Note however that tinnitus nearly always consists of fairly simple sounds -- for example, hearing someone talking that no one else can hear would not ordinarily be called tinnitus -- this would be called an auditory hallucination. Musical hallucinations in patients without psychiatric disturbance is most often described in older persons, years after hearing loss.
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Tinnitus can be perceived in one or both ears or in the head. It is the description of a noise inside a person’s head in the absence of auditory stimulation. The noise can be described in many different ways. It is usually described as a ringing noise but, in some patients, it takes the form of a high-pitched whining, electric buzzing, hissing, humming, tinging or whistling sound or as ticking, clicking, roaring, "crickets" or "tree frogs" or "locusts (cicadas)", tunes, songs, beeping, sizzling, sounds that slightly resemble human voices or even a pure steady tone like that heard during a hearing test.[4] It has also been described as a "whooshing" sound because of acute muscle spasms, as of wind or waves.[7][not in citation given] Tinnitus can be intermittent or continuous: in the latter case, it can be the cause of great distress. In some individuals, the intensity can be changed by shoulder, head, tongue, jaw or eye movements.[8] Most people with tinnitus have some degree of hearing loss.[9]


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.
Subjective tinnitus is the most common type and accounts for 95 percent of cases. Only you can hear it and it’s usually caused by exposure to excessive noise. It can appear suddenly and may last three months (acute) to 12 months (subacute), or longer. Subjective tinnitus is often accompanied by hearing loss due to hair cell nerve damage. The severity of symptoms varies from patient to patient, and largely depends on your reaction to the noise.
Don’t ignore ear pain. Pain or discomfort in your ear can be a sign of conditions associated with tinnitus, including ear infections and earwax buildup. These conditions, and the discomfort they cause, can also interfere with sleep. Whether your ear pain is sharp or dull, constant or intermittent, accompanied by itching or not, take these symptoms to your doctor.
Tinnitus can be caused by a variety of less common underlying conditions or injuries. If you have tinnitus, start your treatment path by seeking out a hearing healthcare professional who specializes in tinnitus diagnostics so they can help identify the underlying cause. If the common causes for tinnitus are ruled out, the practitioner will refer you to another specialist for further evaluation. Listed below are related medical specialties who might be able to help you determine the cause of your tinnitus. 
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.
Auditory-somatosensory stimulation is a similar treatment approach to Kilgard’s, in that its goal is to retune the faulty patterns of brain activity that can cause tinnitus. It involves pairing sounds played in the ear with specially timed electric impulses, which are administered to touch-sensitive nerves using a pad attached to the neck, Dr. Shore explains about the research she’s working on.

Most experts refer to tinnitus as the condition that causes ringing in the ears, however other abnormal sounds and sensations can also be attributed to tinnitus. The definition of tinnitus is “the perception of noise or ringing in the ears.” Some also describe this condition as “hearing sounds in the ears when no external sound is present.” Although tinnitus is only a significant problem for about 1 percent to 5 percent of the population, up to 10 percent to 15 percent of all children and adults are believed to experience ringing in the ears at least from time to time.
ABR (ABR) testing may show some subtle abnormalities in otherwise normal persons with tinnitus (Kehrle et al, 2008). The main use of ABR (ABR test) is to assist in diagnosing tinnitus due to a tumor of the 8th nerve or tinnitus due to a central process. A brain MRI is used for the same general purpose and covers far more territory, but is roughly 3 times more expensive. ABRs are generally not different between patients with tinnitus with or without hyperacusis (Shim et al, 2017).

When tinnitus is unexpected and unwelcomed, it can lead to a negative reaction to the tinnitus. This can create a vicious cycle. When tinnitus is perceived, it can prompt emotions, including frustration, fear, unhappiness, etc.  These can, in turn, cause physical reactions such as anxiety and stress.  This reinforces the tinnitus and perpetuates the cycle. 
When a medication is ototoxic, it has a toxic effect on the ear or its nerve supply. In damaging the ear, these drugs can cause side effects like tinnitus, hearing loss, or a balance disorder. Depending on the medication and dosage, the effects of ototoxic medications can be temporary or permanent. More than 200 prescription and over-the-counter medicines are known to be ototoxic, including the following:
Patients with head or neck injury may have particularly loud and disturbing tinnitus (Folmer and Griest, 2003). Tinnitus due to neck injury is the most common type of "somatic tinnitus". Somatic tinnitus means that the tinnitus is coming from something other than the inner ear. Tinnitus from a clear cut inner ear disorder frequently changes loudness or pitch when one simply touches the area around the ear. This is thought to be due to somatic modulation of tinnitus. We have encountered patients who have excellent responses to cervical epidural steroids, and in persons who have both severe tinnitus and significant cervical nerve root compression, we think this is worth trying as treatment.

