Tinnitus: causes and treatment

What is tinnitus?

Tinnitus is the medical term for any noise in the ear, both ears or in the head. These can take a variety of forms such as ringing, hissing, buzzing, whistling, whooshing, clicking or gushing.

Some people with tinnitus even describe musical tunes, singing (musical/auditory hallucinations) or pulse beats (pulsatile tinnitus) as symptoms of the condition. These noises do not come from surrounding environments even though they may sound like they do.

Tinnitus is very much an individual condition, with each person experiencing different sounds and reacting differently. The noise may be intermittent or continuous, temporary or permanent. If you suspect you have tinnitus, consult your GP for advice.

Causes of tinnitus

There are many different causes of tinnitus. In addition to prolonged exposure to loud noise, tinnitus is also linked to the sudden onset of hearing loss, ear or head injuries, ear infections and diseases, as well as emotional stress and trauma.

"In the majority of cases tinnitus is not a sign of an underlying medical condition," says Karen Brunger, tinnitus and audiology information manager at RNID, the charity for deaf and hard of hearing people. "However, if your tinnitus comes on suddenly, or it is particularly troublesome, do ask your GP for a referral to an ear, nose and throat (ENT) consultant."

Despite continuing research, the exact physiology behind tinnitus remains a mystery. "At this time we can not pinpoint the exact location of where these noises are produced," says Karen. "Recent studies suggest it is likely to be occurring on the nerve connecting the ear to the brain, rather than being caused by the ear itself, as previously thought."

It is important to remember tinnitus doesn't necessarily indicate there is something medically wrong with your ears. Perfectly healthy ears can have tinnitus and it is likely we will all, at some point in our lives, experience varying levels of the condition.

Is there a cure for tinnitus?

There is no medical cure for tinnitus, so treatment focuses on acceptance and management. For many people, the biggest hurdle can be learning to accept they have tinnitus. But learning to acknowledge that you have the condition without focusing too much on the noises can be difficult.

"Initially, the brain tends to associate these noises as unnatural and invasive," says Karen. "And many people find themselves focusing on the noises rather than accepting and accommodating them."

"Negative feelings and resentment are a natural process when dealing with tinnitus. But it's important not to dwell on these, as this will contribute to stress and anxiety levels, which in turn will leave you run down, irritable and emotional," she says.

"Do your best to be positive and distract yourself from your tinnitus by doing something you find relaxing and enjoyable."

Getting referred to a tinnitus clinic

If you find tinnitus causing considerable impact on your life, you should consult your GP for a referral to a tinnitus clinic. There you'll be given further advice and taught management techniques.

Tinnitus clinics are run by trained professionals within audiology departments and are a good place for you to get support and guidance. Therapies offered will differ between clinics, though most involve forms of habituation - the process of accepting and incorporating the new stimulus as a part of your everyday life.

Learning to manage tinnitus noise

Being able to distract yourself from the noises in your ear is a key part of successfully treating tinnitus. Tinnitus Retraining Therapy (TRT) and Cognitive Behaviour Therapy (CBT) are popular techniques used to treat tinnitus. Both focus on an individual's emotional reaction, psychological noise association and thought processes.

Many professionals will complement TRT or CBT with sound therapy, which aims to distract you from tinnitus noises by filling moments of silence with therapeutic, ambient sounds, using special equipment - either a wearable noise generator or desktop/bedside noise generator.

Wearable generators look very similar to hearing aids and produce a gentle 'sshhh' sound called 'white noise'. These need to be fitted by a trained professional.

Bedside/desktop generators are freestanding units that look similar to an alarm clock. These generators emit soothing sounds such as a waterfall, light rain, birdsong etc. They can be programmed to turn off after a selected time period, making them ideal as a sleeping aid.

Famous tinnitus sufferers

• Steve Martin
• Sylvester Stallone
• Ronald Reagan
• Pete Townshend
• Sting  
• Beethoven
• Schumann
• Goya
• Oscar Wilde
• Joan of Arc

Find out more

For further information on tinnitus and available treatments, contact the RNID Tinnitus Helpline. It's open 9am to 5pm Monday to Friday, on tel 0808 808 6666 (voice) or 0808 808 0007 (text).