Tinnitus is an ear condition where a person perceives sound that has no corresponding external source. People with tinnitus complain of hearing a ringing, roaring, hissing, buzzing, swishing, or tinkling noise in one or both ears. It is normal for this to happen on occasion and generally only lasts for a few minutes. However, if you experience this on a continuous basis or the sound does not go away or improve, then you probably have tinnitus.
Tinnitus is not a disease, but rather it is a symptom of an underlying medical problem. Noise-induced hearing loss is the most common cause of this condition. Other things that can lead to the onset of tinnitus include consumption of some medications, age, ear injury, objects in the ear, and wax build-up.
There are two types of tinnitus: pulsatile and nonpulsatile. Pulsatile tinnitus is sound created by vascular problems in the neck or face, muscle movements in the vicinity of the ear, or ear canal changes. Nonpulsatile tinnitus is sound that seems to come from inside the head and is caused by problems with the nerves that are involved with hearing. In almost all cases, tinnitus is subjective and only the person can hear the noise.
What Causes Tinnitus?
Tinnitus is a symptom, an indicator that there is an overarching problem in the body. There are several things that can cause a person to develop tinnitus.
- Exposure to Loud Sounds
The most common cause of temporary tinnitus is exposure to loud sounds. This could be anything from loud music to heavy equipment to a bomb exploding nearby. Generally, tinnitus will resolve itself within a couple of hours. However, continuous exposure to loud noise over a long period of time can lead to noise-induced hearing loss and ongoing tinnitus due to damage to the inner ear’s sensory hair cells.
- Hearing Loss
Another common cause of tinnitus is age-related hearing loss, also known as presbycusis. In a healthy human, hearing starts to degrade around age 60 as the result of accumulated deterioration beginning around age 18. Presbycusis can be aggravated by environmental noise but is distinct from noise-induced hearing loss. Scientists think tinnitus may be the result of the brain compensating for the hearing loss by turning up the ear’s sensitivity to sound.
Meniere’s disease causes tinnitus in addition to hearing loss and vertigo. It is an inner ear disorder characterized by fluctuating hearing loss (comes and goes in one or both ears) that becomes permanent after awhile. Typically the tinnitus is a low-pitch ring that becomes louder shortly before a vertigo attack occurs.
- Head and Ear Trauma
Trauma to the head or ear can cause temporary or permanent tinnitus. A blow to the ear can cause damage to the nerves inside. Additionally, the auditory cortex in the brain may be affected by a head injury and contribute to the development of tinnitus. Even something as simple as cleaning the inner ear with a cotton swap can damage it enough to cause tinnitus.
- Ototoxic Medications
Ototoxic medications are, or contain, substances that are toxic to the cochlea, auditory nerve, or vestibular system. Use of these medications can result in sensorineural hearing loss and tinnitus. Certain nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, loop diuretics, chemotherapy, and antiviral drugs contain toxins that affect the ears. If you develop tinnitus shortly after using these medications, you may want to talk to your doctor about changing to a different kind.
- Diseases, Infections, and Disorders
There are a number of diseases, infections, and disorders that can cause tinnitus. They include
- External and internal ear infections
- Eardrum rupture
- Thyroid disease
- Vitamin B12 deficiency
- Multiple sclerosis
- Lyme disease
- Nasal decongestion and sinus infections
- Depression and anxiety
- Dental problems such as jaw misalignment
- Cardiovascular disease
- Brain tumors
- Obstructions in the Ear
Earwax is a substance that traps dirt and inhibits bacterial growth in the ear. The body naturally cleans the ear of earwax. If an excessive amount of earwax accumulates, however, it can become impacted in the ear canal. Tinnitus may result from hearing loss or eardrum irritation caused by earwax impaction.
- Other Causes
Consuming excessive amounts of caffeine or alcohol, rapid changes in environmental pressure, severe or rapid weight loss from extreme dieting or malnutrition, and hormonal changes in women can all contribute to the development of tinnitus.
Signs and Symptoms
Tinnitus is a symptom of an underlying medical condition. People who suffer from tinnitus hear sounds that do not have external causes. These phantom noises can take the form of
The pitch of the sound can vary from low to high and may be heard in one or both ears. Tinnitus may come and go, or occur on a continuous basis. The condition is not painful or life-threatening, but is generally considered a nuisance and can negatively impact a person’s performance in life.
Diagnosing tinnitus can be a challenge because the sound is rarely heard externally (subjective tinnitus). In rare instances, the sound may be heard externally (objective tinnitus) by the doctor when he or she examines your ears. Typically, objective tinnitus is caused by a problem with the inner ear bone, muscle contractions, or blood vessels.
The doctor will generally diagnose tinnitus based on the patient’s self-reported symptoms and perform tests to determine the cause. These tests may include a physical exam, hearing exam, and imaging scans. Your health care provider will also ask you to describe the sound you hear, which can help him or her determine what is causing it.
Types of sounds and their possible causes:
- Clicking – Sharp clicking sounds that occur in bursts usually comes from muscle contractions around the ear.
