Tinnitus (Ringing in the Ears): Causes, Self-Care and When to Be Seen

What it involves

MedlinePlus defines tinnitus as hearing noises in your ears when there is no outside source of the sounds. It is often called ringing in the ears, but it may also sound like blowing, roaring, buzzing, hissing, humming, whistling, or sizzling. MedlinePlus says almost everyone notices a mild form once in a while, usually lasting a few minutes.

Who this is for

• Patients with ear noises, such as ringing or buzzing, that are constant or keep coming back
• Patients whose ringing is in one ear only
• Patients whose ear noise keeps them from focusing or sleeping
• Patients wondering if a medicine, wax, or blood pressure could be involved

What to expect

• Questions about the sound, which ear, how long it lasts, and what makes it worse
• A look in the ears and a review of every medicine, vitamin, and supplement you take
• A check of blood pressure and a plain look at common causes such as wax
• A referral for hearing tests or imaging when the story calls for it

What can cause ear noises

MedlinePlus says no one knows exactly why a person hears sound with no outside source, but tinnitus can be a symptom of almost any ear problem:

• Ear infections
• Wax or a foreign object in the ear
• Hearing loss
• Meniere disease, an inner ear disorder with hearing loss and dizziness
• A problem with the eustachian tube between the middle ear and the throat

Medicines and other triggers

MedlinePlus says antibiotics, aspirin, and other medicines may cause ear noises, and that alcohol, caffeine, or smoking may make existing tinnitus worse. It advises reviewing every current medicine with your provider, including over-the-counter drugs, vitamins, and supplements, and not stopping any medicine without talking to your provider first. Ear pain along with noise points toward the problems in the ear pain and ear infection guide.

When ringing is a clue to something else

MedlinePlus says tinnitus is sometimes a sign of high blood pressure, an allergy, or anemia, and its list of other risk factors includes diabetes, thyroid problems, obesity, TMJ disorder, and head injury. In rare cases it signals a serious problem such as a tumor or an aneurysm. That range is the reason a primary care review of blood pressure and general health is a sensible first step. The anemia guide and the thyroid blood tests guide cover two of the related checks.

Contact a provider if

MedlinePlus says to contact your provider if ear noises begin after a head injury, if they come with dizziness, feeling off balance, nausea, or vomiting, or if you have unexplained noises that bother you even after self-help measures. It says to call too if the noise is only in one ear and continues for several weeks or longer, or if it is pulsatile, meaning a rhythmic noise that follows a steady beat. Dizziness alone is covered in the dizziness guide.

Easing it at home

Tinnitus is often more noticeable at night because the surroundings are quieter, and MedlinePlus suggests masking it with background noise such as a white noise machine, a humidifier, or a dishwasher. It advises learning to relax, getting enough rest, sleeping with your head propped up, avoiding caffeine, alcohol, and smoking, and protecting your ears from loud sounds with earplugs if needed.

Tests and treatment

MedlinePlus says tests that may be done include audiometry for hearing loss, a head CT or MRI, and blood vessel tests. Fixing the cause, such as removing ear wax, may stop the sound. Maskers, hearing aids, counseling, and biofeedback may help, and MedlinePlus says no medicine works for everyone. The practice's role is the exam, the medicine review, and follow-up; hearing tests and imaging would be arranged through a referral.

Sources

• MedlinePlus — Tinnitus
• MedlinePlus — Tinnitus health topic