Everything seems just fine until you settle into bed for the night in your nice, quiet room. Suddenly, you notice an annoying ringing in your ears that won’t go away. What is it and why is it happening?
That aggravating sound has a technical term: tinnitus. According to the American Tinnitus Association (ATA), it’s a sensorineural reaction in the brain to damage in the ear and auditory system. In layperson’s terms, it’s the loud, irritating and relentless ringing or buzzing sound in the ear. The ringing can be intermittent or continuous; some people find it intrusive and burdensome while others aren’t bothered by it until they get in a quiet room.
“Pretty much any abnormal perception of sound we would term as tinnitus,” says Kristen Angster, MD, senior staff neurotologist in the Department of Otolaryngology, Head and Neck Surgery at Henry Ford Health System in Detroit. “Some people describe it as a ringing sound, while some hear a buzzing, clicking, pulsing or whooshing sound,” she explains.
Tinnitus is usually the result of some sort of hearing loss. “The brain recognizes that it’s missing sounds and has this now adaptive feedback loop where it adds sound back in,” Dr. Angster says.
We know ringing in the ears can be absolutely annoying and for some become such a burden that it leads to depression and anxiety. The ATA says that about 50 million Americans experience some form of tinnitus and nearly 20 million people struggle with chronic tinnitus. It estimates that two million people have severe and debilitating cases. We rounded up a few reasons why your ears might be ringing and what you can do about it.
1) Loud Music
Yes, those jams you were blasting through your wireless headphones may have gotten you through your run, but they may have also caused your ears to ring. “That’s what we call a temporary threshold shift from noise exposure, which is noise-induced hearing loss. It is typically temporary and recovers within 72 hours. But it does temporarily decrease your hearing, so you have that ringing in your ears as the result,” explains Dr. Angster. Bottom line: Be careful about how loud you’re listening to your music through your ear buds. Also, if you’re exposed to loud sounds like sledgehammers or drilling due to construction work, protect your ears with earplugs.
2) Too Much Wax
Ear wax is there for a reason—that gooey, sticky substance protects our ears and has antibacterial properties. But a buildup of it can cause hearing loss, which can then lead to tinnitus. But once you get the impacted wax out of your ear, either by these safe at-home methods or by a medical professional if its severe, your hearing usually improves and the tinnitus goes away.
3) Ear or Sinus Infection
Suffering from a cold or an infection in your ears or sinuses could be causing that ringing in your ears. “When we talk about the ear, we talk about it in three parts. The external ear is the canal all the way down to the eardrum, the middle ear is behind the eardrum and the inner ear is really a bony structure within the skull that has the organs for hearing and the organs for balance,” says Dr. Angster. “So depending which part of that system is infected, you can have hearing loss and it may be either sensory neural, if it’s the inner ear, or it could be a conductive hearing loss if it’s the middle ear or the external ear. Treating the infection often will improve hearing depending on where it is.”
Sinus infections usually create abnormal pressure in the middle ear, which can affect normal hearing and cause tinnitus symptoms. If you suspect you have an ear or sinus infection, see your primary care physician or ENT, who may prescribe an antibiotic to clear up the infection and possibly a steroid to alleviate the tinnitus.
Tinnitus can be a side effect of certain prescription meds such as antibiotics, nonsteroidal anti-inflammatory drugs, and diuretics (water pills), and even OTC pills like aspirin. In addition to that, quinine-based medications may also lead to ringing in the ears. A full list of possible tinnitus-inducing meds can be found here. Talk to your doctor if you’re on any of these medications and experiencing ringing in your ears.
5) Head Injury
Remember when you hit your head on the cabinet—really hard—while making a cup of coffee? That could also be the reason for your tinnitus. “There are several things that can happen with a blow to the head. Obviously, something really severe can cause a fracture of the skull, which can get passed through the bones of the middle ear and even through the ear canal or middle ear,” says Dr. Angster. “More commonly, a blow to the head causes blood behind the eardrum which resolves over a period of about six weeks and people’s hearing recovers.”
When you get a concussion, you can actually get a concussion of the inner ear which can cause hearing loss, dizziness, or some ringing, she says. Your inner ear—and the ringing that came with the trauma—usually spontaneously recovers. But if you have a lot of dizziness or if your hearing doesn’t recover on its own after a few days, see a doctor for further evaluation.
More than a year into the pandemic, we’re learning of different troublesome ailments and long-term effects caused by Covid-19. Tinnitus has been one of them, although there have only been a few studies reporting on the issue. One study published in the journal Frontiers in Public Health found that out of the more than 3,100 people surveyed with tinnitus, 237 respondents said they’d suffered coronavirus symptoms and about 40 percent of that group said their tinnitus worsened. Dr. Angster says it’s still too early to link tinnitus with covid-19. “Yes, I’ve seen some patients have tinnitus as part of having covid-19, but it has not been as widespread as loss of smell, obviously. I think we’ll learn more about it as we do retrospective chart reviews. It’s something we’re still paying attention to.”
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