Ringing in the ears can be distressing but how we react can lessen the impact
Tinnitus means ringing in the ears – hissing, whistling, buzzing, humming, music, or any sounds that come from inside our bodies.
And while there’s rarely a serious cause, it can seriously affect our health.
We all get it occasionally, for example after exposure to very loud noise, but around one in 10 of us has it regularly, and it severely affects everyday life for around 600,000 people.
Sound waves stimulate tiny hairs wafting in the fluid inside our inner ear (cochlea); these send electrical signals to the brain along the auditory nerve.
Ageing changes (or noise damage) can gradually or suddenly create false signals/sounds that may be permanent or come and go.
Tinnitus can also be caused by earwax, noise/physical damage to the eardrum, middle ear fluid, infections, Ménière’s disease (recurrent attacks, often with vertigo), some medicines (including aspirin and stronger antibiotics) and, rarely, a nerve tumour (acoustic neuroma).
Anaemia, high blood pressure, diabetes and thyroid disease can trigger it. Pulsatile (throbbing) tinnitus, which can be heard by others, may be due to blood vessel abnormalities. Head injuries and damage to tiny ear bones (otosclerosis) or the skull (Paget’s disease) can cause it, too.
Symptoms and tests
Noises may be continuous or intermittent, or worse when there’s no background noise or at night; up to 70% of people attending tinnitus clinics report sleep disturbance.
Some forms may ‘sound’ more annoying or distressing than others. There may also be linked symptoms, such as hearing loss, dizziness/vertigo/room-spinning, nausea, earache or a discharge.
Your GP can identify and treat wax, middle ear fluid and raised blood pressure, and arrange relevant blood tests. But you may also need hearing tests, telescope examinations of your nose and throat, X-rays and/or CT/MRI scans of your ears, auditory nerve and brain.
Treating underlying conditions may help; Ménière’s may improve with medication and hearing loss can be helped by a hearing aid or cochlear implant. But tinnitus itself can’t be cured or silenced, although we can help ourselves.
Tinnitus can be stressful, and stress can make tinnitus harder to tolerate, so socialising, absorbing hobbies or learning relaxation techniques may help.
Counselling and cognitive behavioural therapy (CBT) can help us understand the condition and its effects on our thoughts and behaviour, so we can change the way that we react and cope.
Sound therapy works by distracting your brain with real sound – try listening to music or the radio in quiet environments, or attach them to headphones or a pillow speaker to avoid disturbing others. You could also try a sound generator.
This can produce ‘white’ noise (like radio interference) or play soothing sounds, such as rainfall or waves. Tinnitus retraining therapy can help you to ‘tune it out’ with a combination of sound training, stress reduction and talking treatment.
5 ways to protect your ears
1. Don’t poke anything down them – you could perforate your eardrum.
2. Keep the noise down – if it drowns someone talking two metres away, it’s too loud.
3. You should be given ear defenders and regular hearing tests at work if noise levels often reach 85 decibels (shouting is 80 decibels).
4. At concerts, don’t stand next to speakers, and wear earplugs if the noise hurts your ears or your hearing is reduced by the interval.
5. If listening to music through headphones, turn it down if it’s uncomfortable or you can’t hear someone speaking, and don’t listen for long periods.