Tinnitus – “Ringing in the ear”

Tinnitus is a physical condition, experienced as noises or ringing in the ears or head when no such external physical noise is present. Tinnitus is usually caused by a fault in the hearing system; it is a symptom, not a disease in itself.

The word “tinnitus” means “tinkling or ringing like a bell”. Latin origin; usually pronounced tinn-itus, the “i” as in “sit”.

What are the causes of tinnitus?

Almost everything that can go wrong with our ears can produce tinnitus as a symptom! Perhaps as simple as wax against the eardrum, or as serious as a tumour on the hearing nerve. Otosclerosis (fixation of the tiny stirrup bone in the middle ear) can produce tinnitus; so can Meniere’s disease. A major cause of tinnitus is EXPOSURE TO EXCESSIVE NOISE, e.g. chain saws, machinery, rock concerts.

What do we understand about tinnitus?

Worldwide research continues but the actual mechanisms, or processes of tinnitus are not yet fully understood. We do know that tinnitus is real, not imagined, and that it is a symptom of a malfunction, usually somewhere in the hearing system (includes ear and brain). The inner ear, or cochlear, is involved for many people. See diagram below.

Do Many People Suffer From Tinnitus?

Yes, millions around the world! Probably 18% of Australians have tinnitus at some time of their lives and approximately ’50 million Americans have tinnitus in some form’. Countries with self-help groups include USA, UK, Germany, Canada, New Zealand and, of course, Australia. Severe tinnitus is recognised as a very major affliction, but most people have tinnitus to a milder degree. Given time, commitment and up-to-date professional help, tinnitus can reduce for many people.

What Can Make Tinnitus Worse?

1. Loud noise! – Exposure to sudden or long-term noise can damage your hearing with resultant deafness and tinnitus. High-risk groups include industrial workers, farmers, transport workers – and don’t forget that noisy lawn mower! Reduce the noise source or protect your ears with earplugs, or earmuffs. Leisure noise can also be a hazard, e.g. rock concerts, boom boxes in cars and misuse or earphones – never play them loudly.

2. Stress and Fatigue – They make tinnitus worse! Keeping busy – trying to focus your energies OUTWARD AND AWAY from the tinnitus – is an excellent idea, but stress and fatigue only undermine you. Minimise them by rethinking your lifestyle. Relaxation therapy can help greatly if learnt and practiced daily. Hypnotherapy from a qualified practitioner may help. Also good – sports, hobbies, yoga, tai chi, reflexology or massage.

3. Medications – It is essential to tell your family doctor about your tinnitus; some common medications cause tinnitus as a side effect or make your existing tinnitus worse. Take special care with medications for arthritis, rheumatic diseases, some antibiotics, and anti-depressants. Also aspirin – ask your doctor about alternatives.

4. Try easing off caffeine (tea, coffee, Coca-Cola, chocolate), and alcohol as they can temporarily worsen tinnitus for some people. Avoid quinine – as in tonic water. Nicotine and marijuana too. Smoking narrows your blood vessels which supply vital oxygen to your ears and their sensory cells. PLEASE – quit smoking!

Does Tinnitus Mean That One Is Going Deaf?

Tinnitus is a symptom of a fault in the hearing system, so usually it is associated with a hearing loss. Sometimes tinnitus is present with normal hearing and for no discernible reason. TREAT TINNITUS AS A WARNING SIGNAL AND SEE YOUR DOCTOR.

I Have Tinnitus – What Should I Do?

Do see your doctor and have your hearing checked by an audiologist (hearing scientist). Some people may require a referral to an ENT specialist. There may be a TREATABLE medical cause.

Hearing Aids

Good quality and properly fitted hearing aids reduce and even eliminate most tinnitus associated with hearing losses. Hearing aids take away the strain of listening and distract from the tinnitus by bringing you more environmental sounds from the outside world.

Therapeutic Noise Generator

Device which looks like a hearing aid and recommended for people with no hearing loss. It produces a blend of external sounds which stimulate most fibres of the hearing nerve helping to deviate attention away from the tinnitus.

Tinnitus Retraining Therapy (TRT)

Aims to reduce and ultimately eliminate tinnitus perception. It combines auditory therapy – hearing aids and/or therapeutic noise generators – to provide the brain with maximum environmental sounds to reduce tinnitus perception. Directive counselling helps to change negative beliefs, distract from tinnitus and reduce stress.

Cognitive Behaviour Therapy (CBT)

Effective in alleviating distress and producing adaptation to tinnitus. CBT is threefold: changing the way a person perceives tinnitus; teaching ways to focus attention away from tinnitus and achieving control over stress. Offered by clinical psychologists.

Is There An Operation For Tinnitus?

For the vast majority of people there is no specific operation for tinnitus. However, following successful surgical treatment for some ear problems, an existing tinnitus may sometimes disappear, e.g. otosclerosis, Meniere’s disease, middle ear infection.

Is There Any Medication For Tinnitus?

Perhaps for some people. It depends on the cause of the tinnitus; consult your specialist. Vitamin B12 may be helpful. Herbal remedies, if taken under medical supervision, may be of some use.

Check With Your Dentist

Perhaps 5% of tinnitus is caused by a jaw joint (*TMJ) problem which is treatable. This type of tinnitus occurs because jaw muscles and a muscle in the middle ear are closely connected. When jaw muscles spasm the ear muscles react by pulling the eardrum too tight, and this situation can result in tinnitus.
*Temporo-mandibular joint or TMJ for short.

Everybody’s tinnitus noise is individual to them, although of course there are several major types e.g. ringing, buzzing, whistling, roaring, humming etc. The range of tinnitus is very wide from mild to severe. It is usual for tinnitus to fluctuate with stress or tiredness and this has no sinister significance.

Reference; Australian Tinnitus Association 2019. For more information please visit their website at http://www.tinnitus.asn.au

Other helpful Resources

There are many tinnitus apps that have relaxation music and sounds to help people fall asleep or to just listen to in the background if tinnitus is becoming intrusive

o    Oto: Tinnitus Relief Therapy App, created by audiologists, tinnitus therapists and doctors and has had a lot of good reviews. There are a lot of free options on the app, but if you wanted to have more intensive cognitive therapy and mindfulness training there is a paid subscription.

Oto Tinnitus Relief Therapy App – https://www.joinoto.com/


For A registered Psychologist that Specialises in Tinnitus and Hyperacusis,

Please see the Psychology and Hearing Centre website at https://www.psychologyandhearing.com.au/

Psychology and Hearing

Suite 11/133 Alexander St

Crows Nest, NSW, 2065


tel: 0411 196 956