Tinnitus has to be one of the most frustrating conditions. Having a constant ringing in ears can drive you mad … trust me … I know! It’s worst in those quiet times of the day when the perception of sound is amplified and not masked by outside sounds or distractions.
For some it’s temporary but for many it’s relentless and, as there is no cure, it’s a question of adapting their life to accommodate tinnitus and best manage the ringing in ears.
In this article we try to answer all the questions you may have and tell you all you need to know about the tinnitus ringing in ears.
What Is This Ringing In My Ears?
Tinnitus is the perception of noise when there is no external cause. People who suffer from it hear ringing, whistling, buzzing or other noises when there is no external sound present. The ringing in ears can be constant or intermittent and at varying volumes.
For many, the experience of this perception of internal ringing sounds may only last for a few seconds or minutes – for example you’ll be particularly susceptible to a temporary form of tinnitus after being exposed to extremely loud noise, like a concert or machinery or as a result of certain drugs such as aspirin. While this tempory issue may cause minor annoyance for a while for many others, millions of Americans in fact, the ringing in ears is constant and a major disruption to personal and professional lives.
What Does Tinnitus Sound Like?
Although tinnitus usually presents itself as a ringing sound (hence the name ‘ringing in ears’). It can be heard in many ways including buzzing, humming, hissing, chirping, whooshing, roaring, clicking, shrieking and even music.!
This YouTube video produced by TinnitusTalk-Support Forum shows some sounds heard.
The condition differs from one person to the next in terms of the type of noise heard intensity and frequency. In essence, no two people’s experience are the same. Ringing in ears is often most noticeable at night or during quiet periods. The noise can be loud or soft, medium or high pitched, constant or intermittent. You may also experience one type of sound or a combination of several sounds.
What Causes The Constant Ringing In Ears?
Damage or activity in the auditory system (especially the tiny sensory hair cells in the ears) is the main cause. The damage causes loss of certain sound frequencies and changes how the brain processes sound.
Tinnitus is your brain’s way of adapting to receiving fewer stimuli from the specific frequencies. It fills in by changing the signals sent to your brain that control how you hear sound.
Exposure to loud noise
Damage in the auditory system is usually from exposure to loud noise. It also tends to happen as people age due to the deterioration of the cochlea and other parts of the ear. Exposure to loud noise such as loud bangs, firearms/explosives and listening to headphones or other speakers too loudly can put you at risk of developing tinnitus.
According to the National Institute of Occupational Safety and Health (NIOSH), individuals working in noisy environments are more likely to develop ringing in the ear. People who work in a noisy environment such as rock musicians, carpenters, pilots, landscapers, engineers, and architectures, as well as people who work with guns are among those whose jobs put them at risk.
Underlying health conditions
Most doctors agree that tinnitus isn’t a disease but a symptom of an underlying health condition. In some instances, ringing in the ear can disappear once you treat the underlying condition. However, in most cases it continues after the underlying cause has been treated.
Some common health conditions generate tinnitus symptom are:
- Earwax blockage: Any blockage or disturbance in the ear canal can cause irritation of the eardrum which can lead to ringing in the ear.
- Meniere’s disease: can cause pressure in the ear the inner part of the ear that causes ringing noise in the ear.
- Injuries to the head or neck: Trauma can affect the hearing nerves or brain function linked to hearing.
- Temporomandibular joint (TMJ) disorders: These are the two joints connecting the jawbone to the skull. Problems with muscles, ligaments, or cartilage near the TMJ can cause tinnitus which usually clears once the underlying is treated.
- Ear and sinus infections: The congestion related to sinus and ear infections creates abnormal pressure in the middle ear that can cause ringing in the ear.
- High blood pressure / anemia: Change in blood flow can cause pulsatile tinnitus which causes the sensation of your heart beating in your ears.
- Otosclerosis: usually occurs when the small bone in your middle ear stiffens or grows abnormally. This can be one of the symptoms of this disorder.
Medications that can cause or worsen tinnitus
Certain medication such as aspirin, Water pills (diuretics), Quinine, aminoglycoside antibiotics, cytotoxic drugs, diuretics, and cancer medications have been linked to the condition.
