Tinnitus usually comes in the form of a high-pitched tone in one or both ears, but can also sound like a clicking, roaring or whooshing sound. While tinnitus isn't fully understood, it is known to be a sign that something is wrong in the auditory system: the ear, the auditory nerve that connects the inner ear to the brain, or the parts of the brain that process sound. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus, but it can also arise from a number of health conditions. For example, when sensory cells in the inner ear are damaged from loud noise, the resulting hearing loss changes some of the signals in the brain to cause tinnitus.
Tinnitus is commonly accompanied by hearing loss, and roughly 90% of persons with chronic tinnitus have some form of hearing loss (Davis and Rafaie, 2000; Lockwood et al, 2002). On the other hand, only about 30-40% of persons with hearing loss develop tinnitus. According to Park and Moon (2004), hearing impairment roughly doubles the odds of having tinnitus, and triples the odds of having annoying tinnitus.
About 25-30 million Americans have tinnitus as a condition, and they experience these noises on a regular, most often daily, basis. About 40 percent of people with tinnitus hear tinnitus noise through 80 percent of their day. And for a smaller group of people—about 1 in 5, tinnitus is disruptive enough to significantly interfere with daily functioning, becoming disabling or nearly disabling.
Antidepressants are occasionally associated with tinnitus (Robinson, 2007). For example, Tandon (1987) reported that 1% of those taking imiprimine complained of tinnitus. In a double-blind trial of paroxetine for tinnitus, 3% discontinued due to a perceived worsening of tinnitus (Robinson, 2007). There are case reports concerning tinnitus as a withdrawal symptom from Venlafaxine and sertraline (Robinson, 2007). In our clinical practice, we have occasionally encountered patients reporting worsening of tinnitus with an antidepressant, generally in the SSRI family.
The sound perceived may range from a quiet background noise to one that can be heard even over loud external sounds. The specific type of tinnitus called pulsatile tinnitus is characterized by hearing the sounds of one's own pulse or muscle contractions, which is typically a result of sounds that have been created by the movement of muscles near to one's ear, or the sounds are related to blood flow of the neck or face.[10]
Tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high pitched or low pitched. You might hear it in either one or both ears. Roughly 10 percent of the adult population of the United States has experienced tinnitus lasting at least five minutes in the past year. This amounts to nearly 25 million Americans.
When there does not seem to be a connection with a disorder of the inner ear or auditory nerve, the tinnitus is called nonotic (i.e. not otic). In some 30% of tinnitus cases, the tinnitus is influenced by the somatosensory system, for instance people can increase or decrease their tinnitus by moving their face, head, or neck.[27] This type is called somatic or craniocervical tinnitus, since it is only head or neck movements that have an effect.[25]
In addition to treating associated problems (such as depression or insomnia), there are several strategies that can help make tinnitus less bothersome. No single approach works for everyone, and you may need to try various combinations of techniques before you find what works for you. If you have age-related hearing loss, a hearing aid can often make tinnitus less noticeable by amplifying outside sounds.
This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
Wearable sound generators are small electronic devices that fit in the ear and use a soft, pleasant sound to help mask the tinnitus. Some people want the masking sound to totally cover up their tinnitus, but most prefer a masking level that is just a bit louder than their tinnitus. The masking sound can be a soft “shhhhhhhhhhh,” random tones, or music.
Some patients choose to get involved in “tinnitus retraining,” which involves wearing a device in the ears that provides soothing music or noise, along with undergoing counseling. The goal is to help your body and brain learn to get accustomed to tinnitus noise, which reduces your negative reactions to unwanted sounds. Support and counseling during the process can be helpful for reducing anxiety. Researchers are now learning more about the benefits of coherent cognitive behavioral therapy interventions to help treat distress associated with tinnitus. (3)
Physical exam: Physical examination will focus on the head and neck, and especially the ears, including the auditory canals and tympanic membranes. Since the sense of hearing is conducted through one of the cranial nerves (the short nerves that lead directly from the brain to the face, head and neck), a careful neurologic exam also may be performed. Weakness or numbness in the face, mouth, and neck may be associated with a tumor or other structural abnormality pressing on a nerve. The healthcare professional may listen to the flow in the carotid arteries in the neck for an abnormal sound (bruit), since carotid artery stenosis (narrowing of the artery) can transmit a sound to the ear that may cause tinnitus.
