Tinnitus — a ringing, whooshing, chirping or humming sound that only you can hear — can become extremely stressful for people. In a few rare circumstances, it can indicate a more serious problem that requires immediate medical attention. But most of the time, you can manage tinnitus with the help of an audiologist and your health care team.
What is tinnitus?
Tinnitus itself is not a disease. Usually, it is a symptom of some other type of underlying health condition. Experts estimate that around 10-15% of the population experiences tinnitus, so if you are struggling with this, you are not alone.
The most common cause of tinnitus is your brain reacting to hearing loss, ear damage, or other ear conditions. But sometimes tinnitus is literally the “canary in the coal mine,” or the first symptom of a more serious condition. In fact, according to the American Tinnitus Association, there are roughly 200 different health disorders that can generate tinnitus as a symptom, and some of these should be considered emergencies.1
When should I worry about tinnitus?
- Sudden onset – If you have not experienced tinnitus before and all of a sudden, you are having severe tinnitus that interferes with your daily life or sudden unexplained hearing loss, especially in just one ear, talk with your health care professional or audiologist as soon as possible.
- After a head injury – Anytime you have a traumatic physical event, like a car accident, fall or concussion, you should receive emergency medical care. Tinnitus is one of several indicators of head trauma.
- Mental health emergency – Sometimes, tinnitus that gets in the way of sleeping or everyday activities can cause severe depression or anxiety. If you are feeling hopeless, completely overwhelmed, or suicidal because of your tinnitus, seek emergency mental health care. The 988 helpline is available 24/7 to provide mental health and crisis support, or you can go to the nearest emergency room or mental health treatment facility.
- Pulsatile tinnitus – This rare form of tinnitus is a whooshing or thumping noise in your ears that happens at the same time as each heartbeat. If it comes on suddenly, happens in just one ear, or is accompanied by other symptoms like dizziness, numbness or weakness, get medical help right away. It can be a sign of a more serious heart or blood pressure issue.
Other causes of tinnitus
Below is a limited list of some of the most common health issues that may have tinnitus as a symptom. If you notice tinnitus along with some of these other symptoms, make an appointment with your health care provider or an audiologist as soon as possible to determine the cause.
Medical conditions associated with tinnitus
Tinnitus is a reported symptom of the following medical conditions:
- Metabolic disorders: hypothyroidism, hyperthyroidism, anemia.
- Autoimmune disorders: Lyme disease, fibromyalgia, rheumatoid arthritis, lupus.
- Blood vessel disorders: high blood pressure, atherosclerosis (buildup in the walls of the arteries).
- Psychiatric disorders: depression, anxiety, stress, post-traumatic stress disorder (PTSD).
- Vestibular disorders: Ménière’s disease, thoracic outlet syndrome, otosclerosis, vestibular migraines.
- Tumor-related disorders (very rare): acoustic neuroma, vestibular schwannoma, other tumorous growths.
- Head and neck injuries.
Sinus pressure and barometric trauma
Nasal congestion from a severe cold, flu, or sinus infection can create extra pressure in the middle ear, which impacts normal hearing and often causes tinnitus symptoms. If you are having ear pain, fluid that comes out of your ear, or fever along with your tinnitus, see your health care professional.
Acute barotrauma, caused by extreme or rapid changes in air or water pressure, can also damage the middle and inner ear. Potential sources of this type of trauma include:
- Diving, snorkeling or scuba diving.
- Flying (only during extreme, abnormal elevation changes; normal commercial air travel is generally safe).
- Concussive explosive blasts.
- Traumatic brain injury (TBI).
Traumatic brain injury, caused by concussive shock, can damage the brain’s auditory processing areas and generate tinnitus symptoms. TBI is one of the major reasons for tinnitus in military and veteran populations. Nearly 60% of tinnitus cases diagnosed by the U.S. Department of Veterans Affairs are attributable to mild to severe traumatic brain injuries.
Medicines that are harmful to the ear (ototoxic)
Tinnitus is a potential side effect of many prescription medications. However, in most cases and for most drugs, tinnitus is an acute, short-lived side effect, meaning if you stop taking the medication, the tinnitus symptoms typically subside.
However, there are some ototoxic drugs that cause permanent tinnitus symptoms. These include:
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).
- Certain antibiotics.
- Certain cancer medications.
- Water pills and diuretics.
- Quinine-based medications used to treat malaria.
- Some antidepressants.
- Marijuana and tobacco.
- Some herbal supplements.
If you are worried about tinnitus as a side effect of your medications, please consult your prescribing physician or pharmacist. You should never stop taking a medication without first consulting your health care provider. The risk of stopping a medication may far exceed any potential benefit in the reduction of the tinnitus sound.
Obstructions in the middle ear
Objects directly touching the eardrum can irritate it and cause the perception of tinnitus symptoms. Common obstructions include:
- Excessive earwax
- Head congestion
- Loose hair from the ear canal
- Dirt or foreign objects
In many cases, the removal of the blockage will relieve the tinnitus symptoms. However, in some situations, the blockage may have caused permanent damage that leads to chronic tinnitus.
Jaw problems
Issues with the temporomandibular joint (TMJ), the place where your lower jawbone connects with your skull, can cause tinnitus. These often include clenching or grinding your teeth and extra tension or stress in the muscles of your jaw.
A dental professional can often diagnose and treat these conditions, which in turn, may help improve your tinnitus.
What kind of doctor helps with tinnitus?
Since tinnitus has so many different causes, you may need to see more than one kind of health care professional to address it. Here are some of the specialists who can help with tinnitus:
Audiologist
An audiologist is a doctor who specializes in hearing and balance problems. They can test your hearing with a comprehensive hearing evaluation. Since hearing loss is the most common cause of tinnitus, an audiologist can be a great place to start if you’re having problems with tinnitus.
At Associated Audiologists, we also have an audiologist with additional training and expertise specifically in tinnitus diagnosis and treatment: Dr. Susan Smittkamp. She has access to the latest tinnitus treatment options, including Lenire, which is FDA-approved and proven to reduce tinnitus severity in people with bothersome tinnitus.
Schedule an appointment with a doctoral-level audiologist.
Ear, Nose and Throat specialist (ENT)
An ENT is a medical doctor who specializes in treating problems with the ears, nose, throat and other parts of the head and neck. You might benefit from seeing an ENT if you have symptoms of an ear infection, blockage, or structural problem with your ears that could be causing your tinnitus.
Dentist
If you have frequent headaches, jaw aches or facial pain along with tinnitus, a dentist may be able to help. They can treat TMJ, which can contribute to tinnitus.
Mental health professional
Anxiety, depression and stress are often linked to tinnitus. There are many kinds of mental health professionals who can provide therapy, medication, and other types of support for mental health concerns. Consider seeing a psychologist, psychiatrist, licensed clinical social worker, or other mental health professional.
If you’re not sure what’s causing your tinnitus or which type of doctor might help, your primary care provider is a great place to start. They can check for physical problems and refer you to another provider if necessary.
Will my tinnitus ever get better?
Tinnitus can feel like an itch you can’t scratch or a pain you can’t identify. It’s frustrating and for some people, debilitating. But there is hope and help.
While there is no specific cure for tinnitus yet, there are many different treatments and techniques to manage it so it doesn’t overwhelm you. If you have more questions, make an appointment with an audiologist or other health care professional. We are here to help!
1 https://www.ata.org/about-tinnitus/why-are-my-ears-ringing/causes/
