Ringing in the ears, also called tinnitus, is not caused by an external sound. No one else can hear it, except in rare cases by a healthcare provider. The ringing can happen after short-term exposure to power tools or fireworks, for example, but it's a concern if it doesn't resolve.
Ringing in the ears often occurs as a result of another health condition. Common causes include hearing loss, earwax buildup, medications, diabetes, head injuries, and certain ear conditions. Treatment for ringing in the ears depends on the cause. Talk with your healthcare provider if you experience symptoms of tinnitus.
Symptoms
Ringing in ears affects people differently. It may be faint or loud. The pitch of the sound can also vary. It can be erratic or, at times, seem to keep pace with your heartbeat. Types of sound can include:
- Buzzing
- Roaring
- Whistling
- Humming
- Clicking
- Hissing
- Squealing
Some people may hear a whoosh, whistle, or buzz that happens all the time. Others may experience intermittent sounds, or hear them when they move their head a certain way. It also can be high-pitched or low, or even linked to sounds caused by ear wax, hairs, or bone structure changes.
Types of Ringing in the Ears
People who have ear ringing usually experience one of the following types of the condition:
- Subjective tinnitus is linked to a sound that doesn't exist externally. Only you can hear it. It is often caused by nerve damage or a problem with the ear.
- Objective tinnitus is linked to a sound that originates inside or near your ear. Your healthcare provider may be able to hear the sound during an exam.
Other Effects
In addition to physical symptoms, some people may experience psychological effects from ringing in the ears. These can cause distress and significantly impact quality of life:
- Anxiety
- Depression
- Disrupted sleep
- Memory problems
- Concentration problems
Some studies have identified shared pathways in the brain for both tinnitus and stress-related disorders. The findings suggest that more research is needed to understand how tinnitus and mental health can affect each other, or which might influence the other.
Help for Depression
If you or a loved one is struggling with depression, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat800-662-4357for information on support and treatment facilities in your area.
Causes
Ringing in the ears is caused by a disorder in the auditory system. This can involve the ear, the cochlear nerve that connects the brain and the inner ear, and neurochemicals and areas of the brain key to processing sound.
The causes can range from simple to complex. For some people, there isn't an obvious reason for the sound they hear. Common causes of ringing in the ears include the following:
Hearing Loss
Ringing in the ears is often linked to sensorineural (inner ear) hearing loss. This type of damage results from harm to the inner ear or the nerve pathways that connect the inner ear to the brain.
This problem often occurs as the result of noise-induced hearing loss, either from one incident or over time, such as work-related exposure.
Ringing in the ears can also result from age-related hearing loss. This normal deterioration of hearing usually starts around age 60 and affects both ears. It often begins with the loss of high-frequency sounds, such as a whistle or squeal.
Outer Ear Canal Obstruction
Outer ear canal obstruction is often caused by an earwax blockage. When earwax builds up, it can block the ear canal and cause ringing in the ear.
Sources of middle ear obstruction can include:
- Sinus congestion
- Middle ear infection
- Dirt or foreign objects
- Loose hair in the ear canal
- Abnormal bone growth in the ear (otosclerosis)
Health Conditions
Ringing in the ears is often linked to certain health conditions. These can include:
- Ear infections
- Meniere’s disease
- Diabetes
- Head injuries
- Brain tumors
- Multiple sclerosis
- Thyroid disorders
- Temporomandibular joint (TMJ) disorders
Pulsatile tinnitus causes a rhythmic type of ringing that may be associated with a blood vessel disorder, such as narrowing of the arteries (atherosclerosis) or high blood pressure affecting the cranium (skull). Tell your healthcare provider if your tinnitus pulsates.
Medications
Ringing in the ears can occur as a side effect of more than 200 medications. These medications are referred to as ototoxic. In many cases, the problem disappears when the medication is stopped. These medications include:
- Salicylate pain relievers (aspirin among them)
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil and Motrin (ibuprofen) or Aleve (naproxen)
- Certain antibiotics
- Anti-cancer drugs
- Anti-malaria drugs
- Antidepressants
Treatment
Treatment for ringing in the ears depends on the source of the problem and how it affects you. Temporary ringing can resolve without treatment. If your tinnitus is linked to a health problem, that issue is treated first.
If the ringing remains, the treatment goal is to reduce it and help you live with it. Depending on your age, medical history, current condition and medications, you may benefit from one or more of these treatments:
- Hearing aids to correct hearing loss and allow your brain to hear the external sounds above the ringing
- Cognitive behavioral therapy (CBT) to help you manage symptoms and learn how to lessen the impact ringing in ears may have on your quality of life
- Wearable or tabletop sound generators to mask the tinnitus with a soft, pleasant sound, such as white noise or waves crashing
- Acoustic neural stimulation, a technique that uses a device to stimulate change in the neural circuits in the brain to desensitize you from the sound
- Cochlear implants to bring in outside sounds to mask the ringing
- Antidepressants and antianxiety medications to help improve your mood and sleep patterns
Some people don't achieve the results they desire with traditional treatments and may want to try an alternative approach, such as acupuncture and biofeedback. These treatments may lack evidence of success or they may provide relief for some people.
Check with your healthcare provider before trying common natural remedies for ringing in ears.
Complications and Risk Factors
Ringing in the ears often occurs as the result of an underlying condition. The symptom doesn't cause harm on its own but can impact your quality of life and emotional well-being.
Ringing in the ears is associated with mental health problems that include:
- Moderate to severe depression
- Anxiety
- Schizophrenia
- Post-traumatic stress disorder
- Cognitive decline and dementia in older adults
The following factors can increase your risk of developing ringing in the ears:
- High noise exposure without ear protection
- Age
- High sound level tolerance
- Recurring ear infections
- Hearing loss
- Smoking
Be sure to protect your ears when you're around loud noises. Sources of hearing damage can include rock concerts, power tools, and fireworks.
Diagnosis
If you have ringing in your ears, a healthcare provider (such as an audiologist, or hearing specialist) will likely start with a general physical exam and hearing exam to diagnose your condition.
Depending on the results of these preliminary exams, your provider may advise the following tests:
- Audiography
- Speech discrimination testing
- Tympanometry
- Audiogram
- Pitch masking
- Minimum masking level
- Residual inhibition
- Magnetic resonance imaging (MRI)
- Computed tomography (CT)
When to See a Healthcare Provider
Contact your healthcare provider if you have ringing in your ears that continues longer than a week. Seek evaluation for any type of sound that interferes with your sleep and/or concentration.
In some cases, tinnitus is associated with the risk of mental health problems. Report feelings of depression or anxiety to your healthcare provider as soon as you recognize them.
Summary
Ringing in the ears is a common problem that occurs as a result of hearing loss or damage to the areas that control hearing. It can also be linked to a health condition or medication side effect. It becomes a problem when it persists longer than a week.
Treatment involves finding if the problem is linked to an underlying health condition, medication use, or other causes. Chronic tinnitus may improve with hearing aids and other hearing devices. Treatments that include counseling can help you deal with the challenges of living with the problem.
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Anna Giorgi
Giorgi is a freelance writer with more than 25 years of experience writing health and wellness-related content.
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