Tinnitus: Ringing in the ears
What is tinnitus?
A person with tinnitus will often hear ringing, buzzing, hissing, chirping or whistling sounds that appear to come from inside the body itself.
Tinnitus is often called ringing in the ears, and may be in time with a person's heartbeat.
Around 10% of people in the UK are thought to have mild tinnitus symptoms, while for around 1%, the sounds affect their quality of life.
There are two types of tinnitus:
- Subjective tinnitus: When the sounds a sufferer hears may be perceived as very loud and only heard by them.
- Objective tinnitus: A rare condition when the sounds can be heard by the person with the condition and a healthcare provider, for example using a stethoscope.
For most people the condition is merely an annoyance. In severe cases, however, tinnitus can cause people to have difficulty concentrating and sleeping. It may eventually interfere with work and personal relationships, resulting in psychological distress. This is how Will.I.Am - one of the members of the Black Eyed Peas - describes the condition: "I can't be quiet as that's when I notice the ringing in my ears. There's always a beep there every day, all day. Like now. I don't know exactly how long I've had this but it's gradually got worse."
Although tinnitus is often associated with hearing loss, it does not cause the loss, nor does a hearing loss cause tinnitus. In fact, most people with tinnitus experience no difficulty hearing, and in a few cases they even become so acutely sensitive to sound that they must take steps to muffle or mask external noises.
Some instances of tinnitus are caused by infections or blockages in the ear, and the tinnitus can disappear once the underlying cause is treated. Frequently, however, tinnitus continues after the underlying condition is treated. In such a case other therapies - both conventional and complementary - may bring significant relief by either decreasing or covering up the unwanted sound.
What causes tinnitus?
Prolonged exposure to loud sounds is the most common cause of tinnitus. Up to 90% of people with tinnitus have some level of noise-induced hearing loss. The noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear. Carpenters, pilots, rock musicians and street repair workers are among those whose jobs put them at risk, as are people who work with chain saws, guns or other loud devices or who repeatedly listen to loud music. A single exposure to a sudden extremely loud noise can also cause tinnitus.
A variety of other conditions and illnesses can lead to tinnitus:
- Blockages of the ear due to a build-up of wax, an ear infection or rarely, a tumour of the nerve that allows us to hear (auditory nerve)
- A perforated eardrum
- Certain medicines - most notably aspirin, several types of antibiotics, anti-inflammatories, sedatives and antidepressants as well as quinine medications. In fact, tinnitus is cited as a potential side effect for about 200 prescription and non-prescription medicines.
- The natural ageing process can result in a deterioration of the cochlea or other parts of the ear
- Ménière's disease, which affects the inner part of the ear
- Otosclerosis, a disease that results in stiffening of the small bones in the middle ear
- Other medical conditions such as high blood pressure, cardiovascular disease, circulatory problems, anaemia, allergies, thyroid disease and diabetes
- Neck or jaw problem, such as temporomandibular joint (TMJ) syndrome
- Injuries to the head and neck
Tinnitus can worsen in some people if they drink alcohol, smoke cigarettes, consume caffeinated drinks or eat certain foods. For reasons not yet entirely clear to researchers, stress and fatigue seems to worsen tinnitus.