What is tinnitus? Causes and symptoms

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Can you hear sounds that others say aren't there? Do your ears whistle, ring, hum, hiss or throb without any reason? One in two people experiences noises in their ears at least once in their lifetime, with one in five people developing chronic tinnitus. The problem is that these sounds seem very real to those affected but cannot be heard by those around them. What is tinnitus? Will it go away on its own? Can it be cured? Do you have to learn to live with it? You can find answers and helpful tips below!

What is tinnitus?

Tinnitus can present itself in many different forms and your experience may be very different to another’s. It can be perceived in one ear or both and may appear in passing phases, in save-like intervals or may be continuous. Tinnitus may sound like:

Buzzing
Whistling
Hissing
Roaring
Throbbing
A cicada like noise
Constant ringing in your ears

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Tinnitus can develop gradually or suddenly, and most people experience occasional tinnitus, especially in quiet surroundings. The development of tinnitus in the inner ear and brain remains a mystery; one thing we do know, however, is that it is not an illness but a symptom.

Our hearing (or auditory) system is constantly listening; even quietness has a sound. For tinnitus sufferers with hearing loss, the sounds they are missing create an absence of noise which the brain attempts to correct with a tinnitus-like sound.

Think of it like a radio that is not quite tuned correctly; to hear better, you turn the volume up! Except this increases the level of background static at the same time and subsequently increases frustration.

Is tinnitus harmful?

From a medical perspective, no. However, permanent exposure to noise and an inability to relax can affect your mind. Tinnitus can disturb concentration through the day and rob you of your sleep at night.

If the noise in the ear is perceived as threatening or significant, emotional reinforcement mechanisms are activated in the limbic system (responsible for processing emotions in the brain) that set off a vicious cycle.

There are two different types of tinnitus:

Compensated tinnitus – described by those affected as not particularly intrusive. Ideally, they can block out the noise and be unawave of it most of the time.
Decompensated tinnitus – always present and causes high levels of psychological strain. It has a direct negative impact on your quality of life and can cause: insomnia, stress, anxiety, depression and social isolation. In some patients, the phantom noise also triggers headaches, earaches, dizziness and muscular tension.

How long does tinnitus last?

Tinnitus may occur briefly and immediately disappear, or it may remain for several months to a lifetime. Generally, audiologists and medical professionals distinguish between three forms:

Acute tinnitus: persists for less than three months and often stops spontaneously. Treatment with medication may sometimes help in this case.
Subacute tinnitus: constantly recurs within three to twelve months; treatment with medication and/or relaxation exercises may show improvements.
Chronic tinnitus: symptoms persist for over twelve months and rarely subside without therapeutic or pharmaceutical intervention.

How do I get tinnitus?

Despite no one other than the person affected being able to hear the noise tinnitus presents and no doctors being able to diagnose it using conventional methods, tinnitus is neither a hallucination nor an imaginary disorder. However, how the phantom noise develops is still not entirely clear. Although there are various theories, they are yet to be proven.
But one thing is clear: only in rare cases do these annoying noises in the ear occur for no reason at all. The most common causes of tinnitus are injuries, illnesses and anatomical changes.

There are four main causes of tinnitus:
1. Inner ear
Tinnitus may develop in the inner ear due to acoustic trauma, sudden hearing loss or age-related hearing loss. Scientists suspect that after damage to the sensory cells in the cochlear, certain sounds are only faintly transmitted to the brain or not transmitted at all. The auditory response area in the brain then tries to compensate for the missing frequencies by ‘turning up the volume’. Therefore, it is calculated that tinnitus sounds correspond to those frequencies that the person has difficulty hearing.

2. Middle ear
We cannot measure subjective tinnitus externally. This makes it difficult for a doctor to determine the specific trigger and treatment even more difficult. The cause may originate in different areas of the ear, and nerves of the brain and tinnitus can also occur when the auditory canal is blocked.

One trigger in the middle ear may be a defective eardrum or inflammation.

3. Brain
In some clients, tinnitus may be due to a malfunction in the brain. In these cases, the tinnitus will not disappear, even if the auditory nerve is severed. There are rarely concrete causes of this malfunction. Still, sometimes meningitis or a tumour in the auditory centre of the brain can be behind it. Additionally, tinnitus sometimes has a psychological cause.

4. Objective tinnitus
Usually a side effect of another disorder, for example, Meniere's disease (a condition of the inner ear accompanied by dizziness, nausea and hearing loss).

In rare cases or objective tinnitus, the noises in the ear can be measured by an ear, nose and throat (ENT) doctor or an audiologist using special equipment. Anatomical changes in the blood vessels in the inner ear or damage to the middle ear are usually responsible for the noise in the ear. Doctors can treat this type of tinnitus with medication or surgical intervention.

Typical characteristics include:

A noise in a person’s ear that is in time with their pulse
A clicking noise in the ear
Grinding and crunching noises in the ear

What are the main triggers of tinnitus?

1. Stress
Studies have shown that those affected by sudden hearing loss and tinnitus have more frequently been under severe stress. Tinnitus is particularly linked to chronic, continuous stress due to family and work-related worries

2. Medication
Specific pain and rheumatism medications, remedies for malaria and some antidepressants may trigger tinnitus symptoms.

3. Noise
Those who have regularly been in a noisy environment (workplace noise, traffic, loud music) for years without suitable hearing protection are at much higher risk of tinnitus. The same applies to patients with acoustic trauma.

What should I do if I am affected by tinnitus?

In some cases, tinnitus can disappear on its own, and it is often sufficient to give yourself and your hearing a rest. If the noise in your ear lasts longer than 24 hours, you should seek the advice of an audiologist. The earlier you do something about acute tinnitus, the better your chances of recovery.

Click here to book an appointment at your local hearing clinic to discuss tinnitus systems with an audiologist. A hearing aid can help with tinnitus. Learn more about the different types of hearing aids.

You can find important information about treatments and therapy for tinnitus here: Tinnitus – Treatment and prevention

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Tinnitus symptoms and their causes

Overview