What is ringing in the ears (tinnitus)?

Many people have ringing (or roaring, hissing, buzzing, or tinkling) in their ears now and then. The sound usually lasts only a few minutes. Ringing in the ears that doesn't get better or go away is called tinnitus. You may hear a sound, such as a ringing or roaring, that doesn't come from your surroundings. (So nobody else can hear it.) The sound may keep time with your heartbeat, or it may keep pace with your breathing. It may be constant, or it may come and go. Tinnitus is most common in people older than age 40. Men have it more often than women do.

There are two main types of tinnitus.

• Pulsatile (like a heartbeat) tinnitus is often caused by sounds created by muscle movements near the ear, changes in the ear canal, or blood flow (vascular) problems in the face or neck. You may hear sounds such as your own pulse or the contractions of your muscles.
• Nonpulsatile tinnitus is caused by problems in the nerves involved with hearing. You may hear sounds in one or both ears. Sometimes this type of tinnitus is described as coming from inside the head.

The most common cause of tinnitus is hearing loss that occurs with aging (presbycusis). But it can also be caused by living or working around loud noises (acoustic trauma). Tinnitus can occur with all types of hearing loss. It may be a symptom of almost any ear disorder. Other possible causes of tinnitus include:

• Medicines, especially antibiotics or large amounts of aspirin.
• Injuries. This may include whiplash or a direct hit to the ear or head.
• Blood flow problems. These include carotid atherosclerosis, arteriovenous (AV) malformations, and high blood pressure.
• Nerve problems, such as multiple sclerosis or migraine headache.

Most tinnitus that comes and goes doesn't need medical treatment. You may need to see your doctor if tinnitus occurs with other symptoms, doesn't get better or go away, or is in only one ear. There may not be a cure for tinnitus, but your doctor can help you learn how to live with the problem. Your doctor can also make sure that a more serious problem isn't causing your symptoms.

There isn't a cure for tinnitus, but your doctor can give you ideas on how to manage it. There are things you can do to ease the way it affects your life. One example is to use background noise to mask the sound. Your doctor may suggest hearing aids.

Your doctor will ask questions and may do tests to find the cause of your tinnitus. You might be asked when you started having ringing in your ears. Your doctor may have you take a hearing test. You may also have a CT scan or an MRI.

• Do not smoke or use other tobacco products. Nicotine reduces blood flow to the ear and makes tinnitus worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Talk to your doctor about whether to stop taking aspirin and similar products such as ibuprofen or naproxen.
• Get exercise often. It can improve blood flow to the ear.

Ways to cope with noise

Some tinnitus may last a long time. To cope with noise, try to:

• Avoid noises that you think caused your tinnitus. If you can't avoid loud noises, wear earplugs or earmuffs.
• Ignore the sound by paying attention to other things.
• Relax using biofeedback, meditation, or yoga. Feeling stressed and being tired can make tinnitus worse.
• Play music or white noise to help you sleep. Background noise may cover up the noise that you hear in your ears. You can buy a machine that makes soothing sounds, such as ocean waves.

When you have tinnitus, it means you hear a sound, such as ringing or roaring, that doesn't come from your surroundings. No one else can hear it. You may hear the sound all the time. It also may come and go. It may keep time with your heartbeat or your breathing.

The most common cause of tinnitus is hearing loss that happens with aging. You can also have this problem if you live or work around loud noises. Tinnitus can happen with all types of hearing loss. It can be a symptom of almost any ear problem.