Despite being a common hearing health condition, there’s still much we don't know and understand about tinnitus – including exactly what causes it. However, there are a few common contributing factors, such as:
Earwax buildup Too much earwax can block your ear canal, which can affect your hearing and eardrum, and cause tinnitus.
Eardrum perforation Injuries to or infections in your outer or middle ear can result in a ruptured eardrum, and this can cause tinnitus.
Ear infection You might experience temporary tinnitus as a result of an infection in your middle ear, as the increased amount of fluid can affect your hearing. Your tinnitus should ease once the infection has cleared up.
Medication side effects Some medicines, such as antibiotics, aspirin, chemotherapy medication and non-steroidal anti-inflammatory drugs (NSAIDs) can cause tinnitus.
Prolonged exposure to loud noise Listening to music at too high a volume, as well as sirens, machinery and traffic can all cause tinnitus if you’re exposed for a long period of time.
Cholesteatoma Often caused by an ear infection, this growth of skin cells collects behind the eardrum, and can lead to hearing loss and tinnitus.
Illness Diseases and conditions such as multiple sclerosis and cancers in the throat, nose or brain can cause tinnitus that usually only affects one ear (unilateral tinnitus).
Ménière’s disease This disease can cause a build-up of fluid in your inner ear, which can result in tinnitus, as well as dizziness and hearing loss.
Some of these causes are temporary, and your tinnitus should subside a few days after your exposure, infection or condition has eased. However, if your symptoms are severe and persist for longer than a few days, make sure you speak to your GP or a hearing healthcare professional.
There are three types of tinnitus. While all cause sounds with no apparent external source, they are all distinct.
Subjective tinnitus
This is the name given to the sounds you hear that don’t have a particular source (such as buzzing, hissing or ringing) that are typically associated with tinnitus. This is the most common type of tinnitus. It only affects the sufferer, and is usually caused by the way the nerves responsible for your hearing communicate with your brain, or by issues in your ear.
Pulsatile tinnitus
With this type of tinnitus, the buzzing, hissing or ringing sounds usually come in time to the rhythm of your heartbeat. Usually brought on when blood flow around your head, neck and ears is constricted, pulsatile tinnitus can be a symptom of an underlying condition or illness, so it’s always best to get it assessed by your doctor or hearing healthcare specialist.
Objective tinnitus
This is much more rare than subjective and pulsatile tinnitus as the buzzing, hissing and ringing sounds are heard not just by the sufferer, but by those who are in close proximity to them. Typically, objective tinnitus is caused by muscle contractions, or the blood vessels in the ear narrowing, which produces sound.
If you have any symptoms of tinnitus, it’s always best to speak to your doctor or a hearing specialist so they can make sure there are no underlying causes that need treatment, and so they can help you manage your symptoms.
Tinnitus has one main symptom: hearing sound that’s not associated with any external cause. This can be anything from hissing and waves crashing to full-on roaring, buzzing, whistling or ringing; what you hear varies from person to person.
The volume level of the phantom noises may vary or stay constant, and the noises themselves may come and go completely.
Secondary symptoms of tinnitus include:
Hearing that’s not as good as before
Sensitivity to everyday sounds (hyperacusis)
If you have persistent tinnitus, it’s only in one ear, or if your tinnitus is accompanied by dizziness and/or balance issues, make sure you speak to your doctor.
Whether your tinnitus is new, has come on suddenly or been building for a while, or is getting worse, it’s important that you speak to your GP so that they can assess your ears and diagnose the issue.
They’ll review your symptoms, and ask:
Whether the sounds affect one or both ears
Whether the sounds are constant or intermittent
Whether your hearing is affected
They’ll also talk through your medical history.
As well as this, your doctor will examine your ears using an otoscope, checking to see if there are problems such as earwax build-up or an infection that could be causing your tinnitus.
If only one ear is affected and there’s no obvious cause, your doctor may refer you for an MRI or CT scan to investigate further and determine any underlying cause.
Treatment for tinnitus varies and there’s no single cure.
If your tinnitus is due to an underlying cause, such as an ear infection, treating or eliminating the cause can sometimes make the tinnitus go away. Where your tinnitus has no discernible cause, treatment will focus almost exclusively on symptom relief and management.
