A person with tinnitus hears ringing or other sounds in one or both ears. Tinnitus can be temporary or long term. Exposure to loud noise can increase the risk of tinnitus, but the exact cause may be unclear.

A person may also hear hissing, roaring, or whistling sounds, which may be high or low pitched. The sound may be constant or only occur sometimes.

In this article, find out what tinnitus feels like, why it happens, when to contact a doctor, and how to manage it.

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Tinnitus refers to atypical sounds in the ear. People commonly describe the sound as:

  • ringing
  • hissing
  • buzzing
  • roaring
  • whistling

In most cases, tinnitus is subjective. This means only the individual with tinnitus can hear the sound, and there is no way to measure it. In fewer than 1% of cases, other people can hear the noise.

The sound may:

  • affect one or both ears
  • be intermittent or continuous
  • be high or low pitched

The sound can change in volume and is often most noticeable at night or during quiet periods.

Some people with tinnitus also have hypersensitivity to noise, which is known as hyperacusis. For example, they may find it uncomfortable to hear a door closing or a book dropping.

Some people with tinnitus may hear a pulsing sound, like a heartbeat. This is a rarer form of the condition called pulsatile tinnitus. Sometimes, this type of tinnitus indicates a problem with blood vessels near the ear.

Many factors can potentially lead to tinnitus. Among the most common is hearing loss.

Exposure to loud sounds or music can damage the ears, resulting in a ringing sound. Over time, this ringing sound may become permanent and occur with hearing loss.

Some types of noise that can cause tinnitus include:

  • workplace noise, for example, in buildings or factories
  • the sound of gunshots and explosions, including on movie sets
  • loud music, such as working near powerful speakers

People can also experience hearing loss as they age. Tinnitus is common in older adults for this reason.

Other potential causes include:

  • obstructions in the ear, such as earwax
  • injuries to the brain, head, or neck
  • nasal or sinus congestion
  • temporomandibular joint disorders, which affect the jaw joint and surrounding muscles and ligaments
  • acute barotrauma, which occurs when pressure changes rapidly in the ears

Acute barotrauma can occur in people who dive, snorkel, or fly planes. It can also occur in people who are near blasts or explosions.

Various chronic conditions can also lead to tinnitus or make it worse, including:

  • high blood pressure
  • cardiovascular disease
  • fibromyalgia
  • Lyme disease
  • thyroid conditions
  • anxiety or depression
  • diabetes
  • Ménière’s disease
  • multiple sclerosis
  • palatal myoclonus, a rare condition that involves rhythmic contractions of muscles in the roof of the mouth
  • in rare cases, tumors in the ear or brain

Additionally, a number of medications can cause tinnitus if a person starts using them or stops taking them. They include:

  • aspirin
  • nonsteroidal anti-inflammatory drugs
  • antibiotics
  • chemotherapy

While tinnitus is not harmful, it can be distressing and affect a person’s well-being. Potential complications of tinnitus include:

If tinnitus is a sign of an underlying condition, it may also mean a person needs medical treatment.

A person should seek medical advice if:

  • they have new or sudden tinnitus or tinnitus with other symptoms
  • the sound pulses or whooshes like a heartbeat
  • there may be earwax or a foreign object in the ear
  • tinnitus affects the person’s sleep, ability to interact with others, and other aspects of daily life
  • tinnitus is causing anxiety or depression

People should seek emergency medical help for tinnitus if it occurs after a head injury or if the person also has:

  • tinnitus that another person can hear, as this may be a sign of a serious condition
  • vertigo (dizziness)
  • weakness in the facial muscles
  • sudden hearing loss

If a person seeks medical advice for tinnitus, the doctor may:

  • ask about symptoms
  • do a test to check for hearing loss
  • assess for conditions that may be causing tinnitus
  • refer the person to a specialist doctor for more investigations

The doctor may ask the following questions:

  • When and how did tinnitus first start?
  • Are the noises constant, intermittent, or pulsating?
  • Is there any hearing loss or dizziness?
  • Is there any pain or jaw clicking?
  • Have you had a recent illness or injury?
  • Has there been any exposure to loud noise?

Depending on the cause of tinnitus, treatment may involve:

  • prompt care for an ear infection
  • removal of earwax
  • discontinuation or adjustment of medications that may be causing it
  • treatment of an underlying condition
  • treatment for hearing loss, if present
  • steps to manage or mask the sounds of tinnitus
  • counseling to help with related issues, such as anxiety or depression

If tinnitus does not go away, the following strategies may help:

Masking

Sound therapy, or masking, involves using external noise to mask the perception of tinnitus. This could involve:

  • playing low level background music
  • playing white noise
  • wearing sound generators that fit in the ear and generate background noise or music
  • using a tabletop sound generator that plays relaxing sounds, such as waves or rain
  • using hearing aids to amplify environmental sounds

These strategies aim to redirect the attention away from tinnitus.

An audiologist may offer tinnitus retraining therapy, a specialized therapy that may help people live more comfortably with tinnitus.

Cochlear implants and hearing aids

Addressing underlying hearing loss may help reduce the symptoms of tinnitus. A range of interventions can address hearing loss, from amplification devices to surgical implants.

Hearing aids often have programs to help mask tinnitus.

Behavioral therapy

In addition to other therapies, people may try cognitive behavioral therapy (CBT) to help them live with tinnitus. CBT can also address anxiety or depression.

Lifestyle tips

Lifestyle changes that people may find helpful include:

  • practicing relaxation techniques, such as meditation or deep breathing
  • trying to avoid stress
  • developing a sleep routine, for example, taking a bath and avoiding caffeine before bed
  • joining a support group for people with tinnitus
  • avoiding total silence, which can make symptoms worse
  • seeking distraction, such as from a hobby, to direct attention away from tinnitus

It may not always be possible to prevent tinnitus, but people can take measures to reduce the risk by:

  • playing music or other sounds at a moderate volume
  • using special earplugs that do not distort sound when attending a concert
  • using hearing protection, such as ear mufflers and earplugs, in noisy environments
  • discussing the adverse effects of any medications with a doctor before using them

Here are some questions people often ask about tinnitus.

Can tinnitus go away?

Tinnitus can go away if it results from a treatable cause, such as earwax, drug use, or an underlying condition. If it results from permanent damage to the ear or another structure, though, it will not disappear.

How can you get rid of tinnitus?

This depends on the cause. Not all causes of tinnitus go away, but some do. Treating any underlying problems may help.

What are the first signs of tinnitus?

People with tinnitus may hear a ringing, buzzing, roaring, or whistling sound.

Tinnitus is a sound a person hears that nobody else can hear. People describe it as ringing, hissing, buzzing, or roaring. It is common and often affects older adults, though it can happen at any age.

In most cases, tinnitus will not go away completely. However, it may resolve after treatment if it is due to earwax or medication. People can manage tinnitus through strategies such as masking, which means playing other sounds to distract their attention from tinnitus.