How to Manage Tinnitus

What is Tinnitus?

Tinnitus is the experience of hearing sounds, such as ringing, buzzing, or hissing, without any external source. There are two main types: subjective tinnitus and objective tinnitus.

Subjective tinnitus is the most common form, where only the person experiencing it can hear the sound. It occurs due to issues within the auditory system, such as hearing loss, prolonged exposure to loud noise, or changes in the way the brain processes sound. The noise itself can vary in pitch and intensity, and while it may seem louder during quiet moments, it does not come from an actual external source. Stress, fatigue, and certain medications can sometimes make it worse, making it more noticeable and disruptive.

Objective tinnitus, on the other hand, is tinnitus that may be detected by someone else or has an identifiable cause, such as a heartbeat or muscle contractions. It is much rarer and tends to be linked to specific medical conditions, like blood vessel irregularities or involuntary muscle movements. Because objective tinnitus has a physical source, it may be treatable with medical or surgical intervention.

How Common is Tinnitus?

Tinnitus, the perception of ringing, buzzing, or other sounds in the ears without an external source, is quite common. Studies estimate that around 14.4% (roughly 1 in 7) of adults experience some form of tinnitus, though the numbers vary significantly, ranging from 4.1% (about 1 in 24) to 37.2% (approximately 1 in 3) depending on the research.

Severe tinnitus, which can have a big impact on daily life, affects about 2.3% (roughly 1 in 43) of adults. Chronic tinnitus (lasting more than 3 months), has been reported in roughly 9.8% (around 1 in 10) of people.

What are the Medical Causes of Tinnitus

Ménière’s Disease: Ménière’s disease is an inner ear disorder that affects balance and hearing. It is characterised by episodes of vertigo, hearing loss, and a feeling of fullness in the ear. Doctors believe tinnitus occurs due to excess fluid build-up in the inner ear, which disrupts normal auditory signals. This condition can cause fluctuating tinnitus that worsens during attacks.
Otosclerosis: Otosclerosis is an abnormal bone growth in the middle ear that interferes with sound transmission. It can lead to progressive hearing loss and tinnitus. The abnormal stiffening of the stapes bone affects the inner ear’s ability to process sounds correctly, which may result in persistent ringing or buzzing.
Ear Infections: Ear infections, whether affecting the middle or inner ear, can cause inflammation and fluid build-up. This swelling disrupts normal auditory functions, potentially leading to tinnitus. Once the infection clears, tinnitus often resolves, but recurring infections may cause long-term auditory changes.
Head or Neck Injuries / Concussion Syndrome: Injuries to the head or neck can damage auditory pathways, nerves, or blood vessels that are crucial for hearing. Trauma may cause a misalignment in the way the brain processes sound, leading to tinnitus. Concussion-related tinnitus is often accompanied by dizziness or sensitivity to noise.

Acoustic Neuromas and Other Tumours: An acoustic neuroma is a benign tumour on the auditory nerve. It disrupts signals between the ear and brain, causing hearing loss and tinnitus. Other tumours near the auditory pathway may also compress nerves or blood vessels, altering auditory perception and leading to persistent ringing or buzzing.
Conditions Affecting Blood Flow in the Neck and Head (Pulsatile Tinnitus): Changes in blood flow near the auditory system can result in pulsatile tinnitus, where sounds match the rhythm of the heartbeat. Causes include high blood pressure, aneurysms, or vascular malformations. The noise occurs due to turbulent blood flow near the ear.
Temporomandibular Joint (TMJ) Disorder: TMJ disorders affect the jaw joint and surrounding muscles. Since this area shares nerve pathways with the ear, dysfunction in jaw movement can lead to tinnitus. Patients often experience clicking sounds, jaw pain, and tension that worsen their symptoms.
Diabetes or Thyroid Problems: Diabetes and thyroid disorders can impact circulation and nerve health. Poor blood sugar control and abnormal thyroid hormone levels may damage the auditory nerve, affecting hearing and causing tinnitus. These conditions may also contribute to balance problems or fluctuating hearing loss.
Multiple Sclerosis (MS): MS is an autoimmune disorder affecting the nervous system. Damage to nerve pathways involved in hearing can lead to tinnitus. The condition disrupts how the brain processes auditory signals, resulting in phantom sounds such as ringing or buzzing.
Anxiety or Depression: Mental health conditions can exacerbate tinnitus by increasing sensitivity to sound. Anxiety and depression may heighten the brain’s perception of auditory signals, making tinnitus more noticeable. Stress also influences blood flow and muscle tension, which can further contribute to the condition.
Ear Wax or Anything That Blocks the Ear: A build-up of ear wax or blockages from foreign objects can affect sound transmission. Blockages distort how sounds are processed, leading to temporary tinnitus. Once the obstruction is cleared, symptoms often improve.

What to Do If You Notice Tinnitus

Stay Calm

The first and most crucial step is to stay calm. Anxiety and stress can make tinnitus seem louder or more intrusive, so worrying about it may actually worsen your perception of the noise.

Use Sound to Mask the Tinnitus

Tinnitus tends to be more noticeable in quiet environments, especially at night when trying to sleep. Using white noise machines, fans, soft music, or even a podcast can help to mask the tinnitus and make it less intrusive.

Keep Your Mind Engaged

Engaging in hobbies, social activities, or work can take your focus off the tinnitus. Many people find that when they are busy or concentrating on something else, the sound fades into the background. The key is to avoid silence, where tinnitus tends to stand out more.

Avoid Loud Noise and Protect Your Ears

Exposure to loud noises can sometimes trigger or worsen tinnitus. It’s best to avoid loud environments and wear ear protection if necessary. If you listen to music or podcasts through headphones, make sure the volume is kept at a safe level to prevent further irritation of the ears.

Maintain a Healthy Lifestyle

A well-balanced diet, regular exercise, and good sleep hygiene can help manage tinnitus effectively. Staying hydrated, limiting caffeine and alcohol, and reducing salt intake may also help in some cases. Additionally, relaxation techniques such as deep breathing, meditation, and gentle yoga can reduce stress levels, making tinnitus less intrusive.

When to See a Doctor

Most cases of tinnitus resolve on their own. However, if the noise persists for several months, worsens, or is accompanied by sudden hearing loss, weakness of the face, dizziness, fullness sensation or discomfort, it’s best to seek medical advice. An ENT specialist can assess whether there is an underlying condition that needs treatment.

You Are Not Alone

Tinnitus can feel frustrating, but in time, most people naturally stop noticing it. Ruling out any underlying medical cause of tinnitus can be reassuring, and help to improve symptoms. Your GP can guide you to the right specialist, to help with your individual problem.