What Is Tinnitus and How Can You Manage It

What Is Tinnitus and How Can You Manage It

Introduction

If you're experiencing ringing, buzzing, or other phantom sounds in your ears, you're far from alone. Tinnitus affects approximately 1 in 6 Australians—that's around 4.5 million people living with some form of this condition. For many people with tinnitus, these phantom sounds can range from a mild annoyance to a persistent challenge that affects daily life. Understanding tinnitus and knowing what treatment options exist can make a significant difference to your quality of life.

This comprehensive guide explores what tinnitus is, what can cause tinnitus, and—most importantly—how tinnitus can be managed effectively. Whether you're experiencing tinnitus for the first time or you've been living with tinnitus for years, you'll find evidence-based information to help you take the next steps toward finding relief and learning to live with tinnitus more comfortably.

What is Tinnitus?

Tinnitus is the perception of sound when no external sound source is present. Tinnitus is a symptom rather than a disease itself, indicating that something in your auditory system or overall health needs attention. The sounds associated with tinnitus can vary considerably from person to person.

The most common sounds people with tinnitus experience include:

• Ringing (the most commonly reported tinnitus sound, often described as a ring in the ears)
• Buzzing or humming sensations
• Hissing or whistling noises
• Clicking or pulsing sounds
• Roaring or whooshing sensations

For some individuals, tinnitus may be a minor annoyance that comes and goes intermittently. For others who experience tinnitus more severely, it's a constant presence that affects concentration, sleep, and emotional wellbeing. The experience of tinnitus is highly individual—what works for one person may not work for another, which is why professional assessment is so important.

The sounds can occur in one ear, both ears, or appear to come from inside your head. They might be constant or intermittent, low-pitched or high-pitched. Some people describe their tinnitus as barely noticeable, whilst others find the ringing in the ears loud enough to interfere with daily activities.

Understanding that tinnitus is a genuine neurological phenomenon—not "just in your head" in the dismissive sense—is the first step toward effective management. Your brain is genuinely perceiving these sounds, even though they're not coming from your external environment. When you experience tinnitus, your auditory system is creating these phantom sounds internally.

Types of Tinnitus

Tinnitus is generally classified into several categories, each with different characteristics and potential causes. Understanding which type of tinnitus you may have helps guide appropriate treatment of tinnitus.

Subjective Tinnitus

This is by far the most common type of tinnitus, accounting for approximately 95% of all cases. Subjective tinnitus means that only you can hear the sound—it can't be measured or heard by anyone else, including your audiologist during a diagnosis of tinnitus assessment.

Subjective tinnitus is typically associated with changes in the auditory system, from the outer ear through to the auditory cortex in your brain. It's often related to hearing loss and tinnitus together, though not always. The phantom sounds occur when your brain attempts to compensate for reduced auditory input from damaged hair cells in the inner ear.

This type of tinnitus may be:

• Continuous or intermittent
• Tonal (a single pitch) or multi-tonal
• Variable in loudness and pitch throughout the day

Many people find their subjective tinnitus fluctuates, with some days when tinnitus symptoms seem more prominent than others. Various factors can make tinnitus worse, including stress, fatigue, exposure to loud noise, and certain dietary choices.

Objective Tinnitus

This rare form accounts for fewer than 5% of cases. Objective tinnitus produces sounds that can actually be heard by an examiner using specific diagnostic equipment. These sounds typically originate from vascular or muscular structures near the ear, including blood vessel abnormalities.

Objective tinnitus requires thorough medical investigation, as it may indicate an underlying condition that could respond to targeted treatment. The sounds are often rhythmic and may synchronise with your heartbeat or breathing.

Pulsatile Tinnitus

pulsatile tinnitus is a specific type where you hear rhythmic pulsing, often in time with your heartbeat. This whooshing or thumping sound is caused by blood flow changes near the inner ear or alterations in blood vessel structure. Unlike other forms of tinnitus, pulsatile tinnitus has a distinct rhythmic quality.

