What Is Tinnitus?

Tinnitus is the perception of sound — ringing, buzzing, hissing, whooshing, clicking, or humming — in one or both ears when no external sound is present. It is a symptom, not a disease in itself, and can range from a minor inconvenience to a significantly disruptive condition that affects sleep, concentration, and emotional wellbeing.

Tinnitus is very common. It can affect people of all ages, though it becomes more prevalent with age and is frequently associated with hearing loss.

Types of Tinnitus

Subjective Tinnitus

By far the most common type. Only you can hear the sound. It's typically caused by problems in the outer, middle, or inner ear, or in the auditory pathways in the brain.

Objective Tinnitus

Much rarer. A healthcare provider can also hear the sound during examination using a stethoscope. It usually has a physical cause such as blood vessel abnormalities or muscle spasms near the ear. This type is often treatable once the underlying cause is identified.

Pulsatile Tinnitus

A subtype where the sound pulses in rhythm with your heartbeat. It is often vascular in origin and warrants prompt medical evaluation.

Common Causes of Tinnitus

  • Noise exposure: Prolonged or sudden loud noise is one of the leading causes, damaging the delicate hair cells of the inner ear
  • Age-related hearing loss: As hearing naturally declines, tinnitus often accompanies it
  • Earwax blockage: A buildup of wax can cause temporary tinnitus
  • Ear infections or fluid: Middle ear problems can trigger tinnitus
  • Ototoxic medications: Certain drugs (including some antibiotics, chemotherapy agents, and high-dose aspirin) can cause or worsen tinnitus
  • Menière's disease: A disorder of the inner ear that can include tinnitus, vertigo, and fluctuating hearing loss
  • Stress and anxiety: While not a direct cause, emotional stress can significantly worsen tinnitus perception
  • TMJ disorders: Problems with the temporomandibular joint (jaw joint) can contribute to tinnitus

When to See a Doctor

You should seek medical advice if your tinnitus:

  • Starts suddenly or after a head injury
  • Occurs in only one ear
  • Is pulsatile (beats with your heart)
  • Is accompanied by dizziness or sudden hearing loss
  • Significantly affects your sleep, concentration, or mental health

Management Strategies

There is currently no universal cure for chronic tinnitus, but many people find effective ways to manage it and reduce its impact on daily life.

Sound Therapy

Using background sound — white noise machines, nature sounds, or music — can reduce the contrast between tinnitus and silence, making it less noticeable. This is particularly helpful at bedtime.

Tinnitus Retraining Therapy (TRT)

TRT combines sound therapy with counselling to help the brain habituate to tinnitus — essentially learning to "tune it out." It requires a structured program with a trained audiologist or specialist.

Cognitive Behavioural Therapy (CBT)

CBT addresses the emotional and psychological responses to tinnitus. It doesn't reduce the sound itself but can significantly reduce distress and improve quality of life. It is one of the most well-supported approaches in tinnitus management.

Hearing Aids

For those with tinnitus and co-existing hearing loss, hearing aids can help. By amplifying external sounds, they reduce the brain's focus on internal tinnitus sounds. Many modern hearing aids also include built-in tinnitus sound generators.

Lifestyle Adjustments

  • Limit caffeine and alcohol if you notice they worsen your tinnitus
  • Protect your ears from loud noise using earplugs or earmuffs
  • Manage stress through mindfulness, exercise, or relaxation techniques
  • Avoid silence — keep a low level of background sound in your environment

Living with Tinnitus

Many people with tinnitus go on to live full, productive lives. The key is finding the right combination of support, therapy, and coping strategies. Working with an audiologist who specialises in tinnitus can make a significant difference — you don't have to manage it alone.