Tinnitus: What You Need to Know

Medically Reviewed by Shruthi N, MD on June 30, 2024
Written by Stephanie Langmaid
8 min read

Tinnitus (pronounced ti-NIGH-tus), or ringing in the ears, is the sensation of hearing ringing, buzzing, hissing, chirping, whistling, or other sounds. You may hear the noise all the time, or it may come and go, and it can vary in loudness. It may be in one ear or both. It's often worse when background noise is low, so you may be most aware of it when you're trying to fall asleep in a quiet room.

Tinnitus is very common, affecting tens of millions of adults in the U.S. For most people, it's just an annoyance. However, tinnitus can make it hard to concentrate and fall asleep. It may end up interfering with your work and personal relationships.

Some of the time, tinnitus has an underlying cause, and when that's treated, it improves. Most of the time, though, tinnitus can't be cured. However, there are things you can do to cover up the unwanted sound or make it less bothersome.

Does tinnitus cause hearing loss?

Although tinnitus is often associated with hearing loss, it doesn't cause the loss. Neither does hearing loss cause tinnitus. But experts think that when your hearing gets damaged, it changes the way your brain processes sound. If you lose the ability to hear at certain sound frequencies, your brain may try to fill the gap by perceiving sounds that don't actually exist.

Tinnitus and hyperacusis

Some people with tinnitus have no trouble hearing and are, in fact, unusually sensitive to sound. That's called hyperacusis. Someone with that condition is uncomfortable with even a normal level of noise and has to take steps to muffle or mask it.

Usually, when you develop tinnitus, it's your brain's response to a problem with the nerves or other parts of your ear that control your hearing. Ear damage from loud sounds is the most common cause. Up to 90% of people with tinnitus have some level of noise-induced hearing loss. Long-term exposure to noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear. 

Carpenters, pilots, musicians, street-repair workers, and landscapers are among those whose jobs put them at risk, as are people who work with chainsaws, guns, or loud machinery. You're also more likely to have tinnitus if you go to a lot of concerts or loud sporting events, or if you listen to loud music. But it can also come from a single exposure to an extremely loud noise, such as a gunshot or an engine backfire.

There are many other potential causes of tinnitus:

Aging

Tinnitus is especially common in older people. Cells inside your inner ear and the nerve fibers that help you hear break down as part of the natural aging process. That can lead to both hearing loss and tinnitus.

Ear Blockage

Congestion, along with ear and sinus infections, can cause pressure to build up in your inner ear. The same thing can happen if you have too much earwax. That pressure can cause tinnitus.

Treating the cause will likely ease your symptoms. But if your ear has been blocked for a long time, the damage may be permanent.

Medications

More than 200 prescription and nonprescription drugs can cause tinnitus, especially when you start or stop taking them. These include:

The form that tinnitus takes can vary, depending on the drug and its dose. Some drugs can cause permanent hearing damage. With others, tinnitus may go away when you stop taking it.

Head or neck injury

Either can cause problems with your nerves, blood flow, and muscles. That can lead to tinnitus, along with headaches and memory issues.

Other medical conditions

Tinnitus can be a symptom of many different illnesses and conditions, among them:

  • Meniere's disease, which affects the inner part of the ear
  • Otosclerosis, a disease that causes stiffening of the small bones in the middle ear
  • Neck or jaw problems, such as temporomandibular joint (TMJ) syndrome
  • Tumor on the nerve that sends sound signals to your brain
  • Migraine
  • Traumatic brain injury
  • High blood pressure
  • Cardiovascular disease
  • Circulatory problems 
  • Anemia
  • Allergies
  • Under- or overactive thyroid gland
  • Autoimmune disorders such as lupus and rheumatoid arthritis
  • Diabetes
  • Fibromyalgia
  • Low vitamin levels
  • Hormonal changes
  • Depression or anxiety

It's rare, but there's a type of tinnitus called pulsatile tinnitus in which the sound beats in sync with your heart. This could mean you have a blood vessel problem, and you should tell your doctor about it right away.

What makes tinnitus worse?

Loud noise is the main cause of tinnitus, and continuing to be exposed to it can make the condition worse. Protect your hearing by wearing earplugs, noise-blocking headphones, or other safety gear, and turning your music down.

Tinnitus can get worse for some people if they drink alcohol, smoke cigarettes, drink caffeinated beverages, or eat certain foods.

