Tinnitus, also known as ringing in the ears, is the perception of sound without an external source. This condition can be temporary or persistent and affects millions of people worldwide. Symptoms include ringing, buzzing, or other noises heard in the ears, and causes can range from prolonged noise exposure, stress, and circulatory issues to inner ear disorders. Correctly identifying the underlying causes is essential for effective tinnitus treatment.
What is Tinnitus?
Tinnitus is an abnormal auditory sensation characterized by hearing sounds such as ringing, buzzing, clicking, or whistling without an external source. It is not a disease itself but a symptom associated with hearing or medical problems. Individuals affected by tinnitus may experience intermittent or constant sounds, with varying intensity.
Types of Tinnitus
Tinnitus can be classified into several types, depending on the characteristics and duration of the perceived sound:
Subjective
This is the most common type of tinnitus, heard only by the affected person. It is often associated with hearing loss or exposure to loud noises.
Objective
A rare form of tinnitus that can be heard by a doctor using a stethoscope. It is usually caused by circulatory problems or involuntary muscles in the inner ear.
Acute
Acute tinnitus appears suddenly and lasts less than three months. Causes may include exposure to loud noise, ear infections, or ototoxic medications.
Chronic
This type lasts longer than three months and may be associated with progressive hearing loss or inner ear conditions.
Pulsatile
Pulsatile tinnitus is perceived as a ringing that follows the heartbeat. It is usually caused by vascular problems or abnormalities near the ear.
Causes of Ringing in the Ears
Tinnitus can be triggered by a wide range of factors. The most common causes include:
▪️ Prolonged exposure to loud noise
▪️ Age-related hearing loss
▪️ Inner ear infections or inflammations
▪️ Earwax blockages
▪️ Circulatory problems or high blood pressure
▪️ Head or ear trauma
▪️ Stress and fatigue
▪️ Side effects of certain medications (ototoxic drugs)
▪️ Conditions such as Meniere’s disease or diabetes
▪️ Disorders of the cervical spine or surrounding ear muscles
What are the risk factors?
Risk factors for tinnitus include prolonged exposure to loud noises, aging, inner ear infections, head or ear trauma, chronic stress, high blood pressure, and certain metabolic or neurological conditions. Certain ototoxic medications can also increase the likelihood of developing ringing in the ears.
Symptoms of tinnitus
Tinnitus can be accompanied by a variety of symptoms that affect daily comfort and quality of life. The most common symptoms include:
▪️ Ringing in the ears (constant or intermittent)
▪️ Sounds such as buzzing, clicking, whistling, or hissing
▪️ Increased sensitivity to sound (hyperacusis)
▪️ Difficulty concentrating
▪️ Sleep disturbances
▪️ Irritability or anxiety
Manifestations that may occur alongside ringing in the ears
In many cases, tinnitus can appear together with other conditions or symptoms, such as vertigo, dizziness, partial hearing loss, migraines, chronic fatigue, or cognitive issues. Monitoring these manifestations is essential for accurate diagnosis and appropriate treatment selection.
Diagnosis
Tinnitus diagnosis involves a comprehensive evaluation, including a full medical history, physical examination of the ear, audiometric tests, laboratory tests to detect associated conditions, and, in some cases, imaging studies. Accurate diagnosis allows for identification of causes and selection of the most effective treatment methods.
What is the best treatment for tinnitus?
Tinnitus treatment depends on its cause and symptom severity. Options include medication, natural therapies, and effective integrative treatments.
Medication treatment
Medication may include drugs that alleviate symptoms, reduce inflammation, or manage stress and anxiety associated with tinnitus. In some cases, medications can help diminish perceived noises or improve sleep quality.
Natural treatment
Many people turn to natural remedies, supplements, and stress-management strategies to reduce tinnitus intensity.
Effective integrative treatments
Integrative treatments combine conventional medicine with natural methods and complementary therapies to provide a personalized plan for reducing tinnitus. These include lifestyle changes, relaxation techniques, balanced nutrition, and therapies specifically designed to support inner ear health. Methods such as acupuncture can help relax the nervous system and alleviate symptoms. Other therapies, such as ozone therapy or hyperbaric oxygen therapy and systemic hyperthermia may support circulation and tissue regeneration in the auditory system.
Complications caused by tinnitus
Persistent tinnitus can lead to several complications that affect quality of life. These may include chronic sleep disturbances, heightened stress and anxiety, difficulties concentrating, social withdrawal, and an increased risk of depression. Early management of tinnitus is essential to minimize these effects and maintain overall well-being.
Prevention
Preventing tinnitus involves protecting your ears and maintaining overall auditory health. Key preventive measures include:
▪️ Avoiding prolonged exposure to loud noises or using ear protection in noisy environments
▪️ Managing stress through relaxation techniques, exercise, or mindfulness practices
▪️ Maintaining healthy blood pressure and cardiovascular health
▪️ Limiting ototoxic medications when possible, under a doctor’s guidance
▪️ Regular audiological check-ups to detect early hearing issues
Conclusions
Tinnitus, or ringing in the ears, can significantly impact daily life, but early recognition, accurate diagnosis, and personalized treatment strategies can help reduce symptoms and prevent complications. By combining conventional and integrative therapies, including acupuncture, ozone therapy, hyperbaric oxygen therapy and systemic hyperthermia patients can improve auditory health and quality of life.
Frequently Asked Questions
What does it mean when you hear a ringing in your ears?
Ringing in the ears, also known as tinnitus, is the perception of sound without an external source. It can be temporary, caused by exposure to loud noise or fatigue, or persistent, indicating auditory imbalances or underlying health issues.
Can tinnitus be a sign of a serious illness?
In most cases, tinnitus is not a sign of a serious condition. However, if it is accompanied by sudden hearing loss, pain, dizziness, or other unusual symptoms, it may indicate more serious issues such as vascular disorders, ear infections, or neurological problems, and requires prompt medical evaluation.
At what age does ringing in the ears most commonly occur?
Tinnitus can occur at any age, but it is more common in people over 40 due to prolonged noise exposure, hormonal changes, or natural degeneration of the auditory system.
When is it mandatory to consult a doctor?
Medical consultation is recommended immediately if:
▪️ Tinnitus appears suddenly or severely
▪️ It is accompanied by partial or total hearing loss
▪️ Dizziness, headaches, or imbalance occur
▪️ Tinnitus interferes with sleep, work, or social life
How can you get rid of tinnitus?
Although there is not always a complete cure, tinnitus can be managed through:
▪️ Medications prescribed by a doctor
▪️ Natural and integrative therapies such as acupuncture, ozone therapy, hyperbaric oxygen therapy and systemic hyperthermia.
▪️ Lifestyle changes, hearing protection, and stress management
Bibliography:
Baguley, D., McFerran, D., & Hall, D. (2013). Tinnitus. The Lancet, 382(9904), 1600-1607.
Bauer, C. A. (2018). Tinnitus. New England Journal of Medicine, 378(13), 1224-1231
Langguth, B., Kreuzer, P. M., Kleinjung, T., & De Ridder, D. (2013). Tinnitus: causes and clinical management. The Lancet Neurology, 12(9), 920-930.
https://my.clevelandclinic.org/health/symptoms/14164-tinnitus - Accessed on 13.08.2025
https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156 - Accesed on 13.08.2025
