Tinnitus

Key points about tinnitus

  • Tinnitus is hearing noise or ringing in your ears without a sound from outside. It is common, affecting about 15% of the population, especially older adults.
  • It can be described as a buzzing, roaring, clicking, booming, hissing, whistling or cicada-like noise. For some people, these symptoms are severe.
  • It's common in older adults, especially men and smokers. Causes can include ageing, diabetes, Meniere’s disease, medicines, stress or anxiety, high blood pressure or head injury but it's not always clear why it occurs. 
  • Things you can do to manage tinnitus include quitting smoking, keeping your blood pressure well controlled, managing stress and avoiding triggers.
Young man holding right ear with pain or hearing problem
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Tinnitus is noise or ringing in your ears without an outside sound. It can also be described as a buzzing, roaring, clicking, booming, hissing, whistling or cicada-like noise. It can be heard as a single sound or as a mix or blend of different sounds. In some cases, the sound is a whooshing noise associated with your heartbeat. In some cases, the sound may be actual noise from musculoskeletal and vascular structures near your ear.

Tinnitus can affect one or both ears, and can start suddenly or gradually. The sounds can stay there all the time or come and go. The sound can vary in loudness, pitch and intensity.

In many people with tinnitus, the exact cause is not known, but it can be caused by factors such as:

  • ageing
  • living or working around loud noises
  • a buildup of earwax
  • ear infections
  • eardrum rupture
  • hearing loss – 80% of people with tinnitus have hearing loss
  • scuba diving
  • stress or anxiety – caused by the tinnitus or causing the condition
  • some medicines such as aspirin
  • drinking an excessive amount of alcohol or caffeinated drinks
  • dental or other problems affecting your mouth such as problems with your temporomandibular joint (TMJ), the joint that connects your jaw with your skull
  • head, neck or ear injuries
  • spasms in muscles close to your inner ear
  • injury to your inner ear following surgery or radiation therapy to your head or neck
  • severe weight loss from malnutrition or excessive dieting
  • repeated exercise with your neck in a hyperextended position, such as when cycling 
  • diabetes
  • Meniere’s disease
  • autoimmune conditions, such as rheumatoid arthritis 
  • blood flow problems such as carotid atherosclerosis (a buildup of plaques in your arteries) and high blood pressure (hypertension)
  • nerve problems such as multiple sclerosis or migraine headache
  • tumours, particularly acoustic neuroma.

See your GP if:

  • your tinnitus is new or getting worse
  • you only have tinnitus in one ear
  • your tinnitus is affecting your daily functioning
  • your tinnitus beats in time with your pulse. 

Your doctor will ask you some questions related to your symptoms and your work, and examine your ears. Depending on what they think is causing your problems, they may perform tests such as hearing tests, blood tests, x-rays or scans such as an MRI or CT scan. Not everyone with tinnitus will need all these tests.

Contact your GP, call 111 or go to the nearest emergency department immediately if you or someone you care for experiences any of the following:

  • tinnitus after a head injury
  • tinnitus with sudden hearing loss, muscle weakness or vertigo.

Tinnitus is a diagnosis not a disease. Treatment depends on what is causing it. In some cases, tinnitus is easily treated if the cause is found, such as removing ear wax or changing medicines. For most people, there is no underlying cause. You may be referred to an audiologist (a hearing specialist) or an ear, nose and throat (ENT) specialist for further tests and treatments. If you have tinnitus and deafness on one side, you will be referred to a specialist so an MRI can be done. 

Treatment of tinnitus may include lifestyle changes, medicines, hearing-based treatments and other treatments. In some cases you may get used to the sound and your brain ‘switches off’ the sounds. This may take several months. Reassurance that this can happen may be all the treatment you need.

Lifestyle changes

For some people, lifestyle changes can help to make the symptoms easier to manage or defer the onset of them.

  • Know your triggers for tinnitus and try to avoid them.
  • Reduce your exposure to loud noises – turn down the volume on loud music.
  • Reduce alcohol or caffeine intake.
  • Keep your blood pressure well controlled.
  • Get support to quit smoking.
  • In a quiet setting, use a fan, play soft music or use low-volume radio static to help cover up the noise from tinnitus.
  • Play soothing music at bedtime.
  • Manage stress and try to relax, as stress can make tinnitus worse. 
  • Talk to your doctor or pharmacist about medicines that can make your tinnitus worse. This includes over-the-counter medicines and supplements. 

Medicines

In some people, medicines may be helpful in reducing the severity of tinnitus, but there is no medicine to cure tinnitus. Medicines that have been trialled in individual patients include antidepressants, anticonvulsants (such as gabapentin and carbamazepine), and benzodiazepines. Sometimes, vitamin B12 injections are helpful, especially in older women. 

Hearing devices or other treatments

You may be referred to an audiologist (a hearing specialist) if your tinnitus is ongoing. Some of the treatments that may be offered include:

  • hearing aids
  • sound devices to mask the sound
  • counselling for stress
  • sound therapy
  • bedside noise generators
  • in rare cases, surgery.

There is no good evidence that complementary therapies, including acupuncture, hypnosis or homeopathy, have any benefit in managing tinnitus.

Some people with tinnitus experience other conditions as a result of their tinnitus. These can include:

If you experience any of these complications, talk to your healthcare provider about self-care and other treatments to help you manage them.

Hearing NZ(external link) provides education and support for people who are deaf or hard of hearing. Visit their website(external link) or contact them via the online form here(external link).

The following links provide further information on tinnitus. Be aware that websites from other countries may contain information that differs from New Zealand recommendations

Tinnitus(external link) HealthInfo Canterbury, NZ
Understanding tinnitus(external link) Auckland University Tinnitus Clinic, NZ
Treatments for tinnitus(external link) The University of Auckland Clinics, NZ 
Tinnitus(external link) Health Direct, Australia
Tinnitus(external link) Better Health Channel, Australia
What is tinnitus(external link) Tinnitus Australia
Tinnitus(external link) Patient Info, UK
Tinnitus(external link) NHS, UK
Self-help tips for tinnitus(external link) ENT Group Clinic, Auckland
Other hearing conditions(external link) Hearing Association NZ

References

  1. Tinnitus(external link) Auckland Regional HealthPathways, NZ, 2020
  2. A review of tinnitus(external link) Australian Journal of General Practice, Australia, 2018
  3. Tinnitus(external link) Patient Info, UK

Clinical pathways and guidelines

Tinnitus(external link) Auckland Regional HealthPathways, NZ, 2020
Tinnitus – the sound of silence(external link) BPAC, NZ, 2023
A review of tinnitus(external link) Australian Journal of General Practice, Australia, 2018
Tinnitus(external link) Patient Info, UK

Podcasts

Tinnitus(external link) Goodfellow Unit, NZ, 2018
Dr Giriraj Singh Shekhawat talks about tinnitus.

Videos and webinars

Video: Tinnitus doesn’t need to rule your life – Dr Grant Searchfield

This video may take a few moments to load.

(Goodfellow Unit, NZ, 2018)

Video: Common ENT problems – Mr Sumit Samant

This video may take a few moments to load.

(Goodfellow Unit, NZ, 2018)

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Bryan Frost, FRNZCGP, Morrinsville

Last reviewed:

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