People with warning signs should see a doctor right away. People without warning signs in whom tinnitus recently developed should call their doctor, as should people with pulsatile tinnitus. Most people with tinnitus and no warning signs have had tinnitus for a long time. They can discuss the matter with their doctor and be seen at a mutually convenient time.
When tinnitus is unexpected and unwelcomed, it can lead to a negative reaction to the tinnitus. This can create a vicious cycle. When tinnitus is perceived, it can prompt emotions, including frustration, fear, unhappiness, etc.  These can, in turn, cause physical reactions such as anxiety and stress.  This reinforces the tinnitus and perpetuates the cycle. 

The yearlong Dutch trial gave adults with tinnitus a standard package of care or a programme which added cognitive behavioural therapy (CBT) to elements of standard therapy for tinnitus. CBT is a type of therapy that challenges people’s negative assumptions and feelings to help them overcome their worries. Compared with those given usual care, the group receiving specialised treatment reported improved quality of life, and reduced severity and impairment caused by tinnitus.
The cause of tinnitus may be difficult to determine. Your doctor will ask if you have been exposed to loud noise at work or home and will ask about medications you take, including all herbs and supplements. He or she may look in your ears to see if you have wax blockage or if the eardrum appears abnormal. If your hearing is affected, then your doctor may have you undergo a hearing test called an audiogram to measure your hearing ability in each ear.
The sound you hear is actually being generated by the part of your ear known as the cochlea. It’s a very complicated organ with sensory hairs, internal fluid and nerve receptors, that when damaged (or as it naturally degrades as you get older), can cause it to send incorrect input into your brain. In layman’s terms, because it’s no longer working as well as it used to, it thinks there’s a ringing sound in the area and tells your brain to generate that sound in your head. There are other symptoms of tinnitus, but this is the main one.
Serenade by SoundCure is based on S-tones. The MP3 player-like device was developed through research from the University of California, Irvine, where it was proven that the temporal-patterned sounds produced by SoundCure can suppress a patient’s tinnitus. Instead of drowning out tinnitus with another sound played at a louder volume, it actively reduces the condition. The therapy is custom-designed by a patient’s audiologist following testing.
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.
If your doctor cannot find any medical condition responsible for your tinnitus, you may be referred to an otolaryngologist (commonly called an ear, nose, and throat doctor, or an ENT). The ENT will physically examine your head, neck, and ears and test your hearing to determine whether you have any hearing loss along with the tinnitus. You might also be referred to an audiologist who can also measure your hearing and evaluate your tinnitus.
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.

Therefore, the Department of Defense and Congress have taken an interest in furthering tinnitus research, adding it to a list of researchable conditions that impact the military. Both American Tinnitus Association and the Department of Defense fund tinnitus research. New research developments are reported in journals such as Tinnitus Today and the International Tinnitus Journal.
Can an iPhone app truly relieve tinnitus? Believe it or not, the answer is yes. The ReSound LiNX2 app utilizes a combination of sound therapy and relaxation exercises to reduce the severity of tinnitus. The convenient app can be used in combination with hearing instruments, which are small but strong. This groundbreaking program transforms your iPhone into a remote control for your hearing aid.
The accepted definition of chronic tinnitus, as compared to normal ear noise experience, is five minutes of ear noise occurring at least twice a week.[50] However, people with chronic tinnitus often experience the noise more frequently than this and can experience it continuously or regularly, such as during the night when there is less environmental noise to mask the sound.

