Tinnitus

What is tinnitus?

Tinnitus is the perception of sound in the ears or head not caused by an external sound source. Ringing and buzzing sounds may be heard in one or both ears or appear to be generally in the head region, but this can vary, and it can be difficult to pinpoint exactly where the sounds seem to occur.

Tinnitus is not an illness or a disease in itself, but it is often a symptom of a problem with the ear or the hearing pathways to the brain. Usually, it occurs when the inner ear is damaged or impaired in some way.

What causes tinnitus?

Most of the time, tinnitus is a symptom of a larger hearing health condition, though other factors may also trigger it. Common causes include:

Exposure to excessive loud noise. Loud noises, such as those from heavy equipment, headphones, concerts or even one-time events like a close-range gunshot, can lead to noise-induced hearing loss (NIHL). This hearing loss changes how the brain processes sound, and tinnitus may be how the brain fills in the gaps to the missing sound frequencies.
Extreme stress or trauma. Research suggests that there is a link between psychological disorders and tinnitus, particularly stress, which can not only trigger but worsen the ear ringing as well. For some people, this can turn into a vicious cycle, with the tinnitus leading to emotional distress and, in turn, making the uncomfortable ringing worse.
Age-related hearing loss. Similar to NIHL, age-related hearing loss can result in tinnitus – in fact, a 2020 study found the condition to affect 1 in 5 people in a general elderly population.
Injury. Tinnitus can also derive from an injury, in which case, it typically affects only one ear. Neck and head injuries, specifically, can trigger ear ringing – often as a result of whiplash.
Ear canal blockages. When fluid, earwax or other residue accumulates in the ear canal, the pressure in the ear changes, which can cause tinnitus.
Other ear conditions. Meniere’s disease and otosclerosis are two ear disorders commonly associated with tinnitus. The first affects the inner ear, which plays a key role in balance and hearing, while the latter refers to an abnormal bone grown in the middle ear, preventing sound from travelling properly through the ear.

Additionally – and although anyone can develop tinnitus – there are risk factors associated with the condition:

Working environments that expose you to prolonged periods of noise; for example, working with heavy machinery and power tools.
Increasing age resulting in previously established, age-related hearing loss issues or other forms of hearing loss.
Listening to loud music with headphones and attending concerts frequently.
Lifestyle habits, like excessive alcohol consumption, smoking, drinking too much coffee and an unhealthy diet.
Certain health problems, including obesity, high blood pressure, cardiovascular issues and a history of arthritis.

What are the symptoms of tinnitus?

Tinnitus is often described as a "ringing in the ears” or a “high-pitched tone or noise”. However, each case is different, and what people with the condition hear can range from hissing or whooshing to roaring, whistling or clicking. Plus, some people hear it constantly, while for others, it is intermittent and may affect one or both ears.

Whether tinnitus occurs daily or at specific times, it can have a noticeable effect on your concentration levels and ability to focus on other sounds or conversations around you. You may find that the condition worsens according to posture, often due to the pressure changes associated with moving your head or lying down. The noise can also seem more prominent when you're tired or stressed or in noticeably quiet surroundings.

As for severe or long-standing tinnitus, the symptoms tend to align with one of two disorders:

Hyperacusis
If you are suffering from hyperacusis, you may find that you become more sensitive to everyday sounds. For instance, you might find the noise from a television or radio to be painfully loud despite it being set at a 'normal' volume. Hyperacusis is often the result of prolonged exposure to loud sounds, most prevalent among musicians and those who work regularly with industrial machinery.
Musical hallucinations
This is more common if you struggle with long-term tinnitus or extensive hearing loss. Musical hallucinations can sound like snippets of songs instead of the more common ringing sound. This form of the condition may be caused or exacerbated by stress, epilepsy or substance misuse.

Does tinnitus cause hearing loss?

Tinnitus is not a disease itself or a cause of hearing loss. It is a symptom that can indicate that something may be wrong somewhere in the auditory system, which can include the cochlea, the auditory nerve and the areas of the brain that process sound.

In about 90% of cases, it accompanies hearing loss, and an individual can have both hearing loss and tinnitus from noise damage. However, the two do not always occur together. It is possible to have no measurable hearing loss but experience tinnitus.

How long does tinnitus last?

There isn’t one set answer to this question, as it varies from case to case. Some people may experience ear ringing for a few hours, while others may struggle with the condition for months, and others may even have it permanently.

How long tinnitus lasts usually depends on its cause. Short-term tinnitus often happens after you’ve been exposed to a very loud noise, which temporarily damages the hairs lining the ear canal. Tinnitus that lasts for a few days may be the result of build-up in the ear canal and it may require medical attention. Lastly, long-term tinnitus is typically an aftermath of old age, constant exposure to loud noises or ear bone damage.

What are the treatments for tinnitus?

While in many cases, there is no ‘magical cure’ for tinnitus, there are a number of very effective options to manage the condition and your body’s response to it.

Hearing aids can help manage your tinnitus as they assist in overcoming any underlying hearing loss. By reducing the amount of attention your brain is paying to the ringing, these devices can minimise or, for some people, even eliminate it altogether.

If you’re experiencing hearing challenges as well as ringing, a hearing solution with built-in sound generators may be prescribed as a way to minimise the effects of tinnitus.

Sound therapy has also been proven to effectively relieve tinnitus symptoms – and this is especially true when used in conjunction with hearing aids. This type of therapy is designed to assist the hearing centres of the brain in ‘tuning out’ the tinnitus, using external sounds, such as music or a static-like noise, to partially obscure the tinnitus signal. Over time, the brain becomes able to automatically tune out the sound of the tinnitus.

Additionally, simple changes like using volume-limiting headphones when listening to music and playing calming sounds while trying to sleep or in quiet environments can make a big difference.

If your tinnitus is particularly loud, causing you to experience sleeping difficulties, stress or anxiety, it is worth consulting your GP or your local Bay Audiology clinic, as sometimes there are simple causes, which once addressed, may alleviate or cure the condition.

Relaxation and stress management techniques are often recommended if your tinnitus is triggered by emotional stress. If, on the other hand, you have underlying conditions such as ear infections or blockages, these can usually be remedied by a short course of antibiotics, ear drops or ear wax removal.

Preventing tinnitus

Although, in some cases, tinnitus is unavoidable, there are things you can do to reduce your likelihood of developing the condition:

If you will be exposed to sounds over 85 decibels, wear hearing protection, such as earplugs or earmuffs. Make sure, as well, to keep them clean to avoid ear infections (which could otherwise trigger tinnitus).
Use well-fitted, noise-cancelling headphones at a low volume – preferably no more than 60%.
When in particularly loud environments, take noise breaks to give your ears time to recover and readjust.
Avoid standing near speakers at concerts.
Keep your stress levels in check by taking time to rest and engaging in relaxing activities. If you find that stress and anxiety are often the culprits of your tinnitus, try to identify what triggers those emotions and what coping mechanisms you can adopt.

Make lifestyle changes: exercise regularly, minimise your consumption of alcohol and caffeine, maintain good posture and prioritise sleep.

Conclusion

No matter what causes it, how long you experience it or what you actually hear, tinnitus can be an incredibly distressing condition to live with. But the good news is that there are ways to find relief and regain your quality of life.

If you believe you may have tinnitus or are concerned about your hearing, the expert audiologists at Bay Audiology can help. Book an appointment today and find a treatment that’s right for you.

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