Tinnitus refers to the perception of sounds — often described as ringing or buzzing noises — that do not come from the external world. The condition can make everyday life demanding and stressful, in some cases it can speed up hearing loss.
In the majority of tinnitus cases, the noises do not bother or interfere severely with daily activities, however, about 20% of tinnitus sufferers do require treatment to improve their quality of life.
Understanding what causes your tinnitus is the first step to treating it. Here, we take a look at the various causes of tinnitus, specifically the underlying conditions it can be a symptom of.
What can tinnitus be a symptom of?
In many cases, tinnitus is a symptom of an underlying condition somewhere in the auditory system, such as an ear infection or a change in the levels of fluid in the ear. However, it can also be caused by stress and anxiety.
Ear infections
These are usually caused by fluid becoming trapped in the ear following a throat infection, cold, or allergy attack. Infections in the middle ear can sometimes cause temporary tinnitus as the increase in fluid muffles sound. This causes the brain to re-interpret the sounds, resulting in tinnitus. This type of tinnitus should disappear once the ear infection has been resolved.
Symptoms of an ear infection include pain in the ear, a feeling of fullness, hearing loss and dizziness, as well as the presence of a thick, yellow liquid coming from the ear. An ear infection is usually easily treatable by antibiotics or ear drops.
Stress and anxiety
Stress and anxiety tend to worsen tinnitus1. The auditory system has neural connections to the limbic (emotional) part of the brain. When the limbic system is overly active, the brain has more difficulty shutting down tinnitus.
Furthermore, as the tinnitus continues, it can cause stress and anxiety levels to rise, which in turn increases the symptoms of tinnitus2. In order to break this vicious cycle, you should try to reduce your stress. Simple techniques to help you reduce your levels of stress include mindfulness, deep breathing and physical exercise.
Ménière's disease
Endolymphatic fluid in the cochlea of the inner ear normally helps the hearing mechanism function properly. However, excessive fluid accumulation can lead to fluctuating hearing loss, tinnitus, dizziness, and a feeling of pressure in the ear. Find out more on the link between tinnitus, dizziness and Ménière's disease here.
Treatment for Ménière's disease focuses on reducing the fluid in the inner ear. Patients may be advised to reduce the amount of salt in their diet. In severe cases, surgery may be recommended to remove the fluid.
Hearing aids may help reduce tinnitus as well as address hearing loss from Ménière's disease. Since the hearing loss may change from day to day, the hearing aids should have controls that allow you to change the volume.
What else causes tinnitus?
Tinnitus usually occurs when there is damage to the tiny sensory hairs in the inner structures of the ear — namely, the cochlea. The damage is most often simply due to ageing, although it can also be caused by prolonged exposure to loud noises.
Tinnitus and age-related hearing loss
This is why tinnitus is associated with age-related hearing loss (presbycusis). Most people gradually lose hearing as they grow older, and people tend to lose hearing sensitivity first in the high pitches.
Some research suggests that the loss of sensitivity to certain frequencies of sound, such as the highest frequencies, can lead to changes in how the brain perceives these sounds3. It’s thought that because the brain can no longer sense the high-frequency noises, it replaces the missing sound impulses — causing the ‘phantom sounds’ associated with tinnitus.
Hearing aids are the main treatment for tinnitus associated with presbycusis. Some models of receiver-in-the-canal (RIC) hearing aids allow amplification to effectively treat tinnitus. Hearing aids restore regular auditory stimulation to the brain, which can help reduce tinnitus symptoms over time. In addition, hearing aids may be programmed with special tinnitus masking programs that reduce the person’s ability to perceive the tinnitus.
Tinnitus and noise-induced hearing loss
Exposure to loud sounds over time in factories, construction sites and music concerts, for example, can cause damage to the hair cells of the inner ear.
People with noise-induced hearing loss can have trouble understanding conversations in background noise. The damaged auditory system can no longer separate different sounds as easily. Noise-induced hearing loss worsens if you continue to spend time in loud noise without protecting your ears.
The first step to treating tinnitus from noise-induced hearing loss is to protect the ears from further damage. Consult with a Specsavers audiologist about hearing protection. There are earplugs available from pharmacies, but many people do not insert them correctly, reducing their effectiveness.
Specsavers can make earplugs that have been custom fit to your ear size and shape. The better fit will ensure the maximum amount of protection. There are speciality earplugs that will allow hunters to continue to hear soft sounds while muting louder sounds. Musician earplugs have filters to ensure that the wearer can continue to enjoy music fully.
Noise-induced hearing loss and tinnitus benefit from treatment with hearing aids that provide auditory stimulation, making it easier to ignore the tinnitus. Over time, the brain may re-wire itself to reduce the tinnitus.
You can also learn more about tinnitus and hearing loss by exploring the articles on our dedicated tinnitus resource.
If you have difficulties with tinnitus and have noticed a change in your hearing, the first step is to have a hearing test to uncover any underlying problems with your ears. Book a hearing appointment today with one of our Specsavers audiologists.
References
1. British Tinnitus Association, Tinnitus and Stress. [online] Available at: https://www.tinnitus.org.uk/tinnitus-and-stress, [accessed 2 September 2019].
2. CapTel. (2014). Quell anxiety to improve tinnitus symptoms. [online] Available at: https://www.captel.com/2014/03/quell-anxiety-to-improve-tinnitus-symptoms/ [Accessed 11 Sep. 2019].
3. Roberts, L., Eggermont, J., Caspary, D., Shore, S., Melcher, J. and Kaltenbach, J. (2010). Ringing Ears: The Neuroscience of Tinnitus. Journal of Neuroscience, 30(45), pp.14972-14979.
Gordon Harrison
BAAT, RCCP
In 2017 Gordon joined Specsavers as Head of professional advancement and group clinical lead for Audiology for the UK and Ireland and leads the clinical support team in our desire… Read more