Tinnitus—a persistent buzzing, hissing, whooshing or ringing sound in the ears—is a cause of considerable frustration for around 15% of the US population. For some tinnitus sufferers, this phantom sound starts subtly and intermittently but builds slowly into a major annoyance over the years, typically in conjunction with the gradual progression of their age-related hearing loss. For others, the ringing in the ears arrives suddenly. This “spontaneous tinnitus” might soon disappear—or it might become a lifelong problem or serve as a warning sign of a serious underlying medical issue that requires prompt attention. Neurotologist Dr. Bradley Kesser recently discussed eight potential spontaneous tinnitus causes with Bottom Line Health, as well as tinnitus relief options.
Sudden sensorineural hearing loss, a rapid form of hearing loss that can affect either one or both ears, often is accompanied by tinnitus in the affected ear. This form of hearing loss can be triggered by a viral infection, compromise in the blood supply to the inner ear, a non-cancerous tumor known as a vestibular schwannoma, or by the use of an erectile dysfunction medication such as Viagra or Cialis, among other potential causes. This hearing loss tends to be severe—if someone experiencing sudden sensorineural hearing loss holds a phone to an affected ear, for example, he or she might be able to tell when someone is speaking but probably won’t be able to understand the words, or the voice will sound very distant. When the condition triggers tinnitus, that tinnitus tends to sound like a loud, high-pitched whine or tone. Tinnitus frequently is tied to hearing loss—precisely why is a matter of debate, but one theory is that it’s the result of the brain filling in the sound or frequency of sound that it’s no longer receiving. With or without tinnitus, sudden and severe loss of hearing in one or both ears should be considered a very serious matter—it can become permanent.
What to do: See a doctor as soon as possible, ideally within 24 to 48 hours of the onset of hearing loss. A doctor can provide steroids that improve the odds of a complete or partial recovery from sudden sensorineural hearing loss—as well as from the tinnitus it often triggers—but the longer the delay before these steroids are administered, the lower the odds of success.
Upper respiratory infections that fill the middle ear with fluid can cause a degree of temporary hearing loss in one or both ears, which might be accompanied by tinnitus. This hearing loss tends to be less severe than that associated with sudden sensorineural hearing loss, described above—if someone with middle ear fluid-related hearing loss places a phone to an affected ear, the caller might sound far away or underwater, but they’ll probably still be understandable. The tinnitus triggered by these infections tends to be a “pulsating” ringing or whooshing sound, not a steady buzz. Some patients describe the sound as like the sloshing of liquid.
What to do: Seek treatment for the respiratory infection. The hearing loss and tinnitus should clear up when the infection does. Nasal sprays like Flonase or Afrin can be helpful, but seek medical attention before starting.
Ear wax impaction can cause tinnitus, if the excess ear wax presses against the ear drum or obstructs the ear canal. Other potential symptoms of ear wax impaction include ear pain, a feeling of fullness or pressure in the ear and/or hearing loss.
What to do: Over-the-counter ear wax removal drops sometimes are sufficient to soften and remove impacted ear wax. If these fail, make an appointment with a doctor to remove the ear wax. Do not attempt to use a Q-Tip or other device to dig out ear wax yourself—inserting such things into your ear could push ear wax deeper into the ear or even damage the eardrum.
Temporomandibular joint (TMJ) disorders—that’s the joint that connects the jawbone to the skull—can cause tinnitus due to the close proximity of this joint and its associated muscles to the ear. If a TMJ problem such as inflammation or spasms is indeed the cause of the ringing sound someone is hearing in one or both ears, there almost certainly will be other symptoms as well, potentially including jaw pain, ear pain, ear fullness, headaches, difficulty or soreness opening the mouth and/or clicking sounds when the mouth opens or closes.
