Causes of Tinnitus or Ringing in the Ears

Tinnitus is common; as many as 30 million Americans have the condition. Of this 30 million, 20% report to be disabled by it.

If you have tinnitus, you will hear a sound that is not coming from the environment. Some researchers have also described tinnitus as a “phantom auditory perception.” People with tinnitus most often describe it as ringing, buzzing, cricket sounds, humming, and whooshing—and many other descriptions have been used.

Tinnitus can be associated with anything that causes hearing loss. For example, ear wax or fluid in the middle ear can cause tinnitus. Most commonly, tinnitus is associated with inner ear hearing loss.

Why and How Does Tinnitus Develop?

Tinnitus is believed to be caused by inner ear cell damage. Cilia in your inner ear move in relation to the pressure of sound waves. This triggers the inner ear cells to release an electrical signal through the auditory nerve—a nerve that sends messages from your ear to your brain. Your brain interprets these signals as sound.

Common Causes

The common causes of tinnitus are also often associated with hearing loss. Tinnitus can begin to occur before, after, or around the same time as the hearing loss. Sometimes tinnitus can fluctuate over time.

Noise Exposure

Exposure to loud noises can damage the outer hair cells, which are part of the inner ear. These hair cells do not grow back once they are damaged.

Even short exposure to very loud sounds, such as gunfire, can be damaging to the ears and cause permanent hearing loss. Long periods of exposure to moderately loud sounds, such as factory noise or music played through earphones, can result in just as much damage to the inner ear, with permanent hearing loss and tinnitus.

Medication

Some medications are known to be ototoxic (toxic to the ears or structures of hearing), and some medications list tinnitus as a side effect. For example, some cancer treatments can cause hearing loss.

New medications come out so often that it is difficult to maintain an up-to-date listing. If you want to know if a medication you're taking could cause tinnitus, talk to your pharmacist or look at your medication label.

You should never stop a medication without consulting with your physician, even if you think it may be contributing to your tinnitus.

Age-related hearing loss.

Hearing loss is common with advancing age. This occurs due to nerve damage. Often, tinnitus develop along with age-related hearing loss as a result of the nerve damage.

Earwax

When too much earwax accumulates, it becomes too hard to wash away naturally. This may cause hearing loss or irritation of the eardrum, which can lead to tinnitus. When the earwax is safely removed, tinnitus will usually resolve.

Less Common Causes

Many other medical issues can contribute to tinnitus. Some of these causes can take longer to identify because they aren't common and because the signs and symptoms are not always consistent. And tinnitus is often one of the less common symptoms.

Meniere's Disease

Tinnitus can be an early indicator of Meniere's disease, an inner ear disorder that may be caused by abnormal inner ear fluid pressure. A feeling of ear fullness, vertigo, and hearing loss are other symptoms of Meniere’s disease.

Ear Bone Changes

Otosclerosis is the stiffening of the bones in your middle ear. It may affect your hearing and cause tinnitus. This condition, caused by abnormal bone growth, tends to run in families.

Temporomandibular Joint Disorders

Problems with the temporomandibular joint (TMJ), the joint on each side of your head in front of your ears, where your lower jawbone meets your skull, can cause tinnitus.

Head injuries or neck injuries

Head or neck trauma can affect the inner ear, auditory nerves, or the brain functions linked to hearing. Such injuries generally cause tinnitus in only one ear.

Acoustic Neuroma

Acoustic neuroma is a benign (noncancerous) tumor that develops on the cranial nerve that runs from your brain to your inner ear and controls balance and hearing. Also called vestibular schwannoma, this condition generally causes tinnitus in only one ear.

A Word From Verywell

If you are experiencing tinnitus, it is important to have a complete hearing evaluation. Your audiologist and ear, nose, and throat specialist will consider underlying medical conditions that require treatment before discussing treatment options with you.

To hear some sound samples of what tinnitus sounds like, you can access the American Tinnitus Association website, where they have put together files of different manifestations of tinnitus to listen to for educational purposes.