Symptoms of tinnitus
Tinnitus is often described as "ringing in the ears". However, many different sounds can be heard, including:
Sometimes, people may hear noises that beat in time with their pulse (pulsatile tinnitus). Rarely, people may hear music or singing
You may also notice that your hearing is not as good as it used to be or you're more sensitive to everyday sounds (hyperacusis).
When tinnitus might be serious
Tinnitus is rarely a sign of a serious underlying condition. For some people it may come and go and only be a minor irritation.
However, it can sometimes be continuous and have a significant impact on everyday life. Severe cases can be very distressing, affect concentration, and cause problems such as difficulty sleeping (insomnia) and depression.
In many cases, tinnitus will get better gradually over time. But it's important to seek medical advice. This is to see if an underlying cause can be found and treated, and to help you find ways to cope with the problem.
When to see your GP
You should see your GP if you have continuous or frequent tinnitus that you find annoying. You should also see your GP if your tinnitus is mainly in one ear or if it is pulsatile (see above).
They can also do some simple checks to see if you have any hearing loss.
If necessary, your GP can refer you to a hospital specialist for further tests and treatment.
Causes of tinnitus
Tinnitus can develop gradually over time or occur suddenly. It's not clear exactly why it happens, but it often occurs along with some degree of hearing loss.
Tinnitus can be caused by the following including:
- age-related hearing loss
- inner ear damage caused by repeated exposure to loud noises
- an earwax build-up
- a middle ear infection
- perforated eardrum
- glue ear - a build-up of fluid in the middle ear
- Ménière's disease– a condition that also causes hearing loss and vertigo (a spinning sensation)
- otosclerosis – an inherited condition where an abnormal bone growth in the middle ear causes hearing loss
- some prescribed medication may cause tinnitus in some people
- neurological disorders — including acoustic neuroma (also called vestibular schwannoma) and multiple sclerosis
- metabolic disorders — including hypothyroidism, hyperthyroidism, and diabetes
- psychological disorders — including anxiety and depression
In very rare cases, your body may produce noise causing tinnitus that can be heard externally by others; for example if you have a malformation of your blood vessels causing noisy blood flow.
Around one in every three people with tinnitus doesn't have any identifiable problem with their ears or hearing.
Who is affected
Most people have experienced short periods of tinnitus after being exposed to loud noises, such as after a music concert.
In the UK, more persistent tinnitus is estimated to affect around six million people (10 per cent of the population) to some degree, with about 600,000 (1 per cent) experiencing it to a severity that affects their quality of life.
Tinnitus can affect people of all ages, including children, but is more common in people aged over 65.
There's currently no single treatment for tinnitus that works for everyone. If your tinnitus is caused by an underlying health condition, treating the condition will help stop or reduce the sounds you hear.
For example, if your tinnitus is caused by an earwax build-up, eardrops or ear irrigation may be used. Ear irrigation involves using a pressurised flow of water to remove the earwax.
The most common identifiable cause of tinnitus is uncorrected hearing loss. Correcting the hearing loss with regular use of hearing aids will very often cause the tinnitus to reduce or stop.
If a specific cause can't be found, treatment will focus on helping you manage the condition on a daily basis. This may involve:
- sound therapy – listening to neutral sounds to distract you from the sound of tinnitus
- counselling – therapy that aims to educate you about tinnitus and help you learn to cope with it more effectively
- cognitive behavioural therapy (CBT) – therapy that aims to help change the way you think about your tinnitus so it becomes less noticeable
- tinnitus retraining therapy (TRT) – therapy that aims to help retrain the way your brain responds to tinnitus so you start to tune the sound out and become less aware of it
You may also find self-help measures, such as relaxation techniques or sleep hygiene measures, helpful.