Tinnitus: Symptoms, Causes & Treatment

Tinnitus is the sensation of hearing a sound in the ear or head without a real external source for that sound. People describe it in different ways: ringing, buzzing, humming, hissing, or pulsing. It is a very common symptom experienced by many people to varying degrees, and it is important to understand that it is not a disease in itself but a symptom that may result from multiple causes in the ear or auditory system.

The most common causes of tinnitus relate to the auditory system, foremost exposure to loud noise (whether a single severe instance or chronic exposure such as working in a noisy environment or listening to music loudly), and age-related hearing loss. There are other causes such as earwax impaction, ear infections, some medications that may affect hearing, jaw-joint disorders, and rarely blood-vessel problems (in pulsatile tinnitus). Tinnitus is often noticed more in quiet places or when sleeping, and may increase with stress and lack of sleep.

In most cases tinnitus is not a sign of a serious disease, but it can be bothersome and affect concentration, sleep, and mood. Its evaluation begins with an ear examination and a hearing test to identify a treatable cause (such as removing wax or treating an infection). Although there is not always a medication that completely removes tinnitus, there are effective ways to relieve it and live with it: treating the underlying cause if present, using hearing aids for those with hearing loss (they improve hearing and reduce noticing the tinnitus), sound-masking devices and quiet background sounds, and relaxation techniques and cognitive behavioral therapy that help reduce the brain's annoyance from the tinnitus. Avoiding loud noise and protecting hearing are among the most important means of prevention.

• Hearing ringing, buzzing, humming, or hissing without an external source.
• Noticed more in quiet or when sleeping.
• May affect concentration, sleep, and mood.
• Sometimes accompanied by hearing loss or dizziness.

• Exposure to loud noise (acute or chronic) — among the most common causes.
• Age-related hearing loss.
• Earwax impaction and ear infections.
• Some medications, jaw-joint disorders, and rarely blood-vessel problems (pulsatile tinnitus).

• Ear examination (wax, infection, eardrum).
• A hearing test to assess accompanying hearing loss.
• Additional tests with pulsatile tinnitus, one-sided tinnitus, or neurological symptoms.

Treating the cause

• Removing wax, treating infection, or reviewing affecting medications.

Relief and coping methods

• Hearing aids for those with hearing loss (improve hearing and reduce noticing the tinnitus).
• Sound-masking devices and quiet background sounds.
• Relaxation techniques and cognitive behavioral therapy to reduce annoyance.

This content is educational and does not replace consulting an ENT specialist.

• Sleep disturbance and difficulty concentrating.
• Anxiety or depression with persistent bothersome tinnitus.
• May indicate a cause deserving evaluation (such as hearing loss).

• Avoiding loud noise and protecting hearing with earplugs.
• Lowering the volume of headphones and music.
• Treating ear infections and removing wax, and managing stress and sleep.