptoms

Tinnitus is defined as ringing in one’s ears, even when there’s no external ringing sound.

Not everyone with tinnitus hears ringing.

Sometimes, people with tinnitus describe the sound as buzzing, hissing, humming, or clicking. 

The sound can be soft or loud and can occur in one or both ears.

Tinnitus may be constant, or it can occur in episodes.

If the sound is loud or persistent, tinnitus may interfere with your ability to concentrate or sleep.

Tinnitus may also affect your ability to hear other noises. 

Causes

Tinnitus is a symptom, not a disease, and it can be a sign of many other medical conditions.

Some of the most common causes of tinnitus are: 

• Hearing loss: Your inner ear contains tiny hair cells that move when your ear hears. The movement of these cells triggers your auditory nerve, and your brain interprets the sound. With age or exposure to loud sounds, these hairs can become damaged or even break, causing your ear to send electrical signals to your brain. These random signals can cause tinnitus. 

• Ear canal blockage: If your ear canal is blocked by fluid, wax, or dirt, the pressure level in your ear can change, triggering tinnitus. Conditions that affect the upper respiratory tract, such as allergies or the common cold, may cause fluid buildup in your ears, potentially resulting in tinnitus.
  
• An injury: A neck or head injury can impact your inner ear, auditory nerves, or the part of your brain that controls hearing.
  
• Meniere’s disease: Tinnitus can be a sign of Meniere’s disease, a disorder that causes abnormal inner ear fluid pressure. Typically, people with this condition also have problems with balance.
  
• Medication: Certain medications, such as non-steroidal anti-inflammatory drugs (aspirin, ibuprofen, naproxen); antibiotics; diuretics; antidepressants; and cancer drugs, can cause tinnitus or make it worse. Usually, tinnitus stops when you stop taking the drug. Talk to your healthcare provider before stopping a prescription.
  
• Temporomandibular (TMJ) joint disorder: Problems with the temporomandibular joint, the joint that connects your jawbone to your skull, can result in tinnitus.
  
• Eustachian tube dysfunction: Your ears have tubes connecting the middle ear to your throat. If this tube stays expanded when it’s not supposed to, you may experience a sensation of fullness and ringing in your ears.
  
• Blood vessel disorders: If blood moves too forcefully through your veins and arteries due to conditions such as high cholesterol and high blood pressure, you may experience tinnitus. 

• Ear muscle spasm: Some people experience muscle spasms in their inner ear, which can cause tinnitus. Ear muscle spasms can be benign (occurring without a medical cause) or a sign of multiple sclerosis.
  
• Chronic illnesses: Certain chronic conditions, such as autoimmune diseases, migraines, fibromyalgia, thyroid problems, and diabetes, can cause tinnitus.
  
• Mental health conditions: Stress, anxiety, and depression can result in the ringing of the ears such as experienced by people with pulsatile tinnitus.
  

Rarely, tinnitus may be a sign of a tumor in the head or neck. 

Diagnosis 

If you’re experiencing tinnitus, your healthcare provider can diagnose you based on your symptoms.

Tinnitus usually occurs due to another medical condition, so your provider will likely try to identify the cause in order to treat you.

Be prepared to share your medical history and a description of your current symptoms. 

Along with a physical exam, your doctor may recommend tests to identify the cause of your tinnitus symptoms.

Tinnitus tests may include: 

• A hearing test: Some people with tinnitus also have hearing loss. In a hearing test, aka an audiological exam, your healthcare provider evaluates your ear function and hearing to better understand how your tinnitus affects you.
  
• Imaging tests: Your healthcare provider may order a CT or MRI scan if your tinnitus is unilateral, or in just one ear. Detailed imaging of your inner ear may show a structural problem contributing to your tinnitus symptoms.
  
• Lab tests: Blood tests can help determine if you have certain conditions that can result in tinnitus, such as anemia, diabetes, or thyroid problems. 

Managing Tinnitus 

Even mild forms of tinnitus can be frustrating.

While there’s no “cure” for tinnitus (e.g., the underlying condition has no cure), the symptom can be managed with lifestyle changes.

