Tinnitus can be a real bother to many people, as it usually means a constant high-pitch ringing in the ears.

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“a constant perception of noise or ringing in the ears that you cannot mute”

Have you ever tried hearing those ear-piercing beep sounds when the telephone lines seem to be out of order? It sounds a bit like an old fax machine trying to come back to life. Now, imagine this sound and then think of the joy of hanging up the phone, ending the misery. For some, this is not as simple. Tinnitus is a constant perception of noise or ringing in the ears that you cannot mute. At this point, there is no treatment for tinnitus. It affects about 15 to 20% of Americans and is not a condition in itself but rather a symptom of an underlying hearing disorder.

In this article, you will learn more about tinnitus and what to look out for. While the downside to tinnitus is that there is no apparent cure, it does become more manageable over time when knowing what you are dealing with. An important note is that tinnitus is a symptom of an underlying condition. Therefore, you should always get checked out by your audiologist if you experience tinnitus-like symptoms.

The two types

When talking about tinnitus, you first need to establish which kind you refer to—subjective or objective tinnitus. Subjective tinnitus is one only you can hear. This is the most common type of tinnitus caused. It can appear through damage to the auditory nerves or the part of the brain that translates nerve signals into sounds. Objective tinnitus is the type that is not only detectable by yourself. An audiologist will also be able to hear this type during an examination. Its causes are damage to the middle ear bone, muscle contractions, or blood vessel issues. As such, we are talking about external damage.

Symptoms on tinnitus

The most well-known symptom of tinnitus is the sensation of hearing sound when no sound is present. This is in the form of ringing, buzzing, clicking, or hissing sounds that will play continuously in your ear like a terrible soundtrack. These sounds can vary in volume and pitch. They can appear on either one or both ears. In some cases, it is a constant, whereas, in others, it may come and go.

Many people link tinnitus with exposure to loud noises – noise-induced tinnitus. Everyone has probably been told by their parents to turn the volume down on their headphones, where the warning of tinnitus was the first and last reminder. Most people have probably also tried to be at a concert where they have experienced temporary tinnitus right after the show. Tinnitus experiences such as these are often short-lived and over with quickly. However, the diagnosis of chronic tinnitus happens after six months. Then, there is no turning back. As with other hearing-related issues, both recreational and professional activities links to a higher risk of developing it. So if you are working with, e.g., roadwork, you should take extra care.

The symptoms related to tinnitus can be fickle. The sounds you hear and the volume level can stay consistent through a significant period of your life, or they can worsen. In large parts, this does also relate to the amount of care people take after being diagnosed with tinnitus and the sound levels they expose themselves to. In about 10% of the United States cases, the condition plays such an active role in people’s everyday lives that professional aid is required.

Other causes that develop tinnitus

Loud noises are not the only factor behind developing tinnitus. It is a naturally occurring thing for some people, when they age, as the cochlea and other parts of the ear start to deteriorate. It can be the first signs of hearing loss for older people and a clear signal that it is time to get checked out by an audiologist. Ménière’s disease can also cause it due to its effect on the inner ear, while the middle ear can be affected by otosclerosis and stiffening of the bones in the ear. Lastly, blockages or infections in the outer ear can also drive tinnitus.

Furthermore, there are examples of people developing tinnitus for no apparent reason. The underlying factors behind these cases are usually mentally based. This could be fatigue, depression, or anxiety that can lead to mental and emotional anguish.

Managing tinnitus

The bad thing about tinnitus is that it is – most likely – something that people need to learn how to live with. The good thing is that it is definitely manageable to increase the quality of life for people suffering from it. There are no FDA-approved treatments nor herb alternatives that can cure it or keep the noise level in check. Hearing aids can work if you have age-related tinnitus, as they can amplify the outside noises to match the tinnitus. Outside of this, there are no medical devices that can solely relieve the noise-levels.

The most effective approaches are a combination of devices and behavioral strategies. Cognitive-behavioral therapy (CBT) is a technique that teaches patients how to cope with tinnitus. This happens through homework and diaries that the patient has to keep. This increases their ability to deal with the tinnitus by continually learning and exploring the downsides and triggers behind it and what drives positive change. CBT needs to be in combination with devices that generate an equalizing sound. Tinnitus retraining therapy (TRT) is a technique that does precisely this. Here, a device is inserted in the ear that causes low-level noise and sounds from the surrounding environment. It is possible to reduce the severity by matching the pitch and volume to the patients’ tinnitus. Masking is another technique used for this, where a device will generate a low-level white noise that diminishes the perception of the tinnitus.

Tinnitus without hearing loss

In most cases, tinnitus is related to hearing loss issues. However, there are a fraction of people that can experience the symptoms without underlying hearing disabilities.

Head trauma can cause an aftereffect with damage to the nerves, blood flow, or muscles in the ear. Here, there is no reduced hearing, but the constant ringing will still be present. Some medications can also cause tinnitus, while these do tend to be more short-term and disappear as you stop taking the specific medicine.

If you want to read more on what to do with a hearing loss, you can read our ultimate hearing loss guide.

When to see a doctor

As tinnitus, more often than not, is related to hearing issues, you should always see a doctor or audiologist if you are experiencing symptoms. If you have just woken up from last night’s Bruce Springsteen concert and hear a ringing to your ear, you can give it a day to see if it gets better. However, if you experience symptoms for more than 48 hours, you should go straight to the doctor or audiologist.