Until recently, most tinnitus patients had little reason to believe doctors would ever be able to completely cure or reverse the affliction. Drug therapies had consistently failed, and so had more invasive procedures — including some surgeries to remove the auditory nerve that transmits sound from the ear to the brain, according to past research. (1,2)
The treatment involves implanting a small electrode into a person’s neck near the vagus nerve. The patient then listens to specific tones that are paired with small electric pulses sent to the vagus nerve. This vagus nerve stimulation, coupled with the sound-based stimulation of the auditory cortex, can “turn down” the patient’s tinnitus. Though, Kilgard adds, “It’s not 100 percent yet.”
Tinnitus also could be the result of neural circuits thrown out of balance when damage in the inner ear changes signaling activity in the auditory cortex, the part of the brain that processes sound. Or it could be the result of abnormal interactions between neural circuits. The neural circuits involved in hearing aren’t solely dedicated to processing sound. They also communicate with other parts of the brain, such as the limbic region, which regulates mood and emotion.
In many cases, tinnitus is caused by hyperactivity (or too much activity) in the brain’s auditory cortex. “When there’s damage or a loss of input in the ear [such as hearing loss, head trauma, or a blood vessel problem], the brain tries to turn up certain channels in order to compensate,” Dr. Kilgard explains. When the brain doesn’t get that tuning quite right, the result is tinnitus.
Addressing Any TMJ Disorders. A small percentage of people will experience tinnitus if they are having problems with their temporomandibular joint. This joint is located in front of the ears, on each side of the head, where the lower jawbone meets the skull. In these rare cases, a dental treatment or bite realignment may relieve you of the ringing you hear in your ears.
It is very well accepted that tinnitus often is "centralized" -- while it is usually initiated with an inner ear event, persistent tinnitus is associated with changes in central auditory processing (Adjamian et al, 2009). Sometimes this idea is used to put forth a "therapeutic nihilism" -- suggesting that fixing the "cause" -- i.e. inner ear disorder -- will not make the tinnitus go away. This to us seems overly simplistic -- while it is clear that the central nervous system participates in perception of sounds, and thus must be a participant in the "tinnitus" process, we think that it is implausible that in most cases that there is not an underlying "driver" for persistent tinnitus.
Persistent tinnitus may cause anxiety and depression.[14][15] Tinnitus annoyance is more strongly associated with psychological condition than loudness or frequency range.[16][17] Psychological problems such as depression, anxiety, sleep disturbances and concentration difficulties are common in those with strongly annoying tinnitus.[18][19] 45% of people with tinnitus have an anxiety disorder at some time in their life.[20]
Being exposed to loud noise on a regular basis from heavy equipment, chain saws or firearms are common causes of hearing loss and tinnitus. Noise-induced hearing loss and tinnitus can also be caused by listening to loud music through headphones or attending loud concerts frequently. It is possible to experience short-term tinnitus after seeing a concert, but long-term exposure will cause permanent damage.
We conducted a randomized, double-blind, placebo-controlled trial investigating the effects of the customized music-based sound therapy for reducing tinnitus. Participants (N = 50) who suffered from tinnitus were randomly allocated (with 1:1 ratio) to the treatment and placebo groups with assessments at baseline, 3, 6, and 12 months. The primary outcome was the differences in mean scores of the THI compared at four time intervals. Independent and paired samples t-tests were conducted to compare THI scores between and within groups, respectively.
Some people experience a sound that beats in time with their pulse, known as pulsatile tinnitus or vascular tinnitus.[40] Pulsatile tinnitus is usually objective in nature, resulting from altered blood flow, increased blood turbulence near the ear, such as from atherosclerosis or venous hum,[41] but it can also arise as a subjective phenomenon from an increased awareness of blood flow in the ear.[40] Rarely, pulsatile tinnitus may be a symptom of potentially life-threatening conditions such as carotid artery aneurysm[42] or carotid artery dissection.[43] Pulsatile tinnitus may also indicate vasculitis, or more specifically, giant cell arteritis. Pulsatile tinnitus may also be an indication of idiopathic intracranial hypertension.[44] Pulsatile tinnitus can be a symptom of intracranial vascular abnormalities and should be evaluated for irregular noises of blood flow (bruits).[45]
We use cookies and similar technologies to improve your browsing experience, personalize content and offers, show targeted ads, analyze traffic, and better understand you. We may share your information with third-party partners for marketing purposes. To learn more and make choices about data use, visit our Advertising Policy and Privacy Policy. By clicking “Accept and Continue” below, (1) you consent to these activities unless and until you withdraw your consent using our rights request form, and (2) you consent to allow your data to be transferred, processed, and stored in the United States.
