The Run-Down on Tinnitus

Tinnitus is when you experience ringing or other noises in one or both of your ears.

Tinnitus is most often described as a ringing in the ears, even though no external sound is present. However, tinnitus can also cause other types of phantom noises in your ears, including buzzing, clicking, hissing, roaring and humming.

Tinnitus is a common problem and is especially common in older adults. It is usually caused by an underlying condition, such as age-related hearing loss, impacting ear wax, an ear injury or a problem with the circulatory system.

Tinnitus is an internal sound generated in the brain. The noises of tinnitus 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 interferes with your ability to concentrate or hear external sound. Tinnitus may be present all the time, or it may come and go.

In rare cases, tinnitus can occur as a rhythmic pulsing sound, often in time with your heartbeat. This is called pulsatile tinnitus. If you have pulsatile tinnitus, it is advised you mention this to your family doctor, as the underlying cause could require medical attention.

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

In many people, tinnitus is caused by one of the following:

Hearing loss.There are tiny, delicate cells in your inner ear (cochlea) that move when your ear receives sound waves. This movement triggers electrical signals along the nerve from your ear to your brain (auditory nerve). Your brain interprets these signals as sound.

If the cells inside your inner ear are damaged, this happens as you age or when you are regularly exposed to loud sounds, the damaged cells fire spontaneously, when no sound is present, sending impulses to your brain, and causing tinnitus.

Ear infection or ear canal blockage. Your ear canals can become blocked with a buildup of fluid (ear infection), earwax, dirt, or other foreign materials. When the ear is blocked with debris or fluid, there is a reduction of sound from the external environment, making internal sounds, like the ringing in our ears, seem much louder. Clearing the wax or fluid often relieves the ringing as well.

Head or neck injuries. Head or neck trauma can affect the inner ear, hearing nerves, or brain function linked to hearing. Such injuries usually cause tinnitus in only one ear.

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

Medications known to cause tinnitus include nonsteroidal anti-inflammatory drugs and certain antibiotics, cancer drugs, diuretics, and antidepressants.

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.

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.

Temporomandibular joint (TMJ) disorders. Problems with the TMJ, the joint on each side of your head in front of your ears, where your lower jawbone meets your skull, can cause tinnitus.

Acoustic neuroma or other head and neck tumors. Acoustic neuroma is a noncancerous (benign) tumor that develops on the cranial nerve that runs from your brain to your inner ear and controls balance and hearing. Other head, neck, or brain tumors can also cause tinnitus.

Blood vessel disorders. Conditions that affect your blood vessels such as atherosclerosis, high blood pressure, or malformed blood vessels can cause blood to move through your veins and arteries with more force. These blood flow changes can cause tinnitus or make tinnitus more noticeable.

Other chronic conditions. Conditions including diabetes, thyroid problems, migraines, anemia, and autoimmune disorders such as rheumatoid arthritis and lupus have all been associated with tinnitus.

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

Loud noise exposure. People who work in noisy environments such as factory and construction workers, musicians, and soldiers are particularly at risk.

Loud noises, such as those from heavy equipment, chain saws, and firearms, are common sources of noise-related hearing loss. Portable music devices also can cause noise-related hearing loss if played loudly for long periods.

Age. As you age, the number of functioning nerve fibers in your ears declines, possibly causing hearing problems often associated with tinnitus.

Tobacco and alcohol use. Smokers have a higher risk of developing tinnitus. Drinking alcohol also increases the risk of tinnitus.

Certain health problems. Obesity, cardiovascular problems, high blood pressure, and a history of arthritis or head injury all increase your risk of tinnitus.

Tinnitus affects people differently. For some people, tinnitus can significantly affect their quality of life. 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.

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

Turn down the volume. Long-term exposure to amplified music with no hearing protection or listening to music at a very high volume through headphones can cause hearing loss and tinnitus.

Use hearing protection. Over time, exposure to loud sounds can damage the nerves in the ears, causing hearing loss and tinnitus. Try to limit your exposure to loud sounds. And if you cannot avoid loud sounds, use ear protection to help protect your hearing. If you use chainsaws, 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.

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 obesity and blood vessel disorders.

Limit alcohol, caffeine and nicotine. These substances, especially when used in excess, can affect blood flow and contribute to tinnitus.

Treat your hearing loss. Hearing loss makes tinnitus seem louder because external sounds from the environment are less audible. Hearing aids help by reintroducing sounds and stimulating the brain, which in turn helps decrease the perception of tinnitus by making external sounds audible.

Consider the holistic approach to improve the symptoms and address the mental health effects of tinnitus. Yoga, mindfulness meditation, educational counseling and stress management, integration of sound therapy, and the use of integrative medicine may allow for the synergy needed between conventional treatments and complementary therapies in patients with tinnitus.

A further advantage is that integrative medicine therapies may provide a global approach to treatment that allows for the selection of the most effective strategies for management of individual patients. They may help to reduce or ignore the perception of tinnitus and improve the patient’s quality of life.

In closing, while tinnitus is bothersome, it is typically benign and nothing to worry about. If you have tinnitus that is bothersome, it is best to seek medical attention and visit your local hearing healthcare professional.

Written by: Liliana Jurado, HIS.