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Tinnitus: Causes, Symptoms, and Diagnosis

What Causes Ringing in the Ears


Can you hear it? Do you hear this every now and then but can’t find the source for it? Maybe a different sound? 

Just as a ringing bell can be a warning sign, ringing in the ears can be a signal that something in your body is wrong and you need to pay attention to it. Constant ringing in the ears can be annoying, especially when you can’t find the source outside. This happens to a person when he or she suffers from tinnitus. You can easily understand the relation between the term and the sound “ting.” The word tinnitus has a Latin origin, which means "ringing or tinkling."

Over 50 million of the American population is struggling with tinnitus, while 2 million people have it to a debilitating degree. This article contains all you need to know about tinnitus. We also have an article on how long does tinnitus lasts incase you have identified that you are suffering from tinnitus and want to know a time period. Let’s start with the tinnitus definition. 

What is Tinnitus?

Tinnitus is the name for hearing sounds that are not caused by sounds from the outside world. Tinnitus is a medical term for ringing or ringing in the ears, but you may hear more than just ringing. It can be roaring, buzzing, whistling, or hissing. In some rare cases, tinnitus patients report auditory music. Tinnitus can develop gradually or appear suddenly. A person suffering from tinnitus is usually the only one who hears the sounds.

Surprisingly, these sounds have no external source, which means that there is nothing outside your body that makes these unusual sounds. So how can you feel them if there is no source outside the body? Tinnitus is the perception of sound when there is no real external noise present. This is why sounds heard in tinnitus are also called phantom sounds.

So if there is no source, how do you hear these sounds?

What Are the Causes of Tinnitus?

The most common causes of tinnitus include exposure to loud noises or explosions (acoustic trauma), aging (presbycusis), certain medications that damage the ear (aspirin, NSAIDs, some antibiotics, antimalarial, and some anticonvulsants), and Meniere's disease.

Abnormal Sound Processing:

This is usually caused by abnormal activity in the part of the brain responsible for processing sound. Scientists are unable to fully understand how this abnormal activity develops.


In many people, hearing deteriorates as their age progresses. Hearing loss usually starts when a person turns 60. You will likely notice a problem with high-frequency sounds in both ears.

Loud Noises:

Loud noises are another main cause. This includes everything from concerts and sporting events to loud cars and failing engines. They can cause temporary or permanent hearing loss and pain. This is known as subjective tinnitus. These people hear constant sounds, such as constant ringing in their ears or ringing in their ears, and most of them have some degree of hearing loss.

Other Causes of Tinnitus:

You can experience tinnitus due to various other reasons such as middle ear infections, disorders that can result in blocking of the ear canal (such as external ear infections, excessive ear wax, or foreign bodies such as insects), anything obstructing or irritating Eustachian tube (a canal or passage that connects back of the nose to the middle ear) due to allergies or other causes of obstruction, excessive bone growth in the middle ear, and less often a tumor of the part of the nerve that starts from the inner ear.

Tinnitus can occur anywhere in the hearing path. This type is known as objective tinnitus. It is much less common. Other people can hear the sounds of tinnitus if you are suffering from this form if they listen carefully.

Diseases such as high blood pressure and high cholesterol can also affect the ear. Other less common causes are head and neck injuries and dental problems.

Why Do You Hear Ringing in the Ear?

Ringing in the ears or tinnitus begins in the inner ear. This is most often caused by damage or loss of sensory hair cells in the cochlea or inner ear.

The sound waves reach the inner ear by passing through the middle ear canal. Inside the inner ear, there are these hair cells located in the cochlea that perform the function of transforming the sound waves into electrical signals, which then travel to the auditory cortex via the auditory nerve.

When hair cells are damaged, for example, by loud noises or ototoxic drugs, the brain circuitry does not receive the signals they expect. This stimulates the neurons to initiate neuronal activity, which leads to the illusion of sound or tinnitus.

What Are the Symptoms of Tinnitus?

Tinnitus is not a disease. Yes, you read that right. It is not a disease, but it is a symptom itself. The sounds of tinnitus can range in pitch from a low rumble to a high-pitched whistle, and you can hear it in one or both ears. In some cases, the sound can be so loud that it impairs the ability to concentrate or hear external sound. These sounds can be present at all times, or they can come and go. The sound can be in one or both ears, constant or occasional, loud or weak.

In rare cases, tinnitus can appear as a rhythmic pulsating or hoarse sound, often in time with a heart rhythm. This is another rare form of tinnitus known as pulsatile tinnitus. Some people hear more complex sounds, which can vary at different times. These sounds are most pronounced in a quiet environment and when people aren't focusing on something else. Therefore, tinnitus tends to be of more concern to people when they try to fall asleep. However, the experience with tinnitus is highly individual. Some people are very concerned about their symptoms, while others find them quite tolerable.

The course of chronic tinnitus is unpredictable. Sometimes the symptoms might not get intense or even improve over time, but sometimes, they can get worse. This is often associated with hearing loss. Sure, it's not life-threatening, but it can be debilitating. This can cause extreme distress, depression, frequent mood swings, depression or anxiety attacks, tension, irritability or frustration, poor concentration, and sleep problems. Although tinnitus can be a result of a number of medical conditions that require expert attention, it doesn’t hint at something medically serious. However, the fear and anxiety it often evokes can turn people's lives upside down.

How To Know If I Have Tinnitus?

Tinnitus, which is continuous, stable, and loud (the most common type), generally indicates a problem in the auditory system and requires hearing tests performed by an audiologist. Pulsating tinnitus requires medical attention, especially if the noise is frequent or constant. MRI or CT may be needed to check for abnormalities in the tumor or blood vessels.

