What is tinnitus? Tinnitus is a sound in the head with no external source. It can cause constant ringing, whistling, buzzing, or other noises. Here’s what you need to know about the causes and management of tinnitus.

Understanding Tinnitus: Causes and Symptoms

Tinnitus is the perception of sound in the head or ears when no external sound is present. It can manifest as ringing, buzzing, whistling, hissing, humming, roaring, or even shrieking. The sound may seem to come from one ear, both ears, or from inside the head. Tinnitus can be constant or intermittent, steady or pulsating.

Almost everyone has experienced a short-term bout of tinnitus after being exposed to extremely loud noise, such as attending a concert. Certain medications, especially aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) taken in high doses, can also cause tinnitus that goes away when the drug is discontinued. However, when tinnitus lasts for more than six months, it is considered chronic tinnitus.

Chronic tinnitus is a common condition, affecting an estimated 50 to 60 million people in the United States, especially those over the age of 55. It is strongly associated with hearing loss, as 90% of those with tinnitus also have some degree of hearing impairment.

Types of Tinnitus: Subjective and Objective

Tinnitus can be either subjective or objective. Subjective tinnitus is the most common type, where only the individual can hear the sound. Objective tinnitus, on the other hand, is a rare condition where the sound can be heard by others, such as a healthcare provider using a stethoscope.

Pulsatile tinnitus is a type of objective tinnitus where the individual hears a rhythmic sound that is in sync with their heartbeat. This is more likely to occur in older people, as the arteries tend to stiffen with age, leading to more turbulent blood flow.

Hearing Loss and Tinnitus

Hearing loss is a major contributing factor to tinnitus, with 90% of those with tinnitus also having some degree of hearing impairment. The damage to the tiny hair cells in the inner ear, which can be caused by age-related changes, exposure to loud sounds, or a combination of both, may be the reason for the perception of tinnitus in some individuals.

When hearing loss occurs, the brain attempts to compensate by becoming more sensitive to the remaining sounds, which may lead to the perception of tinnitus. This is why treating the underlying hearing loss can often provide relief for those experiencing tinnitus.

Tinnitus Management Options

While there is no scientifically proven cure for tinnitus, there are several management options available to help reduce its impact on daily life:

1. Hearing aids: Using a hearing aid can help treat the underlying hearing loss, which in turn can reduce the perception of tinnitus.
2. Sound generators: These devices produce soothing background sounds, such as white noise or gentle music, which can help mask the tinnitus and provide relief.
3. Tinnitus retraining therapy: This form of therapy aims to help the brain “habituate” to the tinnitus, reducing its perceived impact on daily life.
4. Stress management: Reducing stress and anxiety can also help alleviate the impact of tinnitus, as these factors can exacerbate the perception of the condition.

When to Seek Medical Attention

If you are experiencing persistent or bothersome tinnitus, it is recommended to see your healthcare provider for a comprehensive evaluation. They can perform a hearing test and help determine the underlying cause of your tinnitus, as well as provide guidance on the most appropriate management strategies.

It’s important to note that while tinnitus can be annoying, it rarely indicates a serious health problem. However, seeking medical attention can help you find ways to manage the condition and improve your quality of life.

Dispelling Tinnitus Myths

Many people worry that tinnitus is a sign of an underlying serious medical condition, such as going deaf. However, this is rarely the case. Tinnitus is a common condition that is not typically associated with any major health problems.

It’s also important to note that tinnitus is not contagious and cannot be transmitted to others. If you are experiencing tinnitus, it is a personal experience and does not pose a risk to those around you.

Conclusion

Tinnitus is a common condition that can be a source of significant distress for those affected. Understanding the causes, symptoms, and management options can help individuals with tinnitus find ways to cope with the condition and improve their quality of life. If you are experiencing persistent or bothersome tinnitus, it is important to seek medical attention to address the underlying cause and explore the most appropriate treatment strategies.

Mayo Clinic Minute: Is tinnitus causing that ringing in your ear?