Can Stress Cause Tinnitus?
The relationship between stress and tinnitus is a delicate one. Anxiety, depression, and stress can trigger ringing in the ear or make it worse.
A study by Herbert S showed that 53.6% of people with tinnitus report that their condition appeared during a stressful period of their lives. The study also shows that 52.8% of people reported that the condition increased during stressful periods.
Does Tinnitus Mean That I’m Going Deaf?
No. Ringing in ears is a sign to you and your doctor that something is wrong in your auditory system.
Some conditions such as long-term exposure to loud noise can cause both tinnitus and hearing loss. Therefore, if you experience ringing in ears it’s important to have a hearing test to determine if your condition is accompanied by hearing loss.
Why Is The Ringing In My Ears Worse At Night?
Our ears pick up faint noises and other sounds throughout the day such as music playing in the background or TV humming without us noticing. At bedtime, there is less noise to distract you which makes your tinnitus sound more noticeable. It’s as simple as that!
Are There Different Types Of Tinnitus & What Are They?
There are 4 main types of tinnitus:
- Subjective Tinnitus: this is the most common form. It consists of sounds that can only be heard by the affected individual.
- Objective tinnitus: This type is very rare. It can be heard by the affected individual and also by a doctor or any other interested person using a stethoscope. Patients with this type of tinnitus hear real sounds. The noise is normally produced by the body such as a person’s heartbeat (known as pulsatile tinnitus), blood flow or pulse near the ear. It also has the most potential for a permanent fix-it usually stops entirely once the underlying cause is treated.
- Sensory tinnitus: This is another common type. It is actually a form of subjective tinnitus. Most people who have the condition will experience sensory tinnitus. It’s mainly caused by health disorders such as Meniere’s disease that affect the way the brain processes sound.
- Somatic tinnitus: Also referred to as conductive tinnitus mainly because it is caused by outer functions, rather than neurological/sensory causes. This type is typically related to physical movement and touch mainly due to the muscle fits in the ear or neck.
How Is Tinnitus Evaluated?
Each person perceives tinnitus differently so it’s important to have a professional diagnosis. If you experience a constant ringing in your ears, you should visit a doctor for an examination.
An audiologist may conduct special diagnostic and hearing test. This may involve transmitting different sounds through headphones to your ears one at a time. You may be asked to respond by raising your hand (or making a similar gesture) when you hear each sound. Your doctor will then compare what you can hear to what other people of your age and sex should be able to hear.
Doctors also examine your ears, head, and neck to look for any possible causes of tinnitus. Imaging test such as CT or MRI scans are used to see if you have deformities or damage to your ears. They may also be used to check the metabolic activity of your auditory cortex to determine if it’s exclusively related to the ear.
What Should I Do If I Have Tinnitus?
Most people experience occasional ringing in ears that usually lasts only a few minutes. For instance if it’s caused by short term exposure to loud noise it usually disappears in a few hours/days but long-term exposure can cause constant ringing in ears.
Tinnitus that disappears after a short period does not require medical treatment. However, you may need to see a doctor if the sound in your ear doesn’t get better, if it occurs with other symptoms or if it’s only in one ear.
Is There A Cure For Tinnitus?
The bad news is that there currently is no cure – research is ongoing though. The good news is that you can find help … it can be treated or managed in various ways.
Should I Treat Or Manage My Tinnitus ?
Consider both – treat the underlying cause whilst managing the annoying symptoms. Many sufferers adopt this two pronged approach with great success.
Does Tinnitus Cause Hearing Loss?
No – tinnitus is not a disease, it is a symptom of a disease or condition. Many people don’t realize or forget that this is the case because, very often, hearing loss and tinnitus go hand in hand. Tinnitus does not cause the hearing loss, in fact it’s more likely to be the other way round, with the hearing loss causing the tinnitus.
Is There An Effective Drug?
Although research to find an effective treatment is continuing, the Food and Drugs Administration has not approved any single drug for the treatment of ringing in ears.