Whilst pulsatile tinnitus can sometimes have benign causes, it warrants medical investigation to rule out vascular conditions. Many people with pulsatile tinnitus find that certain head positions make the sound louder or quieter, which can provide diagnostic clues for identifying the cause of tinnitus.

Somatic Tinnitus

Somatic tinnitus is influenced by movements or positions of your head, neck, jaw, or eyes. People with this type often notice their tinnitus changes when they clench their jaw, turn their head, or move their shoulders.

This type suggests that tinnitus can be caused by factors related to the somatosensory system—the network of nerves that provide information about body position and movement. Somatic tinnitus may respond particularly well to treatments that address musculoskeletal issues.

Common causes of tinnitus

Understanding what causes your tinnitus is essential for finding the most effective management approach. Research has identified numerous factors that can cause tinnitus, and often multiple causes contribute simultaneously.

Noise Exposure and Loud Noise Damage

Prolonged or sudden exposure to loud noise is one of the leading causes of tinnitus. When sound waves damage the delicate hair cells in your inner ear, your brain may generate phantom sounds to "fill in" the missing auditory information. This is one of the most preventable causes that can cause tinnitus.

• Chronic exposure to loud environments: Years of workplace noise, loud hobbies (power tools, music venues), or recreational activities (motorsports, shooting)
• Acoustic trauma: A single very loud event (explosion, concert, machinery accident)

Exposure to loud noise damages the cochlear hair cells in your inner ear. The good news is that noise-induced tinnitus is largely preventable with proper hearing protection. However, once hair cells in the inner ear are damaged, they don't regenerate, making early protection crucial.

People who regularly work in loud environments or frequently have exposure to loud music face significantly higher risk of developing tinnitus. Protecting your hearing from loud noise is one of the most effective ways to prevent tinnitus.

Age-Related Hearing Loss and Tinnitus

As we age, the sensory cells in our inner ear naturally deteriorate—a condition called presbycusis or age-related hearing loss. This gradual hearing loss often brings tinnitus along with it, typically starting around age 60, though it can begin earlier.

The connection between hearing loss and tinnitus is significant: approximately 80-85% of people with tinnitus also have some degree of hearing loss, even if they haven't noticed it yet. This is why a comprehensive hearing assessment is such an important part of tinnitus evaluation. Age-related hearing loss can cause tinnitus by reducing the auditory input to your brain, which may then generate phantom sounds.

Ear Conditions That May Cause Tinnitus

Several ear-related issues can trigger or worsen tinnitus symptoms:

• Earwax blockage: When excessive wax presses against your eardrum, it can cause tinnitus temporarily
• Ear infection: Middle ear infections (otitis media) can cause temporary tinnitus. An ear infection affects the inner ear function and may make tinnitus more noticeable
• Otosclerosis: Abnormal bone growth in the middle ear
• Meniere's disease: Inner ear disorder affecting both hearing and balance, commonly associated with tinnitus
• Eustachian tube dysfunction: When the tube connecting your middle ear to your throat doesn't function properly

Many of these conditions are treatable, and addressing them may reduce or eliminate symptoms of tinnitus. If you suspect an ear infection or other ear condition might cause tinnitus in your case, professional evaluation is essential.

Medications (Ototoxic Drugs)

More than 200 medications are known to potentially cause or worsen tinnitus. Some medications can cause tinnitus as a side effect, whilst others may make existing tinnitus worse. This list includes:

• Aspirin (in high doses)
• Certain antibiotics (particularly aminoglycosides)
• Some cancer chemotherapy drugs (cisplatin, vincristine)
• Loop diuretics (furosemide)
• Antimalarial medications (quinine)
• Some antidepressants

If you suspect your medication is contributing to tinnitus, speak with your prescribing doctor before making any changes. There may be alternative medications available, or the benefits may outweigh the tinnitus symptoms.

Head and Neck Injuries

Trauma to the head or neck can affect the auditory nerves, blood flow to the inner ear, or the processing centres in your brain. Even whiplash or concussion can sometimes trigger tinnitus. Head injuries represent a significant cause of tinnitus in some individuals.

