Causes of Tinnitus
It can sometimes be difficult to find the root causes of tinnitus. The most common causes are listed below although hearing damage, earwax and infections are the most often diagnosed. Tinnitus does become more likely as you age as the delicate hairs in your inner ear become damaged. This affects how sound is transported to your brain. Although many cases of tinnitus are associated with hearing loss and other common conditions, around one in every three people with tinnitus does not have any obvious problem with their ears or hearing.
If tinnitus is caused by underlying issues, treating these can help to alleviate the tinnitus and often get rid of it completely even if permanent hearing loss is the cause.
Table for known risk factors for developing tinnitus and conditions associated with tinnitus symptoms:
| Specific diseases or conditions | |
|
Otological - Infectious |
Otitis Media, labrynthitis, mastoiditis |
| Otological - neoplastic | Vestibular schwannoma, meningioma |
| Otological - Labrynthine | Sensorineural hearing loss, Ménière's disease, vestibular vertigo |
| Otological - Other | Impacted cerumen, otosclerosis, presbyacusis, noise exposure |
| Neurological | Meningitis, migraine, multiple sclerosis, epilepsy |
| Traumatic | Head or neck injury, loss of consciousness |
| Orofacial | Temporomandibular joint disorder |
| Cardiovascular | Hypertension |
|
Rheumatological |
Rheumatoid arthritis |
| Immune-mediated | Systemic lupus erythematosus, systemic sclerosis |
| Endocrine & Metabolic | Diabetes mellitus, hyperinsulinaemia, hypothyroidism, hormonal changes during pregnancy |
| Psychological | Anxiety, depression, emotional trauma |
| Ototoxic Medications | Analgesics, antibiotics, antineoplastic drugs, corticosteroids, diuretics, immunosuppressive drugs, non-steroidal anti-inflammatory drugs, steroidal anti-inflammatory drugs 8 |
Below, we'll take a closer look at the some of the more common causes of tinnitus.
Ear Infections
Inner, middle and outer ear infections can all cause tinnitus along with many other symptoms.
There are three kinds of ear infections corresponding to each section of the ear that they effect - the inner, middle and outer ear. All ear infections are very common and more so in children. They are most common in the middle ear (beyond the ear drum) and in the outer ear (ear canal).
You do not always need to see a GP for these types of ear infections as they often get better on their own within 3 days. However, as soon as it's gone beyond the 3 days or it becomes painful you should seek medical help.
Inner ear infections are more rare and may actually be a case of inflammation, and not an actual infection. Symptoms may include tinnitus, pain, dizziness, nausea and vomiting. Inner ear problems may be a sign of something more serious such as meningitis.
Inner Ear Damage
Sounds pass from the outer ear through to the inner ear, which contains the cochlea and auditory nerve. The cochlea is a coiled, spiral tube containing a large number of sensitive hair cells. The auditory nerve transmits sound signals to the brain.
If part of the cochlea is damaged, it will stop sending information to your brain. The brain may then actively "seek out" signals from parts of the cochlea that still work. These signals might then become over-represented in the brain, which may cause the sounds of tinnitus.
There are two main causes of inner ear damage.
Age Related Hearing Loss
Damage to the cochlea often occurs naturally with age and the occurrence (not the loudness) of tinnitus does increase with age.
Exposure to Loud Noise
In younger people, it can be caused by repeated exposure to loud noise, or a single traumatic experience. If you regularly use heavy machinery, listen to music at loud volumes or operate firearms, tinnitus could become a problem. While short-term exposure (such as attending a concert) may have temporary effects, longer-term use without appropriate ear protection can cause permanent damage.
Read more about tinnitus and loud music.
Earwax Build-up
Although a healthy level of earwax can help protect your ear canal from unwanted bacteria, compacted or excessive wax can lead to hearing loss or tinnitus. If you experience blocked ears then you should make an appointment with your audiologist to have them professionally cleaned on a regular basis.
Ear Wax Removal
Ear Wax Clinic has over 300 locations around the UK & Ireland. They use the microsuction technique which is the safest way to remove earwax as the professional can see everything they are doing during the removal.
Unlike ear syringing or ear irrigation, where ear wax is flushed out without a view of the canal, during microsuction, the canal and the ear wax are being directly viewed whilst it is being removed. This makes the procedure much quicker, safer and comfortable for the patient. Microsuction also has the lowest risk of infection.
Ménière's disease
Ménière’s disease affects 1 in 1,000 people in the UK and causes severe dizziness and tinnitus. Although it can be managed effectively, there is currently no cure.
Read more about conditions that cause both tinnitus and vertigo.
High Blood Pressure
There is an association between tinnitus and arterial hypertension. This association is particularly strong in older patients. However, hypertension treatment with medication may be ototoxic in nature and causing/worsening the tinnitus.
Read more about tinnitus and blood pressure.
Perforated Eardrum
A tear in the eardrum that prevents hearing and makes you susceptible to infections. Both the tear and the infection can be the cause of tinnitus and hearing loss. As this usually only happens in one ear at a time, it will result in single sided hearing loss and tinnitus. Read more about perforations and single sided tinnitus...
Metabolic Disorders
Various metabolic abnormalities may be associated with tinnitus. These abnormalities include hypothyroidism, hyperthyroidism, hyperlipidemia, anemia, and zinc or vitamin B12 deficiency.
Read more about tinnitus and metabolic disorders.
Head or Neck Injury
An injury to the head or neck can cause nerve, blood flow and muscle issues that again can result in the perception of tinnitus. People who credit their condition to head and neck trauma often report higher tinnitus volume and burden, as well as greater variation in sound, frequency and location of their tinnitus. Traumatic brain injury caused by concussive shock can damage the brain's auditory processing areas, and this can also cause tinnitus symptoms.
Temporomandibular Joint Syndrome (TMJ)
TMJ syndrome causes a pain in the jaw joint. The Temporo Mandibular Joint connects the lower jaw to the skull in the front of the ear. Certain facial muscles that control chewing are also attached to the lower jaw. TMJ pain can be caused by a variety of problems that can be difficult to determine. It may be due to a combination of factors, including genetics, arthritis or jaw injury. Tinnitus can result from TMJ.
Stress
Tinnitus can seem worse when your stress levels are higher, if you have increased levels of stress it may seem like your tinnitus is worse. This can lead to stress being a common cause of tinnitus seeming worse.
Otosclerosis
This is the medical term for a stiffening of bones in the ear. Otosclerosis is an abnormal bone growth condition, normally passed down genetically. This condition can cause partial deafness as well as tinnitus.
Medications
These can be both prescription and over the counter medicines. Tinnitus can be accounted for as a potential side effect for around 200 prescription and non-prescription drugs.
Padget's Disease
A condition in which the normal cycle of bone renewal and repair is disrupted
Autoimmune Disorders
Autoimmune disease is when healthy tissue (cells) get destroyed by the body’s own immune system. However, autoimmune disorders of the ear are very rare but it is possible that the body's immune system may mistakenly attack the inner ear.