If you’ve ever heard a sound that only you can hear, that’s called tinnitus. It’s a symptom of many common medical conditions. This guide will go over the potential causes of tinnitus and all the factors that put you at risk.
What Causes Tinnitus?
Tinnitus is often described as a “ringing in the ears,” but you might hear various sounds, including hissing, buzzing, humming and whooshing. Tinnitus isn’t a disease or a disorder but rather a symptom of another underlying condition.
Let’s look at some of the most common causes of tinnitus.
Hearing Loss and Other Auditory Conditions
Tinnitus most often signifies that something is wrong inside the ear itself. Some typical causes of tinnitus directly rooted in the auditory system include:
- Noise-induced hearing loss
- Age-related hearing loss
- Earwax blockage
- Meniere’s disease
In particular, exposure to loud noises is one of the primary causes of tinnitus. Loud sounds can do massive damage to the middle and inner ear, harming the tiny sensory hair cells.
You can develop acute tinnitus and temporary hearing loss after encountering a single loud noise like an explosion.
Long-term exposure to loud music and construction noise will cause permanent hearing damage and chronic tinnitus.
Acoustic neuroma and other growths inside the inner ear or lesions in the auditory nerve can also cause tinnitus.
Head Trauma, Nerve Damage and Neurological Disorders
Injuries to the nervous system and various neurological disorders can cause subjective tinnitus in one or both ears by affecting how the brain processes sound. Tinnitus is a symptom of the following conditions:
- Multiple sclerosis
- Migraine headaches
- Head or neck trauma
The body’s immune response to various infections can cause inflammation of the ears or the auditory cortex. The most common infectious cause of tinnitus is an ear infection or otitis. Ear infections can damage the eardrum, possibly requiring reconstructive surgery on the middle ear.
Other infectious diseases that cause tinnitus include:
- Lyme disease and other tick-borne illnesses
There are nearly 750 drugs that have known toxic effects on the ears, and tinnitus is one sign that you might be having a negative reaction to a drug. If you report symptoms of tinnitus to your doctor, they will review the medications you’re taking to see if any have adverse effects.
Discontinuing the medicine will typically cause the symptoms to disappear. If no suitable alternatives exist and the tinnitus burden isn’t too significant, the doctor may recommend you stick with the medication—especially when it’s essential to your treatment.
Some standard classes of medications that can harm the ear include:
- Diuretics like furosemide, bumetanide, torsemide and acetazolamide
- Antibiotics like neomycin, gentamicin, and amikacin
- Antivirals like ganciclovir and zalcitabine
- Antifungals like amphotericin and flucytosine
- Antimalarials like chloroquine, mefloquine, and quinine
- Anti-cancer drugs like cisplatin, carboplatin, oxaliplatin, vindesine, vinblastine, vincristine, bexarotene, and taxane
- Nonsteroidal anti-inflammatory drugs like aspirin and ibuprofen
Also Read: Can Caffeine Cause Tinnitus?
Muscle and Joint Issues
Disorders, spasms, deformities, and injuries affecting the bones and muscles surrounding the inner and middle ear can cause tinnitus.
Typical musculoskeletal causes of tinnitus include:
- Temporomandibular joint disorders
- Dental disorders
- Neck injuries
- Neck surgery
- Abnormal bone growth
Studies also show that dental care and jaw exercises are effective ways to manage tinnitus caused by musculoskeletal disorders.
Cardiovascular issues are the underlying cause of some forms of tinnitus.
Pulsatile tinnitus is when a person experiences sounds that pulse or throb in time with the heartbeat.
Irregular blood flow in the arteries surrounding the middle ear can directly affect the auditory system, causing objective tinnitus.
Common causes of pulsatile tinnitus include:
- Plaque buildup in arteries
- Blood vessel disorders, including aneurysms and malformations
- High blood pressure
- Glomus tumors that put pressure on blood vessels
Certain mental health conditions are known to cause or worsen tinnitus. These include:
Mental health interventions like cognitive behavioral therapy have proven effective in treating some forms of tinnitus.
