If you hear whooshing, buzzing, ringing, clicking, hissing or other sounds in your ears and no one else can hear the sounds, you could have a condition called tinnitus.
According to the American Tinnitus Association, tinnitus is a neurological and audiological condition that can be temporary or chronic. More than 50 million adults in the U.S. have tinnitus, and about 5 million Americans have chronic tinnitus. Tinnitus is usually caused by an underlying medical condition.
Tinnitus can manifest itself in many different forms. In addition to hearing clicking, swooshing, whistling, hissing or buzzing sounds in your ears, some people who have tinnitus also hear music in their ears. In rare cases, the sounds can be heard by others.
Types and Causes
Two main types of tinnitus exist:
- Subjective tinnitus: Patients with subjective tinnitus hear noises in their ears that only they can hear. Subjective tinnitus can result from hearing loss or other causes.
- Objective tinnitus: Patients with objective tinnitus hear noises in their ears that others can also hear. The sounds may result from functions in the circulatory and musculoskeletal systems. This type of tinnitus is very rare – less than 1% of patients with tinnitus have objective tinnitus.
Tinnitus can be caused by many other health conditions. Some of the most common causes include, but are not limited to:
- Hearing loss (age-related or noise-induced)
- An obstruction in the middle ear
- Neck or head trauma
- Temporomandibular joint disorder, which occurs as a result of damage to cartilage, ligaments or muscles in the temporomandibular joint, where your skull and lower jaw connect
- Sinus pressure or a sinus infection
- Traumatic brain injury (TBI)
Some medications can also have tinnitus as a side effect, especially:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Antibiotics
- Cancer medications
- Diuretics (water pills)
- Medications containing quinine
Effects
Tinnitus can affect you in different ways. For example, it can:
- Cause you to get less sleep at night
- Make it harder to concentrate on tasks
- Cause you to feel anxious or depressed
Diagnosis
Fortunately, tinnitus is not an emergency medical condition, unless it is associated with head or neck trauma or a TBI, such as a concussion. If you feel you could have tinnitus and it is not associated with neck trauma or a TBI, you can see your primary care provider or an audiologist. Your provider will conduct a physical examination and refer you to a specialist as needed.
There are tests your medical provider may perform to check for hearing loss and evaluate the level of tinnitus you have, including but not limited to:
- A speech recognition test, which measures how well you can hear and repeat words
- A pure tone audiogram, which measures your hearing across different frequencies and volumes
- A tympanogram, which measures how your middle ear functions
- An acoustic reflex test, which measures how well your middle ear muscles contract when you hear loud noises
- An otoacoustic emission test, which uses sensitive microphones to measure how hair cells move inside your inner ear
- A tinnitus evaluation, which can assess the level and pitch of your tinnitus as well as assess if there is any concern for a decreased sound tolerance, which is common among patients with tinnitus.
Treatment
To effectively treat tinnitus, your medical provider must determine if there is any underlying medication condition that may be the root cause of your tinnitus and assess whether treating that medical problem or monitoring is most appropriate. Treating your underlying medical condition may reduce your tinnitus or cause you to no longer have it. Depending on your underlying condition, you may have a medical team of any of the following:
- An audiologist, which is a provider trained to identify, diagnose and treat hearing loss, tinnitus, dizziness and other conditions related to hearing
- An otolaryngologist (ENT), which is a provider trained to evaluate and treat ear, nose, throat, head and neck disorders and can determine if you have excessive ear wax, an obstruction in your middle ear or a benign (non-cancerous) tumor on your auditory nerve
- A neurologist if you have headaches that accompany your tinnitus or if you are sensitive to sound
- A psychologist or a licensed clinical social worker if your tinnitus is impacting your mental health
- A dentist if you have temporomandibular joint disorder
- A physical therapist if you have pain in or difficulty moving your head or neck
Treatment options could include any of the following depending on your needs:
- Hearing aids to improve hearing and communication as well as reduce tinnitus symptoms
- Tinnitus management therapies, which will be customized for you
- Mental health counseling to help reduce negative emotions associated with tinnitus
In cases of chronic tinnitus, it may take three months to a year to notice improvement with treatment. You may find success by doing the following activities in addition to your treatments:
- Listening to relaxing music or other enjoyable sounds
- Gardening and other enjoyable outdoor activities
- Meditating
- Exercising or doing yoga
- Getting enough sleep (at least seven to nine hours of sleep a night)
If your tinnitus is a side effect of any prescription medications you take, talk with your prescribing medical provider or pharmacist about different medication options.
UofL Health is Here for You
If you need a primary care provider, visit UofL Physicians – Primary Care or call 502-588-4343 to find one near you. Our Primary Care offices accept many types of health insurance and have self-pay options. Several of our offices are accepting new patients.
UofL Physicians – Hearing & Balance audiologists provide top-notch clinical care, education and research related to deafness, hearing loss, balance disorders and tinnitus. With locations downtown and in the East End of Louisville, UofL Physicians – Hearing & Balance prides itself on being a top-tier clinical audiology program in Louisville. To make an appointment, call 502-583-3687.
UofL Physicians – Ear, Nose & Throat (EN&T) surgeons are board-certified world-class experts who specialize in the medical and surgical treatment of diseases of the ear, nose, throat, head and neck. To make an appointment, call 502-583-3687.
