Tinnitus: Description, Causes, Prevention, and Treatments

Diagnosis at the audiologist

The old theory is that someone is talking about you…that might be true, but there’s much more to the ringing in your ears sensation that we’ve all experienced in one way or another. For chronic sufferers,  it’s far from the occasional passing annoyance, and is a series of symptoms collectively known as tinnitus. 

Tinnitus is usually experienced as a high or low-pitched ringing, buzzing, whooshing, or hissing sensation in your ears, only the sound isn’t caused by external noise. These sounds can be chronic and continuous or they may come and go with varying degrees of volume and can occur in one or both ears. But tinnitus is only a symptom of a deeper issue concerning the functioning of your ear which can be caused by many different factors. 

Inner ear diagram visually explaining tinnitus

What’s Happening: Underlying Cause of Tinnitus

Tinnitus is commonly due to damage, blockage or deterioration of cells within the ear’s cochlea, which is a spiral-shaped organ residing within the inner ear. These hair-like structures provide input to the auditory nerves, which in turn send auditory signals to the brain. When the inner ear cells aren’t working properly, it affects both how and what we end up hearing. In this way, tinnitus is a symptom of the malfunctioning of these inner-ear cells, rather than a disease itself.  To determine how to best treat tinnitus, it’s important to understand the various ways and reasons it presents itself in so many people worldwide. 

Tinnitus is common — More than 50 million Americans (and over 750 million people worldwide) experience tinnitus for a number of different reasons. According to studies from the JAMA Neurology research journal, people over the age of 65 are the largest cohort (24%) experiencing tinnitus. Their research also indicates: 

  • 14% of all adults experience tinnitus
  • Tinnitus is present in 10% of people aged 18 – 44, 14% of adults aged 45 – 65

While adults are most likely to experience tinnitus to some degree, it can affect all age groups. In fact, studies have found pediatric tinnitus to affect 15% of children, but it commonly resolves on its own before adulthood. 

Understanding Tinnitus

Symptoms of Tinnitus

There are a number of different symptoms for tinnitus, but the most common include hearing the following sounds:

  • Ringing
  • Buzzing
  • Whooshing
  • Hissing 
  • Clicking

These sounds are heard only by the person experiencing the tinnitus, but can sometimes be detected by a hearing professional. These sounds can be heard constantly or intermittently and can occur in one or both ears. Some people have problems sleeping when they have tinnitus because they feel as though their brain never “shuts off.”

Possible Causes of Tinnitus

There are numerous environmental, physiological and chemical factors that can cause tinnitus. Ranging from high-decibel exposure to simple aging, the wide breadth of possible causes is part of the reason tinnitus is so prevalent across the globe. Below are some of the most common scenarios that may result in the onset of tinnitus. 

Loud noise exposure: the most common cause of tinnitus 

Construction workers, musicians, military personnel, and even those who aren’t careful in the general public can be exposed to high-noise environments that can cause permanent damage to ear function and lead to tinnitus. Symptoms arising from loud noise are sometimes described as “trigger tinnitus”, but the underlying cause here is some degree of hearing loss. Even something as benign as listening to headphones at too high a volume can lead to tinnitus.    

Medication: certain meds can lead to tinnitus symptoms

From painkillers to beta blockers, there are numerous types of medications (even over the counter) that can affect the ear’s cells in a way that causes tinnitus. Some of these include: 

  • Analgesics (Pain Medications): ibuprofen, acetaminophen, high-dose aspirin, and many other over the counter painkillers have been found to contribute to tinnitus when taken over the long term.
  • Antibiotics: treatments like aminoglycosides used to fight E. coli and other bacteria can bring on the collection of symptoms known as tinnitus, and have been found to lead to hearing loss in rare instances. 
  • Antidepressants: on occasion, selective serotonin reuptake inhibitors (SSRIs) have caused worsening tinnitus, as has the abrupt cessation of taking these medications.
  • Blood Pressure Medications: while high blood pressure is itself a risk factor for tinnitus, hypertension medications like beta blockers and ACE inhibitors can also lead to tinnitus symptoms. 
  • Cancer Treatments: several chemotherapy drugs, including those commonly used to treat cervical, lung, ovarian, breast colorectal and testicular cancers contain ingredients which can lead to hearing loss and tinnitus. 

Hearing loss: tinnitus is a symptom, but not always

Those who are experiencing hearing loss will occasionally also experience tinnitus. While tinnitus is a symptom of hearing loss, not all who lose their hearing will experience tinnitus as a pathology. 

Ear infection: blockages lead to ear-ringing

The same mechanisms that the body develops to fight infections, like swelling and fluid build-up, can cause a person to experience the auditory experiences of tinnitus due to it partially blocking the ear canal.  

