What Does Ringing In Your Ears Indicate?

Are you hearing a high-pitched ringing, buzzing, or chirping sound that won’t go away?

Having a ringing noise in your ears start suddenly can raise alarm bells, leaving many Australians feeling concerned about what’s going on, what could be causing it, and if it could be a sign that something may be wrong with their hearing or their health.

Medically speaking, the ringing in your ears is called tinnitus and is described as any noise that occurs in the ears without the presence of any external sound. While tinnitus can feel very isolating, it is estimated to affect 2 out of every 3 Australians at some point in their lives.^[1] Here’s a look into what tinnitus really means, what causes it, and what you should do when you hear that ringing start.

Tinnitus: The Ringing In Your Ears

Tinnitus may be a sign that something is malfunctioning in one or multiple parts of the auditory system, which is made up of the ear, the auditory nerve which connects the ear to the brain, and the parts of the brain that make sense of the sounds we hear. Interestingly, tinnitus is not a condition or disease in and of itself but may be a symptom of many other possible conditions. Hence, an important part of managing tinnitus is identifying this underlying cause.

What does tinnitus sound like?

Interestingly, every person’s experience of tinnitus is unique, often going far beyond a one-noted ringing to whooshing sounds, buzzing, clicking, hissing, or even shrieking, roaring, or musical sounds.^[2] Tinnitus can be gentle or loud, high-pitched or low, and it can be present in either one or both ears.

How long does tinnitus last?

Many of us are familiar with the feeling of ringing in our ears after listening to blaring music at a live concert - and in most cases, tinnitus will last mere minutes or a few days,[3] often resolving on its own. For others, tinnitus can persevere for years[4] and is often loud and persistent, worsening over time. This kind of tinnitus can cause severe disruption to a person’s ability to sleep,[5] concentrate and hear the people around them,[6] which is why tinnitus can also lead to fatigue, and depression and affect a person’s overall quality of life.^[7]

What Causes Tinnitus?

While many can’t pinpoint a cause for their tinnitus, there is a range of known causes and contributors. For some, it may be as simple as a piece of wax blocking the ear canal. For others, it may be linked to:

- Age: Tinnitus tends to affect a higher number of people as they get older, with people over the age of 65 being three times more likely to be troubled by tinnitus than those who are younger.^[8] This is believed to be a result of damage happening within the ear itself.

- Hearing loss: Tinnitus often occurs along with some degree of hearing loss, and can sometimes be the first sign that hearing loss is beginning to occur.

- Exposure to excessive noise: Noise is one of the most common causes of tinnitus.[9] A single incident experienced at close range may permanently damage your hearing in an instant, such as exposure to a bomb blast, with tinnitus being one of the most common disabilities in war veterans.[10] Repeated exposure to loud noise over an extended period of time can also cause tinnitus. People such as musicians, construction workers, or even early childhood teachers who work in noisy environments can develop tinnitus over time.

- Injury to the ear or head: A neck or head injury can trigger the development of tinnitus.

- Ear and sinus infections: All ear infections carry a risk of damaging any area of the ear and blocking hearing, and make the chance of developing tinnitus much more likely.

- A side effect of medication: More than 200 prescription and over-the-counter drugs list tinnitus as a known side effect, and they can trigger tinnitus or cause it to worsen by affecting the nerves of the ear. These medications include aspirin and ibuprofen, certain antibiotics and anticonvulsants, antimalarial drugs, certain cancer drugs, and tricyclic antidepressants.

- Blood flow issues: A rare type of tinnitus named pulsatile tinnitus sounds like pulsing in the ear, which is rhythmic and in time with your heartbeat. It usually indicates a change in blood flow to the vessels near the ear or an increase in awareness of the blood flow to the ear.^[11]

- Musculoskeletal factors: Clenching your jaw, grinding your teeth, and neck muscle tension can make the symptoms of tinnitus more noticeable and severe.^[12]

- Neurological factors: Rarely, a disorder such as Meniere’s disease, can affect the brain’s ability to process sound, resulting in tinnitus.^[13]

Is The Tinnitus Sound In My Ears Or In My Head?

The way that we hear any sound, from music on our radio to people talking or dogs barking, is when sound waves enter our ear canal. Tiny hair cells within our ear pick up on these sounds and send messages to the brain through the auditory nerve, and our brain makes sense of what we are hearing. The way our brain interprets these sounds determines what we hear. When these hair cells get damaged by things such as loud noises, medications, or infection, our brain doesn’t receive the sound signals adequately, and it essentially turns up its sensitivity to sound in an effort to try to find a signal - much like turning up the volume on your radio when you're trying to find a station. This increase in electrical signals can cause the brain to create the illusion of sounds - ultimately leading to tinnitus.^[14]

What Can I Do To Prevent And Manage Tinnitus?

