Tinnitus is hearing a sound that does not come from an external source. People describe it as ringing, buzzing, humming, hissing, whistling or roaring. It may be intermittent or continuous, quiet or intrusive, and may affect one ear, both ears or seem to come from inside the head. Tinnitus is a symptom, not a complete diagnosis, and its impact varies from person to person.
What can cause tinnitus?
Tinnitus is commonly associated with some degree of hearing loss and exposure to loud noise. Other possible contributors include earwax blockage, an ear infection, certain medicines, head or neck injury, jaw-joint problems and some inner-ear conditions. Sometimes no single cause is identified.
Do not stop a prescribed medicine on your own if you think it may be contributing. Instead, record the medicine and dose and ask the clinician who prescribed it whether it needs review.
When should tinnitus be checked?
Arrange medical assessment if tinnitus is persistent, recurrent, affects sleep or concentration, or is associated with hearing difficulty or ear symptoms. New tinnitus in one ear, especially when persistent or accompanied by asymmetric hearing, deserves assessment. Tinnitus that beats in time with the pulse also needs medical evaluation because it can have causes different from typical non-pulsatile tinnitus.
Seek urgent assessment if tinnitus starts with sudden hearing loss. Do not assume that a sudden hearing change is simply a temporary side effect of the ringing.
How is tinnitus assessed?
The assessment usually includes questions about onset, which ear is affected, the type of sound, noise exposure, medicines and related symptoms. An examination may identify wax or infection. A hearing test is often useful, and further tests are considered when the history or examination suggests a specific cause—for example, a rhythmic pulse-like sound or a one-sided pattern.
What can help?
There is no single treatment that works for every person, and no medicine or supplement has been proven to cure all tinnitus. The most useful approach depends on the cause and on how much tinnitus affects daily life.
- Address a treatable cause. If wax, infection or another condition is identified, treating it may reduce the sound.
- Protect hearing without over-isolating from sound. Use hearing protection for genuinely loud environments, but avoid wearing earplugs all day in ordinary safe settings unless a clinician advises this.
- Consider hearing support. When hearing loss is present, hearing aids may improve communication and make tinnitus less noticeable for some people.
- Use sound thoughtfully. Gentle background sound at bedtime or in quiet rooms may make tinnitus less intrusive for some people. Keep audio at a comfortable level.
- Address distress and sleep. Structured counselling, including cognitive behavioural therapy, can help some people reduce tinnitus-related distress. A clinician can discuss options for persistent sleep or anxiety problems.
What should you avoid?
Be cautious of products advertised as guaranteed tinnitus cures, especially supplements with unsupported claims. Avoid loud sound exposure and do not put objects or unprescribed drops into the ear. If tinnitus is getting worse, new or changing, seek reassessment rather than assuming that you must simply live with it.
Common questions
Does tinnitus always mean permanent hearing loss? No, but tinnitus is often associated with hearing changes, so assessment may be helpful.
Can stress make tinnitus feel worse? Stress and poor sleep can make tinnitus harder to cope with, even when they are not the original cause.
Is pulsatile tinnitus the same as ordinary ringing? A sound that repeatedly matches your heartbeat has a different pattern and should be assessed medically.
Sources and further reading
Educational information only; treatment decisions should be based on an individual assessment.