Head & neck trauma: injuries and damage

Injuries to the head or neck can also damage the intricate structures of the ear or nerve pathways to the brain. Additional swelling can also block the hearing passages, which will present as tinnitus.

Earwax buildup: blocked pathways cause problems

Excessive earwax or impacted earwax within the ear canal can cause irritation in addition to the ringing, buzzing or humming associated with tinnitus. Impaction like this can be the result of narrow ear canals, frequent cotton swab usage, or simply above-normal earwax production. 

Menière’s disease: balance and hearing loss

As a side-effect of hearing loss brought about by Maniere’s disease, sufferers may experience ringing in the ears described as tinnitus. This is in addition to balance issues and a feeling of congestion in the ear canal. 

Vascular disorders: blood flow and tinnitus

People with high blood pressure, a hardening of the arteries known as atherosclerosis, or malformed blood vessels affecting their ears are likely to experience tinnitus, and often take medications to fight these conditions which can contribute to the onset of tinnitus. 

Tinnitus Treatments

Depending on the cause of your tinnitus, there are a number of different treatment methods available to help you find relief. Your hearing care provider will assess the severity of your tinnitus, symptoms, how it impedes your daily life, and possible causes and recommend one of the following solutions:

  • Address the problem: If your tinnitus is due to earwax build-up, medication, or infection, a doctor will recommend the proper course to resolve the issue. This may include removing the earwax, switching medications or antibiotics. Behavioral therapy may also be recommended to help treat the varying emotions you may experience with tinnitus, from anxiety to anger. 
  • Hearing aids: Hearing devices are incredibly helpful in treating tinnitus. Even if a hearing loss isn’t present, hearing aids can be equipped with tinnitus-masking features that help cover the tinnitus and offer relief from unwanted noise.
  • White noise machines: If your tinnitus isn’t as severe or only experienced at night time, a white noise machine may be ideal for helping you find relief. White noise machines produce a steady sound to help mask the tinnitus noises you hear.
  • Tinnitus retraining therapy (TRT): TRT is a form of therapy designed to help individuals with tinnitus find relief. This therapy involves retraining your mind to block out and hear certain tones, which in turn, helps to ease the symptoms caused by tinnitus.

When to Seek Medical help for Tinnitus

With tinnitus being so common, and its causes and experience so varied, it can be difficult to know when to see a doctor about the condition. 

  • When the condition doesn’t subside after a few days
  • The sounds you experience are getting louder or more common
  • Your sleep is being affected by the sounds in your ear, or it hurts your concentration
  • You experience increasing anxiety or depression resulting from the condition
  • The tinnitus sounds match the rhythm of your heart beat


What exactly is tinnitus?

Tinnitus is the perception of noise or ringing in the ears when there’s no external sound present. It can manifest as ringing, buzzing, hissing, chirping, or other sounds. The condition can be temporary or chronic, and it can vary in loudness and pitch.

What causes tinnitus?

Tinnitus can result from various underlying conditions. Common causes include age-related hearing loss, exposure to loud noise, earwax blockage, changes in the ear bones, Meniere’s disease, and ear or sinus infections. Some medications can also cause or worsen tinnitus.

How is tinnitus diagnosed?

Tinnitus is diagnosed based on medical history, a physical examination, and hearing tests conducted by an audiologist. Additional tests might include imaging tests like MRI or CT scans, if your healthcare provider suspects your tinnitus is caused by an underlying condition.

Can tinnitus be cured?

While there’s no cure for most cases of tinnitus, there are ways to manage the condition and reduce its impact on your life. Treatment focuses on identifying and managing underlying conditions, using sound therapy, and employing strategies to minimize its interference with daily activities.

What treatments are available for tinnitus?

Treatments include sound therapy, counseling, hearing aids if hearing loss is present, tinnitus retraining therapy (TRT), and cognitive-behavioral therapy (CBT). Lifestyle changes, such as reducing caffeine and managing stress, may also help.

How can I cope with tinnitus on a daily basis?

Coping strategies include using background noise to mask tinnitus, practicing stress management and relaxation techniques, avoiding silence, and joining support groups. Protecting your hearing from further damage by avoiding loud noises and using hearing protection is also crucial.

Can tinnitus be prevented?

While not all cases can be prevented, you can reduce your risk by protecting your ears from loud noises, maintaining good cardiovascular health, avoiding ototoxic medications when possible, and managing earwax properly.

When should I see a healthcare provider about my tinnitus?

You should consult a healthcare provider if your tinnitus is constant, affects one ear only, suddenly worsens, or is associated with hearing loss or dizziness. Early evaluation and treatment can help manage the symptoms and improve your quality of life.


If you are suffering from tinnitus, schedule an appointment with a hearing professional to be evaluated. The hearing provider will work to identify the cause behind your tinnitus and recommend the appropriate treatment.

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