Tinnitus (pronounced "tin-it-tus") is an abnormal noise in the ear (note that it is not an "itis" -- which means inflammation). Tinnitus is common -- nearly 36 million Americans have constant tinnitus and more than half of the normal population has intermittent tinnitus.   Another way to summarize this is that about 10-15% of the entire population has some type of constant tinnitus, and about 20% of these people (i.e. about 1% of the population) seek medical attention (Adjamian et al, 2009). Similar statistics are found in England (Dawes et al, 2014) and Korea (Park and Moon, 2014).
Most of the causes of tinnitus alter neurological activity within the auditory cortex, the portion of the brain responsible for hearing. The transmission of sound is interrupted, so some of the neural circuits fail to receive signals. Instead of causing hearing loss, as you might expect due to the lack of stimulation, the neural circuits begin chattering. First, they chatter alone. Then, they become hyperactive and synchronous. When we experience this deviation, our brains attempt to compensate for the change by interpreting the neurological activity as sound. This can resemble ringing, buzzing, hissing, whistling, or roaring, amongst a variety of other noises.
Take medication for a thyroid disorder, if necessary. Tinnitus can be related to both hyperthyroidism, or an overactive thyroid, and hypothyroidism, or an underactive thyroid. Your doctor can check for swelling or lumps in your thyroid gland, which is in your throat, and order blood screens to test its function. If they find an issue, they’ll prescribe medication to regulate your thyroid hormone levels.[17]
Most people with tinnitus also have hearing loss. Hence, hearing aids can be an effective part of any sound therapy.  Hearing aids alone can provide partial or total relief from tinnitus. If you’re experiencing challenges with your hearing as well as tinnitus, a combination of a hearing solution with built-in sound generators can often be prescribed. You can expect improved levels of hearing which also helps to minimise the effects of the condition in the same way that sound therapy might.

On the internet, on TV and radio commercials and in papers and magazines you can easily find many who offers a method that can cure, or at least reduce, tinnitus. This could for example be in the form of “medication” (pills and injections), herbal treatments, different types of therapy and hypnosis. But other “cures” also exist. The list of “cures” is long, and is getting longer.


Demographic variables (age, sex, type of tinnitus) and baseline THI scores of placebo (n = 16) and treatment (n = 11) groups did not significantly differ from one another at the start of the study. At 3 months, participants in the treatment group reported significantly lower scores on the THI when compared to the placebo group (p < .05). The treatment group also showed an 11-point drop in THI scores when comparing baseline and 3 months (p < .05; please see Figure 2). THI scores for the placebo group comparing both time points were non-significant. Past studies have indicated that the minimum change in the THI score to be considered clinically significant is a drop of 6 to 7 points.9 As such, the results of our clinical study suggest that tinnitus and its related symptoms can produce a clinically significant reduction in tinnitus within the first 3 months using the personalized music-based therapy.

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

^ Jump up to: a b c Han BI, Lee HW, Kim TY, Lim JS, Shin KS (March 2009). "Tinnitus: characteristics, causes, mechanisms, and treatments". Journal of Clinical Neurology. 5 (1): 11–19. doi:10.3988/jcn.2009.5.1.11. PMC 2686891. PMID 19513328. About 75% of new cases are related to emotional stress as the trigger factor rather than to precipitants involving cochlear lesions.