For reasons not yet entirely clear to researchers, stress and fatigue also seem to make it worse.

How do you know if you have it? Your doctor will make the final call, but talk to them if you feel like you hear sounds other people don't.

What does tinnitus sound like?

Ringing in the ears is the classic description of tinnitus, either high- or low-pitched. But it can sound like a lot of different things. People describe it as buzzing, humming, clicking, whistling, squealing, hissing, roaring, and whooshing. Some people say they hear music.

Your doctor will discuss your medical history. They’ll ask about any medicines you take, including supplements. They’ll do a hearing test, examine your head and neck, and look inside your ears. 

They might ask you to clench your jaw, move your eyes, and move your neck, arms, and legs. If the ringing gets worse when you move, that may help find a cause for it. You may also need imaging tests such as CT or MRI scans.

Your doctor may not be able to find the cause. If that happens, they’ll work with you to find ways to lessen the sound or help you manage it better.

It depends on what's to blame for the ringing.

If a medication is the trigger, your doctor might suggest that you stop taking it or change to a different drug. Never stop a medicine on your own without talking to your doctor.

If a health issue, such as high blood pressure, is the cause, your doctor can work with you to treat it. Often, the ringing will improve when you get the condition under control.

If the problem is too much earwax, the doctor can remove the buildup gently. Don't use cotton swabs to try to do it yourself.

Most of the time, treatment options are aimed at making tinnitus less noticeable or bothersome. They include:

Hearing aids. These devices can help with age-related hearing loss and tinnitus. They make the sounds you need to hear louder and make the ringing harder to notice.

Sound maskers. You wear them in or behind your ear to create constant, low-level white noise. This helps block the ringing. You might also try a white noise machine near your bed at night to help you sleep.

Relaxation techniques. Tinnitus can get worse when you’re stressed. You can try different ways to relax, such as exercise, yoga, deep breathing, or biofeedback.

Cognitive behavioral therapy. This type of talk therapy has been shown to improve the overall quality of life for people with tinnitus. You learn to manage feelings of anger, fear, and anxiety that can come from having the condition.

Medicines. No drugs are approved to treat tinnitus, and there aren't any supplements or over-the-counter remedies that have been scientifically proven to help. Some people find that taking antidepressants or antianxiety drugs makes tinnitus more manageable. Ask your doctor if these or other medications may be right for you.

Tinnitus retraining therapy 

This is a combination of counseling and sound habituation, which means getting used to sounds. The goal is to get your brain to stop paying attention to the tinnitus, so you aren't bothered by it.

You're educated on what causes tinnitus and what's happening in your body and brain. This emphasizes the fact that while having it can be very upsetting and even debilitating, tinnitus isn't dangerous.

Then you're exposed to low-level sound constantly. You may wear a device that generates sound or plays white noise at background level all day and while you sleep. This makes it harder for your hearing nerves to pick up tinnitus.

Tinnitus retraining therapy may go on for 6-18 months.

Learning about tinnitus can help you manage it. Ask your doctor these questions so you better understand your condition and treatment options:

  • What's causing my tinnitus?
  • Will it go away on its own?
  • Does having tinnitus mean I have hearing loss?
  • What are the treatments for tinnitus?
  • Are there any risks or side effects from the treatment?
  • What can I do on my own to manage tinnitus?
  • How can I stop tinnitus from getting worse?

Tinnitus is a perception of sound that isn't really there — a ringing, buzzing, whooshing, or other kind of noise that only you can hear. While it isn't dangerous, it can be very annoying and make it hard to concentrate or sleep. It can sometimes go away on its own or improve if there's an underlying cause you can treat. But most people have to take steps to either cover it up or learn to tune it out.

Can tinnitus go away?

It depends on why you have it. Sometimes tinnitus will clear up if, for example, after you get over a cold, or it may go away a few days after a concert. Other times, there's an underlying cause that can be treated to improve the condition. But in most cases, tinnitus is permanent.

What is the best cure for tinnitus?

There's no way to "cure" tinnitus. It may go away if there's a root cause that can be treated. But most of the time, treatment is aimed at making it less noticeable.

How do you deal with tinnitus?

There are ways to train your brain to pay less attention to the sound. You may also be able to mask it with white noise, soft music, or other pleasant sounds you can play either when you're trying to go to sleep, or all the time. Some people benefit from learning more about tinnitus or joining a support group.