• By

  Jason Howland

  January 18, 2023

Have you ever experienced a constant ringing in your ears that you can’t pinpoint the cause? It might be tinnitus (‘tin-nĭ-tus) — the sensation of hearing a sound when no external sound is present. In most cases, tinnitus can be managed, but for some, it’s a chronic condition that can affect sleep and everyday function. Fortunately, there are options to reduce its effects.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (1:03) is in the downloads at the end of the post.  Please courtesy: “Mayo Clinic News Network.” Read the script.

About 1 in 5 people experience the perception of noise or ringing in the ears. It’s called tinnitus. Dr. Gayla Poling is the director of Diagnostic Audiology at Mayo Clinic. She says tinnitus can be perceived a myriad of ways: ringing, buzzing, whistling, a cracking, a chirping. But why?

“Ninety percent of those with tinnitus have hearing loss. So that’s usually where we start as a source or a reason for the tinnitus.”

Hearing loss can be age-related, come from a one-time exposure, or exposure to loud sounds over a lifetime. Dr. Poling says the tiny hairs in our inner ear may play a role.

“Those little hair cells in our inner ear are really delicate structures. That’s what is actually damaged with noise exposure, or wear and tear on your ears across your life span. So those hair cells, that damage might be the reason or part of the cause for tinnitus for some.”

Dr. Poling says there’s no scientifically proven cure for tinnitus, but there are treatment and management options.

“That can be something as simple as getting a hearing aid to really start treating the hearing loss. And once you treat that, then you find that the tinnitus and the perception of that tinnitus is reduced.”

Other options include using a sound generator or a fan at night. And then there are more advanced treatments.

“There’s something called “tinnitus retraining therapy.” There are more ear-level masking devices where you can hear sounds throughout the day, too, that are more distracting.”

If ringing in your ears bothers you, start by seeing your health care provider for a hearing test.

For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was either recorded prior to COVID-19 or recorded in a nonpatient care area where other safety protocols were followed.

Related articles

Mayo Clinic Minute: ABCs of hepatitis

World Hepatitis Day takes places every year on July 28, bringing the world together to raise awareness of the global burden of viral hepatitis.
Hepatitis is …

By Jason Howland • July 27, 2023

Mayo Clinic Minute: Breaking through radiation therapy myths

People who have cancer might have the disease treated with several therapies, including chemotherapy and radiation. Radiation therapy, which more than half of all people …

By Jason Howland • July 26, 2023

Tinnitus: Ringing in the ears and what to do about it

Constant noise in the head— such as ringing in the ears—rarely indicates a serious health problem, but it sure can be annoying. Here’s how to minimize it.

Tinnitus (pronounced tih-NITE-us or TIN-ih-tus) is sound in the head with no external source. For many, it’s a ringing sound, while for others, it’s whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating.

Almost everyone has had tinnitus for a short time after being exposed to extremely loud noise. For example, attending a loud concert can trigger short-lived tinnitus. Some medications (especially aspirin and other nonsteroidal anti-inflammatory drugs taken in high doses) can cause tinnitus that goes away when the drug is discontinued. When it lasts more than six months, it’s known as chronic tinnitus. As many as 50 to 60 million people in the United States suffer from this condition; it’s especially common in people over age 55 and strongly associated with hearing loss. Many people worry that tinnitus is a sign that they are going deaf or have another serious medical problem, but it rarely is.

Most tinnitus is subjective, meaning that only you can hear the noise. But sometimes it’s objective, meaning that someone else can hear it, too. For example, if you have a heart murmur, you may hear a whooshing sound with every heartbeat; your clinician can also hear that sound through a stethoscope. Some people hear their heartbeat inside the ear — a phenomenon called pulsatile tinnitus. It’s more likely to happen in older people, because blood flow tends to be more turbulent in arteries whose walls have stiffened with age. Pulsatile tinnitus may be more noticeable at night, when you’re lying in bed and there are fewer external sounds to mask the tinnitus. If you notice any new pulsatile tinnitus, you should consult a clinician, because in rare cases it is a sign of a tumor or blood vessel damage.

The course of chronic tinnitus is unpredictable. Sometimes the symptoms remain the same, and sometimes they get worse. In about 10% of cases, the condition interferes with everyday life so much that professional help is needed.

