(ringing in ears)
Tinnitus is the name for noises you can hear in your ears, such as buzzing or ringing, which are not caused by sounds coming from the outside world. These sounds are often created by your hearing system and can be more prominent at night or during quiet times.
Tinnitus is a common condition that is not usually serious. It can get better by itself, but there are treatments which may help improve the symptoms.
Symptoms of tinnitus may include sounds such as:
- Ringing in the ears
- Throbbing or a beat matching your pulse rate (pulsatile tinnitus)
- Whooshing or roaring
Other associated problems
- Poor sleep
- Problems at work
- Relationship problems
- Increase in anxiety levels
These sounds may be heard in just one ear (ringing in left ear or ringing in right ear alone). More commonly the ringing is in both ears. They can also just be generally inside your head rather than the ears. The sounds may or may not be heard consistently and, for most people, the noises are not heard by anybody else.
The volume and type of noise you hear may change over time too.
Tinnitus can be noticed more during quiet times, for example, at night when you are trying to sleep.
There is not always a definite cause of tinnitus, but it can be linked to:
- Hearing loss - either age-related or from exposure to very loud noises (for example, attending a high-volume music concert)
- Anxiety and/or depression
- A build-up of wax in the ear which changes the ear pressure and causes tinnitus
- Ear infections
- Eustachian tube problems which are often associated with popping, crackling, pressure and imbalance
- A side effect from certain medicines, such as:
- Medication used to treat depression
- Aspirin/Ibuprofen (Nurofen)
- Chemotherapy medicines
- Jaw joint problems (the jaw joint or TMJ is placed just in front of the ear and problems here can cause tinnitus)
Less common causes include:
- A symptom of anaemia (a lack of iron in the body) or thyroid problems
- Brain problems such as a brain tumour such as acoustic neuroma (a benign, non-cancerous tumour of the hearing nerve)
- A problem with the blood vessels in and around your ears (pulsatile tinnitus)
- Ménière's disease - a condition which is connected to a problem within the inner ear and usually is accompanied by dizziness and ear pressure
What increases the risk of tinnitus?
- Excessive or loud noise exposure – listening to very loud music or working in loud environments without ear protection can damage the ear and cause tinnitus.
- Drinking alcohol
Generally, ringing in the ears is not a cause for concern as it is common and can occur at any age. Many cases are temporary and clear up after a short time, but for some, tinnitus can persist and severely affect their quality of life. For this, patients may want to seek treatment.
Can you prevent tinnitus or reduce the chance of it getting worse?
- Use ear defender or ear plugs in noisy environments
- Limit the amount of loud noise you are exposed to where possible
- Make sure you keep the volume down on devices and TVs when you can
- Control how much alcohol you drink and consider stopping smoking
Do I need other tests or scan for my tinnitus?
You may need some tests to further assess for certain causes of your tinnitus such as:
- Hearing test
- Blood flow tests
Treatment options for tinnitus
In a number of cases, an underlying condition may be identified and corrected, helping ease the symptoms of tinnitus. For example:
- Hearing aids to improve hearing
- Wax removal
- Treatment for an infection
- Changing a medication causing the tinnitus
In many cases, however, there isn’t a clear cause for the problem but there are very effective ways of providing tinnitus relief such as:
- White noise generators – These can be normal household items such as a fan or a radio set on a very low level which can mask the sound of the tinnitus. There are specific white noise generator apps or machines which are specifically designed to reduce the level and impact of tinnitus
- Noise masking products – These are devices specially designed to be worn in the ear and they produce a sound which reduced the noise generated by the tinnitus
Mr Lakhani may refer you to a highly skilled and specialised colleague for therapy to help manage tinnitus, including:
- Tinnitus counselling - to learn about the condition and ways to cope with it
- CBT (cognitive behavioural therapy) - a type of counselling designed to help patients change the way they think about tinnitus and help reduce anxiety surrounding it
- Other tinnitus therapy techniques - to help lessen awareness of symptoms by retraining the brain using sound therapy
Some individuals find that understanding tinnitus and knowing they don’t have a serious underlying condition can help manage the symptoms too.
Coping and additional support for tinnitus
Trying to learn about tinnitus can be helpful in coming to terms with it. A review with an expert like Mr Lakhani can be a very helpful start in understanding the specific cause in your particular case which will help direct you towards specific resources which may be of help.
Reducing stress where possible – Relaxation, changes at work or discussing stress with a counsellor can be very helpful.
Groups – There are a number of online support groups which patients can find immensely helpful. Accessing a group which is approved or moderated by a health professional is most useful as the information you get will be checked for accuracy.
Websites with additional information
Are there any new treatments available for tinnitus?
There is work being performed by research groups on the role on electrical stimulation for the treatment of tinnitus. The work is in its preliminary stages but has some early promising results.
Lenire is a new device with some excellent results. It is a device placed on the tongue along with headphones placed over the ears which emit a sound. It appears to be good at treating tinnitus for a proportion of patients who have had other treatable causes of tinnitus ruled out. Mr Lakhani can provide referral for this treatment should you be deemed suitable.