Doctor, What Causes Tinnitus?
I sometimes hear ringing in my ears. Is this
Not at all. Tinnitus is the name
for these head noises, and they are very common. Nearly 36 million Americans
suffer from this discomfort. Tinnitus may come and go, or you may be aware of a
continuous sound. It can vary in pitch from a low roar to a high squeal or
whine, and you may hear it in one or both ears. When the ringing is constant, it
can be annoying and distracting. More than seven million people are afflicted so
severely that they cannot lead normal lives.
Can other people hear the noise in my ears?
Not usually, but sometimes they are able to hear a certain type of tinnitus.
This is called "objective tinnitus," and it caused either by abnormalities in
blood vessels around the outside of the ear or by muscle spasms, which may sound
like clicks or crackling inside the middle ear.
What causes tinnitus?
Most tinnitus comes from damage to the microscopic endings of the hearing
nerve in the inner ear. The health of these nerve endings is important for acute
hearing, and injury to them brings on hearing loss and often tinnitus. If you
are older, advancing age is generally accompanied by a certain amount of hearing
nerve impairment and tinnitus. If you are younger, exposure to loud noise is
probably the leading cause of tinnitus, and often damages hearing as well.
There are many causes for "subjective tinnitus," the noise only you can hear.
Some causes are not serious (a small plug of wax in the ear canal might cause
temporary tinnitus). Tinnitus can also be a symptom of stiffening of the middle
ear bones (otosclerosis).
Tinnitus may also be caused by allergy, high or low blood pressure (blood
circulation problems), a tumor, diabetes, thyroid problems, injury to the head
or neck, and a variety of other causes including medications such as
anti-inflammatories, antibiotics, sedatives, antidepressants, and aspirin. If
you take aspirin and your ears ring, talk to your doctor about dosage in
relation to your size.
Treatment will be quite different in each case of tinnitus. It is important
to see an otolaryngologist to investigate the cause of your tinnitus so that the
best treatment can be determined.
What is the treatment?
In most cases, there is no specific treatment for ear and head noise. If your
finds a specific cause of your tinnitus, he or she may be able to eliminate the
noise. But, this determination may require extensive testing including X-rays,
balance tests, and laboratory work. However, most causes cannot be identified.
Occasionally, medicine may help the noise. The medications used are varied, and
several may be tried to see if they help.
The following list of DOs and DON'Ts can help lessen the severity of
- Avoid exposure to loud sounds and noises.
- Get your blood pressure checked. If it is high, get your doctor's help to
- Decrease your intake of salt. Salt impairs blood circulation.
- Avoid stimulants such as coffee, tea, cola, and tobacco.
- Exercise daily to improve your circulation.
- Get adequate rest and avoid fatigue.
- Stop worrying about the noise. Recognize your head noise as an annoyance
and learn to ignore it as much as possible.
What can help me cope with tinnitus?
Concentration and relaxation exercises can help to control muscle
groups and circulation throughout the body. The increased relaxation and
circulation achieved by these exercises can reduce the intensity of tinnitus in
Masking. Tinnitus is usually more bothersome in quiet surroundings. A
competing sound at a constant low level, such as a ticking clock or radio static
(white noise), may mask the tinnitus and make it less noticeable. Products that
generate white noise are also available through catalogs and specialty
Hearing Aids. If you have a hearing loss, a hearing aid(s) may reduce
head noise while wearing it and sometimes cause it to go away temporarily. It is
important not to set the hearing aid at excessively loud levels, as this can
worsen the tinnitus in some cases. However, a thorough trial before purchase of
a hearing aid is advisable if your primary purpose is the relief of
Tinnitus maskers can be combined within hearing aids. They emit a
competitive but pleasant sound that can distract you from head noise. Some
people find that a tinnitus masker may even suppress the head noise for several
hours after it is used, but this is not true for all users.
Prior to any treatment of tinnitus or head noise, it is important that you
have a thorough examination and evaluation by your otolaryngologist.
An essential part of your treatment will be your understanding of tinnitus and
© 2004 AAO-HNS/AAO-HNSF
Please read our disclaimer. Any information provided on this Web site should not be considered medical advice or a substitute for a consultation with Dr. Hector N. Hernandez or other healthcare professional. If you have a medical problem, contact us for diagnosis and treatment.