While there’s no cure for chronic tinnitus, it often becomes less noticeable and more manageable over time. You can help ease the symptoms by educating yourself about the condition — for example, understanding that it’s not dangerous. There are also several ways to help tune out the noise and minimize its impact.

What’s going on?

Most people who seek medical help for tinnitus experience it as subjective, constant sound like constant ringing in the ears or a buzzing sound in the ear, and most have some degree of hearing loss. Things that cause hearing loss (and tinnitus) include loud noise, medications that damage the nerves in the ear (ototoxic drugs), impacted earwax, middle ear problems (such as infections and vascular tumors), and aging. Tinnitus can also be a symptom of Meniere’s disease, a disorder of the balance mechanism in the inner ear.

Tinnitus can arise anywhere along the auditory pathway, from the outer ear through the middle and inner ear to the brain’s auditory cortex, where it’s thought to be encoded (in a sense, imprinted). One of the most common causes of tinnitus is damage to the hair cells in the cochlea (see “Auditory pathways and tinnitus”). These cells help transform sound waves into nerve signals. If the auditory pathways or circuits in the brain don’t receive the signals they’re expecting from the cochlea, the brain in effect “turns up the gain” on those pathways in an effort to detect the signal — in much the same way that you turn up the volume on a car radio when you’re trying to find a station’s signal. The resulting electrical noise takes the form of tinnitus — a sound that is high-pitched if hearing loss is in the high-frequency range and low-pitched if it’s in the low-frequency range. This kind of tinnitus resembles phantom limb pain in an amputee — the brain is producing abnormal nerve signals to compensate for missing input.

Most tinnitus is “sensorineural,” meaning that it’s due to hearing loss at the cochlea or cochlear nerve level. But tinnitus may originate in other places. Our bodies normally produce sounds (called somatic sounds) that we usually don’t notice because we are listening to external sounds. Anything that blocks normal hearing can bring somatic sounds to our attention. For example, you may get head noise when earwax blocks the outer ear.

Evaluate and treat underlying problems

If you develop tinnitus, it’s important to see your clinician. She or he will take a medical history, give you a physical examination, and do a series of tests to try to find the source of the problem. She or he will also ask you to describe the noise you’re hearing (including its pitch and sound quality, and whether it’s constant or periodic, steady or pulsatile) and the times and places in which you hear it. Your clinician will review your medical history, your current and past exposure to noise, and any medications or supplements you’re taking. Tinnitus can be a side effect of many medications, especially when taken at higher doses (see “Some drugs that can cause or worsen tinnitus”).

Musculoskeletal factors — jaw clenching, tooth grinding, prior injury, or muscle tension in the neck — sometimes make tinnitus more noticeable, so your clinician may ask you to tighten muscles or move the jaw or neck in certain ways to see if the sound changes. If tight muscles are part of the problem, massage therapy may help relieve it.

Tinnitus that’s continuous, steady, and high-pitched (the most common type) generally indicates a problem in the auditory system and requires hearing tests conducted by an audiologist. Pulsatile tinnitus calls for a medical evaluation, especially if the noise is frequent or constant. MRI or CT imaging may be needed to check for a tumor or blood vessel abnormality.

Your general health can affect the severity and impact of tinnitus, so this is also a good time to take stock of your diet, physical activity, sleep, and stress level — and take steps to improve them. You may also be able to reduce the impact of tinnitus by treating depression, anxiety, insomnia, and pain with medications or psychotherapy.

If you’re often exposed to loud noises at work or at home, it’s important to reduce the risk of hearing loss (or further hearing loss) by using protectors such as earplugs or earmuff-like or custom-fitted devices.

Managing tinnitus

In addition to treating associated problems (such as depression or insomnia), there are several strategies that can help make tinnitus less bothersome. No single approach works for everyone, and you may need to try various combinations of techniques before you find what works for you. If you have age-related hearing loss, a hearing aid can often make tinnitus less noticeable by amplifying outside sounds.

There is no FDA-approved drug treatment for tinnitus, and controlled trials have not found any drug, supplement, or herb to be any more effective than a placebo. That includes ginkgo biloba, which is sometimes promoted for this purpose. Some patients believe that acupuncture helps, but it too has been found to be no better than a placebo.