Risk Factors for Tinnitus
Some factors put you at risk for tinnitus. These include the following.
Age-related hearing loss is a common cause of tinnitus, so the condition is more prevalent in the elderly. However, studies haven’t conclusively demonstrated that seniors with normal hearing are more likely to develop tinnitus. It’s difficult to show an effect independent of hearing loss.
Research has found a solid link between sleep and tinnitus. Chronic tinnitus sufferers often report that a good night’s rest alleviates tinnitus symptoms.
People who sleep about seven or eight hours a day are less likely to have tinnitus.
Studies show that smokers are more likely to develop tinnitus.
The chemicals in the smoke cause oxidative stress in the inner ear. Some scientists suggest that nicotine also affects the blood vessels in the ear.
High Cholesterol and High Blood Pressure
High cholesterol and blood pressure can affect the inner ear, contributing to hearing loss and tinnitus. Treatment of hyperlipidemia has been shown to improve tinnitus.
Asthma is mildly associated with an increased risk of tinnitus because it triggers an inflammatory response that can affect the ear.
Various thyroid conditions raise your tinnitus risk, including:
- Autoimmune hypothyroid disease
Constant exposure to loud sounds will damage your ears. So if you work as a bartender, construction worker or some other job where you’re around loud noise constantly, you should wear ear protection.
Long-term exposure to loud noises can damage the inner ear and trigger tinnitus.
If you have a recurring buzzing, chirping, humming or ringing in the ears that persists longer than a day or two, you should contact your doctor immediately.
While waiting for your appointment, the American Tinnitus Association recommends keeping a diary.
According to the American Tinnitus Association, you should take notes on the following:
- Onset and duration of symptoms
- Whether symptoms are continuous or episodic
- Potential contributing lifestyle factors like sleep and stress levels
- Actions that alleviate or worsen tinnitus symptoms
When you see your doctor, you’ll be better positioned to identify the underlying cause of your tinnitus.
When you meet with your primary care provider, they will go through a few routine diagnostic medical evaluations.
The doctor will:
- Review your medical history for associated health conditions
- Check your medication list for drugs with known toxic effects on the ear
- Examine your auditory system for blockage and ear infection
- Conduct an overall physical examination
- Administer a basic hearing test
If the doctor suspects you have permanent hearing loss, they will refer you to an audiologist for more extensive hearing tests and possible hearing aid fitting.
Many forms of acute tinnitus disappear or can be alleviated by simply treating the underlying condition.
For example, tinnitus caused by an ear infection or a blockage in the ear canal can be reversed by prescribing medications and flushing out the impaction, respectively.
However, some tinnitus is permanent. The good news is that there are a number of effective ways to treat tinnitus that can substantially reduce the burden and disruption.
Your options include:
- Hearing aids
- Sound therapy
- Tinnitus retraining therapy (TRT)
- Cognitive-behavioral therapy
Tinnitus is typically nothing to worry about. More often than not, it fades as quickly as it appears. However, you shouldn’t ignore the symptoms.
While the cause of tinnitus usually isn’t something severe, it could also be a sign of a serious health problem. Now that you know some common tinnitus causes, you know what to look out for when you start to hear sounds.
If the sounds are getting louder or aren’t going away, take action to get your tinnitus treated. Ask a medical professional about your options for treating tinnitus, including sound therapy and tinnitus retraining therapy (TRT).
If you think you may be at risk, take some basic measures to prevent tinnitus. Limit your exposure to loud noise and wear hearing protection.
3. Edvall NK, Gunan E, Genitsaridi E, et al. Impact of Temporomandibular Joint Complaints on Tinnitus-Related Distress. Front Neurosci. 2019;13:879. Published 2019 Aug 22. doi:10.3389/fnins.2019.00879
4. Nondahl DM, Cruickshanks KJ, Wiley TL, et al. The ten-year incidence of tinnitus among older adults. Int J Audiol. 2010;49(8):580-585. doi:10.3109/14992021003753508