There are, however, excellent tools to help patients manage their condition; treatments that reduce the perceived intensity, omnipresence, and burden of tinnitus. These currently available treatments are not “cures” — they neither repair the underlying causes of tinnitus, nor eliminate the tinnitus signal in the brain. Instead, they address the attentional, emotional, and cognitive impact of tinnitus. They help patients live better, more fulfilling, and more productive lives, even if the perception of tinnitus remains.
The physician may also request an OAE test (which is very sensitive to noise induced hearing damage), an ECochG (looking for Meniere's disease and hydrops, an MRI/MRA test (scan of the brain), a VEMP (looking for damage to other parts of the ear) and several blood tests (ANA, B12, FTA, ESR, SMA-24, HBA-IC, fasting glucose, TSH, anti-microsomal antibodies).
Exposure to Loud Noise: Exposure to loud or excessive noise can damage or destroy hair cells (cilia) in the inner ear. Because the hair cells cannot be renewed or replaced, this can lead to permanent hearing loss and/or tinnitus. Continued exposure can worsen these conditions, so people who work in loud environments should always wear ear protection. This includes musicians, air traffic controllers, construction workers, military personnel, and first responders. In addition, consider lowering the volume on your iPod and wearing earplugs at loud concerts.
If you have tinnitus you also may suffer from anxiety, depression, or insomnia. Discuss treatments with your doctor. While tinnitus cannot always be cured, there are many treatments available for you to make it easier to live with tinnitus. See your doctor if tinnitus is accompanied by dizziness, fever, or headache; as this may signal a more serious condition.
An ultrasound is another test that may be used to aid in the diagnosis of tinnitus. An ultrasound uses reflected high-frequency sound waves and their echoes to create images of structures within the body. An ultrasound can reveal how blood flows within vessels, but is only useful for accessible vessels. It is not helpful for blood vessels within the skull.
Homeopathy, hypnosis, meditation and acupuncture are also thought to suppress tinnitus conditions. Studies have shown acupuncture can help relieve symptoms of tinnitus, but relief may not be seen until you have completed 10 to 15 sessions. Homeopathy, which uses plant, mineral and animal material in doses to help relieve ailments, can also be used as a treatment.  Some remedies can be used to suppress loud roaring noises, echoing, dull humming and other tinnitus symptoms.
In persons with pulsatile tinnitus, additional tests maybe proposed to study the blood vessels and to check the pressure inside the head. Gentle pressure on the neck can be performed to block the jugular vein but not the carotid artery. The Valsalva maneuver reduces venous return by increasing intrathoracic pressure. If there is a venous hum, this usually abates or improves markedly. If the pulsation is arterial, these tests have no effect.
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.
No two patients and no two tinnitus cases are alike. As such, the “best” treatment option is often contingent on an array of factors unique to each patient. Moreover, successful management of tinnitus may require overlapping layers of treatment. ATA recommends that patients work with their healthcare provider(s) to identify and implement the treatment strategy that is best suited to their particular needs.
We encourage you to avoid anything that can make your tinnitus worse. For instance, you may want to avoid smoking, drinking alcohol, or listening to loud noises. Another precaution is protection. If you’re a construction worker, airport worker, hunter, or regularly exposed to loud noise, you should wear custom earplugs or special earmuffs. Ear protection goes a long way towards preventing your tinnitus from getting worse.
TRT depends upon the natural ability of the brain to "habituate" a signal, to filter it out on a subconscious level so that it does not reach conscious perception. Habituation requires no conscious effort. People frequently habituate many auditory sounds -- air conditioners, computer fans, refrigerators, and gentle rain, among them. What they have in common is that they have no importance, so they are not perceived as ''loud.'' Thus, the brain can screen them out.
The majority of cases of tinnitus are subjective. Objective tinnitus is far less common. However, a diagnosis of objective tinnitus is tied to how hard and well the objective (outside) listener tries to hear the sound in question. Because of this problem, some clinicians now simply refer to tinnitus as either rhythmic or non-rhythmic. Generally, rhythmic tinnitus correlates with objective tinnitus and non-rhythmic tinnitus correlates with subjective tinnitus. Specific forms of tinnitus such as pulsatile tinnitus and muscular tinnitus, which are forms of rhythmic tinnitus, are relatively rare. Pulsatile tinnitus may also be known as pulse-synchronous tinnitus. Properly identifying and distinguishing these less common forms of tinnitus is important because the underlying cause of pulsatile or muscular tinnitus can often be identified and treated.
Though the exact cause of tinnitus — as in the specific mechanism that creates these phantom sounds in some people — remains unknown, contributing factors and triggers have been identified. Excessive exposure to loud noise is often a factor because of the damage done to your auditory system. Tinnitus may also result from jaw-joint dysfunction (e.g., teeth grinding, temporomandibular joint disorder) or chronic neck muscle strain.
Tinnitus retraining therapy (TRT). This technique is based on the assumption that tinnitus results from abnormal neuronal activity (see "What's going on?"). The aim is to habituate the auditory system to the tinnitus signals, making them less noticeable or less bothersome. The main components of TRT are individual counseling (to explain the auditory system, how tinnitus develops, and how TRT can help) and sound therapy. A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient's tinnitus. Depending on the severity of the symptoms, treatment may last one to two years.
Most people who seek medical help for tinnitus experience it as subjective, constant sound like constant ringing in the ears or a buzzing sound in the ear, and most have some degree of hearing loss. Things that cause hearing loss (and tinnitus) include loud noise, medications that damage the nerves in the ear (ototoxic drugs), impacted earwax, middle ear problems (such as infections and vascular tumors), and aging. Tinnitus can also be a symptom of Meniere's disease, a disorder of the balance mechanism in the inner ear.
Approximately 50 million Americans have some form of tinnitus. For most people, the sensation usually lasts only a few minutes at a time. About 12 million people have constant or recurring tinnitus that interferes with their daily life so much that they seek professional treatment. For these individuals, tinnitus may result in a loss of sleep, interfere with concentration, and create negative emotional reactions such as despair, frustration, and depression.
The degree of loudness or annoyance caused by tinnitus varies greatly from one individual to another. Loudness and annoyance do not always covary. An individual with loud tinnitus may not be troubled, while an individual with soft tinnitus may be debilitated. Most individuals with subjective tinnitus have hearing loss that shows up in a standard clinical audiogram. Tinnitus can sometimes worsen or sometimes improve over time.

Your doctor will try to determine what is causing the condition. If it is not due to a medication side effect or a general medical condition (such as high blood pressure), he or she may refer you to an otolaryngologist (an ear, nose, and throat doctor) or an audiologist (hearing specialist). It is especially important to see an otolaryngologist if you experience tinnitus in only one ear, tinnitus that sounds like your heartbeat or pulse (pulsatile tinnitus), tinnitus with sudden or fluctuating hearing loss, pressure or fullness in one or both ears, and/or dizziness or balance problems. Unless the cause of the tinnitus is obvious on physical examination, a hearing test is usually required.
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.
Ringing-in-the-ears or a fullness-of-the-head sensation are the most common symptoms of tinnitus. While ringing is the most common experience, the noise can also sound like a buzzing, hissing or whizzing sound. It can range from a low pitch to a high pitch and may be soft or loud at times. For some, tinnitus seems to get louder at night, just before sleep when no other sounds are competing with it. Tinnitus can remain constant or come and go intermittently. In severe cases, the ringing in the ears is loud enough to interfere with work or daily activity, whereas those with mild tinnitus can experience soft ringing that is no more than a minor annoyance.
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