An ENT specialist can help you find the answer to this question. Your doctor will examine your ears and perform a hearing test to diagnose tinnitus.

Some people find that their tinnitus doesn't go away or get worse. In some cases, it can become difficult for you to hear, focus, or even sleep with the passage of time. Your doctor will guide you about how to reduce the severity of the noise and tackle this symptom, so it doesn’t affect your day-to-day activities. 

If the cause is uncertain, then your doctor might ask you to conduct some imaging tests, such as CT or MRI, to see if you have any deformities or damage to your ears. Standard plain film radiographs may not always show tumors, blood vessel disorders, or other abnormalities that can affect hearing.

How to Stop Constant Ringing in the Ears?

Changes in your daily life and your surroundings can make your life with tinnitus easier.

  • First, find out what makes your tinnitus worse. Some people report that certain foods, drinks, or medications can make their symptoms worse. Note what things affect your symptoms and try to avoid doing them one at a time, and keep a written record. Possible triggers include caffeine drinks, energy drinks, alcohol, salt, and aspirin.
  • Second, stop smoking. It damages the blood flow to sensitive nerve cells that control hearing. It works as a stimulant after getting inside your body. This can make the ringing in the ears sound louder.
  • Third, try listening to soft, soothing sounds in a quiet environment. If you want to fall asleep, you can leave the fan on. You can also try a white noise machine. These devices produce the sounds of ocean waves, rain, or flowing currents.
  • Fourth, avoid this stress. It is normal to feel anxious and annoyed when you first experience tinnitus or when it comes on. However, stress and anxiety can make symptoms worse. You can try yoga or meditation.

The most important thing is to get enough sleep. The symptoms of fatigue often get worse. You may be wondering if there is a specific treatment for tinnitus. Here are some ways to handle it.

  • Sound therapy uses external noise to mask an individual's perception of tinnitus. Low-level background music, white noise, or special ear masks will help. The choice of sound should be enjoyable for individuals. Masking devices offer temporary relief, and tinnitus awareness returns when sound therapy is turned off. Hearing aids are another way of providing sound therapy. They amplify ambient sounds and redirect the patient’s attention to these sounds instead of tinnitus.
  • Reconstructive Tinnitus Treatment (TRT) involves retraining the auditory system to accept the abnormal sounds of tinnitus as natural rather than destructive. It includes the help of a trained professional and the use of a low-level white noise device. Consecutive counseling sessions can help the patients to cope with tinnitus. The success of this therapy is proportional to the severity of the tinnitus and the individual's overall mental health. Subsequent studies suggest that TRT  has been proven effective for around 80% of the cases, as proven by the studies.
  • Cognitive-behavioral therapy (CBT) can help relieve depression in people with tinnitus, although it doesn't appear to reduce sound.

Devices to Treat Your Tinnitus 

Now, to answer your tinnitus treatment question, the truth is here.

Hearing Aids:

Hearing aids can help provide relief from tinnitus by amplifying sounds and making tinnitus less noticeable. This can be achieved by increasing the volume of soft sounds (such as refrigerator noise, washing machine sounds, outdoor lawnmowers) and increasing the low voice. Apart from helping patients with tinnitus, hearing aids also improve communication.

Sound Generators:

Sound generators are ear-level adjustable devices that produce a broadband sound (a pleasant sound in the form of a shower). These sounds are delivered straight to the eardrum. The sounds from these devices make people pay less attention to their tinnitus by masking it.

The hearing aid and the sound generator can be placed in one unit as a combined treatment. This combination therapy is best for people who need hearing aids. Such patients can easily benefit from using sound generators.

Devices That Generate Background Sounds:

Different kinds of easy-to-use devices are available in the market that can generate background sound to reduce the perception of tinnitus. These include desktop audio machines capable of generating various types of sounds (such as rain, wind, and waterfalls), CD player, mp3 music recordings, and natural or environmental sounds. There are a number of applications designed specifically for tinnitus relief that can be used with smartphones or tablets. 

Cochlear Implants:

Additionally, cochlear implants can also be effective in restoring lost hearing. A cochlear implant is a device that allows the brain to bypass the damaged part of the ear to help you hear more effectively. Cochlear implants use electrical stimulation to help the brain interpret sounds correctly.

Once the damage has been caused, it cannot be repaired. Improving well-being doesn't stop tinnitus, but overall well-being can help reduce its intensity and provide physical and emotional benefits.

Can I Prevent Tinnitus?

Fortunately, there are several ways to alleviate the problem. Most tinnitus is caused by non-dangerous causes, such as exposure to loud noise, aging, Meniere's disease, and the use of certain medications. Such drugs can easily be avoided. You should avoid using them until needed (medicines are already mentioned above). 

Always check with your doctor if the medication they are prescribing has a side effect that causes or worsens tinnitus. People like industrial workers, farmers, and transport workers that are exposed to high-frequency sounds are at high risk of developing tinnitus. Listening to loud music in your car, on headphones, and at rock concerts can also be dangerous. To stop the sounds from getting worse, you can use mufflers and earplugs in a noisy environment to protect your ear. Try keeping your TV and equipment at medium volume. Wear hearing protection when noise exceeds 85 decibels, a level associated with average noise from heavy traffic.

When Should I See a Doctor?

  • If you developed tinnitus after an upper respiratory infection such as a cold and the tinnitus does not improve within a week.
  • If you suffer from hearing loss or dizziness with tinnitus.
  • You experience anxiety or depression due to your tinnitus.