This type of tinnitus often improves as the injury heals, though some people experience persistent symptoms that require ongoing management and treatment of tinnitus.

Medical Conditions Associated with Tinnitus

Several health conditions are associated with increased risk of tinnitus:

• Cardiovascular disorders: High blood pressure, atherosclerosis affecting blood vessel health
• Diabetes: Can affect blood flow to the inner ear structures
• Thyroid disorders: Both hyperthyroidism and hypothyroidism
• Autoimmune conditions: Such as rheumatoid arthritis
• TMJ disorders: Problems with the temporomandibular joint

Managing these underlying conditions may help reduce tinnitus symptoms, highlighting the importance of a holistic approach to your health. These conditions don't always cause tinnitus directly but may contribute to its development.

Stress, Anxiety, and the Tinnitus Cycle

Whilst stress doesn't typically cause tinnitus on its own, it can certainly make tinnitus more noticeable and bothersome. The relationship works both ways: tinnitus can cause stress, and stress can amplify your perception of tinnitus, creating a challenging cycle.

Understanding this connection is crucial for effective management, as stress-reduction techniques often form an important part of tinnitus treatment options programmes. When you're stressed, tinnitus may seem louder or more intrusive than during calmer periods.

Risk Factors for Developing Tinnitus

Certain factors increase your likelihood of experiencing tinnitus and developing tinnitus symptoms:

Occupational Hazards

• Construction workers, factory employees, musicians, military personnel, and anyone regularly exposed to loud environments face higher risk of tinnitus. Consistent exposure to loud noise in the workplace is a major factor that can cause tinnitus.

Age

• Risk of tinnitus increases with age, particularly after 60, due to natural hearing changes and age-related hearing loss.

Gender

• Research suggests men experience tinnitus slightly more frequently than women, possibly due to higher rates of exposure to loud noise in certain occupations.

Smoking

• Tobacco use affects blood flow to the delicate structures of the inner ear.

Cardiovascular Health

• Conditions affecting blood circulation and blood vessel health can increase risk of tinnitus.

Hearing Loss

• Any degree of hearing loss, even mild, increases the likelihood you'll develop tinnitus. Hearing loss and tinnitus commonly occur together.

Lifestyle Factors

• High caffeine or alcohol consumption may worsen tinnitus symptoms for some people and can make tinnitus more noticeable.

Mental Health

• Depression and anxiety are both risk factors for developing tinnitus and for finding tinnitus more distressing when it occurs.

When to See a Doctor or Audiologist

Whilst tinnitus itself isn't usually a sign of a serious medical condition, certain tinnitus symptoms warrant prompt professional evaluation:

Seek Immediate Medical Attention If:

• Sudden onset of tinnitus, especially if accompanied by hearing loss
• Pulsatile tinnitus (rhythmic sounds matching your heartbeat)
• Tinnitus in only one ear (unilateral tinnitus)
• Tinnitus accompanied by dizziness, vertigo, or balance problems
• New tinnitus following a head injury
• Hearing loss alongside your tinnitus
• Pain or discharge from your ear

Schedule a Professional Assessment If:

• Tinnitus persists for more than a few days
• The sounds are affecting your sleep, concentration, or quality of life
• You're experiencing anxiety or depression related to tinnitus
• You'd like to explore treatment options for tinnitus
• You have concerns about your hearing in general

Here on the Sunshine Coast, Queensland, qualified audiologists like Linda Whittaker—with over 20 years of experience and ACAud certification—can provide comprehensive tinnitus assessments and develop personalised management plans for treating tinnitus.

Early intervention often leads to better outcomes, so there's no benefit in "waiting to see if it goes away." Professional guidance can help you understand your tinnitus and begin effective management strategies sooner rather than later.

