What causes tinnitus?
In many cases
In many people with tinnitus, the cause is not known. The ear is otherwise fine. What seems to happen is that signals are sent from the ear down the ear nerve to the hearing part of the brain. The brain interprets these signals as noise. It is not clear why these signals are sent from the ear. The noise may also originate somewhere else in the hearing nerve pathways in the brain.
In some cases
Sometimes the tinnitus is caused by another condition. For example:
- Tinnitus often develops at the same time as the hearing loss of older age.
- Ménière's disease. In this condition you develop attacks of dizziness (vertigo), hearing loss and tinnitus. It is due to a problem of the cochlea - a snail-shaped chamber filled with fluid, in the inner ear.
- Exposure to very loud noise. Some people develop persistent tinnitus after being subjected to loud noise for a long time. For example, after years of working in a loud factory. Sometimes permanent tinnitus persists after a one-off loud noise experience. For example, following a rock concert.
- As an uncommon side-effect of some medicines. For example, aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) and quinine.
- Following an ear or head injury.
- Wax blocking the ear.
- Some other ear disorders such as otosclerosis.
- Some uncommon diseases of blood vessels, brain or nerves can cause tinnitus. In these situations you are likely to have other symptoms or signs such as nerve weakness, etc. However, rarely, tinnitus may be the first symptom to develop.
- Tinnitus can sometimes be a feature of a lack of iron in the body (anaemia), thyroid disease or diabetes.
- A tumour called an acoustic neuroma occasionally causes tinnitus; this is usually persistent and in one ear only. If you get the noise only in one ear, it is particularly important that you consult a doctor, so this can be ruled out.
- An ear infection. The tinnitus tends to clear when the infection clears.
- Psychological factors may have a role to play. For example, mild tinnitus that is not bothersome may become more bothersome if you become depressed, anxious or stressed.
Did you find this information useful?
- Tinnitus; NICE CKS, April 2010 (UK access only)
- Tunkel DE, Bauer CA, Sun GH, et al; Clinical practice guideline: tinnitus. Otolaryngol Head Neck Surg. 2014 Oct 151(2 Suppl):S1-S40. doi: 10.1177/0194599814545325.
- Phillips JS, McFerran D; Tinnitus Retraining Therapy (TRT) for tinnitus. Cochrane Database Syst Rev. 2010 Mar 17 3:CD007330.
- Hobson J, Chisholm E, El Refaie A; Sound therapy (masking) in the management of tinnitus in adults. Cochrane Database Syst Rev. 2012 Nov 14 11:CD006371. doi: 10.1002/14651858.CD006371.pub3.
- Martinez-Devesa P, Perera R, Theodoulou M, et al; Cognitive behavioural therapy for tinnitus. Cochrane Database Syst Rev. 2010 Sep 8 (9):CD005233. doi: 10.1002/14651858.CD005233.pub3.
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