What is Tinnitus?

Interest in tinnitus and its treatment has grown in recent years, largely due to increasing awareness that tinnitus is the most common service-connected disability for veterans returning from recent military service in Iraq and Afghanistan (Department of Veterans Affairs, 2010). Tinnitus is a medical term for acoustical perceptions heard in the ear(s) or head, but not produced by external sound. EarPuzzleThis sound, which is often described as a ringing, buzzing, pulsing, whistling, or humming, can be experienced in one or both ears with varying intensity, loudness, and pitch. Approximately 50 million people in the United States experience tinnitus at some point in their lives. Around 16 million of these Americans experience tinnitus bothersome enough to consult their doctor. Two to three million are so severely affected by their tinnitus that their ability to function is severely impaired.

Tinnitus is a symptom rather than a disease and may develop from exposure to loud noise; a head injury; aging, outer, inner, or middle ear problems; neck or jaw disorders; cardiovascular disease; or use of prescription or non-prescription drugs. While many theories have been proposed to explain the occurrence of tinnitus, it is a multimodal disorder that may have different causes and different pathophysiologies. This makes tinnitus difficult to treat; oftentimes, interventions meet with only variable success. 

closeupTinnitus can have a major impact on a person’s life. Severe tinnitus is most commonly associated with anxiety, distress, sleep disturbance, and depression. Disrupted sleep is the most significant complaint, affecting as many as 70% of tinnitus patients. Studies report a lifetime prevalence of 62% for major depression, with 48% of people with tinnitus displaying current depression, and 45% reporting an anxiety disorder. Poor attention and concentration, interference with work, and negative impact on personal relationships are commonly reported by patients. Almost all patients indicate that stress or tension makes their tinnitus worse.

Hearing Loss & Tinnitus

Most—as many as 95%—of people with tinnitus have some degree of hearing loss. But not all people with hearing loss have tinnitus (about 50% of people with hearing loss have tinnitus).

EarAlthough we do not always know the exact cause, it is largely accepted that sensorineural hearing loss (loss of hair cells in your cochlea or inner ear) is somehow related. But while the damaged hair cells and the resulting hearing loss is part of the tinnitus picture, it is how the brain processes—or doesn’t process—the sound that is then experienced as the ringing, buzzing, chirping, and roaring that so many with tinnitus describe. For this reason, tinnitus is happening in the brain and not in the ears.

Did hearing loss cause my tinnitus?

Noise exposure is one of the leading causes of hearing loss, which, in some, co-occurs with tinnitus as described above. From loud concerts to blasting music through earphones to power tools, few would argue that noise exposure is an increasing facet of modern living.

Head injuries are another top cause of tinnitus. The natural course of aging can leave us with diminished hearing as well. Once hearing loss occurs, it is hard or impossible to restore, so efforts to reduce noise exposure should start early. As the old adage states, “An ounce of prevention is worth a pound of cure.”