You might know of tinnitus as a condition that causes ringing in your ears, but what are the causes & how can it be treated? We talk you through all you need to know about tinnitus
What is tinnitus?
Tinnitus is the name for hearing sounds that don’t come from an outside source.
Tinnitus is often described as hearing a ringing in your ears, but it can also sound like:
• Hissing
• Buzzing
• Whooshing
• Humming
• Throbbing
• Whistling
• Grinding
• Music or singing
This might be something you hear in one ear, both ears or inside your head. It’s possible for the sounds to come and go or be there all of the time.
Tinnitus often co-exists with hearing loss, and 80% of people with tinnitus often have hearing loss. Helping with hearing loss can often have a positive impact on the perception of the tinnitus.
Some people may also experience hyperacusis (sensitivity to certain sounds) with or without tinnitus and/or hearing loss.
There are three different types of tinnitus:
• Subjective or primary tinnitus: is where you hear sounds (like ringing, buzzing or hissing) that don’t have an obvious cause. It’s the most common form of tinnitus and is often associated with some form of hearing loss. This type of tinnitus is only experienced by the individual concerned
• Secondary or systemic tinnitus: is where a cause of the tinnitus can be identified. This can include ear wax blockages, ear infections or other ear disorders or health conditions
• Objective or pulsatile tinnitus: is a type of tinnitus that is heard in the head or ears but can also be heard externally by others, typically via a stethoscope. It can be due to a problem with a tube in the ear or with blood flow pressure. It’s often caused by conditions that may constrict blood flow in the vessels around the head, neck and ears, and it can be a symptom of an underlying condition so it’s important to speak to your GP or hearing care specialist straight away if you’re experiencing symptoms
Who experiences tinnitus?
A lot of people will have experienced short periods of tinnitus, after being exposed to loud noises, such as after a concert.
In the UK, persistent tinnitus is thought to impact around six million people to some extent, which is around 10% of the population. Around 600,000 people experience it to the degree that it affects their quality of life.
It can affect people of all ages, including children, but is more common in people aged over 65.
Common causes of tinnitus
It’s not always possible to tell what’s caused tinnitus, but it can be linked to:
• A form of hearing loss – for instance a natural and gradual hearing loss that’s acquired over time
• Inner ear damage – due to repeated exposure to loud noises
• An earwax build-up – which can increase someone's perception of their tinnitus because external sounds are blocked
• Eardrum perforation – where a tear or hole in your eardrum can cause tinnitus symptoms
• A middle ear infection – fluid from an ear infection can trigger tinnitus
• Otosclerosis – this is an inherited condition where abnormal bone growth in the middle ear causes hearing loss
• Side effects of a medicine – including some chemotherapy medicines, antibiotics, non-steroidal anti-inflammatory drugs (NSAIDS) and aspirin
• Ménière's disease – this is a rare inner ear condition that can affect balance and hearing
• Acoustic neuroma –a type of non-cancerous tumour
• Other conditions – like diabetes, thyroid conditions or multiple sclerosis
It’s important to note that around one in three people with tinnitus don’t have any obvious problem with their ears or hearing.
When to seek help for tinnitus & what to expect
Tinnitus isn’t usually serious, and most people learn to get used to it and can be helped with hearing technology where appropriate. However, if you experience any of the following, go to see your GP:
• You have tinnitus that has changed significantly in the last six months
• Your tinnitus is impacting your life, for instance it might be making it hard to sleep or concentrate, or making you feel anxious or depressed
• You have the symptoms of pulsatile tinnitus or it occurs in one ear only
If you have tinnitus that develops after a head injury or you have tinnitus along with sudden hearing loss, vertigo or weakness in the muscles of your face, go to A&E or call 999 immediately.
At your appointment, your GP will examine your ears to see if your tinnitus is caused by something they can treat, like earwax build up or an infection. They may also check to see if you have any hearing loss.
They may refer you to a specialist for further tests or treatment, should you require it.
If you have tinnitus that’s been present and stable for some time, visit a hearing care specialist for advice.
Tips for living well with tinnitus
There are some self-management tactics that can help you to get used to your tinnitus and switch your attention away from listening to it.
• Avoid complete silence – listening to soft music or sounds can help to distract you from your tinnitus, which is often known as sound therapy. Tinnitus UK have more information on sound therapy
• Try to take your mind off your tinnitus, rather than focusing on it – hobbies and activities can help with this
• Try to find ways to improve your sleep – this could include reducing how much caffeine you have and practicing good sleep hygiene
• Find relaxation methods that work for you – meditation or yoga, for example
• Where possible, avoid things that you may have noticed make your tinnitus worse, perhaps loud noises, certain foods or drinks, getting overly tired or stressed
• Find a support group – talking to other people who also have tinnitus may help you to cope. You may be able to find a support group near you through Tinnitus UK
Treatment for tinnitus
Depending on the reason you’re experiencing tinnitus, the treatments offered might be different. Some of the potential treatments for tinnitus include:
• Ear wax removal – if your tinnitus is caused by a build-up of earwax, earwax removal can help to treat it. This can be done by your GP, but you can also access this service through Boots Hearingcare*
• Medication review – tinnitus can sometimes be a side effect of a particular medicine. If your GP suspects a medicine may be contributing to your tinnitus, they may suggest changing it and monitoring your tinnitus symptoms. Always speak to a GP for advice before considering any changes to your medicines
• Hearing technology – if your tinnitus is related to hearing loss, hearing technology can make it easier to feel connected with life, and hearing better and having to concentrate less hard often has a positive impact on the perception of tinnitus. You can book an appointment for a free hearing assessment and to discuss your tinnitus with Boots Hearingcare** to see if this is suitable for you. Devices are also available that can generate sound therapies which can be used to enrich silence around a person and allows the tinnitus to blend in, so it becomes less noticeable
Other treatments may include the following, but please bear in mind that the success of these treatments is variable amongst individuals, and should be chosen based on individual preference and circumstance:
• Tinnitus counselling – this is designed to help you learn about your tinnitus and find ways of coping with it. For most people, understanding what tinnitus is allows them to relax and begin to switch off their focus on it
• Tinnitus retraining therapy – this uses sound therapy and counselling to retrain your brain to be less aware of the tinnitus and not attribute negative importance to it. Tinnitus clinics are available on the NHS and privately
• Cognitive behavioural therapy (CBT) – this aims to help you to change how you think about your tinnitus and reduce unhelpful negative associations and anxiety that an individual attributes to their tinnitus
• Acoustic neuromodulation therapy – this is an approach where an individual regularly listens via headphones to some selected tones for a given period of time. The technology is thought to act by disrupting synchronous brain activity that may cause tinnitus
• Apps – there are also a number of apps available that support tinnitus management
Remember, if your tinnitus is having a negative impact on the quality of your life, book an appointment to see your GP or hearing care specialist. You can also find more information and support about tinnitus from Tinnitus UK.
