What is tinnitus?

Have you ever experienced a ringing or buzzing in your ears? Maybe you thought it was just temporary, but if it has continued for more than a few days, you may be experiencing something called tinnitus. Tinnitus is a sensation of sound that originates from inside the ear, not from an external source. While tinnitus isn’t life-threatening, it can disrupt everyday life. It can impact sleep quality and concentration and it may even lead to feelings of anxiety and depression. As such, it’s important to understand what causes tinnitus and how to manage its symptoms.

What Is Tinnitus?

Understanding how humans hear can be helpful for those suffering from this condition.

The human ear is composed of several parts, each with its important role:

• The auditory nerve is the auditory pathway responsible for relaying sound information to the brain
• The eardrum, which lies behind the auditory canal and separates the outer ear from the inner ear, collects auditory information and sends it on to other structures of the inner ear
• The inner ear allows us to perceive auditory signals by hosting hair cells that generate an electric signal sent through the auditory nerve to the brain. This process means we can hear noise around us

Tinnitus is a medical condition where auditory signals not from outside sources are experienced and heard as ringing or buzzing in one or both ears. This occurs when auditory hair cells become damaged or dysfunctional due to overexposure to loud noise, medication side effects or presbycusis (age-related hearing loss).

The intensity of tinnitus varies from person to person. Some people only hear faint ringing, while others may listen to loud noises that interfere with their daily activities. It can occur on one side of the head or both sides at the same time. Some people may only experience tinnitus occasionally, while others may have constant symptoms that make it difficult for them to concentrate or sleep.

Different types of tinnitus

There are several different types of tinnitus and they may have other causes.

The primary type is subjective tinnitus, which usually begins with hearing loss. It is typically caused by noise-induced hearing loss, medications or ear infections. Most cases of tinnitus will fall into this category if no underlying cause can be found.

The other type is pulsatile tinnitus or objective tinnitus, caused by turbulent blood flow through the veins or arteries near the ear. This usually occurs in those with high blood pressure or certain health conditions, though it can also occur on its own.

A third type of tinnitus is called recurrent tinnitus. It tends to come and go over time, often related to illness or stress levels when it reappears. Fortunately, whatever kind of tinnitus you are struggling with, treatments are available to help reduce your symptoms and improve your overall quality of life.

What are the common causes of tinnitus?

Tinnitus has many potential causes, including:

• Age-related hearing loss
• Ear infections
• Earwax buildup in the ear canal
• Side effects of certain medications, e.g. non-steroidal anti-inflammatory drugs
• Stress or anxiety
• Neck or jaw problems, such as temporomandibular joint (TMJ) syndrome
• Allergic reactions to certain medications or foods
• Exposure to loud noises, e.g. concerts
• Working in noisy environments or exposed to loud sounds over a lifetime, e.g. construction sites
• Head injuries

In some cases, the cause of tinnitus cannot be determined, so these cases are called “idiopathic”, meaning “no known cause”. Speaking with your healthcare provider if you have tinnitus is important, as they can help identify the cause and recommend treatment options.

Is tinnitus dangerous?

Most of the time, tinnitus isn’t a sign of a severe health problem. However, it can be a symptom of underlying diseases such as Meniere’s disease, acoustic neuroma, otosclerosis, blood vessel disorders and thyroid abnormalities. Meniere’s disease is an inner ear disorder that causes balance issues, vertigo and fluctuating hearing loss. Acoustic neuroma can cause headaches, double vision, hearing loss and facial muscle weakness. Otosclerosis is caused by new shards of bones developing in the middle ear, which disrupts the balance system resulting in possible hearing loss and tinnitus.

It is important to make sure any chronic tinnitus is assessed by a healthcare professional so they can rule out underlying conditions.

What are the symptoms of tinnitus?

The most common symptom of tinnitus is a persistent ringing in the ears. However, some people experience other sounds, such as buzzing, humming, hissing, clicking, roaring or whistling. These sounds may vary in pitch and volume and can occur in one or both ears. Some people also report an increase in the volume of their voice when they speak, known as autophony. In addition to these symptoms, some people with tinnitus experience difficulty concentrating or sleeping due to the constant noise in their ears.

What does tinnitus sound like?

It is characterised by a persistent ringing, buzzing, whooshing or humming sound in one or both ears. While descriptions and examples vary, most people liken this sound to that of a cricket chirping, an electric fan blowing, white noise static or even a distant train passing. For some individuals, the tinnitus sound can become so loud that it interferes with everyday tasks like concentrating during work or having conversations with others.

How long does tinnitus last?

Most cases of tinnitus are temporary and generally last anywhere from a few minutes to several hours. In some cases, however, tinnitus can be chronic and, as a result, may have long-lasting effects or even be permanent, depending on its underlying cause.

Diagnosis of tinnitus

Healthcare professionals can diagnose tinnitus by taking a complete medical history and performing a physical examination. They may ask you to describe the type, pitch and volume of the sound you are experiencing. Additional tests, such as hearing difficulties or an imaging scan may also be performed to rule out any other underlying medical issues that could be causing the symptoms. The professional will also consider lifestyle factors such as diet, alcohol consumption, stress levels, and exposure to loud noises that can worsen the tinnitus in some individuals. With this information, they will be able to construct an accurate diagnosis that they can develop into an appropriate treatment plan tailored to their needs.

How is tinnitus treated?

Depending on its cause and severity, many treatments are available for tinnitus. These include:

• Sound therapy (e.g. white noise machines)
• Masking devices (e.g. ear plugs)
• Wearing hearing aids (sound generators)
• Cognitive behavioural therapy (CBT)
• Incorporating relaxation techniques and meditation into your daily routine
• Visiting an audiologist for counselling or education on coping with tinnitus
• Medications prescribed specifically for controlling symptoms of tinnitus
• Alternative therapies such as acupuncture
• Taking specific vitamins or supplements that have been linked to reducing symptoms of tinnitus, like zinc and ginkgo biloba extract

Tinnitus retraining therapy (TRT)

This treatment can be pretty effective for those with mild to moderate levels of tinnitus. This type of therapy involves two components: a habituation program that aims to reduce the significance of undesired sounds and an educational program that educates patients on managing their tinnitus more effectively.

Self-help tips for tinnitus

Taking these simple steps can be an effective way for managing your condition, helping increase comfort and improve overall health.

• Learning relaxation techniques such as deep breathing, mindfulness meditation, yoga and progressive muscle relaxation. These methods all help to reduce stress levels and ease the anxiousness that can often accompany tinnitus
• Stick to a consistent sleep schedule – going to bed at the same time each night and getting plenty of restful sleep. You should also turn off any electronics or screens at least an hour before you intend to sleep
• Avoid loud environments or listening to loud music for prolonged periods, as this can aggravate your symptoms
• Lifestyle changes that may help; limiting your caffeine intake and eating a balanced diet may provide relief from tinnitus

Seek help

Tinnitus can be extremely frustrating and make it hard to concentrate or hear properly. If you think you might be suffering from tinnitus, you should speak to your pharmacist or doctor. Some support groups can help you manage your condition, such as The British Tinnitus Association (BTA). Their free helpline number is 0800 018 0527.

Sources

• Tinnitus – NHS 
• What is Tinnitus – Hearing link 
• What can I do, self-help tips – Tinnitus