Possible tinnitus treatments include:
Earwax removal Whether carried out by your doctor or a hearing care specialist, such as our team, earwax removal can help alleviate tinnitus symptoms.
Medication changes If your doctor suspects your medication could be contributing to your tinnitus, they may suggest changing it and monitoring your tinnitus symptoms.
White noise or sound therapy Background sound, such as the TV, radio or natural sounds, can help make your tinnitus much less noticeable.
Hearing aids If your tinnitus is intermittent, or if you don’t notice it all the time, you may benefit from hearing aids that can adjust the tinnitus sounds.
Counselling and therapy Tinnitus can be very distressing, particularly where it affects everyday life, so therapy such as Tinnitus Retraining Therapy (TRT) or Cognitive Behavioural Therapy (CBT) can be helpful for changing the way you think about and react to your tinnitus.
Your GP will be able to advise on the best methods of treatment for your tinnitus.
If you suffer from tinnitus, you might also find that your hearing is affected. If this persists once any underlying cause, such as an infection, has been treated and cleared up, it’s important that you speak to your GP.
They may refer you to an ear, nose and throat (ENT) specialist, who will be able to investigate further. They’ll also be able to suggest ways to deal with the issue, such as hearing aids, or help you manage the condition.
If your tinnitus comes and goes or isn’t always noticeable, hearing aids may be helpful in combating any disturbance. Some hearing aids have tinnitus programmes that can mask your tinnitus sounds by emitting their own sounds. This can be set through a button, remote or through connecting to an app on your phone that you can use to adjust the sounds. This can help keep your brain ‘busy’ so that the tinnitus sounds are less noticeable.
If you’d like to find out more about how hearing aids can help you manage tinnitus, speak to one of our hearing healthcare professionals.
It is possible that earwax can lead to tinnitus; if it blocks your ear canal, ringing in the ear can be a side effect. However, this can be remedied: any build-up can be professionally removed by your GP, and the symptoms associated with tinnitus - such as hissing, ringing or roaring sounds - should be relieved as a result.
If your symptoms persist or get worse, it’s important that you contact your GP for further investigation.
Tinnitus is often a symptom of hearing loss or other medical issues. Periods of significant anxiety or stress can trigger tinnitus (though there’s no evidence to suggest that tinnitus is caused by stress), and stress can make symptoms worse or more noticeable.
Many people with tinnitus find that they suffer from stress, especially when the ringing in their ear gets unbearable, and this can make the symptoms worse. So it’s important to take care of your mental health as well as your physical health to manage symptoms.
For advice on managing stress when you have tinnitus, speak to a doctor or hearing specialist such as one of the audiologists here at Boots Hearingcare.
Yes. Tinnitus can be a long-term, debilitating condition even with treatment. It may take some effort to get past the effects of tinnitus, and this will need to be maintained to manage the condition.
However, do keep in mind that the type of tinnitus you have will play a role in any disability benefit process.
There’s evidence to suggest a link between tinnitus and headaches, with some tinnitus symptoms appearing at the same time as symptoms of disorders such as migraines.
However, not every tinnitus sufferer will experience headaches, and not everyone who suffers from headaches will experience tinnitus symptoms. So it’s not possible to definitively say that tinnitus causes headaches.
While tinnitus and dizziness can sometimes occur together, tinnitus itself doesn’t cause dizziness.
If you’re suffering from tinnitus and dizziness, it may be that they indicate an underlying condition, such as Ménière’s disease or a problem with your inner ear.
It’s therefore important that you get any symptoms checked by your doctor, so they can investigate any possible causes and advise you on any treatment.
If your tinnitus is caused by earwax build-up or impaction, once the earwax has been removed, your symptoms should improve and eventually ease. Any removal should always be done professionally to protect your ear canal and eardrum.
If your tinnitus persists, changes or gets worse, or if you notice any other symptoms after any build-up has been removed, speak to your doctor so that they can investigate further. On a brighter side, tinnitus can be lived with as it may occur only occasionally and quietly. However, you should definitely see an audiologist for advice on the best way to treat or manage your symptoms.