The most effective approaches are behavioral strategies and sound-generating devices, often used in combination. They include the following:

Cognitive behavioral therapy (CBT). CBT uses techniques such as cognitive restructuring and relaxation to change the way patients think about and respond to tinnitus. Patients usually keep a diary and perform “homework” to help build their coping skills. Therapy is generally short-term — for example, weekly sessions for two to six months. CBT may not make the sound less loud, but it can make it significantly less bothersome and improve quality of life.

Tinnitus retraining therapy (TRT). This technique is based on the assumption that tinnitus results from abnormal neuronal activity (see “What’s going on?”). The aim is to habituate the auditory system to the tinnitus signals, making them less noticeable or less bothersome. The main components of TRT are individual counseling (to explain the auditory system, how tinnitus develops, and how TRT can help) and sound therapy. A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient’s tinnitus. Depending on the severity of the symptoms, treatment may last one to two years.

When TRT was developed in the 1980s by neuroscientist Dr. Pawel Jastreboff, it was designed to be administered according to a strict protocol. Today, the term TRT is being used to describe modified versions of this therapy, and the variations make accurate assessment of its effectiveness difficult. Individual studies have reported improvements in as many as 80% of patients with high-pitched tinnitus.

Masking. Masking devices, worn like hearing aids, generate low-level white noise (a high-pitched hiss, for example) that can reduce the perception of tinnitus and sometimes also produce residual inhibition — less noticeable tinnitus for a short time after the masker is turned off. A specialized device isn’t always necessary for masking; often, playing music or having a radio, fan, or white-noise machine on in the background is enough. Although there’s not enough evidence from randomized trials to draw any conclusions about the effectiveness of masking, hearing experts often recommend a trial of simple masking strategies (such as setting a radio at low volume between stations) before they turn to more expensive options.

Biofeedback and stress management. Tinnitus is stressful, and stress can worsen tinnitus. Biofeedback is a relaxation technique that helps control stress by changing bodily responses. Electrodes attached to the skin feed information about physiological processes such as pulse, skin temperature, and muscle tension into a computer, which displays the output on a monitor. Patients learn how to alter these processes and reduce the body’s stress response by changing their thoughts and feelings. Mindfulness-based stress reduction techniques may also help.

Not all insurance companies cover tinnitus treatments in the same way, so be sure to check your coverage. If you’re willing to enroll in a research study, you may be able to receive a cutting-edge treatment free. (For more information, go to www.clinicaltrials.gov, and enter the search term “tinnitus.”)

Image: Casarsa_Guru/Getty Images

Tinnitus, ringing in the ears – symptoms, causes, treatment

What is tinnitus?

The word tinnitus comes from the Latin tinnire, “to tinkle” , but tinnitus can sound more like a hum, hiss, chirp or a thin squeak.

About 40% of adults experience tinnitus from time to time. About 8% suffer from it often or constantly. For 1% of people, tinnitus is a serious problem that interferes with a normal life. It almost never affects children and very often elderly people with hearing loss.

This noise is not associated with external sounds and is “heard” better in silence than with external noise. Tinnitus lasts for a long time (more than 5 minutes) and should be distinguished from a short, transient sound that lasts a few seconds or occurs after a strong sound stimulus. Such noise is in no way connected with the mechanical processes occurring in the ear, its cause is in the nerve cells.

IMPORTANT! Information from the article cannot be used for self-diagnosis and self-treatment! Only a doctor can prescribe the necessary examinations, establish a diagnosis and draw up a treatment plan for a consultation!

Why does tinnitus occur?

There are two theories about its origin.

1) Due to the constant high level of noise in the life of a city dweller, cells in the inner ear are constantly dying, turning sounds into nerve impulses. They do not die immediately, but for some time they are in a “death” state. They can still send information to the brain, but are no longer able to generate impulses specific to each sound. The result is “noise”.

2) According to another theory, tinnitus is something like phantom pains. The auditory cortex of the brain “remembers” that information about external sounds should be transmitted through the auditory pathways, but the corresponding auditory cells have already died, and the brain “has to” find information that is similar to sound impulses. This information travels along pathways through the mood center, which is why tinnitus sufferers have such a hard time with noise. Gradually, as a result of incorrect adaptation, this path becomes the main one for the brain, and the person, as it were, gets used to hearing noise.