Your medical provider may recommend any of the below tools for managing tinnitus: 

• Stress reduction: Do your best to reduce stress and promote relaxation. Mindfulness, meditation, yoga, and deep breathing can help stave off tinnitus-related stress.
  
• Psychotherapy: Cognitive behavioral therapy and acceptance and commitment therapy can help you shift your negative thoughts about tinnitus and, hopefully, improve your quality of life.
  
• Limit alcohol and caffeine: Both alcohol and caffeine can affect your blood flow, which could make tinnitus symptoms worse. If you consume caffeine or alcohol and have tinnitus, try to cut back on your consumption.
  
• White noise machines: If you’re having trouble sleeping or your tinnitus makes it hard to concentrate, consider using a white noise machine or fan to decrease the impact of your symptoms.
  
• Masking devices: Similar to a hearing aid, a masking device is worn in the ear. Instead of helping you hear, it delivers white noise that can make tinnitus symptoms less noticeable.
  
• Hearing aids: For many people, tinnitus can result in hearing problems. Even if you don’t have hearing loss due to tinnitus, a hearing aid amplifies sound in your environment, which may help drown out your tinnitus symptoms. 

Treatment 

Tinnitus treatment depends on the underlying cause.

Sometimes, medical providers can’t identify a cause, in which case they may recommend focusing on symptom management. 

If your provider finds the root cause of your tinnitus, treating it may help your symptoms and overall well-being.

The following treatments may help with tinnitus: 

• Hearing aids: If your tinnitus is occurring due to age-related or noise-induced hearing loss, a hearing aid may help.
  
• Stopping or changing a medication: Stopping the medication that contributes to tinnitus symptoms can bring relief. Never stop a medicine unless recommended by your medical provider. 

• Removing buildup: For those whose tinnitus is caused by a blockage in the ear, removing the buildup of fluid or wax can help with symptoms.
  
• Treating blood vessel problems: If a blood vessel condition like high blood pressure or cholesterol is contributing to tinnitus symptoms, your medical provider may recommend lifestyle changes or medication to improve your symptoms.
  
• Treating anxiety or depression: Psychotherapy and medication can help both anxiety and depression, which may also improve tinnitus symptoms related to those conditions. 

• Treating migraine: If your tinnitus stems from migraines, it may help to take migraine medication. 

There are many other medical causes of tinnitus, and your medical provider will work with you to determine the cause and find the most effective treatment for you. 

Prevention 

It’s not always possible to prevent tinnitus, but certain lifestyle choices can help protect your hearing and overall health, which may decrease the likelihood of developing tinnitus. 

To prevent tinnitus from starting or worsening, try the following: 

• Prevent hearing loss: Loud noises, such as concerts, can cause ringing in the ears that typically resolves with time. Ongoing exposure to loud noise can damage structures in your inner ear, causing chronic tinnitus. Do your best to protect your ears from such loud noises with earplugs or earmuffs. Avoid listening to music with headphones at loud volumes.
  
• Protect your blood vessels: Preventing high cholesterol, and high blood pressure can protect your blood vessel health and, in turn, prevent tinnitus. Routine exercise, a healthy diet, and weight loss are simple but effective ways to protect your blood vessels. Your medical provider can also recommend best practices for blood vessel health.
  
• Choose a healthy lifestyle: Not all medical conditions related to tinnitus are preventable, but healthy lifestyle practices such as exercise, a nutritious diet, weight loss, and a healthy sleep routine may reduce your risk factors. Decreasing alcohol consumption and quitting smoking are also important.
  
• Manage your stress: Stress can worsen tinnitus, and conditions such as anxiety and depression are also linked with tinnitus. Find healthy ways to manage your stress levels and promote your mental health, such as psychotherapy, mindfulness, journaling, and social support. 

When To See a Medical Provider

Because tinnitus can indicate an underlying medical problem, see a medical provider as soon as you develop symptoms.

Also, check in with your provider if you’ve already been diagnosed with tinnitus, but your symptoms or the condition causing them seem to be worsening. 

How K Health Can Help

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