Hearing a ringing, buzzing or hissing sound when there is no sound around you can be unsettling. This is known as tinnitus. It is common and can affect one ear, both ears or feel as though it is coming from inside the head.
For some people, tinnitus is occasional and fades into the background. For others, it can be persistent and interfere with sleep, concentration, mood or everyday conversations. Understanding possible tinnitus symptoms and causes can help you decide whether the sound is likely to settle or should be assessed.
Tinnitus is usually a symptom rather than a condition in its own right. It can be linked with changes in hearing, ear wax, infections, noise exposure and some inner ear conditions. In many cases, there is a clear explanation that can be addressed or managed.
What is tinnitus?
Tinnitus is the perception of sound without an external source. People often describe it as ringing in the ears, but it can also sound like:
- Buzzing
- Hissing
- Whistling
- Humming
- Roaring
- Clicking
The sound may be quiet or loud, constant or intermittent. It may seem more noticeable in a quiet room, particularly at night when there are fewer background sounds to distract from it.
Tinnitus itself is not always a sign of a serious problem. However, a new sound that persists, changes or affects one ear only should not be ignored.
Tinnitus symptoms: what can it feel like?
Tinnitus symptoms vary widely from person to person. Some people notice a soft background noise that comes and goes. Others experience a more intrusive sound that makes it difficult to relax or sleep.
You may notice tinnitus:
- In one ear or both ears
- All the time or only occasionally
- After exposure to loud sound
- During periods of stress, tiredness or illness
- Alongside blocked ears, reduced hearing or pressure in the ear
Some people also notice that their tinnitus changes with head or neck movement, jaw movement or changes in posture.
What is pulsatile tinnitus?
Pulsatile tinnitus is a sound that beats in time with your heartbeat. It may be heard as a rhythmic whooshing, thumping or pulsing noise.
This can sometimes relate to blood flow in vessels close to the ear. Persistent pulsatile tinnitus needs prompt assessment so that an underlying cause can be identified or ruled out.
What causes tinnitus?
There are several possible tinnitus causes. Sometimes more than one factor is involved and it is not always possible to find a single explanation.
Exposure to loud noise
Repeated exposure to loud music, machinery or workplace noise can affect the delicate sensory cells in the inner ear. Tinnitus may develop after a single very loud event or gradually over time.
Using hearing protection in noisy environments and keeping headphone volume at a safe level can help reduce the risk of noise-related hearing changes.
Hearing loss
Tinnitus frequently accompanies hearing loss. When the brain receives less sound information from the ear, it can become more aware of internal sound signals. This is one reason why ringing in the ears is more common as hearing changes with age or after noise exposure.
Tinnitus does not automatically mean you have hearing loss, but it is worth having your hearing checked if you notice either symptom. Read more about the symptoms and triggers of partial or complete hearing loss.
Ear wax
A build-up of ear wax can block the ear canal and reduce the sounds entering the ear. This can make tinnitus more noticeable or trigger it in some people.
Ear wax is a common and reversible cause, so it is often worth ruling out first. Learn more about the risks of ear wax blocking the ear.
Avoid putting cotton buds or other objects into the ear. These can push wax further inside and irritate or injure the ear canal. Instead, opt for professional ear wax removal.
Ear infections and middle ear problems
Ear infections, fluid behind the eardrum and pressure problems in the middle ear can all affect hearing temporarily. Tinnitus may develop alongside ear pain, a blocked sensation, discharge or reduced hearing.
Treating the underlying ear problem can sometimes reduce or resolve the tinnitus.
Inner ear conditions
Some conditions affecting the inner ear can cause tinnitus alongside hearing changes, dizziness or vertigo. Ménière’s disease is one example. It can cause episodes of spinning dizziness, fluctuating hearing loss, tinnitus and a feeling of pressure in the ear.
Certain medicines
Some medicines can be associated with tinnitus, particularly at higher doses or in particular circumstances. Do not stop prescribed medication because of tinnitus without speaking to the clinician who prescribed it. They can advise whether the medicine could be contributing and whether an alternative is appropriate.