While many cases of tinnitus resolve themselves within a few hours or days, the first step to help prevent and manage tinnitus is to identify the underlying cause, given that the ringing in the ears is a symptom and not a problem of its own. This is where your hearing care professional can help with a comprehensive assessment to determine whether the tinnitus can be related to the structure or function of your ears.

Helpful tinnitus management strategies can include:

- Protecting your ears: If you expose your ears to loud noises at work or at home, it's important to reduce your risk of damage by using non-invasive noise protector earmuffs. Opt for these rather than earplugs as they can push the wax into your ear if used incorrectly.

- Considering a hearing aid: Hearing amplification often improves the perception of tinnitus. The amplification of environmental sounds covers (masks) the sound of tinnitus. This makes it more difficult to consciously perceive tinnitus and helps the brain focus on the outside, ambient noises. The masking impact of hearing aids is particularly strong for patients who have hearing loss in the same frequency range as their tinnitus. Hearing aids can be an effective mode of sound therapy and have a sound masking feature that is proven to reduce tinnitus in many people who are also experiencing hearing loss.^[15] Hearing aids are designed to improve the perception of speech and to make background noise easier to hear, which helps to mask the troubling symptoms of tinnitus.

- Try gentle background music: Increasing ambient noise can help you stop focusing on the sounds of your tinnitus. Some people find playing background music or radio can be beneficial, while white noise could be a great asset to include in your sleep routine when the house is quiet.

- Seeking support therapies: There is a wide range of therapies available that have been shown to provide long-term and consistent relief from tinnitus,^[16] which you can be referred to by your audiologist.

- Avoiding certain medications: Some medications can cause or worsen tinnitus by altering the nerves in the ear, so it’s a good idea to read the information documents with your medications and discuss these with your doctor if they are concerning you.

- Implementing relaxation tools: Worrying about tinnitus will make it more noticeable, so learning relaxation techniques through mindfulness, muscle relaxation, meditation, or breathing exercises can help to provide relief.

- Taking care of your general health: Your overall physical health can affect the severity and impact of tinnitus, so keeping a watchful eye over your diet, physical activity, and sleep will help your body to be better equipped to heal and restore anything that is physically contributing to your tinnitus.

Book An Appointment With A Hearing Care Professional

If you’re experiencing tinnitus, booking an appointment with a hearing care professional will allow them to assess your overall ear health, help to uncover the underlying cause of your tinnitus, and create a tailored management plan to help you manage your symptoms.

At our clinics, our experienced hearing care professionals will take a full medical history, give your ears a physical examination, and do a series of tests to try to find the source of the problem. If necessary, they can refer you to your doctor for a further otological investigation to rule out retrocochlear pathologies.

As part of your assessment, they may ask questions about the noise you're hearing (such as its pitch and whether it's constant or intermittent) and the situations in which you hear it. We will analyse your current and past exposure to noise, and any medications or supplements you're taking and will carry out hearing tests to determine whether your tinnitus indicates a problem in the auditory system.

For prolonged or severe tinnitus, if you’re an eligible candidate, our hearing care professionals may be able to create custom hearing aids to minimise the disruption of tinnitus as much as possible using a tinnitus masking feature.

Don’t let your tinnitus get in the way of you living the life you wish to lead. Book an appointment with one of our friendly audiologists today at your local centre here.

^[1] https://www.healthdirect.gov.au/tinnitus

^[2]https://books.google.com/books?hl=en&lr=&id=weJtKjIYf3sC&oi=fnd&pg=PP1&ots=nITRJYcRt_&sig=JsJ2hu_fAL0UEDhABcPvfTk0Fd8

^[3]https://scholar.google.com/scholar_lookup?title=Tinnitus+theory+and+management&author=JA+Kaltenbach&author=J+Zhang&author=MA+Zacharek&publication_year=2004&

^[4]https://www.ncbi.nlm.nih.gov/pubmed/1642568

^[5]https://scholar.google.com/scholar_lookup?title=Tinnitus+Retraining+Therapy&author=PJ+Jastreboff&author=JW+Hazell&publication_year=2004&

^[6] https://www.ncbi.nlm.nih.gov/pubmed/4074979

^[7]https://www.proquest.com/openview/1d1a1774a56ff34963a88c41e3149318/1?pq-origsite=gscholar&cbl=1056335

^[8] https://pubmed.ncbi.nlm.nih.gov/26645752/

^[9] https://www.ncbi.nlm.nih.gov/pubmed/1882967

^[10] https://www.nidcd.nih.gov/health/tinnitus

^[11] https://www.ncbi.nlm.nih.gov/pubmed/18632767

^[12]https://scholar.google.com/scholar_lookup?title=Tinnitus:+theory+and+management&author=RA+Levin&publication_year=2004&