Ringing in Your Ears? Listen Up: It Could Be Tinnitus.

Everything you need to know about the second most common type of hearing condition.

If you’ve been to a concert recently, you might have experienced a post-show ringing in your ears (especially if you were right under a speaker). But if you haven’t been exposed to extraordinarily loud sounds lately, and you’ve got a pretty good ringing in one or both of your ears anyway, you could be one of every ten Australians living with tinnitus. Here we outline the causes, symptoms and treatments of tinnitus, so you know what to look for and what to do next.

Most people describe tinnitus as a steady, high-pitched ringing in their ears, but there’s actually a pretty wide variety of sounds experienced by people with the condition. If you hear sounds that you’d call a buzzing, whooshing, humming, hissing, whistling, clicking, or even a ‘throbbing’ noise, it could be tinnitus.

It might be a combination of sounds; you might hear it intermittently or constantly. You might also hear it in one ear or both. In some cases, it can even feel like the sound is actually inside your head. The volume can also vary: roaring and thunderous or whispery quiet – barely but definitely (and worryingly) there. 

Tinnitus can range from mildly irritating to debilitating and severely distressing. Whether you experience ringing continuously or at specific times, the condition can affect your concentration and ability to focus on conversations or sounds around you. 

Not surprisingly, it can be confusing and incredibly scary the first time it happens. Over time, tinnitus can also cause anxiety, depression, or sleep disturbances. If this is the case, book an appointment with your GP or a hearing health professional. The first step to determining if you are experiencing tinnitus or a form of hearing loss is a full diagnostic hearing test.

People who suffer from severe or long-standing tinnitus tend to have symptoms that fall under one of the following three categories:

• Hyperacusis: this is where you’re more sensitive to everyday sounds, such as a radio or television playing at ‘normal’ volume. In many cases, hyperacusis is the result of prolonged exposure to sounds and is commonly experienced by people who work with industrial machinery, or musicians, for instance.

• Musical hallucinations: this is where, rather than tinnitus’ common ringing or whistling, you hear snippets of songs. This is frequently caused or made worse by stress, epilepsy or substance misuse. This form of tinnitus may sound fun, but it’s actually distressing.
  
  
• Pulsatile tinnitus: similar to regular tinnitus, this is where you hear a rhythmic sound in time with your pulse. Most of the time, this can be attributed to changes in blood flow in the vessels near the ear, or to a condition such as perforated eardrums or atherosclerosis.

Unlike surfer’s ear, which is fully diagnosable and now relatively easy to treat, tinnitus is not a disease or illness in itself. Its root causes can be difficult to identify or understand. After age-related hearing loss, tinnitus is the second most common form of hearing impairment and is now classified by the World Health Organisation (WHO) as a distinct disorder.

Approximately 90 percent of cases of tinnitus are accompanied by hearing loss, particularly in older people. The main reason for this is that as you age, the delicate hairs in your inner ear can become damaged, affecting how nerve impulses are sent to your brain. It is also possible (though rarer) to not experience any form of hearing loss, yet still suffer from tinnitus.

Additional possible causes of tinnitus include:

• Ear infections
• Long-term exposure to heavy machinery, firearms or loud music without proper ear protection
• A build-up of excessive or compacted ear wax
• Otosclerosis – a stiffening of bones in the ear

Rarer causes of tinnitus include:

• High blood pressure
• Perforated eardrums
• Hyperthyroidism, or an overactive thyroid (which leads to feeling overtired or weak, anxious or irritable, and can cause sudden weight loss)
• Solvent, drug or alcohol abuse
• Adverse reactions to specific medications, such as certain antibiotics, diuretics or aspirin
• Meniere’s disease, which causes abnormal fluid pressure in the inner ear

Like most hearing concerns, the first step is to recognise the symptoms. Start by noting in your calendar whenever you hear the ringing (or whooshing, or chirping, or whatever), so you understand how often the sounds are occurring or whether they happen at particular times. You might find it’s always after a concert, for instance, or whenever you’re lying down (due to pressure changes).

Other common occurrences include when you’re feeling stressed, tired, or are in very quiet surroundings. If the ringing is only in one ear, or is significantly louder in one ear than the other, book an appointment with your GP or a hearing health professional as soon as you can.

Even if there’s no treatable cause of your tinnitus, there are a bunch of things you can do to minimise and manage symptoms:

• Reduce exposure to loud noise: use earplugs or earmuffs
• Try to relax and/or meditate as often as possible: this will help you focus your attention away from the symptoms
• Check your glass: reducing your caffeine and alcohol intake can help ease your tinnitus symptoms
• Exercise: like meditation, this will help you ignore and better cope with tinnitus
• Quit smoking: give your blood vessels a break – smoking narrows them, making it harder to send oxygen to your ears and sensory cells.

If you’ve checked and been treated for any possible underlying conditions – like ear infections or excessive ear wax – and your tinnitus hasn’t reduced, your GP or hearing health professional may suggest a hearing aid. Modern versions come with digital amplification as well as special technology designed to relieve the symptoms of tinnitus. You may also find relief with sound therapy, which can help mask the ringing noise.

Even if you may never completely beat tinnitus, you can definitely learn to live with it with the right treatment. By incorporating some of the lifestyle tips above, as well as treating your symptoms with hearing aids and/or sound therapy, you can reduce the amount of attention you pay to the ringing – and get relief as a result. Over time, you might even find that you’re able to ignore the ringing altogether.