The What, Why, and How of Ringing in the Ear (Tinnitus)

The What, Why, and How of Ringing in the Ear (Tinnitus)

Are you hearing sounds that no one else can listen to? This may be due to ringing in one or both the ears, commonly known as tinnitus. A common problem affecting almost 15% to 20% of people, tinnitus is a medical term characterised by ringing, buzzing, chirping, hissing, whistling, and other sounds in the ear. Although you hear these sounds in your ears, there is no external source for them. Ringing in the ear is not a disease, but the condition can be extremely annoying and, in severe cases, may interfere with your daily life. 

Read on to find out more about the ringing in your ears. 

 

What are the Types of Tinnitus?

Usually, tinnitus can be of four types:-

  1. Subjective tinnitus is the most common type where only the affected person can hear the noises in their ear. It usually results from exposure to excessive noise and temporarily lasts up to 3-12 months at a time. However, in severe cases, it may be permanent. 
  2. Objective tinnitus is a rare type caused by vascular deformities or involuntary muscle contraction, affecting mechanical structures near the ear. In objective tinnitus, both you and other people near you can hear ringing in your ears. Moreover, it is the only type that can be permanently fixed. 
  3. Neurological tinnitus is usually caused by a disorder like Meniere’s disease, affecting your brain’s auditory functions. 
  4. Somatic tinnitus is related to physical movement and touch. Somatic tinnitus is caused by muscle spasms in the ear, neck, or other mechanical sources. 

What are the Causes of Tinnitus?

Almost 200 or 75% of all health conditions can affect your ears and cause tinnitus. Some of the most common causes include:-

  1. Hearing loss: The movement of tiny hair cells in your inner ear on receiving sound waves triggers electrical signals from your ear to your brain. When these hair cells are damaged, they deliver random electrical signals to the brain, causing tinnitus. 
  2. Ear infection or blockage: A blockage in the ear due to earwax, fluid buildup (ear infection), dirt, or rarely a benign tumour, such as acoustic neuromas in the ear, can increase the pressure in the ear. 
  3. Medication: Aspirin, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like naproxen and ibuprofen, cancer drugs, water pills, antidepressants, and certain antibiotics like gentamicin and tobramycin can cause or worsen ringing in the ear.
  4. Injuries to head or neck: Head or neck injuries caused by falls, car crashes, or a jolt to the head can affect the inner ear and hearing nerves, causing ringing in one ear. 

Other less common causes of tinnitus include

  1. Meniere’s disease: A chronic ear disorder affecting hearing and balance, caused by a buildup of fluid in the inner ear or labyrinth.
  2. Temporomandibular Joint (TMJ) disorder is a condition caused by inflammation of jaw joints and surrounding muscles.
  3. Acoustic neuroma: It is a benign tumour that affects the nerve running from the brain to the inner ear. The nerve is responsible for controlling balance and hearing. 
  4. Eustachian tube dysfunction: The tube connecting your middle ear to your upper throat remains expanded, causing a feeling of fullness in the ear. 
  5. Ear bone changes: Bone stiffening in the middle ear (otosclerosis) can affect hearing and cause tinnitus. 
  6. Blood vessel disorders: Conditions such as high blood pressure and atherosclerosis can affect the blood vessels, caused to move with more force through your arteries and veins. 
  7. Foreign objects in the ear: Using foreign objects such as pens or pencils to clean the ear can rupture the eardrums, causing tinnitus. 
  8. Other conditions: Chronic conditions such as diabetes, anaemia, migraine, thyroid, and autoimmune disorders like rheumatoid arthritis and lupus can cause ringing in the ear. 

What are the Risk Factors for Tinnitus?

Certain factors can increase your risk of tinnitus. These factors include:-

  1. Age: The number of functioning nerve fibres decreases as you age, causing hearing problems related to tinnitus. 
  2. Sex: Men are more likely to experience ringing in the ear than women. 
  3. Loud Noise Exposure: Being exposed to loud noises or people who work in noisy environments are more prone to developing tinnitus. 
  4. Health conditions: Certain conditions, like high blood pressure, obesity, or cardiovascular problems, can increase your risk of tinnitus. 

Can Tinnitus be Prevented?

Yes, certain kinds of tinnitus can be prevented. The preventive measures include:-

  1. Turn down the volume of music or sound: Exposure to high-volume music without ear protection can lead to hearing loss and tinnitus. 
  2. Use ear protection: If you cannot avoid loud volume noises, you should use ear protection to protect your hearing. Moreover, if you work in an environment with loud noises, you must always wear over-the-ear hearing protection. 
  3. Reduce alcohol, caffeine, and nicotine intake: Intake of these substances can affect blood flow and lead to tinnitus. 
  4. Maintain good cardiovascular health: Regular exercise and the right diet are important for healthy blood vessels. This can reduce the occurrence of tinnitus linked to blood vessel disorders or obesity. 

