Tinnitus is the perception of sound when no actual external noise is present. While it is commonly referred to as “ringing in the ears,” tinnitus can manifest many different perceptions of sound, including buzzing, hissing, whistling, swooshing, and clicking.  Millions of Americans experience tinnitus, often to a debilitating degree, making it one of the most common health conditions in the country. The U.S. Centers for Disease Control estimates that nearly 15% of the general public — over 50 million Americans — experience some form of tinnitus. Roughly 20 million people struggle with burdensome chronic tinnitus, while 2 million have extreme and debilitating cases. While tinnitus is common, but it is not a condition on its own. Rather, it is a symptom of another underlying condition. Although severe tinnitus can interfere with your hearing, the condition does not cause hearing loss.

The Connection Between Hearing Loss and Tinnitus

Most people who suffer from tinnitus also experience hearing loss to some degree. The two conditions may be correlated; In fact, some researchers believe that subjective tinnitus can only occur if the auditory system has been previously damaged. The loss of certain sound frequencies due to hearing loss may change how the brain processes sound, causing it to adapt and fill in the gaps with tinnitus. The underlying hearing loss typically results from exposure to loud noises or advanced age:

Exposure to Loud Noise

Exposure to loud or excessive noise can damage or destroy hair cells (cilia) in the inner ear. Because the hair cells cannot be renewed or replaced, this can lead to permanent hearing loss and/or tinnitus. Continued exposure can worsen these conditions, so people who work in loud environments should always wear ear protection. This includes musicians, air traffic controllers, construction workers, military personnel, and first responders. In addition, consider lowering the volume on your iPod and wearing earplugs at loud concerts.

Age-Related Hearing Loss

Also known as presbycusis, age-related hearing loss results from the cumulative effect of aging on hearing. This permanent, progressive, and sensorineural condition is most pronounced at higher frequencies. It commonly impacts people over the age of 50, as all people begin to lose approximately 0.5% of the inner ear’s hair cells annually starting at age 40.

Ear Wax Buildup

If cerumen, commonly known as earwax, accumulates in your ear canal, it can diminish your ability to hear. Your auditory system may overcompensate for the loss, fabricating noises that do not exist. Your audiologist can safely remove the buildup, and in most cases, this will immediately alleviate your tinnitus. Earwax is not the only obstruction in the middle ear that can increase pressure in the inner ear, producing tinnitus. Other examples include dirt, foreign objects, and loose hair from the ear canal.

Ménière’s Disease

A disorder of the inner ear, Ménière’s disease typically affects hearing and balance and may cause debilitating vertigo, hearing loss, and tinnitus. People who suffer from Ménière’s disease often report a feeling of fullness or pressure in the ear (it typically affects only one ear).

Ototoxic Medications

When a medication is ototoxic, it has a toxic effect on the ear or its nerve supply. In damaging the ear, these drugs can cause side effects like tinnitus, hearing loss, or a balance disorder. Depending on the medication and dosage, the effects of ototoxic medications can be temporary or permanent. More than 200 prescription and over-the-counter medicines are known to be ototoxic, including certain antibiotics, some cancer medications, some anticonvulsants, diuretics and water pills, anti-inflammatory drugs, including aspirin, ibuprofen, and naproxen, quinine-based medications and tricyclic antidepressants

Tinnitus and Stress

A healthy lifestyle can reduce the impact of tinnitus. Avoid physical and emotional stress, as these can cause or intensify tinnitus. You may be able to reduce your stress levels through exercise, meditation, deep breathing, or massage therapy. Make sure to get plenty of rest to avoid fatigue and exercise regularly to improve your circulation. Although this won’t eliminate the ringing in your ears, it may prevent it from worsening.

Orange County Physicians’ Hearing Services

If you have been experiencing tinnitus or a hearing loss visit us at Orange County Physicians’ Hearing Services to schedule a hearing test. In many cases, hearing exams completed by one of our skilled audiologists are a key part of a tinnitus assessment. A hearing exam may be able to help identify ear disorders or hearing problems. If an evaluation reveals an underlying condition, then treatment for that condition often relieves tinnitus as well.