Tinnitus, hearing loss and dizziness
Tinnitus and hearing loss often occur together because both can involve the hearing system. A hearing assessment can help identify whether reduced hearing is contributing to the problem.
Tinnitus and dizziness may also occur at the same time, particularly where an inner ear condition affects both hearing and balance. However, tinnitus does not usually cause dizziness on its own. Instead, the two symptoms may share an underlying cause.
Persistent dizziness, recurrent vertigo or new balance problems should be assessed, especially when they occur with hearing changes or tinnitus. Find out more about dizziness and ear-related balance issues.
Is tinnitus permanent and can it go away on its own?
Many people ask ‘is tinnitus permanent?’ The answer depends on the cause.
Tinnitus can improve or go away on its own, particularly when it follows a short-lived trigger such as an ear infection, ear wax build-up or temporary exposure to loud noise. When it is linked with longer-term hearing changes, it may persist but become less intrusive over time.
There is no single cure that works for every type of tinnitus. However, management can genuinely reduce the impact it has on daily life.
This may involve:
- Treating an underlying cause such as ear wax, infection or hearing loss
- Reviewing hearing and ear health
- Using hearing aids where hearing loss is affecting communication
- Using gentle background sound, especially in quiet environments or at bedtime
- Tinnitus education and support to reduce distress and improve coping strategies
- Talking therapies where tinnitus is affecting sleep, mood or daily life
The most suitable approach depends on your symptoms, hearing and the impact tinnitus is having on you.
When should you seek help for tinnitus?
Arrange an assessment if tinnitus is persistent, worsening or affecting your quality of life. One-sided tinnitus or pulsatile tinnitus are important warning signs that warrant prompt assessment.
Seek urgent medical help or attend A&E if tinnitus occurs after a head injury, or if it comes with sudden hearing loss, facial weakness, severe spinning dizziness or other new neurological symptoms. Call 999 if you think you may be having a stroke or need emergency assistance.
You should also speak to a clinician if you have:
- Tinnitus in one ear only
- Tinnitus that beats with your pulse
- Sudden or rapidly worsening hearing loss
- Persistent dizziness or recurrent vertigo
- Ear pain, discharge or a blocked ear that does not settle
- Tinnitus that is affecting sleep, work, concentration or emotional wellbeing
Getting the right assessment for ringing in the ears
Persistent or one-sided ringing in the ears should be investigated. An ENT assessment can help identify possible causes, including ear wax, infection, hearing loss or an inner ear condition.
The ENT Consultancy’s specialists can assess your symptoms, examine your ears and advise on appropriate next steps. Early assessment is particularly important where tinnitus is pulsatile, one-sided or accompanied by hearing loss or dizziness.
Contact us today to book a consultation.
Tinnitus symptoms and causes FAQs
- Why do my ears keep ringing?
Your ears may keep ringing because of hearing changes, loud noise exposure, ear wax, an infection or an inner ear condition. Sometimes no single cause is found. If the sound persists or affects one ear only, arrange an assessment.
- Is tinnitus a sign of hearing loss?
Tinnitus can be associated with hearing loss, but not everyone with tinnitus has reduced hearing. A hearing test can help establish whether hearing changes are contributing to the ringing or buzzing you notice.
- Can tinnitus cause dizziness?
Tinnitus does not usually cause dizziness directly. However, both symptoms can occur together when an inner ear condition affects hearing and balance. New or persistent dizziness with tinnitus should be assessed.
- Does tinnitus go away on its own?
Tinnitus may settle when it is caused by something temporary, such as ear wax, an ear infection or recent loud noise exposure. If it continues, management and support can help reduce its impact.
- What is pulsatile tinnitus?
Pulsatile tinnitus is a rhythmic sound that seems to match your heartbeat. It may sound like whooshing, pulsing or thumping. Persistent pulsatile tinnitus should be assessed promptly.
- When should I see a doctor about tinnitus?
Seek advice if tinnitus is persistent, one-sided, pulsatile or affecting daily life. Urgent help is needed if it occurs with sudden hearing loss, facial weakness, severe vertigo or after a head injury.