What are the Complications of Tinnitus?

If you have ringing in your ear, you may also experience other complications, such as:-

  1. Headaches
  2. Stress and anxiety
  3. Depression
  4. Fatigue
  5. Problems with memory
  6. Trouble concentrating
  7. Problems with sleep
  8. Irritability
  9. Work and family life problems

When Should You Seek Help for Tinnitus?

Tinnitus may not be a bothering condition for some people. However, for others, it may disrupt their normal lives. You should consult your healthcare professional when you experience ringing in your ear for at least a week. Seek medical care immediately if you experience:-

  1. Tinnitus after an upper respiratory infection that does not get better within a week
  2. Hearing loss
  3. Dizziness
  4. Anxiety or depression

How Do Doctors Diagnose Tinnitus?

The doctor diagnoses ringing in the ear by examining the symptoms. However, the doctor will perform some diagnostic tests to identify the cause and treat those symptoms. These tests include:-

  1. Movement: You will be asked to move your eyes, arms, neck and legs and clench your jaw. The changes in ringing can help determine the underlying disorder. 
  2. Hearing exam (audiometry): In this procedure, the doctor will have you seated in a soundproof room with earphones transmitting sound in one ear at a time. You will be asked to inform your provider when you hear a sound, and the results will be compared with normal hearing for your age. 
  3. Tympanometry: The doctor will use a handheld device called a tympanometer to check your eardrum. 
  4. Imaging tests: Depending on the cause of tinnitus, the doctor may perform imaging tests such as MRI and CT scan. An MRI scan can help discover a tumour near your ear. Imaging tests can also help reveal changes in the blood vessels near the ear to determine if an underlying medical condition is causing ringing in your ears. 
  5. Blood tests: The doctor may take blood samples to check for conditions such as thyroid, heart disease, anaemia, or vitamin deficiencies.

What is the Treatment for Tinnitus?

There are various options for treating ringing in the ear based on the cause and symptom of tinnitus. These treatment options include:-

  1. Medications: Medications cannot treat tinnitus. However, they can reduce the severity of its symptoms. The doctor may prescribe medications to treat the underlying causes, such as anti-anxiety drugs like Valium or antidepressants like Elavil. 
  2. Non-Surgical
    1. Earwax removal: Clearing blockage from the ear by removing wax can help relieve tinnitus symptoms. 
    2. Hearing aids: If the ringing in your ear is accompanied by hearing loss due to noise or age, using hearing aids can improve the symptoms. 
    3. Dental treatment: Dental treatment may relieve symptoms of tinnitus caused by temporomandibular joint (TMJ) problems. The temporomandibular joint is where the jaw bone attaches to your head in front of the ear. 

Devices for Noise Suppression

  1. Masking device: Resembling hearing aids, these devices produce a continuous white sound noise that is more pleasant than the ringing produced by tinnitus. It helps suppress the symptoms of tinnitus. 
  2. White noise machines: These devices produce environmental sounds like ocean waves as an effective treatment for ringing in the ear. Air conditioners and fans in the room also produce white noise, making the symptoms of tinnitus less noticeable at night. 

Counselling and Therapy

Counselling and therapy help you live with tinnitus symptoms by changing your feelings about the symptoms. These treatment options include:-

  1. Tinnitus Retraining Therapy (TRT): TRT is a treatment option for moderate to severe tinnitus involving a combination of sound therapy and counselling. The counselling session aims to change how you perceive the ringing. Sound therapy helps you habituate to the sound of tinnitus. For this therapy, you wear a device in the ear that plays a white noise covering up the ringing. You frequently habituate several auditory signals in the environment, such as refrigerators, air conditioners, etc. 
  2. Cognitive Behavioural Therapy (CBT): It is a form of counselling in which a psychologist or mental health professional helps you modify your reaction to the ringing in your ear. Counselling also helps with other tinnitus-related problems, like anxiety and depression. 
  3. Relaxation techniques: Relaxation techniques such as exercises, deep breathing, and biofeedback can help manage stress and anxiety, reducing tinnitus symptoms. 

Alternate Treatments

People have also experienced relief from tinnitus with acupuncture, magnets, and hypnosis. 

Please note: The treatment selection is based on your condition and your doctor’s opinion. 

Conclusion

Tinnitus or ringing in the ear is a common problem that may be a symptom of an underlying health condition, such as thyroid, anaemia, and migraine. If severe, tinnitus can disrupt your normal life and make it difficult for you to sleep and concentrate. As a result, you may feel depressed, angry, or frustrated. If you experience ringing in your ear, consult a healthcare professional at HexaHealth TODAY! Our team of 1500+ expert doctors can help you manage tinnitus symptoms in several ways.

 

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