A person with tinnitus may hear ringing or other sounds in one or both ears. Tinnitus can be temporary or long-term and persistent. Older age and exposure to loud noise may increase the risk of tinnitus, but the exact cause is unclear.

A person may also hear hissing, roaring, or whistling sounds, which may be high or low pitched.

Tinnitus affects around 10% of adults in the United States. It usually affects older adults, but it can occur at any age.

It is often linked with hearing loss.

There is currently no cure for tinnitus, but there are ways to manage it.

In this article, find out what tinnitus feels like, why it happens, when to see a doctor, and how to manage it.

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In most cases, tinnitus is subjective. This means only the individual with tinnitus can hear the sound, and there is no way to measure it. In fewer than 1% of cases, other people can hear the noise.

People commonly describe the sound as:

  • ringing
  • hissing
  • buzzing
  • roaring
  • whistling

The sound may also:

  • affect one or both ears
  • be intermittent or continuous
  • be high or low pitched

The sound can change in volume. It is often most noticeable at night or during periods of quiet. There may be some hearing loss.

Some people hear a pulsing sound, like a heartbeat, called pulsatile tinnitus. This can happen if there is a cardiovascular problem.

Tinnitus can affect a person’s overall health and well-being.

The American Tinnitus Association notes that tinnitus can lead to:

It can also be a sign of an underlying disease, such as Ménière’s disease or a cardiovascular problem. People who experience tinnitus with other symptoms should see a doctor to rule out an underlying condition.

Objective tinnitus — when other people can hear the noise — may result from cardiovascular or musculoskeletal movements, such as an aneurysm or temporomandibular joint disease.

Doctors do not know precisely why tinnitus occurs. Changes in many parts of the brain and nervous system can trigger it.

Possible causes include:

  • pressure in the inner ear
  • cognitive and emotional factors
  • a reaction to the loss of sensory hair cells
  • change in interactions between neural circuits in the ear and other parts of the brain

Factors that increase the risk of tinnitus include older age and noise exposure. The types of noise that could cause it include:

  • workplace noise, for example in buildings or factories
  • the sound of gunshots and explosions, including on movie sets
  • loud music or working near powerful speakers

People with tinnitus may also have hearing loss. Hyperacusis may also occur, which is hypersensitivity to noise. For example, a person with hyperacusis may find it uncomfortable to hear a door closing or a book dropping.

Various health factors can also lead to tinnitus, including:

  • Ménière’s disease
  • cardiovascular disease
  • hormonal changes
  • thyroid problems
  • having earwax in the ear
  • a brain tumor
  • ear or sinus infections
  • high blood pressure
  • diabetes
  • a head injury
  • multiple sclerosis
  • anxiety or depression
  • having a foreign object in the ear
  • palatal myoclonus, a rare condition that involves rhythmic contractions of muscles in the roof of the mouth

Over 200 drugs can cause tinnitus if a person starts using them or stops taking them. They include:

  • chemotherapy
  • nonsteroidal anti-inflammatory drugs (NSAIDs)
  • aspirin
  • antibiotics

Tinnitus that sounds like a heartbeat could be due to a tumor or a cardiovascular problem.

A person should seek medical advice if:

  • They have new or sudden tinnitus or tinnitus with other symptoms.
  • There may be earwax or a foreign object in the ear that a doctor can remove.
  • Tinnitus affects the person’s sleep, ability to interact with others, and other aspects of daily life.
  • Tinnitus is causing anxiety or depression.
  • The sound is like a heartbeat, which could indicate a cardiovascular problem.
  • Another person can hear it, which may be a sign of a more serious condition.

People should seek emergency medical help for tinnitus if it occurs after a head injury or if the person also has:

  • vertigo (dizziness)
  • weakness in the facial muscles
  • sudden hearing loss

Depending on the cause of tinnitus, treatment may involve:

  • prompt care for an ear infection
  • discontinuing any medications that may be causing it
  • removing earwax
  • treating an underlying condition
  • taking steps to manage or mask the sounds of tinnitus
  • counseling to help with related issues, such as anxiety or depression
  • treatment for hearing loss, if present

If tinnitus does not go away, the following strategies may help:

Masking

Sound therapy uses external background noise to mask the perception of tinnitus.

This could involve:

  • playing low level background music
  • playing recordings of white noise
  • wearing sound generators that fit in the ear and generate background noise or music
  • using hearing aids to amplify environmental sounds
  • using a tabletop sound generator that plays relaxing sounds, such as waves or rain

These strategies aim to redirect the attention away from tinnitus. Most people prefer a sound volume just above that of the tinnitus.

Counseling

A person can attend counseling sessions alongside other options to help them understand and live with tinnitus. Counseling can also address anxiety, depression, and other related issues.

An audiologist may also offer tinnitus retraining therapy, a specialized therapy that may help people live more comfortably with tinnitus.

Cochlear implants and hearing aids

Addressing underlying hearing loss may help reduce the symptoms of tinnitus. A range of interventions can address hearing loss, from amplification devices to surgical implants.

Hearing aids often feature programs to help mask tinnitus.

Lifestyle tips

Here are some more strategies that may help:

  • practicing relaxation techniques, such as meditation or deep breathing
  • avoiding stress or loud background noises when possible, as these can worsen symptoms
  • developing a sleep routine, for example, taking a bath and avoiding caffeine before bed
  • joining a support group for people with tinnitus
  • avoiding total silence, which can make symptoms worse
  • seeking distraction, such as from a hobby, to direct attention away from tinnitus

It is not always possible to prevent tinnitus, but people can take measures to reduce the risk, such as:

  • using hearing protection, such as ear mufflers and earplugs, in noisy environments
  • playing personal listening devices at a moderate volume
  • using special earplugs that do not distort sound when playing music or attending a concert
  • discussing the adverse effects of any drugs with a doctor before using them

If a person seeks medical advice for tinnitus, the doctor may:

  • ask about symptoms
  • do a test to check for hearing loss
  • assess for conditions that may be causing tinnitus
  • refer the person to a specialist doctor for more investigations

The doctor may ask the following questions:

  • When and how did tinnitus first start?
  • Are the noises constant, intermittent, or pulsating?
  • Is there any hearing loss or dizziness?
  • Is there any pain or jaw clicking?
  • Have you had a recent illness or injury?
  • Has there been any exposure to loud noise?

Here are some questions people often ask about tinnitus.

Can tinnitus go away?

Tinnitus can go away if it results from a temporary cause, such as earwax, drug use, or an underlying condition. If it results from permanent damage to the ear or another structure, it will not disappear.

How can you get rid of tinnitus?

Treating an underlying problem or stopping certain medications can resolve tinnitus. If tinnitus does not go away, however, masking and other strategies can help manage it. Finding ways to manage anxiety and stress may also help.

What are the first signs of tinnitus?

Tinnitus is a sound such as ringing, buzzing, roaring, or whistling that only the hearer can hear.

Tinnitus is a sound that a person hears that nobody else can hear. People describe it as ringing, hissing, buzzing, or roaring. It is common and often affects older adults, though it can happen at any age.

In most cases, tinnitus will not go away completely, but if it is due to earwax or medication, it may resolve after treatment. People can manage tinnitus through strategies such as masking, which means playing other sounds, to distract the attention from tinnitus.