What can cause tinnitus?

• Tinnitus is usually caused by hearing loss from constant exposure to loud noises (tractor, lawn mower, loud music on headphones) or acoustic trauma.
• Otitis media, atherosclerosis, traumatic brain injury, cervical osteochondrosis, and hearing loss due to aging or other causes can contribute to tinnitus.
• Much less commonly, tinnitus can be a symptom of diabetes, kidney disease, or head or neck tumors.
• Some drugs cause tinnitus: quinine, non-steroidal anti-inflammatory drugs, paracetamol, diuretics (furosemide…), a number of antibiotics (gentamicin, streptomycin, etc.), certain types of chemotherapy, some psychiatric drugs (amitriptyline, sertraline, anafranil, etc.). e.)

About clinic

Euromed Clinic is a multidisciplinary family clinic in the center of St. Petersburg.

• Doctor’s house call
• 24/7 therapist appointment
• Tests, ultrasound, X-ray
• Whole body diagnostics
• Hospital and surgery
• Vaccinations

900 04 Learn more about the clinic

How to “measure” strength tinnitus?

Since this is a subjective sensation, it cannot be measured in decibels. In fact, the most important thing is how much tinnitus causes discomfort to its “happy” owner.

Therefore, a qualitative scale is used that rates tinnitus from “mild” to “catastrophic”, based on whether the person hears it all the time, whether it interferes with sleep or does something that requires silence.

Severe tinnitus leads to nervous tension, insomnia, inability to concentrate and even depression.

How to cure tinnitus?

There is no cure for tinnitus. Drugs of different groups have been studied, including antiepileptics, antidepressants, tranquilizers, but none of them is able to significantly reduce tinnitus.

Based on the theory that the brain does not adapt properly to the death of nerve cells that conduct auditory impulses, tinnitus is treated with a method called tinnitus retraining therapy (TRT). This is a type of cognitive-behavioral therapy in which a person is taught to be distracted from the noise, to relax, not to hear it. Gradually, a positive feedback is formed, the brain “unlearns” to use the wrong way of conducting impulses, and the noise level really decreases.

In addition to training, the TRT course uses sound therapy individually selected by means of noise measurement – a person is empirically selected “white noise”, which he should listen to from time to time. It can be the sound of the sea, the wind or the rustle of leaves. Such noise is evaluated in the subcortical auditory pathways as a neutral sound, its perception is quickly blocked and it does not reach the cortex, and tinnitus is blocked along with it – the patient ceases to be aware of it.

Both parts of therapy are equally important, but the first is the main one: the patient must stop paying attention to tinnitus, learn to live with it and reduce its significance. The TRT method allows you to completely remove tinnitus in terms of three months to two years.

If you suffer from nocturnal tinnitus, there are Tinnitus Therapy Pro and Tinnitus Therapy Lite mobile apps to help relieve it while you sleep. Applications offer so-called sound maskers (white noise and others), as well as sound tracks developed by doctors lasting 8 hours. There are other apps and tracks, paid and free, that can make life easier and “mask” tinnitus that occurs day or night.

causes and treatment, how to diagnose

Tinnitus (from Latin tinnītus “ringing”) is the sensation of sound in one or both ears in the absence of an external source of sound. This sensation is mostly described as ringing in the ears, but the sounds can also be hissing, humming, clicking, or buzzing. Noise, hum or ringing in the ears can be strong, mild or moderate, constant or intermittent. The perception of tinnitus is individual.

Although tinnitus is heard in the ears, it occurs in the nerve circuits of the brain, which causes us to hear sounds in the head. It is not yet known exactly what is going on in the brain to create the illusion of a sound that is not actually there. Tinnitus is the most common disorder affecting 10 to 15% of the world’s population.

Causes of noise or ringing in the ears

The appearance of tinnitus can be caused by prolonged exposure to loud noises or certain lifestyle habits. Ringing in the ears can also occur in healthy people and for no apparent reason. However, in many cases, the appearance of noise or ringing in the ears is associated with hearing loss.