The main issue associated with curing tinnitus is that it may be triggered by multiple conditions, as opposed to being a symptom from a single condition. In fact, according to the American-Tinnitus-Association, more than 200 health conditions are linked to it.
It’s essential to note that even though drug therapies can’t deliver an obvious cure, there are many established tools and remedies available to help you reduce the intensity of ringing in ears. No single remedy works for everyone and you may have to try various combinations of techniques to find the best that works for you.
What Treatment Options Are Available For Tinnitus?
Treating the underlying health condition:
People experiencing tinnitus caused by health disorders can sometimes get relief from treating the underlying health condition. Find out the cause of your tinnitus from your doctor and stay up to date with your treatments. If any medication you are taking is causing your tinnitus, your doctor may suggest switching to a different drug, reducing or stopping the medication.
There is not sufficient evidence that alternative complementary and alternative treatments work for tinnitus. However, many patients have tried alternative therapies and found relief. Ginkgo biloba, acupuncture, hypnosis, Homeopathy, B vitamins, and Zinc supplements are thought to suppress tinnitus conditions. A study by Ernst, E & Stevinson, C. suggested that trials of G. biloba were favorable but a firm conclusion about its efficacy was not possible. Another study showed that acupuncture may be effective in reducing the severity of nonpulsatile chronic tinnitus.
Antidepressants and antianxiety drugs:
Currently, there isn’t one single treatment for Tinnitus that works for everyone and therefore, pharmacological therapy is aimed at relief rather than cure. Recent studies have found that low-dose anti-anxiety medication such as alprazolam (Xanax) or clomipramine (Anafranil) have shown to be effective for some people. Commonly prescribed medications to help suppress severe tinnitus are; nortriptyline, niravam, amitriptyline, and xanax. However, these medications come with side effects such as blurry vision, heart issues, nausea, dry mouth, drowsiness and can also be habit-forming.
Cognitive behavior therapy:
This is a psychological intervention where your therapist helps you understand how your thoughts and behavior affect how you feel emotionally and physically. This approach uses relaxation and cognitive restructuring to change the way you think and respond to tinnitus. It is widely accepted as an effective means for coping with tinnitus but few people know about it. Your therapist may ask you to keep a dairy to perform tasks to help build your cognitive skills. The goal is to teach patients that while they may not control the constant ringing in ears, they may control how they interpret and deal with it. You’ll learn how to refocus your attention somewhere else and change how you think about the noise in your ears.
Noise Suppression and sound therapy:
Noise suppression and sound therapy are common treatments option for tinnitus patients. Like other treatments, noise suppression does not provide a cure but may significantly lower intensity levels. Patients often observe that the sound is more noticeable/ bothersome in quiet environments for instance, at night. Exposure to external noise can cover over (mask) the tinnitus sound. Sound therapy uses distraction as an external noise to alter your perception or reaction.
Your doctor may suggest electronic devices to alleviate your symptoms such as:
If ringing in your ears is accompanied by hearing loss, hearing aids may help you reduce the awareness. Since tinnitus is more noticeable in quiet environments, hearing aids may help you cope with it. Hearing aids contribute to lower tinnitus intensity by helping you receive natural sounds more clearly. These small electronic devices use a microphone, speaker and amplifier to amplify background sound and increase the volume of external noises which reduces the loudness or prominence.
These devices are worn like hearing aids to produce external noise that competes with the internal tinnitus sounds. These devices play music, white noise, pink noise, nature noises or other ambient sounds to help drown out the tinnitus sounds. Some studies suggest that masking devices are more effective when using broadband noise such as white noise or pink noise.
Customized sound machines:
Customized sound machines block out the noise with tonal music to block out the disturbing noises. The music is individually programmed and tailored specifically to your tinnitus. A study in Annals of Ontology, Rhinology, and Laryngology revealed that customized sound is more effective in decreasing the loudness of tinnitus than white noise and pink noise.
Tinnitus retraining therapy (TRT):
This is a comparatively fresh approach to the treatment of tinnitus and is often accompanied by counseling. It ‘s aimed at helping your brain classifying the noise as unimportant which makes it less noticeable or less bothersome. The device generates low-level noise that matches the pitch, volume and quality of the tinnitus sound.
