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The causes of tinnitus

What is tinnitus?

Tinnitus is the term used to describe a sound that only you can hear in one or both ears, when no matching external sound exists. It also covers when you can hear noises in your head in the absence of any sound in the environment.

Tinnitus is not a disease or an illness – it is a symptom of an underlying condition, usually a fault in the hearing system. This means that there are many possible causes for tinnitus and diagnosis is individual. Although there is much research in this area, the mechanisms of tinnitus are still not largely understood.

How common is tinnitus?

Tinnitus affects more than 15% of the population and is more common in older adults.

What are the symptoms of tinnitus?

People with tinnitus often experience hearing loss, migraine, sleep disorders, discomfort, distress, anxiety and depression. It can sound different to each person, with common descriptions including sounds such as: buzzing, humming, ringing, birds or crickets chirping, static, pulsing, whooshing, a constant tone or clicking. In some cases, the sound of your tinnitus can sometimes give your healthcare professional clues as to what could be causing it:

  • Clicking: Muscle contractions in and around your ear can cause sharp clicking sounds you hear in bursts. They may last from several seconds to a few minutes.
  • Rushing or humming: Usually vascular in origin, you may notice sound fluctuations when you exercise or change positions, such as when you lay down or stand up.
  • Heartbeat: Blood vessel problems, such as high blood pressure, an aneurysm or a tumour, and blockage of the ear canal or eustachian tube, can amplify the sound of your heartbeat in your ears (pulsatile tinnitus).
  • Low-pitched ringing: Conditions that can cause low-pitched ringing in one ear include Meniere’s disease. Tinnitus may become very loud before an attack of vertigo, a sense that you or your surroundings are spinning or moving.
  • High-pitched ringing: Exposure to a very loud noise or a blow to the ear can cause a high-pitched ringing or buzzing that usually goes away after a few hours. However, if there’s hearing loss as well, tinnitus may be permanent. Long-term noise exposure, age-related hearing loss or medications can cause a continuous, high-pitched ringing in both ears. Acoustic neuroma can cause continuous, high-pitched ringing in one ear.
  • Other sounds: Stiff inner ear bones (otosclerosis) can cause low-pitched tinnitus that may be continuous or may come and go. Earwax, foreign bodies or hairs in the ear canal can rub against the eardrum, causing a variety of sounds.

What are the causes of tinnitus?

While the exact cause of tinnitus is often unknown, it is generally thought to develop after some type of mental or physical change and not always one that’s related to the ear.

Other potential causes of tinnitus include:

Hearing loss

The number of hair cells in the inner ear reduce as we grow older – this gradual change in our sensory receptors can cause hearing loss and make tinnitus more prominent.

Exposure to loud noise

Hair cells can be damaged by exposure to loud noise, which leads to tinnitus. The damage can occur gradually, from exposure to noises over prolonged periods or to louder noises over a shorter period of time. (If you are exposed to loud noises, you should always wear ear protection).

Stress and Anxiety

While stress may not directly cause tinnitus, periods of anxiety or stress can increase awareness of intrusive or distracting sounds. The release of stress-hormones can help our bodies deal with a dangerous situation but in the longer-term, prolonged stress can be very uncomfortable for body and mind.

Ear Infections

Middle ear infections are common and while symptoms such as pain, a high temperature or irritation in or around the ear may be temporary, they can also cause hearing loss and tinnitus (please note that any underlying infection should be treated by a GP as soon as possible.).

Earwax build-up

Although earwax is naturally produced to keep our ears clean and hygienic, it can sometimes build up over time, This can cause deafness, problems with hearing aids, discomfort or trigger tinnitus. Many people with existing tinnitus notice that their symptoms are worse when their ears are full with wax. (Visit our Earwax Removal page to find out how we can help.)

Meniere’s disease

A disorder which affects the inner ear, Meniere’s disease can cause tinnitus, hearing loss and pressure in the inner ear. It is a progressive illness which causes acute attacks of vertigo and dizziness, which can be unpredictable. Tinnitus as a condition can be reported in one ear initially but can often progress to both ears. Accurate diagnosis and treatment for Meniere’s may result in significantly less tinnitus.

Glue ear

Glue ear (also known as otitis media with effusion) is a condition mainly affecting children, which causes a build-up of fluid in the inner ear that heals over time. The main symptoms are hearing loss and tinnitus, but these are usually temporary. Glue ear can also occur in adults.


Otosclerosis occurs where there is abnormal bone growth inside the ear – it is a common cause of hearing loss in young adults. Three small bones deep inside the ear vibrate when sound waves enter – they transmit sound waves to the inner ear, which converts them into signals that are sent to the brain. In otosclerosis, the ‘stirrup’ bone begins to fuse with the surrounding bone, eventually becoming fixed so that sound is no longer transmitted into the inner ear efficiently.

Perforated eardrum

A perforated or burst ear drum is a painful condition which can be caused by infections, changes in air pressure (such as when flying or scuba diving) or exposure to loud noise. It usually heals by itself, but can cause symptoms including hearing loss, a high temperature and tinnitus. (If symptoms last for longer than a couple of weeks, see your GP to check for any infection in the ear).


Some medicines are recognised as causing tinnitus as a side effect. If the medicine is for long term use with symptoms last for longer than a couple of weeks, see your GP for a review of your medicines and to look into possible alternatives.

Temporomandibular Joint Issue

In approximately 5% of people tinnitus is caused by the temporomandibular joint in the jaw which is treatable. This type of tinnitus occurs because jaw muscles and a muscle in the middle-ear are closely connected. When jaw muscles spasm the ear muscles react by pulling the eardrum too tight, and this situation can result in tinnitus.

What can I do if I suffer from tinnitus?

Get your hearing checked and our specialist audiologist will be able to diagnose and recommend the best route for treatment to alleviate your tinnitus symptoms. Find out about more our Tinnitus Treatment. Call 01223 661399 with questions or to book your appointment.

A useful source for further tinnitus information is the British Tinnitus Association.