Diagnosis of Tinnitus and Assessment

A thorough diagnosis of tinnitus typically involves several steps to understand the cause of tinnitus and determine how best to help you live with tinnitus:

Initial Consultation

Your audiologist will begin with a detailed discussion of:

• When your tinnitus started and how you experience tinnitus
• What the sounds are like (pitch, volume, type)
• Whether anything makes tinnitus better or worse
• How tinnitus is affecting your daily life
• Your medical history, including medications that might cause tinnitus
• Your history of exposure to loud noise
• Any associated symptoms (hearing loss, dizziness, pain)

Comprehensive Hearing Assessment

Since hearing loss and tinnitus are so closely linked, a complete hearing test is essential for proper diagnosis of tinnitus. This typically includes:

• Pure tone audiometry: Testing your hearing across different frequencies
• Speech testing: Assessing how well you understand words
• Tympanometry: Checking middle ear function
• Otoacoustic emissions: Testing cochlear hair cell function in the inner ear

These tests help identify any hearing loss and provide clues about what factors may cause tinnitus in your specific case.

Tinnitus-Specific Measurements

Your audiologist may also conduct specialised tinnitus testing:

• Pitch matching: Identifying which frequency most closely resembles your tinnitus
• Loudness matching: Determining how loud your tinnitus seems (often the ring is quieter than people perceive)
• Minimum masking level: Finding what volume of external sound makes tinnitus less noticeable
• Residual inhibition: Testing whether masking sounds provide temporary relief and make tinnitus less prominent

Questionnaires

Standardised questionnaires help measure how much tinnitus affects your quality of life:

• Tinnitus Handicap Inventory (THI)
• Tinnitus Functional Index (TFI)
• Visual Analogue Scale (VAS)

These tools help track your progress over time and guide tinnitus treatment decisions. They assess how much tinnitus impacts various aspects of daily living.

Medical Referral

Depending on your tinnitus symptoms and assessment results, your audiologist may recommend referral to:

• An ear, nose and throat specialist (ENT) for evaluation of conditions that can cause tinnitus
• Your GP for medical evaluation
• A specialist for imaging studies (MRI, CT scan) if indicated, especially for pulsatile tinnitus
• Other healthcare professionals as needed

Treatment of Tinnitus and Management Options

It's important to understand that there is currently no cure for tinnitus in most cases. However, saying there is no cure for tinnitus doesn't mean there's no hope. Many effective management strategies can significantly reduce the impact of tinnitus on your life. The most successful approach to tinnitus treatment often involves a combination of therapies tailored to your specific situation.

Sound Therapy

Sound therapy involves using external sounds to make tinnitus less noticeable or less bothersome. Several approaches exist for sound therapy:

White Noise and Background Sounds

• White noise machines generate soothing sounds that can make tinnitus less prominent
• Nature sounds (rainfall, ocean waves, wind) can be particularly relaxing
• Fans, air purifiers, or quiet music provide background sound that helps make tinnitus less noticeable

The goal of sound therapy isn't necessarily to completely cover tinnitus, but to reduce the contrast between silence and the tinnitus sound, making it less intrusive.

Specialised Sound Generators

Modern sound therapy devices can be customised to your specific tinnitus pitch and may include:

• Broadband noise to make tinnitus less prominent
• Notched music therapy (music with your tinnitus frequency removed)
• Customised soundscapes designed to help tinnitus become less bothersome

Smartphone Apps

Numerous apps provide sound therapy options you can access anywhere. Whilst these can be helpful for managing tinnitus, professional-grade equipment is often more effective for consistent, long-term management and treating tinnitus successfully.

Hearing Aid for Tinnitus Relief

For the 80-85% of tinnitus sufferers who also have hearing loss, a hearing aid can be remarkably effective for tinnitus management. Here's why a hearing aid helps:

• Amplification reduces contrast: By bringing in more external sound, a hearing aid reduces the relative prominence of tinnitus and can make tinnitus less noticeable
• Brain receives more input: When your brain gets adequate auditory information through a hearing aid, it's less likely to generate phantom sounds
• Built-in sound therapy: Many modern hearing aids include tinnitus masking features that specifically help make tinnitus less bothersome

Research consistently shows that properly fitted hearing aids can reduce tinnitus perception for many people with hearing loss. Some people notice improvement almost immediately after getting a hearing aid, whilst others experience gradual relief over weeks or months. A hearing aid addresses both the hearing loss and tinnitus simultaneously.