Causes that can trigger tinnitus can be divided into the following groups:

Medical

• Diabetes
• Anemia
• Allergy
• Otosclerosis
• Meniere’s disease
• Earwax plug
• Head and neck tumors
• Low serotonin 9 0034
• Blood pressure problems
• Thyroid problems (hypothyroidism).
• Diseases of the outer, middle or inner ear.

Hearing impairment

According to statistics, 80-85% of patients suffering from tinnitus have some degree of hearing impairment. Despite the fact that tinnitus is not the cause of hearing impairment, but its impact negatively affects concentration, performance, because constant sounds in the head are distracting and prevent you from concentrating on really important sound information. Annoying noise distracts from daily tasks and interferes with meaningful communication with family, friends and loved ones.

Head injury and brain disease
Head injury, such as a concussion, can damage the inner ear and cause tinnitus. Also, neurological diseases, such as multiple sclerosis, can lead to tinnitus, and acoustic tumors of the auditory or vestibular nerve, by putting pressure on the nerve endings, can create tinnitus. In this case, the treatment of tinnitus should begin with an appeal to a neurologist.

Heart and blood vessel problems

If your tinnitus is pulsating, it may be due to a problem with your blood vessels.

Drugs that cause tinnitus

The most common drugs that cause tinnitus are non-steroidal anti-inflammatory drugs (eg, aspirin, gentamicin), diuretics, some antibiotics, and cancer drugs. If you experience tinnitus after starting a drug or changing its dosage, contact your healthcare provider right away to determine further treatment.

Risk factors for tinnitus

Often tinnitus occurs in people with hearing impairment of different ages, but the elderly and those whose professional activities are associated with high-level noise exposure are at risk.

Age-related hearing loss

Hearing loss due to aging is called presbycusis and begins at age 60. The greater the hearing loss, the more likely it is that tinnitus will occur. To prevent the appearance of annoying noise, you must first contact an audiologist for a hearing diagnosis in order to assess its severity (i.e., at what frequencies a decrease is observed) and then select a method for correcting the identified violations.

Loud noise exposure

Regular exposure to loud noise in professional activities (airport workers, factories, construction sites, city transport drivers, military, hunters) is a common cause of hearing loss and tinnitus. Wearing earplugs at work will help protect your hearing.

Lifestyle
Listening to music at high volumes for extended periods of time or frequent concerts can also cause permanent hearing damage. Excessive alcohol consumption, smoking, abuse of foods and drinks containing caffeine can cause tinnitus. Frequent fatigue and stress can also be risk factors.

If you have tinnitus, start your treatment journey by contacting a hearing care professional who specializes in diagnosing tinnitus to help determine the underlying cause. If common causes of tinnitus are ruled out, your doctor will refer you to another specialist for further evaluation and treatment.

How to reduce the effects of tinnitus

Since tinnitus is purely subjective, it can be difficult to diagnose, so following the advice of your hearing care professional on your own can help alleviate the condition:

• Avoid tobacco, coffee, cola, tea;
• Learn to relax, arrange a relaxing minute for yourself;
• Try to control your blood pressure, measure it regularly;
• Avoid loud noise and use earplugs for occupational protection;
• Try to eat less salt, because. its use is one of the causes of circulatory disorders;
• Exercise regularly, exercise improves blood circulation, which helps reduce tinnitus;
• Use a hearing aid. It not only helps with hearing loss, but also has a masking effect that will help you get rid of annoying tinnitus and reduce its impact on daily life.

Hearing loss and tinnitus

Noise or ringing in the ears or head often cannot be treated, but the good news is that tinnitus can be controlled. The latest technological solutions in the field of audiology and deafness come to the rescue. Clinical studies show that digital hearing aids are not only effective in addressing hearing loss, but also help reduce the impact of tinnitus and provide overall relief.
Amplification of environmental sounds through the hearing aid provides activation of the auditory part of the nervous system, which reduces the perception of tinnitus. With constant exposure to amplified environmental sounds, the auditory part of the nervous system is rebuilt, which has a beneficial effect on the function of nervous activity, restoring it and weakening hypersensitivity to auditory sensations.