How Many People Have Tinnitus?
Ringing in ears is one of an extremely common otological problem. According to The Centers for Disease Control and Prevention (CDC), approximately 50 million Americans experience some form of tinnitus for at least 5 minutes. The survey also shows that 20 million adults are struggling with chronic tinnitus. Of these, more than 15 million seek treatment every year and 2 million have extreme and debilitating cases such that they cannot function on a daily level.
But ringing in ears is not just for adults. Another study conducted by the National Health and Nutrition Examination Survey (NHANES) demonstrated that 7.5% of American youths aged 12–19 years have tinnitus.
Why Is Ringing In Ears So Common?
As already mentioned, tinnitus is one of the most common health conditions in the United States. This is probably because there is no cure. There are multiple causes and in many cases it is a symptom of an underlying health issue rather than an isolated medical condition. It’s often a signal that something else is wrong in your body.
Whilst there is no single cure right now and you just can’t take a pill to make it go away there are many treatment options for the management of the condition so don’t just give up searching for the right treatment and resign yourself to a life with tinnitus. You CAN manage it out of your life.
Will My Tinnitus Get Louder And Louder?
No. Although some report varying volumes most patients find that the loudness of the sound remains the same over time.
What Are The Psychological Consequences Of Constant Ringing In Ears?
While some people aren’t bothered by the constant ringing in ears, most people with tinnitus experience psychological side effects including as depression and anxiety. Ringing in ears can have a powerful detrimental impact on a patient’s quality of life.
A study published in the U.S. National Library of Medicine showed that even in moderate cases, tinnitus can cause chronic anxiety and significantly interfere with an individual’s personal and professional work.
Common psychological side effects experienced by people with tinnitus include; depression, anxiety, difficulty sleeping, poor concentration, reduced quality of life, irritability and mood swings.
Ringing in ears is sort of an enigma since it’s not physically observed by others. Patients often have to create their own explanatory narratives. As a result, most fail to speak about their experiences which greatly affect their social well-being.
What Natural Treatment For Tinnitus Can Help Me Cope?
There are various natural remedies that will help. Coping strategies may reduce the physiological effects associated with tinnitus. Each patient with ringing in ears is different and you will probably have an idea of what might help you cope with your tinnitus successfully.
Natural remedies – find ways to relax:
You may notice that your experience with tinnitus may become more severe when you are under a lot of stress. Anxiety and stress can stimulate an already sensitive hearing system and make the ringing seem louder. Avoid stressful situations and practice relaxation techniques such as meditation, yoga, visualization, massage, and progressive muscle relaxation. These relaxation techniques may not cure the condition but will really help you control the aggravation of ringing in ears. Keeping a stress journal will also help you cope and learn how to manage constant ringing in ears.
Join a support group:
A support group gives you the opportunity to share personal experiences. The members not only give you emotional support but may also offer practical advice on how to deal with your tinnitus.
The American Academy of Otolaryngology recommends physical activity as a means of controlling tinnitus. Exercise alleviates the distress associated with ringing in ears. Another benefit of physical activity is that it increases your body’s blood circulation which reduces occurrence.
Protect your hearing:
Exposure to loud noise is not only the main cause of tinnitus but could also make your symptoms worse. Use the 60/60 rule-keep your music at 60% volume when using earbuds and do not listen for more than 60 minutes at a time. Wear earplugs or earmuffs when working in loud environments.
Make a playlist:
Research shows that music helps you to quiet the tinnitus sounds by helping your brain reorganizing the way your brain perceives sound. Put together a playlist of white noise, pink noise and other soothing sounds to alleviate the constant ringing in your ears. There are many public playlists that have been created and shared online. The Tinnitus Talk-forum and YouTube are great sources of tinnitus playlists.
Learn what makes your ringing in ears worse for you and reduce your exposure to those things. Most patients report that drinks with caffeine, alcohol, smoking and loud noises make their tinnitus worse. But tinnitus does not affect every patient the same way. It’s important to keep a diary of what you drink and eat to see if there is any relationship between certain foods and drinks and worse periods of tinnitus.