Ringing in the ears is called tinnitus. Ringing in the ears may occur with dizziness or vertigo for some patients, but not all.
For that reason, I frequently talk to my patients about ringing in the ears and what they can do about it.
In this blog, I will break down this topic into the five major root causes I see in my practice and offer helpful suggestions for each root cause.
At the end of the blog, I also offer five general recommendations for people with tinnitus.
Episodic Tinnitus from Meniere’s Disease
Tinnitus is a cardinal symptom of a classic Meniere’s episode, which occurs as an isolated episode. However, tinnitus during a Meniere’s episode is usually a loud roaring or rushing noise.
During a Meniere’s attack, the loud ear noises typically also occur with reduced hearing in that ear. All of which should resolve when the Meniere’s attack is over, along with any dizziness, vertigo, and imbalance. The frequency of the ear noise is constant for about 20 minutes to four hours, and may last up to 12 hours.
What to Do
Medication management and dietary changes are the most common treatment plans for these cases.
Medication Side Effects Can Cause Tinnitus
Some medications can cause ringing in the ears as a side effect. This can start right away or take a few weeks to build up. These medications are called “ototoxic.”
Sometimes ototoxic medications cause temporary ringing in the ears, which may be reversible when the medication is stopped. An example of this may be occasional use of non-steroidal anti-inflammatory medications like ibuprofen.
Other ototoxic medications can cause permanent damage to the ears, thereby causing permanent, irreversible tinnitus. An example of this may be certain antibiotics and cancer drugs.
What to Do
If you started noticing ringing in the ears after you started a new medication, talk to your doctor.
Your doctor may adjust your dosage or switch you to a different medication with fewer side effects. Or you may need to stay on the medication for the benefits and tolerate the ringing in the ears.
Industrial Exposure to Loud Noises Can Damage Ears
For patients with more constant ringing in their ears, I usually ask about their occupation or vocational background. Patients with a history of industrial or occupational exposure to loud sounds may have permanent ringing in their ears due to damage to the hair cells caused by their work.
In these cases, patients may also have noise-induced hearing loss (NIHL) that co-occurs with the ringing in the ears.
For example, people who use power tools for woodworking, test jet engines, or do audio recordings or podcasting with headphones on all day may develop ear damage over time. This may correlate with the onset of the ringing in their ears.
Industrial exposure to loud sounds usually causes irreversible tinnitus.
What to Do
If this sounds like you, the best suggestion I can make is to either switch careers or recognize the choice you made to sacrifice your ears due to your work.
You can also look into ear protection you can wear or strategies within your industry to protect your ears.
Cervicogenic Tinnitus From Your Neck
Perhaps the most overlooked cause of ringing in the ears is upper cervical issues. If your ears are ringing off and on intermittently or creating a pulsating sound intermittently, then it is possible that your neck is the cause.
Cervicogenic Tinnitus can occur after trauma to the head or neck, which is commonly known. However, I have found this cause in many patients with neck stiffness but no history of trauma.
I especially suspect this root cause if the ears start ringing at night in bed, while reclining to watch TV, working on the computer, or texting on a smartphone.
What to Do
For this type of tinnitus, I suggest that patients straighten up their necks. You can move your head and neck to change the position of your head, then see if you can get the ringing to go away.
You may need to work on body mechanics, posture, and sleeping position to prevent this problem from recurring.
For example, my husband was lounging in a recliner last week, and he said his ears were starting to ring. I advised him to sit up straight and straighten out his neck. Within a few minutes, his ears stopped ringing.
Sometimes, my ears start ringing at night while I am falling asleep. If I adjust my pillow and micro-adjust my neck position, my ears will stop ringing. When that happens, I know my neck is in better alignment to maximize the blood flow to my ears.
If improving your posture or straightening up your neck helps, or ibuprofen relieves your tinnitus, then I suggest you seek upper cervical care.
Check out this blog on Who Can Help with Upper Cervical Dizziness.
Normal Aging of the Ears can Cause Tinnitus
For some patients with age-related hearing loss, tinnitus may be a natural part of the aging of their ears. This does not happen to all older adults, but it may occur as part of normal aging.
If the patient is over 65 years old and has noticed the gradual onset of ringing in the ears as hearing has declined, then this may be the root cause.
This condition is called presbycusis and is caused by the gradual effect of normal aging on the hearing apparatus.
What to Do
In this case, I suggest getting a hearing exam. An audiologist may be a helpful resource for patients with age-related hearing loss and tinnitus.
Five General Recommendations for People with Tinnitus
1. Talk to Your Doctor
Talk to your doctor if you have ringing in your ears, so you can determine a treatment plan that’s right for you. Sometimes, certain underlying medical conditions may be the cause of ringing in the ears, so your primary care provider will be the key to detecting the root cause.
Medical conditions such as thyroid disorders, autoimmune conditions, or blood flow problems like high blood pressure may be addressed by your doctor to help you get relief.
2. Consult a Specialist if Needed
Your primary care provider may refer you to a specialist, like an ENT (ear, nose, and throat) or audiologist, for further testing.
Sometimes tinnitus is a sign of an ear problem like an ear infection, buildup of earwax, inflammation in your ears, or even a foreign object lodged in your ear. Medical treatment by an ear specialist can resolve tinnitus for some patients.
3. Consider Lifestyle Changes
Stress, anxiety, and depression can make tinnitus feel worse. Stress management and treatments for anxiety or depression may help in some cases.
In some cases, cutting down on cigarette smoking, alcohol consumption, or caffeine may help reduce tinnitus.
4. Research Tinnitus-Canceling Hearing Aids
For those of you with tinnitus that’s permanent due to ototoxic medication side effects, hearing loss, or industrial exposure or other causes, there are now Tinnitus-canceling hearing aids.
If you have a couple of thousand dollars to try out a pair, they may be able to give you relief. The technology is fairly new and fascinating. This has been helpful for some of my patients.
5. Background Noise and Sleep Hygiene
A less expensive solution is to use soft music or a white noise machine for sleeping. If tinnitus keeps them awake, some patients take supplements to relax their nervous system to help with sleep or implement a sleep hygiene routine.
I hope that information was helpful. I hope you find answers and get relief soon from the ringing in your ears.
Disclaimer
This blog is provided for informational and educational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.
