Tinnitus: what is it, symptoms, causes, and treatment

Ringing or buzzing in your ears after hearing a loud noise can be very irritating and distracting. 

Imagine if you were stuck listening to that frustrating sound every day. For people with tinnitus, that situation is a reality. 

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Tinnitus is a common condition that affects up to 15% of adults in the United States (Baguley, 2013). People with tinnitus have described the sounds they hear as buzzing or ringing in the ears, but the condition can cause other sounds, too, including hissing or humming. 

So, why does tinnitus happen? It involves how our ears process sounds. We’re able to hear due to special structures in our ears that are like tiny little hairs. When a sound wave comes along, those hairs bend, and our brains translate that movement into sounds. If there are no sound waves, you hear no sounds. But in the case of tinnitus, your brain gets sound signals without any sound waves there as input.   

Tinnitus is more common as you get older. Symptoms can last for years and may get worse over time. Children are less likely to report tinnitus, but they do experience it from time to time. 

Healthcare providers typically diagnose and treat tinnitus based on the cause. Sometimes the cause is unknown (Esmaili, 2018). When the cause is unknown, it’s called primary tinnitus. When it has an identifiable cause, such as a medical condition or drug, it’s called secondary tinnitus. There’s also something called pulsatile tinnitus, which is when a person hears thumping pulses in their ears in time with their own heartbeat.

It’s not always possible to find the cause of tinnitus. However, some common things that can trigger it are (Esmaili, 2018; Baguley, 2013):

• Blockages in the ear canal, such as a buildup of earwax 

• Ear infections (like swimmer’s ear)

• Tumors called acoustic neuromas, which affect the nerves that carry signals from your ear to your brain.

• Medications (like aspirin, chemotherapy drugs, diuretics, and certain antibiotics)

• Scarring of the eardrum

• Migraines

• High blood pressure or blood vessel disease

• Meniere’s disease, an inner ear disease that causes dizziness, vertigo, and tinnitus

• Mental health conditions like depression and anxiety

• Temporomandibular joint disorders, which are conditions that affect a joint in the jaw 

• Age-related hearing loss

While there’s no cure for tinnitus, there are ways to relieve symptoms. What tactics you take depends on the underlying cause, if it’s known. 

Some techniques for alleviating tinnitus include removing tumors from the ear, flushing out earwax, stopping medications like aspirin, and treating underlying conditions like high blood pressure or depression. There are also various types of therapies that have been proven to work. Let’s take a comprehensive look at each option. 

Sound therapy

The idea behind sound therapy is to use pleasant sounds to hide unpleasant ones. This can be done in a variety of ways. One is through a masking device (or masker), which emits relaxing sounds such as white noise to cover the ringing or buzzing. 

Hearing aids or cochlear implants can treat underlying hearing loss that may be contributing to tinnitus. Clinical trials show that some people with tinnitus significantly improve with sound therapy, although it doesn’t work for everyone (Pienkowski, 2019). 

Tinnitus retraining therapy 

Tinnitus retraining therapy (TRT) is a type of behavioral therapy usually performed by an audiologist or hearing specialist. The goal is to make you less aware of the tinnitus and subsequently less bothered by the sounds. 

TRT can be combined with other treatments like sound therapy. One clinical trial found that 82% of people who underwent TRT experienced significant improvements compared to the group that didn’t receive treatment, in which only 10% improved (Herraiz, 2005).

Cognitive-behavioral therapy

Cognitive-behavioral therapy (CBT) teaches techniques that help you relax and distract you from tinnitus symptoms. A research review including more than 2,700 people with tinnitus found evidence that CBT improved quality of life and the ability to cope with tinnitus symptoms. That said, there was also limited evidence these benefits remained after six months (Fuller, 2020). 

Biofeedback 

It sounds a little sci-fi, but there’s a technique called biofeedback which is tied to our awareness and the mind-body connection. It teaches you to harness power from this connection to control bodily functions you don’t typically think about, like your breathing or your heart rate. 

During biofeedback sessions, special sensors are used to record things like breathing, muscle movement, body temperature, and more. Based on this biological feedback, a healthcare professional can suggest techniques to trigger changes in the body. One clinical trial found 80% of people receiving biofeedback therapy experienced significant improvement in tinnitus symptoms (Weise, 2008). 

Medications

Sometimes drugs are recommended to help with tinnitus. Examples include (Palumbo, 2015):

• Benzodiazepines (drugs often used to treat anxiety disorders) 

• Clonazepam (an anti-seizure drug) 

• Misoprostol (an anti-inflammatory medication with a range of uses)

• Amitriptyline (an antidepressant medication)

• Ginkgo biloba (a dietary supplement) 

Keep in mind that all of these drugs usually offer only partial relief, and some carry the risk of side effects. Discuss the various options with your healthcare provider to determine which, if any, is right for you.

If you have tinnitus, a healthcare professional can do a hearing test to help identify any underlying conditions. Following an ear exam, they can recommend appropriate treatment if needed. 

Organizations like the National Institute on Deafness and Other Communication Disorders (NIDCD) offer online resources to learn more about tinnitus. The American Tinnitus Association (ATA) can help you locate a provider or audiology specialist. 

Tinnitus can be uncomfortable and distressing, but there are ways to minimize symptoms. Working with a healthcare professional can help you find the right solution for you.  

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

January 04, 2022

Written by

Gina Allegretti, MD

Fact checked by

Yael Cooperman, MD

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About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.