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Tinnitus

What is tinnitus?

Tinnitus is a condition in which you hear noises when there is no outside source of the sounds. The noises can have many different qualities (ringing, clicking, buzzing, roaring, whistling, or hissing) and can be soft or loud.

Usually, only the person experiencing the tinnitus can hear the sounds. Tinnitus can occur either with or without hearing loss, and can be perceived in one or both ears or in the head.

Approximately 50 million Americans have some form of tinnitus. For most people, the sensation usually lasts only a few minutes at a time. About 12 million people have constant or recurring tinnitus that interferes with their daily life so much that they seek professional treatment. For these individuals, tinnitus may result in a loss of sleep, interfere with concentration, and create negative emotional reactions such as despair, frustration, and depression.

People of any age can suffer from tinnitus, although it does not typically occur in children. Children with tinnitus should be evaluated for hearing loss or other underlying cause.

What causes tinnitus?

Although tinnitus often has no specific cause, the most common identifiable causes of tinnitus include the following:

  • hearing loss
  • exposure to loud noises
  • head injury
  • medication side effects
  • high or low blood pressure
  • wax buildup in the ear canal
  • fluid buildup behind the eardrum
  • problems of the heart, blood vessels, neck, jaw, or teeth

Your doctor will try to determine what is causing the condition. If it is not due to a medication side effect or a general medical condition (such as high blood pressure), he or she may refer you to an otolaryngologist (an ear, nose, and throat doctor) or an audiologist (hearing specialist). It is especially important to see an otolaryngologist if you experience tinnitus in only one ear, tinnitus that sounds like your heartbeat or pulse (pulsatile tinnitus), tinnitus with sudden or fluctuating hearing loss, pressure or fullness in one or both ears, and/or dizziness or balance problems. Unless the cause of the tinnitus is obvious on physical examination, a hearing test is usually required.

What is the treatment for tinnitus?

Learning the cause of tinnitus is often the most important step to determining treatment options. In many cases there are no medical or surgical treatments for tinnitus; however, there are management strategies that can provide some relief.

Treatment options for tinnitus include the following:

  • Hearing aids. Many people who have tinnitus also have hearing loss. Hearing aids may help provide relief from tinnitus by making it less noticeable. This is done by increasing the background noise level. Another benefit of hearing aids is that they improve communication by increasing incoming speech sounds.
  • Sound generators. These adjustable ear-level devices produce a broadband sound (pleasant shower-like sound) that is delivered directly to the ear. These devices help people pay less attention to their tinnitus by masking it with other sounds. Sound generators are also used for tinnitus retraining therapy. (This therapy combines individualized counseling with use of sound generators.)
  • Combination instruments. A hearing aid and sound generator can be housed in a single unit. These units are best for people who need hearing aids and may benefit from the use of sound generators.
  • Environmental enrichment devices. A variety of simple-to-use devices can be used to increase the level of background sound in order to decrease the perception of tinnitus. These include tabletop sound machines that can generate different types of sounds (for example, rain, wind, waterfalls), CD/mp3 recordings of music and/or nature/environmental sounds and apps specifically created for tinnitus relief that can be used with smartphones or tablets.
  • Neuromonics. A pleasant acoustic signal (embedded in music) is delivered to the ear through high fidelity earphones and a small credit-card size processor. This form of music therapy is a very pleasant alternative to other types of sound therapy and requires at least 6 months of active treatment time. The music also tends to further improve relaxation, which helps people cope with their tinnitus.
  • Relaxation techniques. Many people who have tinnitus find that it worsens when they are under stress. Learning techniques to increase relaxation and ease stress can help people better deal with the frustrations of tinnitus.
  • Other options. Cognitive behavioral or acceptance therapy with a psychologist can help people learn ways to limit the attention given to tinnitus and also help them better manage the stress and anxiety resulting from the tinnitus. Management of a temporomandibular disorder (TMD) (the area where the lower jaw and skull meet) by a dentist may be of value in helping to control dental issues, such teeth clenching and grinding, which are associated with tinnitus. An examination by a physical therapist may identify problems with the movement of the head, neck and jaw that can contribute to tinnitus. Follow-up physical therapy can help restore the proper movement of the neck and jaw and improve posture, which may reduce the severity of tinnitus.

Certain behaviors can make tinnitus worse and should be avoided whenever possible. These include:

  • Smoking or using other tobacco products
  • Drinking alcohol
  • Exposure to loud noises and sounds (If you work in a loud setting, wear earplugs to protect your hearing.)
References

© Copyright 1995-2014 The Cleveland Clinic Foundation. All rights reserved

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact the Center for Consumer Health Information at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771. If you prefer, you may visit www.clevelandclinic.org/health/ or www.clevelandclinicflorida.org. This document was last reviewed on: 4/9/2014... index#14164

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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

© Copyright 2014 Cleveland Clinic. All rights reserved.