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OVERVIEW

What is tinnitus?

Tinnitus is a problem that causes you to hear a noise in one ear or both ears. People commonly think of it as ringing in the ear, but it also can be roaring, clicking, buzzing or other sounds. Some people who have tinnitus hear a more complex noise that changes over time. You may hear the noise constantly, or it may come and go.

In most cases, people who have tinnitus hear noise in their head when no outside sound is there. This type of tinnitus is called “subjective tinnitus.” It can happen because certain nerves are not functioning normally or because there is a problem with part of your ear. In rare cases, tinnitus is caused by an actual sound that occurs inside or near the ear, such as from nearby blood vessels. This type of tinnitus is called “objective tinnitus.”

CAUSES & RISK FACTORS

What causes tinnitus?

The following are among the most common causes of tinnitus:

• Exposure to loud noises, which can lead to noise-induced hearing loss over time
• Hearing loss related to aging
• Certain drugs that can damage the inner workings of the ear. For example, taking high doses of aspirin every day may lead to tinnitus.
• Eustachian tube dysfunction
• Infections, such as otitis media or labyrinthitis
• Meniere’s disease, a condition that also causes a spinning feeling (also called vertigo)

Allergies, high blood pressure, low blood pressure, diabetes, tumors and head injuries can also cause tinnitus.

In many cases, the cause of tinnitus cannot be identified.

DIAGNOSIS & TESTS

How is tinnitus diagnosed?

Your healthcare practitioner will probably take a detailed medical history. They will want to know about any medical conditions you may have and any history of infections. Your healthcare practitioner also needs to know what medicines you are taking, including herbal products. They will check your ears and may give you a hearing test or do other tests to find out what is causing your tinnitus.

TREATMENT

How is tinnitus treated?

Treatment will depend on what is causing your tinnitus. For example, if a drug you are taking causes your tinnitus, your healthcare practitioner may recommend you stop taking that drug. Remember you should never stop taking a prescription drug without contacting your healthcare practitioner first.

If an underlying condition, such as high blood pressure, causes your tinnitus, your healthcare practitioner can create a treatment plan for you to follow. Usually, tinnitus goes away once the condition that is causing it is treated.

When no specific cause can be identified, your healthcare practitioner will probably focus on making your tinnitus easier to tolerate. Some possible methods include the following:

• Hearing aids: For people who have tinnitus and hearing loss, using a hearing aid may be helpful. When you wear a hearing aid, things you need to hear will be louder than the ringing, buzzing or clicking sound.
• Maskers: Maskers are placed behind your ear and create white noise (constant background noise). This makes tinnitus less noticeable. Some people also use bedside maskers to help them sleep.
• Combined hearing aids and maskers
• Counseling: Many people who have tinnitus become depressed. If you have tinnitus and are struggling, seeking help through a counselor and/or a support group may help you cope.
• Tinnitus restraining therapy: This method uses a mix of counseling with maskers or other approaches. An otolaryngologist (an ear, nose and throat healthcare practitioner) and an audiologist (a hearing professional) will work with you to help you deal with your tinnitus. This isn’t a quick fix, but many people find it useful with time and practice.
• Relaxing: Stress can make tinnitus worse. Your healthcare practitioner can suggest relaxation techniques that might help you deal with your stress.
• Medicines: Currently, there are no medicines specifically designed for treating tinnitus. Some medicines, such as certain drugs used to treat anxiety, have been shown to relieve tinnitus for some people. Talk to your healthcare practitioner about whether medicine might relieve your symptoms.

PREVENTION

How can I prevent tinnitus, or at least keep it from getting worse?

To prevent tinnitus or keep it from getting worse, avoid long-term exposure to loud noises and activities that put you at risk for hearing loss. If you know you’re going to be around loud noises, take precautions by wearing earplugs or earmuffs. If you listen to music through headphones, keep the volume low.

If you have tinnitus, avoid things that seem to make it worse. These may include nicotine, alcohol or caffeine.

QUESTIONS TO ASK YOUR HEALTHCARE PRACTITIONER

• The noise in my ears makes it hard for me to sleep. What can I do?
• Is there something causing my tinnitus that we could treat?
• Will I lose my hearing?
• I also get dizzy a lot. Could I have Meniere’s disease?
• Could this be caused by an ear infection?
• Should I avoid listening to music on headphones?
• Is there anything I can do at home to help?