FACT: Many people with tinnitus will also have a hearing loss. In fact, a recent French study showed that of 123 people with tinnitus surveyed only one did not have hearing loss.  The British Tinnitus Association estimates that 90 percent of people with tinnitus also have a hearing loss. Moreover, research says that those who don’t may have a “hidden hearing loss.”
Many of the press headlines mentioned that listening to the sound of the sea could help tinnitus, with the Metro claiming this could cure the condition. However, sound therapies that try to neutralise tinnitus using soothing sounds, such as waves or birdsong, are not new, but are part of standard treatments for this condition. Also, the report in the Lancet did not state what kind of sounds were used as therapy. Sound therapy was not the only treatment approach used, but was given as part of a specialised treatment programme delivered by expert health professionals.
Can an iPhone app truly relieve tinnitus? Believe it or not, the answer is yes. The ReSound LiNX2 app utilizes a combination of sound therapy and relaxation exercises to reduce the severity of tinnitus. The convenient app can be used in combination with hearing instruments, which are small but strong. This groundbreaking program transforms your iPhone into a remote control for your hearing aid.
Hair cells can be damaged by exposure to loud noise, which could lead to tinnitus. This can occur gradually as a result of exposure to noises over prolonged periods or may be caused by exposure to louder noises over a shorter period of time. If you are exposed to loud noises, you should always wear ear protection. Find out more about the subject on our How Loud Is Loud article and see if your job or lifestyle could be putting your ears at risk,

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)
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.

The treatment group (245 patients) received some elements of standard care (such as a masking device and hearing aid if needed), but also received CBT. The CBT included an extensive educational session, sessions with a clinical psychologist and group treatments involving “psychological education” explaining their condition, cognitive restructuring, exposure techniques, stress relief, applied relaxation and movement therapy.
Objects or insects in the ear can be placed in the ear by patients themselves, or an insect crawling in the ear. Ear wax can also cause ear problems if Q-tips are overused to clean the ears. Symptoms of an object in the ear are inflammation and sensitivity, redness, or discharge of pus or blood. When to seek medical care for an object or insect in the ear is included in the article information.
Seek out cognitive-behavioral therapy. Cognitive behavioral therapy, or CBT, involves working with a clinician (or independently, with a clinically-developed self-treatment program) to re-frame negative thoughts, emotions, and behaviors. CBT is effective with a wide range of physical and mental health conditions, including stress, anxiety, and depression. CBT is also highly effective in treating insomnia and other sleep problems. And research shows CBT can help improve the management of tinnitus.
Most experts refer to tinnitus as the condition that causes ringing in the ears, however other abnormal sounds and sensations can also be attributed to tinnitus. The definition of tinnitus is “the perception of noise or ringing in the ears.” Some also describe this condition as “hearing sounds in the ears when no external sound is present.” Although tinnitus is only a significant problem for about 1 percent to 5 percent of the population, up to 10 percent to 15 percent of all children and adults are believed to experience ringing in the ears at least from time to time.
Think about your breathing. Notice that it has a natural rhythm. Try to breathe in a steady, even rhythm. It helps to breathe in through your nose, hold your breath for a moment and then breathe out through your mouth. Wait a moment before breathing in again. Every time you breathe out, try to release a little bit of your tension. Do this for a few minutes, until you feel ready to move on to the next step.
Can an iPhone app truly relieve tinnitus? Believe it or not, the answer is yes. The ReSound LiNX2 app utilizes a combination of sound therapy and relaxation exercises to reduce the severity of tinnitus. The convenient app can be used in combination with hearing instruments, which are small but strong. This groundbreaking program transforms your iPhone into a remote control for your hearing aid.
Tinnitus matching is helpful to identify the frequency and intensity of the tinnitus. This is a simple procedure in which the audiologist adjusts a sound until a patient indicates that it is the same as their tinnitus.  Most patients match their tinnitus to the region of their hearing loss (Konig et al, 2006; Mahboubi et al, 2012). Unfortunately, the "gap detection test", does not work to confirm tinnitus in humabs (Boyen et al, 2015).

For some people, the jarring motion of brisk walking can produce what is called a seismic effect which causes movement in the small bones or contractions in the muscles of the middle ear space. You can experiment to find out if this is the cause by walking slowly and smoothly to see if the clicking is present. Then, try walking quickly and with a lot of motion to see if you hear the clicking. You can also test for the seismic effect by moving your head up and down quickly. 
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