- Low-pitch ringing – Meniere’s disease, an inner ear disorder that affects hearing and balance, may cause low ringing in the ear. The sound becomes louder shortly before a vertigo attack.
- High-pitch ringing – This is typically caused by exposure to very loud noises or an ear injury. Typically the ringing subsides after a few hours, but may be permanent if hearing loss results. Certain medications, age-related hearing loss, and exposure to loud noises over a long period of time can also cause this type of ringing in the ears.
- Heartbeat – If it sounds like your heart is beating in your ears, this may indicate problems with the vascular system. High blood pressure, a tumor, or an aneurysm can amplify the sound of your heart beating.
- Other sounds – Otosclerosis, earwax, and foreign objects in the ear canal are other things can cause tinnitus.
Most people with tinnitus agree that the sound is maddening. After sifting through the various tinnitus treatment options available on the market, we found three that we think is the most effective at treating tinnitus.
Currently, there is no cure for tinnitus. However, it can usually be alleviated or eliminated by treating the underlying health condition causing the noise. Noise suppression is another treatment option and consists of using “white noise” to drown out the sound from tinnitus. Lastly, medication like Alprazolam or tricyclic antidepressants may be prescribed to reduce tinnitus. However, prescription drugs can cause side effects to develop.
Stress and Tinnitus
Stress is a normal part of life. Like other biological functions, stress increases our chances of survival by preparing our bodies to react to threats in our environment. However, stress can be harmful when it becomes a chronic condition.
When the body is under stress, it goes through a number of biochemical changes including reduced circulation and increased blood pressure. Reduced circulation can prevent healthy blood flow to the ears. Over time, this can cause hearing to deteriorate and tinnitus to develop.
Stress also makes tinnitus seem more severe than it is. The sounds in the ears can seem louder which increases the amount of stress a person feels. This can start a vicious cycle of feeling stress and perceiving your tinnitus to be worsening which, in turn, increases the level of stress you feel. Prolonged stress and chronic tinnitus can lead to the development of psychiatric disorders such as depression and anxiety.
Steps to Reduce Stress Levels:
- Remember to breathe. Often when people are under a lot of stress, they hold their breaths. Stop and take deep breaths for instant relaxation and improved cognitive function.
- Get plenty of exercise. Swim, walk, golf, or go dancing. Exercise is a natural stress reliever, immune system booster, and you’ll feel stronger and more confident.
- Ditch the caffeine. Coffee, tea, and other caffeinated drinks increase blood pressure and your heart rate. Drinking too much caffeine can make you jittery and irritable.
- Get plenty of sleep. Most people do not get the recommended 7 to 9 hours of sleep per night, which can leave them feeling out of sorts and shorten the fuse on their tempers. Getting a good night’s sleep will provide you with the energy and clarity you need to take on the challenges of your day.
Tips for Preventing Tinnitus
The most common cause of tinnitus is hearing loss. It is not known exactly how hearing loss and tinnitus are connected, but scientists speculate that tinnitus may be the result of the brain attempting to compensate for the loss of hearing by increasing the ears’ sensitivity to sound. Age-related hearing loss is inevitable, but other types of hearing loss, such as noise-induced hearing impairment, can be prevented.
- Limit exposure to loud noises. Always wear protective earmuffs or earplugs if you are unable to avoid loud noise, especially if you are going to be around it for a long period of time.
- When using headphones, especially the in-ear kind, put the sound at the lowest possible setting that you can still hear clearly. This will help you avoid noise-induced hearing loss.
Other Ways to Prevent Tinnitus
Quit using tobacco products. Nicotine is a vasoconstrictor that narrows blood vessels and inhibits the free flow of blood in the body, including the ears. This can lead to tinnitus developing.
On the other hand, exercising regularly stimulates circulation and can lessen or prevent tinnitus by improving blood flow to the ears. Tinnitus also occurs more frequently in obese adults, so maintaining a healthy weight can prevent its onset.
Avoid taking ototoxic medications. These drugs are, or contain, substances that are toxic to the cochlea, auditory nerve, or vestibular system. These medications include
- Aspirins and NSAIDs
- Antibiotics like ciprofloxacin, tetracycline, and vancomycin
- Chemotherapy and antiviral drugs like bleomycin, interferon, and methotrexate
- Loop diuretics
Always ask your doctor if tinnitus is a possible side effect of the medication he or she prescribes to you. If it is, ask for an alternative that won’t cause tinnitus. If you need to take these medications, do not consume more than prescribed.
Tinnitus Facts and Statistics
Approximately 1 out of 7 people worldwide are affected by tinnitus. About 36 million people in the United States alone suffer from this condition. It is one of the most common injuries reported by people fighting in the Iraq and Afghanistan wars, and 75% of adults aged 18-30 that attend concerts or go to dance clubs experience temporary tinnitus.
Although it can affect both genders, men are more likely to develop tinnitus than women. The condition also worsens with age and hearing impairment. Hearing loss is evident in about 85% of patients with tinnitus. The condition is not dangerous or life-threatening, but it can be a nuisance and negatively impact the person’s quality of life. Approximately 62% of people with tinnitus show signs of depression.