What Are the Causes of Ringing in the Ear?

What Are the Causes of Ringing in the Ear?
What Are the Causes of Ringing in the Ear? (Image: Flickr_ende)

Exposure to loud noise can cause tinnitus. You may have heard it after going to a concert or club. It's a ringing sound that lasts for hours, sometimes days. Usually it goes away but sometimes it remains permanent. Some people have tinnitus that can be treated by treating the cause. You see, tinnitus is a symptom of a problem; not a cause. And there are many causes.

Types and description

There are two type of tinnitus: subjective and objective. Subjective tinnitus is the most common and cannot be heard by anyone except the patient. With objective tinnitus other people can hear the sound by simply placing your ear next to the patient's ear. Most often the sound is pulsatile, like a heartbeat. Tinnitus is usually a ringing sound, but it has also been described as the hum from power lines, hissing air, radio static, crickets, buzzing, roaring, screeching, pulsing and many other kinds of sounds. Sometimes two sounds are heard at the same time. This is called diplacusis.


Ringing in the ears, or tinnitus, can occur in the left ear, right ear or both ears. In some cases, it is in both ears but louder on one side. Tinnitus can also be central. This is when the sound occurs in the head rather than in the ears.

Ear damage and tinnitus

The majority of people who have tinnitus also have some degree of hearing loss from inner ear damage.
Noise exposure and age-related hearing loss or presbyacusis top the list of causes, followed by labyrinthitis and Meniere's disease. Dizziness, vertigo, fluctuating hearing loss and tinnitus are common symptoms of labyrinthitis and Meniere's disease. When earwax builds up in sufficient amounts to block your hearing, the existing tinnitus becomes louder. Usually when the wax is removed the tinnitus returns to its previous levels. Many people with outer and middle ear infections experience tinnitus. Fortunately, the tinnitus goes away with successful treatment of the infection.

Temporomandibular joint (TMJ) misalignment

TMJ or jaw misalignment can cause tinnitus. Causes of the misalignment range from uneven bite and habitual teeth grinding to disk erosion and arthritis. The tinnitus is reversible with proper treatment by a dentist or orthodontist.

Cardiovascular disorders

People having cardiovascular disorders describe a murmur, pulsing or swishing sound that is in rhythm with their heartbeat.
Conditions that restrict blood flow such as head and neck tumors, atherosclerosis, arteriovenous malformation (AVM) and glomus tumors of the middle ear cause tinnitus. High blood pressure or hypertension is associated with tinnitus.

Medication and tinnitus

Some medications that are toxic to the inner will cause or worsen tinnitus and cause permanent hearing loss or deafness. Certain antibiotics have tinnitus as a side effect. The "mycin" family of antibiotics, such as erythromycin, streptomycin, vancomycin, kanamycin, tobramycin and gentamycin, all have tinnitus as a side effect. High doses of salicylates (aspirin) for pain and arthritis (12 or more 325 mg tablets per day) will cause reversible tinnitus and hearing loss.
Certain antidepressants, such as Wellbutrin SR, and anti-anxiety medications, such as Xanax SR have tinnitus side effects. Prevacid NarpraPAC 375 for heartburn and acid reflux (GERD) has been noted to cause tinnitus.
Reports of hearing loss and tinnitus have been linked to erectile dysfunction drugs, such as Viagra. Other medications that cause permanent hearing loss and tinnitus include platinum-based chemotherapy drugs, such as cisplatin; Ethacrynic acid and furosemide diuretics (water pills) to reduce water retention; and quinine medication for nighttime cramps and malaria.

Contributing factors

Stress, fatigue, lack of sleep or insomnia, depression, anxiety, increased caffeine, nicotine and alcohol make tinnitus worse. These factors and tinnitus feed on each other with the tinnitus causing more stress and the stress making the tinnitus worse.
This "vicious cycle" can be so disturbing and life-altering that it can drive some people to consider suicide.

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