What is tinnitus?

Tinnitus is the sense of hearing sound even in the absence of all external sounds. This sound is often described as roaring, ringing or buzzing and may vary from soft to loud, and low pitched to high pitched. Like pain, tinnitus is a symptom of an underlying problem and not a condition itself. It may affect one or both ears. An estimated 25 million Americans experience tinnitus, causing stress, anxiety, depression, fatigue, loss of concentration and impaired hearing. While tinnitus itself is not a serious condition, its side effects can be severe.

Tinnitus is most often connected to hearing loss and, in fact, can be the first sign of hearing loss. Most people develop tinnitus through hearing loss caused by age, long-term hearing damage from sound, or trauma to the auditory system. Most tinnitus sufferers do not seek treatment, believing that their tinnitus cannot be helped. An unintended consequence of not seeking help for tinnitus is that the associated hearing loss also goes untreated, which has a considerable negative impact on all aspects of life.

What are the symptoms of tinnitus?

Tinnitus is classified as tonal or non-tonal. Tonal tinnitus is more common and is the perception of almost continuous or overlapping sounds, while non-tonal tinnitus may be described as pulsing, like a heartbeat. Non-tonal tinnitus is rare. Though real, the noises you perceive if you have tinnitus are not actual external noise, and may include any of these descriptions:

Tonal tinnitus sounds:

  • Ringing
  • Roaring
  • Buzzing
  • Whistling

Non-tonal tinnitus sounds:

  • Humming
  • Hissing
  • Crackling
  • Rumbling
  • Thumping

The noise can affect one or both ears, may come and go or be present all the time. The noise can vary from faint to loud enough to interfere with your ability to hear external sounds. You can listen to sample tinnitus sounds on the American Tinnitus Association’s web site.

In addition to tonal or non-tonal, tinnitus can be subjective or objective.

  • Subjective tinnitus: This is the most common form of tinnitus. Only you can hear the noise. Causes include ear problems in the inner, middle or outer ear; or, problems with the hearing nerves or part of your brain that interprets the nerve signals as sound.
  • Objective tinnitus: This form of tinnitus is very rare. Your doctor is able to hear the sound during an examination. Objective tinnitus may be caused by a middle ear bone condition, muscle contractions or a blood vessel problem.

Tinnitus is more than just a nuisance. Beyond hearing impairment, tinnitus also negatively impacts quality of life. Though treating these conditions won’t resolve tinnitus, they may occur alongside or be exacerbated by tinnitus and should be treated accordingly:

  • Anxiety
  • Depression
  • Fatigue
  • Irritability
  • Memory problems
  • Poor concentration
  • Sleep issues
  • Stress

What causes tinnitus?

There are many health issues that can cause or worsen tinnitus; however, it can be hard to find an exact cause. More than one factor may be involved, making the cause hard to pinpoint.

One of the most common causes is damage to the inner ear hair cells, which move when exposed to sound waves. The hair cells then trigger an electrical signal in the auditory nerve, which runs from your ear to your brain. The brain is interpreting these signals as sound. When these inner ear cells are damaged, they send random electrical impulses to the brain, which causes tinnitus to occur. Once these delicate hairs are damaged, they cannot heal or be repaired; the injury is permanent.

Common causes of tinnitus

  • Abnormal bone growth in the ear
  • Age-related hearing loss
  • Ear and sinus infections
  • Earwax blockage
  • Noise-induced hearing loss

Less common causes of tinnitus

Blood vessel disorder causes of tinnitus

Medication causes of tinnitus

More than 200 medications are known to cause or worsen tinnitus, both when starting or stopping medication. The higher the dose, the worse the tinnitus. However, for most drugs, the tinnitus usually resolves after you stop taking the medication.

  • Antibiotics
  • Antidepressants (only certain kinds)
  • Aspirin in high doses
  • Cancer medications
  • Diuretics (water pills)

What is the treatment for tinnitus?

The first thing to do if you notice tinnitus is to see your primary care doctor. Your doctor will perform an exam and take a health history, and if there is no medical condition found for your tinnitus, they may refer you to an audiologist or an otolaryngologist (ear, nose and throat specialist, or ENT). They will evaluate your tinnitus and perform hearing tests.

Finding tinnitus relief with hearing aids

Though tinnitus cannot be cured, hearing aids can help tinnitus and provide much needed relief. In a 2008 survey of 230 hearing care professionals, 60 percent of patients reported minor to major relief of tinnitus while wearing hearing aids, and 22 percent reported major relief.

How do hearing aids help tinnitus?

Many newer hearing aids include a tinnitus therapy feature. One therapy form is by providing soothing sounds, such as ocean waves or calming white noise, which helps distract you from the tinnitus sound. Signia provides four different therapy signal types, including four nature-inspired ocean wave signals and five white noise sounds.

Another hearing aid feature is Notch Therapy, which pinpoints the frequency of your tinnitus and “pushes” it into the background. Over time, your brain learns to ignore the tinnitus sounds. This particular therapy becomes more effective the longer you use it. Notch Therapy is a very effective option for those suffering from continuous (tonal) tinnitus.

New, open-fit hearing aids may be very effective for some tinnitus sufferers.

The bigger benefit of treating tinnitus with hearing aids is that the associated hearing loss is concurrently treated.

Other tinnitus treatments

  • Acoustic neural stimulation uses headphones to deliver a broadband acoustic signal embedded in music. Somewhat similar in concept to Notch Therapy, it changes neural circuits in the brain, retraining them to ignore the tinnitus. This is a new treatment, but has shown effectiveness.
  • Anti-depressants and anti-anxiety drugs may be prescribed to improve mood and sleep quality.
  • Cognitive behavioral therapy helps you learn to mentally live with your tinnitus by changing the way you think and react, as well as giving you other tasks to help you shift your focus away from the tinnitus.
  • Cochlear implants may be used for patients who suffer severe hearing loss as well as tinnitus.
  • Wearable and tabletop sound generators mask tinnitus by producing soothing sounds.

Can I prevent tinnitus?

While not all tinnitus can be prevented, by protecting your hearing, you can also prevent further damage that may cause or worsen tinnitus.

Where can I find hearing aids for my tinnitus?

Find the optimum tinnitus strategy for you by getting in touch with your hearing care professional — they will be happy to advise you. They’ll help you select the ideal hearing aid and find the perfect tinnitus therapy, as well as give you tips and tricks to make life with tinnitus more relaxing.