What Are the Main Causes of Ringing in the Ears? Topic Guide

What Is Tinnitus (Ear Ringing)?

Ringing in the ears (tinnitus) can have many causes, including hearing loss, blockages in the ear canal, head and neck trauma, jaw joint disorders, severe cold, flu, sinus infection, brain tumors, and others.
Ringing in the ears (tinnitus) can have many causes, including hearing loss, blockages in the ear canal, head and neck trauma, jaw joint disorders, severe cold, flu, sinus infection, brain tumors, and others.

Ringing in the ears (tinnitus) is a condition in which people perceive a noise that seems to originate in the ear or head in the absence of an external source.

The ringing sound may be heard in one or both ears, may sound as if it’s within or around the head, or be perceived as an outside distant noise. The ringing noise may be constant or intermittent. 

39 Causes of Ear Ringing

Ringing in the ears may commonly be caused by exposure to loud noises, such as at a concert or construction site, but tinnitus is usually a symptom of a problem with the auditory (hearing) system. It may be a result of:

  • Hearing loss
    • Age-related hearing loss (presbycusis) 
    • Noise-induced hearing loss
  • Blockages in the ear canal 
    • Excessive ear wax (ceruminosis)
    • Head congestion
    • Loose hair from the ear canal
    • Dirt or foreign objects
  • Head and neck trauma
  • Jaw joint (temporomandibular joint) disorders 
  • Sinus pressure 
    • Severe cold
    • Flu
    • Sinus infection
  • Barometric trauma
    • Diving/snorkeling/scuba
    • Flying (only during extreme, abnormal elevation changes)
    • Concussive explosive blasts
  • Traumatic brain injury, caused by concussive shock
  • Ototoxic Drugs
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin
    • Certain antibiotics, such as aminoglycosides
    • Certain cancer medications
    • Water pills and diuretics
    • Quinine
  • Other underlying health conditions
    • Stiffening of the bones in the middle ear (otosclerosis)
    • Brain tumors
    • Blood vessel or heart disease
    • Genetic or inherited inner ear disorders
    • Neurologic disorders
    • Severe anxiety
    • Tumors within the auditory system
    • Ear and sinus infections
    • Ménière’s disease
    • Thoracic outlet syndrome
    • Otosclerosis
    • Hormonal changes in women
    • Thyroid abnormalities
    • Anemia
    • Lyme disease
    • Fibromyalgia
    • High blood pressure 
    • Hardening of the arteries (atherosclerosis)
    • Depression, anxiety, stress 
    • Tumor-Related Disorders (very rare)
      • Acoustic neuroma
      • Vestibular schwannoma 
      • Other tumorous growths

What Are Symptoms of Ringing in the Ears?

Ringing in the ears (tinnitus) involves the perception of sound without the presence of an external source for that sound. 

  • The sound from tinnitus may be characterized as: 
    • A high-pitched steady tone (ringing) 
    • Buzzing
    • Roaring
    • A pulsation that is rushing or humming 
    • Chirping
    • Swishing
    • Clicking
    • Whistling
    • Hissing
    • Sound may vary in intensity with exercise or changing body position
  • Symptoms that may accompany ringing in the ears include:
    • Depression
    • Insomnia

How Is Ringing in the Ears Diagnosed?

Ringing in the ears (tinnitus) is diagnosed with a patient history and a physical exam of the ear canal to check for earwax or other blockages in the ear canal. 

Tests used to diagnose the underlying cause of ringing in the ears include: 

  • Hearing tests, including audiogram or auditory brainstem response (ABR)
  • Blood pressure measurements
  • Brain imaging 
    • Magnetic resonance imaging (MRI) scan
    • Computed tomography (CT) scan
  • Blood tests for hyperthyroidism 
  • Spinal tap to measure the fluid pressure in the skull and spinal cord (in rare cases)

What Is the Treatment for Ringing in the Ears?

There is no cure for ringing in the ears (tinnitus), but treatments can help. Treatment varies based on the underlying cause, the severity of the condition, the patient’s overall health, and patient preferences.

Treatment for ringing in the ears includes: 

  • Treatment for hearing loss 
    • Hearing aids 
    • Cochlear implants 
    • Surgery to the outer or middle ear
  • Behavioral therapies to cope with ringing in the ears
    • Tinnitus retraining therapy (TRT)
    • Masking devices 
      • Devices that resemble hearing aids which produce low-level sounds to help reduce or eliminate ringing in the ears
      • Use of white noise
    • Biofeedback and stress reduction 
    • Cognitive behavioral therapy: teaches patients to manage psychological responses to ringing in the ears using coping strategies, distraction skills, and relaxation techniques
  • Stopping medications that are causing ringing in the ears
    • Never stop taking a prescribed medication without first talking to your doctor
  • Treatment for temporomandibular joint (TMJ) disorder 
    • Bite realignment
    • Dental treatment 
  • Other therapies 
    • Acupuncture
    • Electrical stimulation: certain parts of the inner ear are stimulated using electrodes placed on the skin or using acupuncture needles 
    • Repetitive transcranial magnetic stimulation (rTMS) (experimental)
  • Treatment for insomnia that may accompany ringing in the ears
    • Behavioral changes to improve sleep
    • Sleep medicines
  • Treatment for depression that may accompany ringing in the ears
    • Antidepressants