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What is Tinnitus and what causes it?

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Tinnitus is the term used to describe noises that may be heard in one or both ears, or in your head, in the absence of any sound in the environment. Although there is much research in this area, the mechanisms of tinnitus are still not largely understood. It is not a disease but rather a symptom and is usually due to a fault in the hearing system. We do know that certain medications, stress, diseases, hearing loss and exposure to loud noise can be a factor. Even having too much wax in the ear canal can cause tinnitus.

It is thought that approximately 10% of UK adults suffer from Tinnitus. It can be described in many different ways and can sound different to different people. Some common descriptions of what tinnitus sounds like are: buzzing, humming, ringing, birds or crickets chirping, static, pulsing, whooshing, 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. Here are some examples:

  • 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 tumor, 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.

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.

Some diseases such as Meniere’s Disease may cause tinnitus and deafness in one ear and periodic attacks of dizziness. Either the tinnitus or the dizziness may be the predominant symptom and so some patients may mainly complain of tinnitus in the affected ear. Some patients have tinnitus in both ears. Accurate diagnosis/treatment of Meniere’s disease may result in significantly less tinnitus.

Some medications are known to cause tinnitus so if in doubt speak to your GP if you are concerned about any medications you are taking.

In many cases however the cause of your tinnitus is never found.

What can I do if I suffer from Tinnitus?

Get your hearing checked: If you suffer from Tinnitus it is important to see your GP and get your hearing checked by an audiologist. In many cases tinnitus is associated with a hearing loss. In some cases your tinnitus may be caused by a medical condition which may be treatable. Your audiologist will suggest you see an ENT specialist if they feel this may be the case.

Hearing Aids: Good quality and properly fitted hearing aids reduce and even eliminate most tinnitus associated with hearing losses. Hearing aids take away the strain of listening and distract from the tinnitus by bringing you more environmental sounds from the outside world.

Sound Generator: These devices look like a hearing aid and are recommended for people with no hearing loss. As the name suggests it produces sounds which stimulate most fibres of the hearing nerve helping to deviate attention away from the tinnitus. Depending on the sound of your tinnitus several different sound options and levels of sound can be tried to find the one that works best for you.

Tinnitus Retraining Therapy (TRT): Aims to reduce and ultimately eliminate tinnitus perception. It combines auditory therapy – hearing aids and/or therapeutic noise generators – to provide the brain with maximum environmental sounds to reduce tinnitus perception. It is combined with counselling to change negative beliefs, distract from tinnitus and reduce stress.

Cognitive Behaviour Therapy (CBT): This therapy is offered by clinical psychologists and is effective in alleviating distress and producing adaptation to tinnitus. CBT is threefold: changing the way a person perceives tinnitus; teaching ways to focus attention away from tinnitus and achieving control over stress.

Dietary changes: Try reducing your intake of salt, caffeine, nicotine and alcohol as these are all known to make your tinnitus worse. For some people herbal remedies or Vitamin B12 may be helpful. However please consult your specialist before taking any supplements

Unfortunately tinnitus can’t be resolved in the majority of cases. Some people, however, get used to it and notice it less than they did at first. For many people, certain adjustments make the symptoms less bothersome. Some tips that may help include:

Avoid possible irritants: Reduce your exposure to things that may make your tinnitus worse. Common examples include loud noises, caffeine and nicotine.
Cover up the sound of the tinnitus: In a quiet setting, a fan, soft music or low-volume radio static may help mask the noise from tinnitus.
Manage stress: Stress can make tinnitus worse. Stress management, whether through relaxation therapy, biofeedback or exercise, may provide some relief.
Sometimes it helps to talk with others who also experience tinnitus. They may be able to give you suggestions for new things to try to help manage your tinnitus, provide support or just give you an opportunity to talk to someone else who also suffers from tinnitus. The British Tinnitus Association is an organisation providing support and counselling for people with Tinnitus. For more information on their services please see their website

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