What is Tinnitus?

Talking about hearing. Image courtesy Aston Hearing.

And what is the best way to cope?

Tinnitus is often considered as something that occurs in the ears but actually it originates in the brain. Tinnitus is not a disease itself but can occur as a result of damage to the inner ear or can act as an early warning system as a symptom of another underlying condition, says award-winning audiologists Aston Hearing from Bucks, as part of Tinnitus Awareness Week on 3rd to 9th February.

Tinnitus is an internal sound which you can hear that does not have an external source. Tinnitus is characterised by a ringing, hissing, buzzing, humming or whistling sound that can vary in pitch from high to low and can also be a combination of sounds and can be continuous or come and go.  About 30% of people will experience tinnitus at some point of their lives, with 10% experiencing persistent tinnitus.   It can occur in people of all ages including children and in people with ‘normal’ hearing.

Paula Cook, 2019’s British and European audiologist of the year from Aston Hearing says: “Tinnitus can be very intrusive and depressing for an individual to live with as they are forced to hear a sound over which they seem to have no control, but we have an ever increasing understanding of how the brain is generating the sound and how to deal with it.”

Tinnitus comes from the brain not the ears

Our brain is updated constantly with new information, even though we are unaware of much of it, and we continually receive neural signals from our ears about what is happening in our environment and try to process this information.  You may suffer from hearing loss but not perceive it fully due to its high frequency nature, as such electrical signals from the ear diminish but the brain is still on alert and waiting for the information. This is often when symptoms of tinnitus can appear. In its efforts to make sense of this situation, the brain may become increasingly alert to previously ignored electrical signals and these are perceived as new sounds. Tinnitus therefore is actually brain activity, rather than in the ear itself.  Cook describes it occurring when “The brain hasn’t got enough auditory data so it thinks it will be really helpful and fills in the gaps.”

What causes tinnitus?

The most common cause of tinnitus is damage to the cochlea or the inner ear. This can occur from exposure to noise, such as at a loud music event or from gunfire, or from an infection. Sometimes certain prescription drugs cause tinnitus as a side effect and if your ear is blocked with ear wax this can make you very aware of tinnitus.

Tinnitus is not always caused by a change in the ears however and can act as an early warning. Changes in blood pressure, especially high blood pressure, or changes to the limbic system can also cause tinnitus which means the tinnitus can be a useful ‘red flag’ of a more serious condition. Any sudden drop in hearing, often accompanied by tinnitus, should be assessed quickly as this could be due to Sudden Sensorineural Hearing Loss (SSNHL). Tinnitus can also start after a period of significant stress and anxiety, a traumatic event or decreased general wellbeing. You are much more sensitive when feeling unwell or in an anxious state so may start to hear this extra electrical signal. As the brain detects a change it will try to make adjustments which can result in tinnitus.

Fiona Holmes, 35 from Milton Keynes, developed tinnitus after having her baby. She has no detectable hearing loss according to her audiologist. “My tinnitus started after I had my baby and I really noticed it after seeing a particularly loud film at the cinema. I was devastated at first, it disturbed my sleep and I was very concerned that it would get worse. I am getting more used to it and it is affecting me less, however I am wary of loud places and carry ear plugs with me. When I’m busy I don’t notice it, but when the house is quiet it can be distracting. Or it catches me by surprise, during a quiet moment at my Pilates class or when I switch the engine off in my car. I sleep listening to ‘rain fall’ white noise which really helps.”

Cook says: “There are ways to help us cope with tinnitus.  New nerve pathways can be made, and with time and practice, the brain can be trained to habituate to the noise associated with tinnitus. This requires retraining our thought patterns to separate out meaningful stimuli from those which are not relevant.”


  1. Seek Help – Tinnitus is a complex issue and there is no miracle cure for its symptoms. The best approach is to firstly quickly seek specialist audiology support either via your GP or privately to obtain advice and information on how to help manage tinnitus and its side effects. Armed with an understanding of the condition and an individual plan of action, you can reduce the negative impact of tinnitus on daily life.


  1. Counselling – Since tinnitus is very closely related to emotional stress, counselling can often help, especially when tinnitus is significantly impacting your mental health and well-being. Studies have shown that those who usually suffer from short-term tinnitus are likely to be experiencing high levels of stress during that time period. Cognitive Behavioural Therapy (CBT) is fast becoming a popular and effective treatment for some tinnitus, as are relaxation or mindfulness techniques.


  1. Hearing Devices – It is estimated that 80% of tinnitus cases are accompanied by some degree of hearing loss. Wearing hearing devices certainly seems to help to manage symptoms better. Hearing aids enhance the sounds you want to hear, such as voices and music, which can appear to lessen the noises associated with tinnitus.


  1. Sound Therapy – Hearing technology is advancing rapidly, and many hearing aids now have specialised tinnitus programmes such as ambient sounds for quiet settings as a distraction from the tinnitus. Tinnitus is usually more noticeable whilst lying in bed when it’s quiet so other background noises known to aid sleep through distraction include a ticking clock, soft music, pleasant white noise or a quiet television.


  1. Relax – Fatigue has been proven to influence tinnitus so make sure you have time to relax and have ‘me time’. Take time to read a book or engage in some breathing exercises; do whatever you feel is necessary to relax your mind and body and try to ensure good quality sleep when possible.


  1. Volume control – You may want to avoid very loud sounds such as music concerts and building sites. If you work in either of these industries protect your ears from loud noise. Exposure to loud noise can damage hair cells within the ear which can in turn cause and worsen tinnitus.


  1. Speak to someone – Tinnitus can at times be very trying on our mental health. Tinnitus sufferers can feel alone and distant from those who hear normally. Talk to your friends, family and colleagues about how you feel, which will also help them better understand your situation. Sometimes joining a specialist tinnitus forum may help so you can talk to others going through the same thing.


  1. Getting used to it – It is much easier said than done but if your tinnitus doesn’t go away then most likely it will be something you get used to living with. Get help and take all the time you need.  Tell schools or workplaces so they can understand how to help you. If you are studying for example you may be given longer time to do your exams.