What to do if you’ve been experiencing a ringing, buzzing or whooshing sound in your ears.
Medically reviewed by Dr Juliet McGrattan (MBChB) and words by Dr Michael Wareing
Plagued by an unidentified ringing, buzzing, whooshing or other mysterious noise in your ears? It sounds like you may be suffering from tinnitus. Tinnitus is the name for hearing noises that are not caused by an outside source and while it can be extremely frustrating, the good news is it’s extremely rare that tinnitus is related to anything more serious.
We look at tinnitus causes, diagnosis and treatment tips:
What is tinnitus?
Tinnitus is when you hear a sound that no one else can hear. Different people hear different things such as ringing, buzzing or more complex sounds.
Tinnitus can vary in intensity and be constant or intermittent. In some cases it can be described as a pulsating sound. Tinnitus usually occurs in association with hearing loss.
How common is tinnitus?
Tinnitus is extremely common. Nearly everyone has experienced tinnitus (for example after noisy events or in very quiet environments) 10 per cent of the population experience tinnitus on a regular basis. In about 1-2 per cent of people tinnitus is sufficient to cause distress. However we know that putting anyone in a sufficiently quiet environment will allow them to perceive tinnitus.
Tinnitus is often a combination of both an ear problem and a mind problem. A hearing specialist will usually be able to determine the cause of the tinnitus. They will do this by examining the ear canal and eardrum and by testing the hearing.
• Tinnitus and hearing loss
There is a strong relationship between hearing loss and tinnitus. Any ear problem but particularly hearing loss can ‘unmask’ the perception of tinnitus, but some patients with tinnitus have no hearing loss. Correction of hearing loss with hearing aids is known to have a beneficial effect upon tinnitus, but sometimes simple reassurance alone is sufficient.
• Tinnitus and ear blockage
There may have been an ear event, even as simple as a common cold, that may have led to the perception of tinnitus and when the blockage in the ears clears the tinnitus persists. Essentially any ear problem can lead to tinnitus.
• Tinnitus and stress
There is a strong relationship between stress, anxiety and depression and tinnitus. Whether this causes the perception of tinnitus in the first place or whether it causes an abnormal response to the perception of noise is difficult to know and may vary from patient to patient.
• Tinnitus and ear disorders
Any ear disorder can cause tinnitus. Some of the most common examples of these include the following:
- A disease in the inner ear – damage caused by extreme noise, age-dependent hearing reduction or Ménière’s disease.
- An obstruction in the ear canal – a large amount of earwax or a foreign object.
- A perforated eardrum.
- A disease in the middle ear – inflammation of the middle ear.
Other tinnitus causes include the following:
- High blood pressure
- Some medications may cause tinnitus as a side effect, especially when the dose is exceeded, eg aspirin.
- Rarely, a benign tumour on the acoustic nerve.
Tinnitus treatment tips
Any specific ear problem should be treated as necessary by your doctor or an ear specialist. This may be something simple such as removing wax or dealing with infection. Frequently this will improve or abolish the perception of tinnitus.
There is no cure for tinnitus caused by extreme noise but it can be treated and in some cases, tinnitus disappears without treatment. If you’re really struggling with tinnitus, try one of the following:
✔️ One way to help decrease tinnitus is to use a hearing aid, especially when hearing is impaired.
✔️ A small number of patients who remain worried or concerned about their tinnitus may benefit from seeing a hearing therapist or psychologist. Hearing therapy will involve both neuropsychological explanation behind the mechanisms of tinnitus as well as using masking devices/ sound generators which reduce the perception of tinnitus.
✔️ Tinnitus retraining therapy helps people cope with the noise. Hearing therapists use this to make it less intrusive. Psychological approaches are generally based around a Cognitive Behavioural Therapy approach to the tinnitus and the patient’s perception of it.
✔️ Medical treatment with drugs is rarely indicated but may be appropriate in the management of co-existent depression or anxiety.
✔️ Sound enrichment techniques such as listening to soft music when falling asleep or in particular white noise generators while trying to get to sleep can help. There are also a number of smartphone apps that generate white noise.
A patient history, followed by examination of the ears and a pure tone audiogram is sufficient in diagnosing tinnitus in the vast majority of cases.
Occasionally other investigations are required. In the presence of asymmetric hearing loss or other neurological symptoms, an MRI scan of the brain and inner ears may be required. However, the majority of these scans prove to be normal.
The avoidance of excessive noise exposure can prevent tinnitus. Noisy night clubs or concerts have high levels of noise. Wearing earplugs will reduce the ‘dose’ of noise exposure. Other examples include shooting; this should always be done with earplugs or headphones.