Ringing Ears: What is it and What Can I Do?

Tinnitus, commonly known as ringing in the ears, is a prevalent condition that affects millions of individuals worldwide. While it's not typically a sign of a serious health problem, it can be incredibly bothersome and impact your quality of life. In this blog, we'll explore the causes, symptoms, and management strategies for tinnitus.

What Causes Tinnitus?

Tinnitus can occur for various reasons, but it is often due to ageing or from damage to the auditory system. Exposure to loud noise, such as attending a concert or working in a noisy environment, can trigger temporary tinnitus. Additionally, certain medications, particularly high doses of aspirin and other anti-inflammatory drugs, can cause temporary ringing in the ears.

Chronic tinnitus, lasting more than six months, is more common in older individuals and is often associated with age-related hearing loss. However, it's essential to note that tinnitus can affect people of all ages, and its prevalence tends to increase with age.

Understanding the Sound

Tinnitus manifests as a perceived sound in the absence of an external source. While it's commonly described as a ringing sound, it can take various forms, including buzzing, whistling, humming, or chirping. The sound may seem to originate from one or both ears, inside the head, or from a distance. It can be constant or intermittent, steady or pulsating.

The Role of Auditory Pathways

To understand tinnitus, it's essential to grasp the basics of the auditory system. Sound waves travel through the ear canal to the middle and inner ear, where hair cells help transform them into electrical signals that the brain interprets as sound. When these hair cells are damaged, either by loud noise or certain medications, the brain's auditory pathways may become hyperactive, resulting in the perception of sound when there's none present.

Medications Associated with Tinnitus

Certain medications can cause or worsen symptoms, below is a list of drugs known to be linked to tinnitus.

  • Antibiotics: Ciprofloxacin (Cipro), doxycycline (Vibramycin), gentamicin (Garamycin), erythromycin (Ery-Tab), tetracycline (Sumycin), tobramycin (Nebcin), vancomycin (Vancocin)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Aspirin, ibuprofen (Motrin), naproxen (Aleve, Naprosyn)
  • Antimalarial drugs: Chloroquine, quinine
  • Anticonvulsants: Carbamazepine (Tegretol), valproic acid (Depakote)
  • Tricyclic antidepressants: Amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Tofranil)
  • Loop diuretics: Bumetanide (Bumex), furosemide (Lasix), torsemide (Demadex)
  • Cancer drugs: Cisplatin (Platinol), vincristine (Oncovin)

Identifying Underlying Issues

If you experience tinnitus, it's crucial to consult a healthcare professional for a thorough evaluation. They will conduct tests to determine the underlying cause of your symptoms, which may include:

  • A comprehensive medical history to identify any potential risk factors or underlying health conditions.
  • A physical examination, including an assessment of your ears and hearing.
  • Hearing tests, such as audiometry, to evaluate your hearing function and detect any signs of hearing loss.
  • Imaging studies, such as MRI or CT scans, to rule out structural abnormalities in the auditory system.

Additionally, your healthcare provider may inquire about factors that can exacerbate tinnitus, such as medication use, exposure to loud noise, or musculoskeletal issues like jaw clenching or muscle tension in the neck.

Tinnitus Remedies and Management

While there's currently no definitive cure for tinnitus, several management strategies can help alleviate symptoms and improve quality of life. These may include:

  • Behavioural Strategies: Cognitive Behavioural Therapy (CBT) and Tinnitus Retraining Therapy (TRT) are two behavioural approaches that can help cope with tinnitus more effectively. CBT aims to change negative thought patterns and behaviours associated with tinnitus, while TRT aims to habituate the brain to the sound of tinnitus through a combination of counselling and sound therapy.
  • Sound Therapy: Masking devices, which generate low-level white noise or other soothing sounds, can help reduce the perception of tinnitus and provide relief from symptoms. These devices can be worn like hearing aids or integrated into everyday items like smartphones or bedside noise machines.
  • Stress Management: Stress can exacerbate tinnitus symptoms, so learning stress management techniques like relaxation exercises, mindfulness meditation, or biofeedback can be beneficial. These practices can help reduce the body's physiological response to stress and promote a sense of calm and relaxation.
  • Healthy Lifestyle Choices: Maintaining a healthy lifestyle can also play a role in managing tinnitus. Regular exercise, adequate sleep, a balanced diet, and minimising alcohol and caffeine consumption can all contribute to overall well-being and may help reduce the severity of tinnitus symptoms.
  • Hearing Protection: If you're frequently exposed to loud noise at work or during recreational activities, using hearing protection devices like earplugs or earmuffs can help prevent further damage to your hearing and reduce the risk of exacerbating tinnitus symptoms.


  1. How common is tinnitus among younger individuals, and what are the primary causes in this age group?

Tinnitus is commonly associated with ageing or exposure to loud noise, but it can affect individuals of all ages. While chronic tinnitus is more prevalent among older adults, younger individuals can also experience it, especially if they are exposed to loud noise or have underlying health conditions such as ear infections or temporomandibular joint (TMJ) disorders.

  1. Are there any alternative treatment options for tinnitus that are not mentioned in the article, such as herbal remedies or acupuncture?

Alternative therapies like herbal remedies, acupuncture, or dietary supplements are sometimes used for tinnitus relief, but their efficacy is uncertain. No single approach works for everyone, and there's no FDA-approved drug treatment for tinnitus. Trials haven't shown drugs, supplements, or herbs like ginkgo biloba or acupuncture to be more effective than a placebo. Therefore, finding effective alternative solutions may be challenging, and individuals may need to explore various techniques before finding relief.Top of Form

  1. Can tinnitus be a symptom of underlying health conditions other than age-related hearing loss, and if so, what are they?

Tinnitus can sometimes be a symptom of underlying health conditions other than age-related hearing loss. For example, it can be associated with ear infections, temporomandibular joint (TMJ) disorders, Meniere's disease (a disorder of the inner ear), or vascular disorders. Tinnitus can also be a side effect of certain medications or a sign of more serious conditions such as acoustic neuroma (a noncancerous tumour on the cranial nerve). Therefore, it's crucial for those experiencing tinnitus to undergo a thorough evaluation by a professional to identify any underlying health issues contributing to their symptoms.

While tinnitus can be a challenging condition to manage, it's essential to remember that there are resources and support available to help you cope. If you're experiencing tinnitus symptoms, don't hesitate to seek guidance from a healthcare professional who can provide personalised recommendations and support tailored to your needs.

Schedule a consultation with one of our ENT specialists today to explore personalised treatment options and effectively manage tinnitus.

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