What to do: Take ibuprofen, apply heat to the jaw joints, and switch to a soft, no-chewing-necessary diet for a few days—soup, pasta, and oatmeal are among the soft-meal options. If your tinnitus and other TMJ symptoms decrease, that’s strong evidence that a TMJ disorder is likely the cause. If the tinnitus and other TMJ symptoms rebound when you return to a normal diet, see a dentist to discuss potential TMJ treatments.
Exposure to loud noise is among the most common causes of tinnitus. If you attend a loud rock concert, use power tools, or spend a day on a Jet Ski, for example, there’s a good chance you’ll experience a ringing in your ears afterwards. This tinnitus is believed to be a result of the damage that loud noise does to the delicate “hair cells” inside the ear—these cells play a crucial role in transferring the mechanical energy of sound waves into electrical signals that the brain can understand. The good news is that hair cells can heal from this sort of damage. The bad news is that there are no guarantees that they’ll heal—permanent damage is possible, especially when someone is exposed to very loud noise frequently.
What to do: The best solution is to wear ear plugs or other ear protection when around loud noise to avoid incurring hair cell damage in the first place. Otherwise the treatment is time—this sort of tinnitus typically passes within 24 hours, though it sometimes takes a few days, and occasionally it doesn’t ever go away.
Pharmaceutical side effects sometimes include tinnitus. For example, long-term use of high doses of common over-the-counter NSAID painkillers such as aspirin, ibuprofen (Motrin, Advil), and naproxen can cause tinnitus. Other drugs that sometimes cause tinnitus include antimalarial drugs like quinine and chloroquine, loop diuretics such as furosemide (Lasix) and bumetanide (Bumex), certain cancer drugs including cisplatin and carboplatin, and some intravenous antibiotics such as gentamicin and tobramycin. With some of these pharmaceutical side effect, the tinnitus can be accompanied by hearing loss.
What to do: If you begin experiencing tinnitus when taking any of these drugs, contact your doctor to discuss alternative treatment options. It’s especially important to contact your doctor promptly if you also experience hearing loss. Tinnitus without hearing loss that’s triggered by use of a medication usually ceases once use of the drug is discontinued or its dosage is reduced, but when there is hearing loss, it’s possible that the side effects could become permanent.
Caffeine, alcohol, or marijuana consumption could potentially serve as a tinnitus trigger or exacerbate existing tinnitus. Studies investigating the caffeine-tinnitus connection have produced mixed results, however.
What to do: If you’re searching for a tinnitus solution, it’s worth cutting back on caffeine, alcohol, and/or marijuana use to see if this yields any benefits.
Psychological stress is linked to tinnitus. This connection seems to work both ways—suffering from tinnitus quite understandably causes people stress, but there’s also strong evidence that enduring psychological stress sometimes triggers or exacerbates tinnitus.
What to do: Search for a way to lower your stress levels—if you can find an effective stress-reduction strategy, it might reduce your tinnitus, too. Different stress treatments work for different people—options include yoga, exercise (although vigorous exercise can sometimes make tinnitus louder temporarily), walks in nature, cognitive behavioral therapy, and some anti-anxiety medications.
Tinnitus Relief
Whatever the cause of your tinnitus, there are ways to reduce the toll it takes on your quality of life.
Many tinnitus sufferers find that having white noise playing in the background, either from a sound machine or white noise app (e.g., Rain Rain), makes their tinnitus somewhat less distracting. Others leave a fan, TV, or radio playing in the background for similar reasons. Using a hearing aid often helps, too, when tinnitus is caused by hearing loss—some hearing aids even feature a tinnitus-masking function.
Or try a tinnitus-treatment device called Lenire, which uses a combination of stimulation to the tongue and soothing music to train the brain to pay less attention to the tinnitus. Some though not all patients who try Lenire consider it beneficial. It’s not typically covered by health insurance, however.
Remember, there is no cure for tinnitus. Treatment involves identifying and addressing underlying causes and implementing strategies to manage the tinnitus and reduce its impact on sleep and quality of life.