Counseling helps you learn how to live with your tinnitus. Most counseling programs have an educational component to help you understand what goes on in the brain to cause tinnitus. Some counseling programs also will help you change the way you think about and react to your tinnitus. You might learn some things to do on your own to make the noise less noticeable, to help you relax during the day, or to fall asleep at night.
Ototoxic drugs can also cause subjective tinnitus, as they may cause hearing loss, or increase the damage done by exposure to loud noise. Those damages can occur even at doses that are not considered ototoxic.[30] Over 260 medications have been reported to cause tinnitus as a side effect.[31] In many cases, however, no underlying cause could be identified.[2]
Until recently, most tinnitus patients had little reason to believe doctors would ever be able to completely cure or reverse the affliction. Drug therapies had consistently failed, and so had more invasive procedures — including some surgeries to remove the auditory nerve that transmits sound from the ear to the brain, according to past research. (1,2)
Vascular issues. Some people have blood vessels near their ears that are capable of causing tinnitus. I have found that if the blood pressure is elevated, this increased pressure can cause that dreaded ringing in your ears or even a whooshing sound. Because pregnant women often have elevated blood pressure, they are easily susceptible to tinnitus. Tinnitus caused by pregnancy should go away with an over the counter tinnitus treatment and once the baby is born. An overactive thyroid has also been shown to causes vascular issues that bring on tinnitus.
According to ATA, The American Tinnitus Association, 45 million Americans are struggling with tinnitus. In Germany the “Deutsche Tinnitus-Liga” estimates that 19 million Germans have experienced tinnitus, and that 2,7 million Germans have persistent tinnitus, of which 1 million have very severe tinnitus. The British Tinnitus Association estimates that 10% of the UK population suffers from tinnitus. Read more about the prevalence of tinnitus.
Tinnitus affects males and females in equal numbers. It can affect individuals of any age, even children. Tinnitus, collectively, is a very common condition and estimated to affect approximately 10% of the general population. Rhythmic tinnitus occurs far less frequently than non-rhythmic tinnitus, accounting for approximately 1% of all cases of tinnitus and is considered relatively rare in the general population. The exact prevalence or incidence of rhythmic tinnitus is unknown. Rhythmic tinnitus due to pseudotumor and sinus wall anomalies is found most commonly in overweight women in their 3rd to 6th decade of life. The onset of tinnitus can be abrupt or develop slowly over time.
This tinnitus treatment we developed makes use of software that customizes a music-based therapy for each individual tinnitus sufferer. The software achieves this by incorporating a computational model of the “tinnitus brain.” This model captures changes in the auditory brain which may be causing the tinnitus.5,7 We do this by taking into account the individual’s audiogram and a pitch match of their tinnitus, which generates a tinnitus profile unique to him or her. The software then uses the model to predict how each music track can be altered spectrally to reduce tinnitus for that specific tinnitus profile. Delivering the treatment using headphones that could produce high frequencies (above 10–12 kHz) was an integral part of treatment effectiveness. With such headphones, the treatment could work by taking advantage of the same kind of brain plasticity that may contribute to the person's tinnitus in the first place without being limited by a lack of high-frequency sounds.8 By incorporating the latest tinnitus research into our software, we developed a treatment approach that provides greater promise in treating tinnitus than existing treatments with a one-size-fits-all approach.
Tinnitus can occur as a sleep disorder - -this is called the "exploding head syndrome". This most often occurs while falling asleep or waking up. It is a tremendously loud noise. Some theorize that this syndrome is due to a brief seizure in auditory cortex. It is not dangerous.(Green 2001; Palikh and Vaughn 2010). Logically, anticonvulsants might be useful for treatment.
The diagnosis of tinnitus is usually based on the person's description.[3] A number of questionnaires exist that may help to assess how much tinnitus is interfering with a person's life.[3] The diagnosis is commonly supported by an audiogram and a neurological examination.[1][3] If certain problems are found, medical imaging, such as with MRI, may be performed.[3] Other tests are suitable when tinnitus occurs with the same rhythm as the heartbeat.[3] Rarely, the sound may be heard by someone else using a stethoscope, in which case it is known as objective tinnitus.[3] Spontaneous otoacoustic emissions, which are sounds produced normally by the inner ear, may also occasionally result in tinnitus.[6]
This tinnitus treatment we developed makes use of software that customizes a music-based therapy for each individual tinnitus sufferer. The software achieves this by incorporating a computational model of the “tinnitus brain.” This model captures changes in the auditory brain which may be causing the tinnitus.5,7 We do this by taking into account the individual’s audiogram and a pitch match of their tinnitus, which generates a tinnitus profile unique to him or her. The software then uses the model to predict how each music track can be altered spectrally to reduce tinnitus for that specific tinnitus profile. Delivering the treatment using headphones that could produce high frequencies (above 10–12 kHz) was an integral part of treatment effectiveness. With such headphones, the treatment could work by taking advantage of the same kind of brain plasticity that may contribute to the person's tinnitus in the first place without being limited by a lack of high-frequency sounds.8 By incorporating the latest tinnitus research into our software, we developed a treatment approach that provides greater promise in treating tinnitus than existing treatments with a one-size-fits-all approach.
