Tinnitus refers to the perception of sounds — often described as a buzzing or ringing in the ears — that do not come from the external world. The condition can make everyday life demanding and stressful, and in some cases can bring to light the
symptoms of a 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
Ear infections can be one common cause of tinnitus. These usually occur when fluid becomes 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.
Earwax build-up
Too much earwax can block the ear canal, preventing normal hearing, and causing tinnitus. Find out more about earwax and tinnitus here.
Ménière's disease
Ménière's disease is a condition that affects the inner ear, causing episodes of tinnitus. Endolymphatic fluid in the cochlea of the inner ear normally helps the hearing mechanism function properly. However, with Ménière's disease, excessive fluid build-up can lead to fluctuating hearing loss, tinnitus, dizziness, and a feeling of pressure in the ear. Find out more on the link between tinnitus and dizziness here.
Glue Ear
Glue ear (also known as otitis media with effusion) is a condition caused by a build-up of fluid in the inner ear where there is normally air. This fluid then disturbs the vibrations in the eardrum making it harder to hear, alongside causing symptoms such as tinnitus. Glue ear can affect one or both ears and is more common in children than adults. If your child is experiencing tinnitus related to glue ear, it might be more difficult for them to explain their symptoms, so it's important to keep an eye out for problems with their hearing at home or in school. Find out more about glue ear.
Other underlying causes of tinnitus
Tinnitus can also be a symptom of underlying conditions such as Multiple Sclerosis (MS) and some types of cancer. In these cases, tinnitus is usually caused by damage to the auditory or neurological nerves as a result of cancerous cells, or the immune system attacking healthy cells in the case of MS. Sometimes, tinnitus caused by cancer may also just occur in one ear. If you’re suddenly experiencing tinnitus symptoms, it’s best to visit your GP
for a check-up.
What causes tinnitus?
Besides being caused by an underlying condition, 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.4
Age-related tinnitus
As people grow older, they may find they start to gradually lose their hearing, particularly in those high pitches first.
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 sounds.3 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.
Noise-induced tinnitus
Exposure to loud sounds over time in factories, construction sites and music concerts, for example, can damage the hair cells of the inner ear. This can lead to noise-induced hearing loss, which in-turn may cause tinnitus symptoms. People with noise-induced hearing loss can have trouble understanding conversations in places with lots of background noise because 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.
Here are some examples of loud noises that can cause tinnitus:
- Rock concerts (120 dB)
- Ambulance sirens (120 dB)
- Nightclubs (110dB)
- Loud machinery (115-120 dB)
- Personal music player/headphones (112 dB)
- Hand drills (98 dB)
- Heavy traffic (85 dB)
- Lawn mowers (85 dB)
If you have been recently exposed to loud noises like those above, you may just have temporary tinnitus, which may take anywhere between a few days and a few weeks to go away. If the ringing in your ears lasts longer than two weeks, it is advisable to speak to your GP.
If you work in loud environments like those mentioned above, it’s important to keep your ears protected from noise-induced hearing loss, and to avoid any further damage. 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, ensuring the maximum amount of protection. There are also specialty earplugs for specific occasions, such as musicians earplugs which have filters to ensure that the wearer can continue to enjoy music fully.
Consult with a Specsavers audiologist for more information about hearing protection.
Perforated eardrum
Ringing in the ears, and other tinnitus symptoms, can also be caused by a perforated eardrum. It’s possible to rupture your eardrum by injuring your outer or middle ear, leading to pain, hearing loss, fluid drainage, and tinnitus. Your GP or audiologist will be able to detect whether a perforated eardrum is the cause of your tinnitus by using a magnifying instrument called an otoscope.
Certain medications
Alongside underlying medical causes, tinnitus can also be a side effect of some medications including chemotherapy medicines, antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin. It’s recommended to speak to your doctor if you are taking any medications and have noticed tinnitus symptoms.
Noticing tinnitus symptoms?
If you have have noticed a change in your hearing, or sudden tinnitus symptoms such as a ringing in your ears, the first step is to have a hearing test to uncover any underlying problems. Book a hearing appointment today with one of our Specsavers audiologists. You can also learn more about tinnitus and hearing loss by exploring the articles on our dedicated tinnitus resource.
References
1. British Tinnitus Association (2020), Tinnitus and Stress. [online] Available at: https://www.tinnitus.org.uk/tinnitus-and-stress, [accessed 13/05/21].
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 13/05/21].
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.
4. British Tinnitus Association (2020), What causes Tinnitus?. [online] Available at: https://www.tinnitus.org.uk/faqs/what-causes-tinnitus [accessed 13/05/21].