Tinnitus Retraining Therapy (TRT)

tinnitus retraining therapy is a specialised programme combining sound therapy with counselling. The approach is based on the neurophysiological model of tinnitus, which proposes that tinnitus becomes problematic through a process of conditioning.

Tinnitus retraining therapy typically involves:

• Directive counselling: Education about tinnitus and how your auditory system works
• Sound enrichment: Low-level background sound throughout the day to make tinnitus less prominent
• Gradual habituation: Over time (often 12-24 months), your brain learns to filter out the tinnitus signal, making tinnitus less noticeable

Studies suggest tinnitus retraining therapy can be effective for many people, with success rates often reported around 75-80% for those who complete the full programme. Tinnitus retraining therapy helps you learn to live with tinnitus more comfortably.

Cognitive Behavioural Therapy (CBT)

CBT doesn't reduce the volume of tinnitus, but it can dramatically change how you respond to tinnitus. This psychological approach helps you:

• Identify negative thought patterns about tinnitus
• Challenge unhelpful beliefs that make tinnitus seem more threatening
• Develop coping strategies for living with tinnitus
• Reduce the anxiety and stress that often accompany tinnitus

Research shows CBT can significantly improve quality of life for people with tinnitus, particularly those experiencing anxiety or depression related to their tinnitus symptoms. Many audiologists work with psychologists who specialise in CBT for treating tinnitus.

Mindfulness and Relaxation Techniques

Stress and tinnitus create a reinforcing cycle, so learning to manage stress can reduce how bothersome tinnitus feels:

• Mindfulness meditation: Accepting tinnitus without emotional reaction
• Progressive muscle relaxation: Systematically relaxing muscle groups
• Deep breathing exercises: Activating the relaxation response
• Yoga or tai chi: Combining movement, breathing, and mindfulness

These techniques don't eliminate tinnitus, but they can change your relationship with tinnitus, making it less troublesome and helping tinnitus become less intrusive.

Medications

No medication currently exists specifically as a cure for tinnitus, but certain drugs may help manage associated tinnitus symptoms:

• Antidepressants or anti-anxiety medications: For those experiencing significant distress from tinnitus (prescribed by your doctor)
• Sleep aids: Short-term use may help if tinnitus is severely disrupting sleep

Your GP or ENT specialist can discuss whether medication might form part of your tinnitus treatment plan. It's important to note that some medications can actually make tinnitus worse, so always disclose your tinnitus when discussing medication options.

Lifestyle Modifications to Manage Tinnitus

Several lifestyle adjustments may help reduce tinnitus symptoms and help you live with tinnitus more successfully:

Protect Your Hearing from Loud Noise

• Use earplugs or earmuffs in loud environments
• Limit exposure to loud concerts, power tools, or loud machinery
• Keep personal audio devices at safe volumes to prevent further damage
• Avoid exposure to loud noise whenever possible

Manage Overall Health

• Monitor blood pressure and blood vessel health
• Exercise regularly to improve circulation to the inner ear
• Maintain healthy blood sugar levels

Dietary Considerations

Some people find certain foods or drinks can make tinnitus worse:

• Limiting caffeine (coffee, tea, energy drinks) may help some people with tinnitus
• Reducing salt intake, which can affect fluid balance in the inner ear
• Moderating alcohol consumption, which can temporarily make tinnitus worse
• Staying well hydrated

Everyone's triggers are different, so keeping a diary can help identify what makes tinnitus worse for you personally.

