Patient information from BMJ

Tinnitus

Last published:Nov 16, 2023

Having tinnitus can be upsetting and frustrating. There is no single treatment that will cure it completely. But there are things you can do to help you cope with tinnitus.

What is tinnitus?

If you have tinnitus you hear ringing or other sounds in your ears most of the time, when there is nothing outside causing the noise. Some people hear the sounds in both ears and some people hear them in one ear only. It doesn't harm your ears.

Tinnitus is a symptom, not a disease. This can make it hard to treat. Many things can cause tinnitus, including:

• damage to the ear from being exposed to loud noise (for example, from machinery or loud music)

• ear infection or blockage (for example, from ear wax)

• some medicines, especially non-steroidal anti-inflammatory drugs. This is the group of drugs that includes ibuprofen and naproxen.

• a condition called Menière's disease. This can also cause dizziness, hearing loss, and a feeling of pressure in the ear.

• a type of benign (non-cancerous) growth called a vestibular schwannoma. These slow-growing lumps can cause tinnitus if they press on the nerve that carries sounds to the brain. 

Many people who get tinnitus have lost some of their hearing.

What are the symptoms?

You may hear noises in your ears, such as ringing, roaring, clicking, hissing, and buzzing.

The sounds happen most of the time, but they can come and go. If the tinnitus is very bad, it may be difficult to concentrate or sleep.

Your doctor will refer you for a hearing test. You should also have your ears checked to see if wax or an infection is causing the tinnitus. You may need another test, called a magnetic resonance imaging (MRI) scan, to see if something in your ear or brain is causing the problem (for example, a vestibular schwannoma). 

What treatments work?

There is no treatment that can get rid of tinnitus altogether. But there are lots of things you can try to improve it, so that it doesn't take over your life. Many people find their tinnitus bothers them less once they know it is not caused by anything dangerous.

Tinnitus can cause problems such as anxiety, loss of sleep, and depression. Treatment is often aimed at reducing these effects.

You may be offered a type of psychotherapy or 'talking treatment' called cognitive behaviour therapy to help you cope with tinnitus. This therapy helps you to adjust to having tinnitus and worry about it less.

A hearing aid may help if you have hearing loss. You can also try a masking device, to make the tinnitus sounds less intrusive. This can be helpful if tinnitus is making it hard to get to sleep or to work. You can get masking machines that are small and worn near the ear, like a hearing aid. Some people find it helpful to play quiet background music.

If you have depression or anxiety as well as tinnitus, you may be offered antidepressant medicines. These may help reduce the symptoms of tinnitus but they may also have side effects.

Some people try alternative treatments, such as hypnosis and acupuncture. There isn't much good research about whether they work, but they seem to help some people.

If the tinnitus is caused by a specific condition, your doctor may refer you for treatment for that condition.

What will happen to me?

Your doctor will make sure the tinnitus is not being caused by a serious problem.

Most people learn to manage their tinnitus well and notice it less over time. It may help to avoid loud noises or to use ear plugs when you are in loud places. You may be advised to avoid certain drugs that can cause damage to the ear.

You may need to try a few options before you find a way of dealing with tinnitus that works for you.