Tinnitus (Ringing in the ears)

Tinnitus is the perception of sound (ringing in the ears) that can only be heard by the sufferer. It is not a disease but rather a health issue that affects approximately 15% of adults. The duration, intensity and frequency of noises vary from person to person. There are two types of tinnitus – subjective and objective. Subjective tinnitus, although more common, remains difficult to explain. Objective tinnitus can be the result of a circulation problem in the neck, uncontrollable muscle contractions or an ear defect. The noise from objective tinnitus can be so loud that another person can perceive an actual sound emanating from the affected person’s ear!


There are a wide range of underlying causes for tinnitus with the most common being acoustic trauma. When the ear is exposed to sounds in excess of 85 decibels, the tiny hair cells in the inner ear gradually become damaged. The role of these hairs is to relay sound. Repeated damage to these hairs can lead to tinnitus. To give you an idea, the sound of a conversation is about 60 decibels whereas the music in a nightclub can reach 110 decibels.

An ear infection or wax in the ear can also cause tinnitus. Loss of hearing, jaw joint problems and certain medications can be the source of ringing in the ears as well. Tinnitus is also a symptom of certain diseases. High blood pressure and arteriosclerosis (hardening of the arteries) are examples of diseases that are known to cause this disorder.

Persons most at risk

The elderly are more at risk of developing tinnitus. As we age, our hearing ability is reduced which leads to a loss of hearing. That hearing loss can, in turn, cause tinnitus. People who are exposed to loud noises are also more at risk as are industrial workers, people who live in cities with high population densities, musicians, truck drivers and individuals who spend time in nightclubs.


The most common symptoms include:

  • High pitched whining, buzzing, hissing, humming, whistling, ticking, clicking or roaring (ranging from mild to intense and occurring intermittently or permanently)
  • Concentration problems
  • Insomnia
  • Irritability
  • Depression
  • Vertigo and nausea


A family physician can diagnose tinnitus. During the course of your physical examination, the physician may ask you about your medical history and inquire about medications you are taking as well as your lifestyle. A magnetic resonance imaging (MRI) may also be recommended. The physician could also refer you to an ear, nose and throat specialist (ORL). The ORL specialist may conduct a hearing test to assess your level of deafness as well as an otoscopic test to see if there is cerumen (earwax) in the ear, in addition to auscultating your neck and ears.


The first treatment objective is to eliminate the cause of the tinnitus. If the cause is wax build-up, the physician may decide to unblock the ear. He may also try to treat the disease responsible for the tinnitus (hypertension, for example). A dentist may also be asked to conduct specific dental treatments if there is a jaw-related problem. Medication or dosage changes could also be made in an effort to reduce the ringing. It is extremely important that you consult a pharmacist before making any changes to your medication.

Another treatment option is tinnitus masking. This involves using a device that emits constant and pleasant white noise. Since the sound is slightly louder than the noise of the tinnitus, the body becomes accustomed and the nervous system adjusts so that only relevant noise is perceived. This technique often makes use of rushing water or nature sounds.

Lifestyle changes may also help reduce tinnitus. Good stress management practices are a sure way for many to reduce tinnitus spells. Certain types of therapy offer relaxation, visualisation and sleep management techniques. Certain foods should also be avoided in an effort to reduce tinnitus. Salt, saturated fats, allergy-causing foods and stimulants (alcohol, caffeine and tobacco) are all foods that should be eliminated from one’s diet.


It is advisable to avoid loud noises or to wear ear plugs in noisy environments to help prevent tinnitus. Exercise also helps prevent ringing in the ears. Since one of the underlying causes of tinnitus is connected to cardiorespiratory health, improving one’s fitness level reduces the risk of developing tinnitus.