Understanding That Ringing Sound: Causes, Treatments and Management for Tinnitus

Understanding That Beating or Ringing Noise In Your Ears

Do you occasionally hear ringing, buzzing, hissing or beating sounds in one or both ears? These phantom noises may indicate a common condition called tinnitus. Read on to learn what causes these sounds, when to seek help, and what treatments are available.

Defining Tinnitus

Tinnitus describes the perception of noise when no external sound is present. Instead of coming from an environmental source, the sound originates in the ear or head. Tinnitus is sometimes referred to as “ringing in the ears,” although the sounds can vary.

Subjective tinnitus is the most common type, causing sounds only the affected person can hear. Objective tinnitus is rare, involving noise a doctor can hear through examination.

Tinnitus often manifests as phantom ringing, buzzing, clicking, hissing, or beating sounds. The exact sound varies based on the individual. Episodes may be constant or intermittent.

Prevalence of Tinnitus

Roughly 10 to 15% of people experience some form of tinnitus. Prevalence increases with age, peaking between 60 and 69 years. Exposure to loud noises also boosts tinnitus risk.

Tinnitus affects men more often than women. Veterans are disproportionately impacted as well, likely linked to greater noise exposure.

Causes of Tinnitus

Tinnitus can stem from issues in the auditory system or other physiological factors. Common causes include:

• Hearing loss - Exposure to loud noises can damage hair cells in the inner ear, causing hearing problems and tinnitus.
• Ear wax buildup - Hardened wax blocks sound transmission and can irritate auditory cells.
• Ear bone changes - Stiffening of middle ear bones or ear canal bone spurs can disrupt sound conduction.
• Ear injuries - Trauma like eardrum perforations allow sound waves to bypass proper channels.
• Acoustic neuroma - Noncancerous tumors on cranial nerves can lead to tinnitus.

Medical conditions such as high blood pressure, circulatory disorders, diabetes, allergies, thyroid issues, and autoimmune disease are also tied to a higher risk of tinnitus.

Medications Causing Tinnitus

Over 200 prescription and over-the-counter medications are ototoxins that can contribute to tinnitus. Some examples include:

• Aspirin
• Antibiotics like erythromycin and vancomycin
• Diuretics
• Quinine-containing drugs
• Chemotherapy agents like cisplatin
• Antimalarial medications

Symptoms of Tinnitus

The main symptom is hearing phantom sounds in the absence of any external noise. You may hear these sounds in one or both ears. The pitch, volume, and pattern can vary.

Some describe the sound like ringing, buzzing, roaring, clicking, or beating. Others hear musical sounds or talking. Episodes may last for seconds or be continuous.

Tinnitus is often most noticeable in quiet environments. Background noise like fans or music can help mask and minimize awareness of the sounds.

The condition may cause anxiety, sleep issues, concentration difficulties, and depression in severe cases. Tolerance levels vary based on the individual though.

Pulsatile Tinnitus

If the sound beats in time with your pulse, it is known as pulsatile tinnitus. Causes include high blood pressure, hardening of the arteries, turbulent blood flow, and abnormal connections between arteries and veins near the ear.

Pulsatile tinnitus often signals an underlying issue that needs medical evaluation. Seek treatment if you experience pulsing sounds.

Seeking a Tinnitus Diagnosis

Consult an audiologist or otolaryngologist if bothersome tinnitus arises. The doctor will review your full medical history, conduct a physical exam of your ears, and ask you to describe the sounds you hear.

Be prepared to report on factors like:

• When tinnitus first started
• Whether it is constant or intermittent
• If you have it in one or both ears
• Pitch or quality of the phantom sounds
• Volume and severity of episodes
• Situations that worsen symptoms
• Other symptoms experienced

The physician may order diagnostic testing to pinpoint any underlying cause and assess how your ears and brain are processing sounds.

Hearing Tests

Tests like an audiogram measuring your hearing sensitivity can detect hearing loss that may be contributing to tinnitus.

Imaging Scans

CT or MRI scans produce detailed images inside the ears and brain to spot any tumors, blockages, or abnormalities.

Acoustic Testing

Tests measuring how your ears interpret sounds and what pitches trigger tinnitus can guide treatment approaches.

Tinnitus Treatment Options

Treating any identifiable underlying cause can help reduce tinnitus. Removing ear wax, adjusting medications, or correcting vascular conditions may resolve symptoms.

For chronic tinnitus without a treatable cause, management focuses on making the phantom sounds less bothersome. Some approaches include:

Sound Therapy

Introducing external sounds like white noise or calming music can help mask and distract from tinnitus noises. Hearing aids also amplify ambient sounds to provide relief.

Counseling

Cognitive behavioral therapy helps develop coping techniques for tinnitus symptoms. Relaxation therapy can reduce stress reactions that exacerbate tinnitus.

Tinnitus Retraining

Tinnitus retraining combines sound therapy with counseling to help your brain tune out and be less disturbed by tinnitus signals.

Medications

Drugs like antidepressants, antianxiety, or anticonvulsant medications may be prescribed off-label to reduce tinnitus impact for some patients.

Electrical Stimulation

Devices like cochlear implants can send electrical impulses to the ear to mask tinnitus or promote neural plasticity to help retrain how the brain processes sounds.

Preventing Tinnitus

Protecting your hearing from excessive noise exposure can help reduce the risk of developing tinnitus. Prevention tips include:

• Avoiding dangerously loud environments like concerts and construction sites when possible
• Wearing earplugs or earmuffs around loud machinery, tools, guns, etc.
• Turning down the volume on devices like music players and phones
• Getting regular hearing tests to detect early changes
• Promptly treating any ear infections or injuries that arise

Following safe listening habits allows you to enjoy sounds without causing permanent auditory damage that could lead to tinnitus.

Emerging Tinnitus Treatments

Researchers continue seeking and evaluating new ways to treat tinnitus by better understanding its neurological basis. Promising avenues being studied include:

Vagus Nerve Stimulation

Small studies show implanting electrodes to stimulate the vagus nerve may reduce tinnitus volume and annoyance for some severe sufferers.

Transcranial Magnetic Stimulation

Transcranial magnetic stimulation (TMS) uses magnetic pulses focused on areas of the brain tied to auditory signaling and tinnitus perception.

Transcranial Direct Current Stimulation

This investigational technique uses electrodes on the scalp to deliver low-level electrical current to brain regions linked to tinnitus.

Living With Tinnitus

While searching for a cure, following some best practices can help manage tinnitus:

• Get enough sleep and exercise regularly
• Reduce stress through relaxation techniques
• Avoid smoking and excess caffeine and alcohol
• Use background sounds to mask tinnitus noises
• Turn on captions when watching TV to prevent volume strain

Joining a tinnitus support group can also provide validation and productive coping methods.

The Bottom Line

Experiencing phantom beating, ringing, or buzzing noises is a common condition known as tinnitus. Causes range from ear wax buildup to underlying conditions like high blood pressure or diabetes.

See a doctor if tinnitus arises to pinpoint any treatable source. Sound therapy, counseling, electrical stimulation, and off-label medications represent current management options.

While there is no cure yet, taking steps to protect your hearing, reduce stress, improve sleep, and find enjoyable background noises can help tune out tinnitus.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.