Sleep Hygiene

Tinnitus often seems worse at night in quiet environments. Many people with tinnitus find these strategies helpful:

• Use a bedside sound machine or fan to make tinnitus less noticeable
• Keep your bedroom cool and comfortable
• Establish a consistent sleep schedule
• Avoid screens before bedtime

Emerging Therapies for Treating Tinnitus

Research into tinnitus treatment continues, with several promising areas:

• Neuromodulation: Using electrical or magnetic stimulation to alter brain activity related to tinnitus
• Bimodal stimulation: Combining sound therapy with other sensory stimulation
• Personalised sound therapy: Advanced algorithms that tailor sounds to your specific tinnitus to make tinnitus less bothersome

Whilst these treatments for tinnitus show promise, they're still being researched and may not yet be widely available. However, they represent hope for future treatment options that may help people with tinnitus even more effectively.

How to Live with Tinnitus Successfully

Coming to terms with tinnitus is a process, and it's natural to experience a range of emotions—frustration, anxiety, even grief. However, with time and appropriate support, most people find ways to live with tinnitus comfortably and lead full, satisfying lives despite their tinnitus.

The Habituation Process: Learning to Live with Tinnitus

Habituation means your brain learns to ignore the tinnitus signal, similar to how you stop noticing the feeling of clothes on your skin or the ticking of a clock. This process doesn't happen overnight, but for many people with tinnitus, the ring gradually fades into the background over time.

Key factors that support habituation and help make tinnitus less noticeable:

• Time: Habituation often takes months, not weeks
• Reduced focus: The less attention you give tinnitus, the faster habituation occurs
• Emotional neutrality: When tinnitus stops triggering anxiety, it becomes easier to ignore
• Consistent sound enrichment: Reducing silence helps your brain deprioritise the tinnitus signal

Many people eventually reach a state where tinnitus is barely noticeable, even though the sound remains. This is often described as making tinnitus less bothersome through the natural process of habituation.

Support Networks for People with Tinnitus

Connecting with others who understand what it's like to experience tinnitus can be incredibly valuable:

• Tinnitus support groups: Both in-person and online communities where people with tinnitus share experiences
• Professional counselling: Particularly helpful if tinnitus is affecting your mental health
• Family education: Helping loved ones understand tinnitus can reduce feelings of isolation

Positive Focus

Whilst it may sound simplistic, focusing on what you can do—rather than what tinnitus is taking away—genuinely helps people live with tinnitus successfully:

• Engage in activities you enjoy that provide mental distraction
• Maintain social connections
• Set goals unrelated to tinnitus
• Celebrate small victories in your management journey

Many people with tinnitus eventually reach a point where tinnitus simply doesn't bother them anymore, even though the sound remains. This is the goal of most management approaches: not silence, but indifference.

Take the Next Step in Managing Your Tinnitus

If you're experiencing tinnitus, professional guidance can help you find relief and develop an effective management plan. A comprehensive hearing assessment is the essential first step toward understanding the cause of tinnitus in your case and exploring your treatment options.

Many people with tinnitus find significant relief through proper assessment and management. Whether you need a hearing aid, sound therapy, tinnitus retraining therapy, or other treatment approaches, professional support can help you develop strategies to make tinnitus less noticeable and learn to live with tinnitus more comfortably.

At Hearing Care on the Sunshine Coast, we provide thorough tinnitus assessments and personalised management strategies designed to help you live well with tinnitus. With professional experience and ACAud certification, we offer evidence-based care for treating tinnitus in a supportive environment.

Don't let tinnitus control your life. Many people with tinnitus find that with appropriate management, tinnitus becomes less bothersome over time. Remember, whilst there is no cure for tinnitus currently, there are proven strategies that can significantly reduce how much tinnitus affects your daily life.

Book your comprehensive hearing and tinnitus assessment today. Taking this step is an investment in your wellbeing and quality of life. Whether you're concerned about hearing loss and tinnitus, need help understanding what may cause tinnitus in your situation, or want to explore treatment options, professional assessment provides the foundation for effective management.

Individual results vary. Professional hearing assessment is required to determine the most appropriate management approach for your specific situation. Remember that factors which can cause tinnitus vary by individual, and what makes tinnitus worse for one person may not affect another.