The latest news about tinnitus treatment comes from a UK study showing that Mindfulness Based Cognitive Therapy (MBCT) significantly helps reduce the severity of the disorder. The researchers reported that, among the 75 patients being studied, both relaxation therapy and MBCT worked to alleviate symptoms as well as reducing psychological distress, anxiety and depression related to the disorder. MBCT led to greater reductions in tinnitus severity and the improvements lasted longer.
One group of 247 patients received standard (usual) care for tinnitus. This included audiological checks, counselling, prescription of a hearing aid if indicated, prescription of a “masker” if requested by the patient (a device that generates neutral sounds to distract from the noise of the tinnitus), and counselling from social workers when required.
Along the path a hearing signal travels to get from the inner ear to the brain, there are many places where things can go wrong to cause tinnitus. If scientists can understand what goes on in the brain to start tinnitus and cause it to persist, they can look for those places in the system where a therapeutic intervention could stop tinnitus in its tracks.
It’s been found that exposure to very loud noises can contribute to early hearing loss and ear problems. Loud sounds can include those from heavy machinery or construction equipment (such as sledge hammers, chain saws and firearms). Even gun shots, car accidents, or very loud concerts and events can trigger acute tinnitus, although this should go away within a couple days in some cases. (5)
The best supported treatment for tinnitus is a type of counseling called cognitive behavioral therapy (CBT) which can be delivered via the internet or in person.[5][77] It decreases the amount of stress those with tinnitus feel.[78] These benefits appear to be independent of any effect on depression or anxiety in an individual.[77] Acceptance and commitment therapy (ACT) also shows promise in the treatment of tinnitus.[79] Relaxation techniques may also be useful.[3] A clinical protocol called Progressive Tinnitus Management for treatment of tinnitus has been developed by the United States Department of Veterans Affairs.[80]
Tinnitus – a sound in the head with no external source – is not a disease; it is a symptom that can be triggered by a variety of different health conditions. So what causes tinnitus? Common sources include hearing loss, ear wax buildup, ototoxic medications, and ear bone changes. No matter what the cause, the condition interrupts the transmission of sound from the ear to the brain. Some part of the hearing system is involved as well, whether the outer, middle, or inner ear.
For many, tinnitus symptoms come on gradually and eventually go away as the brain and ears adjust. However, for others tinnitus can last for years and cause various complications. A high percentage of people with tinnitus that’s persistent and untreatable go on to also develop anxiety or depression as a result. What types of things can you do to deal with and lower tinnitus symptoms? Tinnitus treatment includes avoiding excessively loud sources of noise pollution, using certain hearing aids, preventing ear infections and avoiding drug use.
Tinnitus remains a symptom that affects the lives of millions of people. Research is directed not only at its treatment, but also at understanding why it occurs. Research by doctors at the University at Buffalo, The State University of New York, Dalhousie University (Canada), and Southeast China University have published research using electrophysiology and functional MRI to better understand what parts of the brain are involved in hearing and the production of tinnitus. Their research has found that much larger areas of the brain are involved with the process of hearing than previously believed, which may help direct future diagnostic and therapeutic options.
Cognitive Behavior Therapy (CBT) / Hypnotherapy. Another alternative treatment option worth considering is Cognitive Behavior Therapy (CBT), which is often simply referred to as hypnotherapy. The goal of CBT is to help lower any anxiety, anger or depression you are feeling toward your tinnitus, as well as to help retrain your brain to notice the ringing in your ears less. CBT is typically used in conjunction with sound stimulation therapies, like Neuromonics or Transcranial Magnetic Stimulation (TRT). When choosing your therapist, be sure they not only do they have previous experience working with patients with tinnitus, but also have Neural Linguistic Programming (NLP) training.
Tinnitus is the perception of sound when no actual external noise is present. While it is commonly referred to as “ringing in the ears,” tinnitus can manifest many different perceptions of sound, including buzzing, hissing, whistling, swooshing, and clicking. In some rare cases, tinnitus patients report hearing music. Tinnitus can be both an acute (temporary) condition or a chronic (ongoing) health malady.
