Topic Overview
Many people experience an occasional ringing (or roaring, hissing,
buzzing, or tinkling) in their ears. The sound usually lasts only a few
minutes. Ringing in the ears that does not get better or go away is called
tinnitus. You may hear a sound, such as a ringing or
roaring, that does not come from your surroundings (nobody else can hear it).
The sound may keep time with your heartbeat, it may keep pace with your
breathing, it may be constant, or it may come and go. Tinnitus is most common
in people older than age 40. Men have problems with tinnitus more often than
women.
There are two main types of tinnitus.
- Pulsatile (like a heartbeat) tinnitus is often caused by sounds created by muscle movements near the
ear, changes in the ear canal, or blood flow (vascular) problems in the face or
neck. You may hear sounds such as your own pulse or the contractions of your
muscles.
- Nonpulsatile tinnitus is caused by
problems in the nerves involved with hearing. You may hear sounds in one or
both ears. Sometimes this type of tinnitus is described as coming from inside
the head.
The most common cause of tinnitus is hearing loss that occurs
with aging (presbycusis), but it can also be caused by living or
working around loud noises (acoustic trauma). Tinnitus can occur
with all types of hearing loss and may be a symptom of almost any ear disorder.
Other possible causes of tinnitus include:
- A buildup of
earwax.
- Medicines,
especially antibiotics or large amounts of aspirin.
- Drinking an
excessive amount of alcohol or caffeinated beverages.
- Ear
infections or
eardrum rupture.
- Dental or other problems
affecting the mouth, such as
temporomandibular (TM) problems.
- Injuries,
such as whiplash or a direct blow to the ear or head.
- Injury to the
inner ear following surgery or radiation therapy to the head or
neck.
- A rapid change in environmental pressure
(barotrauma).
- Severe weight loss from malnutrition or excessive
dieting.
- Repeated exercise with the neck in a hyperextended
position, such as when bicycle riding.
- Blood flow (vascular)
problems, such as
carotid atherosclerosis,
arteriovenous (AV) malformations, and
high blood pressure (hypertension).
- Nerve
problems (neurologic disorders), such as multiple sclerosis or migraine
headache.
- Other diseases. These may include:
Most tinnitus that comes and goes does not require medical
treatment. You may need to see your doctor if tinnitus occurs with other
symptoms, does not get better or go away, or is in only one ear. There may not
be a cure for tinnitus, but your doctor can help you learn how to live with the
problem and make sure a more serious problem is not causing your
symptoms.
Check your symptoms to decide if and when
you should see a doctor.
Check Your Symptoms
Home Treatment
The following tips may help you
reduce symptoms of tinnitus.
- Cut back on or stop drinking alcohol and
beverages containing caffeine.
- Stop smoking and stop using
smokeless tobacco products. Nicotine use makes tinnitus worse by reducing blood
flow to the structures of the ear.
- Limit your use of
aspirin, products containing aspirin, and other
nonsteroidal anti-inflammatory drugs (NSAIDs) such as
ibuprofen or naproxen.
- Exercise
regularly. Exercise improves blood flow to the structures of the ear. But
avoid extended periods of exercise, such as bicycle riding, that keep your neck
in a hyperextended position. For more information, see the topic
Fitness.
While waiting to see whether tinnitus goes away, or if your
doctor has advised you that your tinnitus will be present for a long time, try
these methods to cope with the constant noise:
- Limit or avoid exposure to the noises you suspect
are causing your tinnitus. If you cannot avoid loud noises, wear protective
earplugs or earmuffs.
- Try to ignore the sound by directing your
attention to other things.
- Practice relaxation techniques, such as
biofeedback,
meditation, or
yoga. Stress and fatigue seem to make tinnitus
worse.
- Quiet rooms can cause tinnitus to seem more distracting.
Background noise may reduce the amount of noise you hear. Play music or
white noise when you are trying to fall asleep or
anytime you find yourself in a quiet place. Try using a fan, a humidifier, or a
machine that makes soothing sounds such as ocean waves.
- Try the
herbal supplement
ginkgo biloba. Some studies suggest that it may help
relieve tinnitus, but other studies do not show a benefit. Further studies are
needed to determine the best dosage.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home
treatment:
- Symptoms develop that are related to nerve
damage, such as loss of coordination or numbness or weakness on one side of the
face or one side of the body.
- Other symptoms develop, such as
significant hearing loss,
vertigo, loss of balance, nausea or
vomiting.
- Tinnitus localizes to one ear.
- Hearing loss
becomes worse after an ear injury, or tinnitus or hearing loss
does not improve.
- Tinnitus continues
for more than a week.
- Your symptoms
become more severe or more frequent.
Prevention
You may be able to prevent ringing in the
ears if you:
- Limit or avoid exposure to loud noises, such as
music, power tools, gunshots, and industrial machinery.
- Wear protective earplugs or earmuffs if you
cannot avoid loud noises. Do not use wadded-up tissue or cotton balls. These do
not protect adequately against loud noises, especially the more dangerous high
frequencies, and they may become lodged in the ear canal.
- Be
careful when using stereo headphones. If music is so loud that others can hear
it clearly or you can't hear other sounds around you, the volume is too
high.
- Cut back on or stop drinking alcohol and beverages
containing caffeine.
- Do not smoke or use smokeless tobacco
products. Nicotine use may cause tinnitus by reducing blood flow to the
structures of the ear. For more information, see the topic
Quitting Smoking.
- Exercise regularly.
Exercise may prevent tinnitus because it improves blood flow to the structures
of the ear. For more information, see the topic
Fitness.
- Maintain a healthy weight.
Tinnitus occurs more frequently in obese adults. For more information, see the
topic
Weight Management.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions:
- When did your tinnitus start?
- Have
you ever had tinnitus before? How old were you when you first had problems with
tinnitus?
- Is the tinnitus in one or both ears? Do you feel like the
noise is inside your head?
- How would you describe your tinnitus?
- Is it high-pitched or
low-pitched?
- Is it constant, or does it come and go?
- Is
it steady, or does it pulsate? If it pulsates, is it in time with your
heartbeat or is it irregular with no steady rhythm?
- Do you hear
roaring, clicking, or blowing noises?
- Does it change when you
swallow or yawn?
- Have you noticed any hearing loss?
- Have
you had a recent injury to the ear?
- Have you recently been involved
in a motor vehicle accident that set off the air bag?
- Do you have
any other symptoms of a nervous system problem, such as numbness, weakness, or
loss of coordination?
- Do you have frequent headaches or
temporomandibular (TM) pain?
- Do you have
any symptoms of
vertigo?
- Have you recently lost
20 lb (9 kg) or more?
- What
prescription and nonprescription medicines are you currently taking?
- How long have you taken these
medicines?
- Have you recently started taking any new
medicines?
- Have you increased your dose of any
medicines?
- Did you ever use streptomycin, gentamicin, or other ear
medicines in the past?
- Do you have any
health risks?
Other Places To Get Help
Organization
| American Tinnitus Association |
| P.O. Box 5 |
| Portland, OR 97207-0005 |
| Phone: | 1-800-634-8978 |
| Phone: | (503) 248-9985 |
| Fax: | (503) 248-0024 |
| Email: | tinnitus@ata.org |
| Web Address: | www.ata.org |
| |
This organization provides education and a network of
services through clinics and self-help groups for patients with tinnitus. It
also publishes a quarterly newsletter. |
|
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | William H. Blahd, Jr., MD, FACEP - Emergency Medicine |
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| Specialist Medical Reviewer | H. Michael O'Connor, MD - Emergency Medicine |
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| Last Revised | January 11, 2012 |
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