Ringing in Ears
Tinnitus, commonly known as ringing in the ears, is a condition where individuals hear intermittent or extended periods of sound not generated by an external source. This noise is often described as a clicking, buzzing, or ringing that takes place inside the individual’s head. Ear ringing can have varying pitch and can occur in one or both ears.
Most individuals have experienced a form of ringing in ears due to being in close proximity to a violent sound, such as the explosion of a firecracker. This ear ringing is temporary and usually dissipates within a few minutes or a few hours, depending on the severity of the noise. However, on some occasions this ringing in the ears will return years later without provocation. Of the close to 36 million Americans who suffer from ringing in the ears, 7 million cases are of such a severity that those affected cannot perform even the simplest of daily functions. Tinnitus has been linked to hearing loss and impairment. It can also be a symptom of a separate physical or psychological issue, such as heart disease, allergies, or persistent stress. It can also be a side effect of certain medicines or excessive nicotine and alcohol intake. However, the majority of cases regarding ear ringing are relatively mild. Currently, there is no cure for ringing in the ears, with most treatments focused on helping patients tolerate the effects of the noise.
Causes of Ringing in Ears
Typically, ringing in ears is caused by exposure to loud noise. Exposure to such noise may not only predispose individuals to short term ringing, but may lead to tinnitus later on. This sound can take the form of a single exposure, as with a gunshot, or an extended period of noise, as with a rock concert. Other examples of such noises include woodworking and construction areas, firecrackers, and explosions. At higher decibels these sounds can damage the hair cells and nerves inside the ear.
Ear ringing can also be exacerbated by existing conditions such as allergies, excessive wax, ear infections, or previous damage to the eardrum. Other diseases such as heart conditions, tumors, or head injuries can also cause ringing in the ears, although the relationship between these symptoms has yet to be discovered. As tinnitus can be the first sign of a more deleterious illness, it is critical for doctors to pinpoint the underlying condition behind it.
Studies have shown that tinnitus may be a side effect of taking medication. This includes commonly used drugs such as aspirin or alcohol, as well as stronger medicines such as antibiotics, anti-inflammatory medication, stimulants, sedatives, and anti-depressants. In these instances, the ringing in ears generally subsides when patients cease taking the medication.
Symptoms of Ringing in Ears
Individuals who have suffered from ear ringing have described the noise as a ringing, clicking, whistling, buzzing, hissing, pulsating, roaring, or blowing sound. This sound can be constant or come in intermittent bursts. It can affect either or both ears. In some cases, tinnitus itself is a symptom or precursor to hearing loss. However, not everyone who experience ringing in the ears will develop long term loss of hearing.
Long Term Risk Factors
Individuals who are subject to protracted or intermittent noise can be predisposed to ear ringing. While scientists have yet to determine the specific cause of tinnitus, a strong correlation exists between the disease and exposure to loud noise. Studies have revealed that 90 percent of all those diagnosed with tinnitus have previously experienced some degree of hearing loss as a result of a loud noise. Although the exact decibel level at which hearing loss occurs can vary from person to person, generally experts agree that prolonged exposure to sound at over 85 decibels will result in some form of hearing impairment. For comparison, a hair dryer roars at a level of 90 decibels, city traffic is generally about 80 decibels, and a normal conversation is approximately 60 decibels.
Not all ringing in ears issues, however, are solely the result of loud noise exposure. A pre-existing medical condition such as allergies, ear or sinus infection, injuries to the head or neck, thyroid disorders, tumors, earwax, or heart disease, can increase the risk of ear ringing. Individuals with rheumatoid arthritis may take anti-inflammatory agents or other medications that may induce tinnitus symptoms.
Ear ringing can come in a cornucopia of different sounds and pitch, much of which varies depending on the nature of the person’s specific malady. Individuals who experience ringing in the ears should notify their physician immediately. A doctor can perform tests to determine whether or not the ear ringing is a symptom of a more serious underlying medical condition, at which point they can refer the patient to a specialist who can provide a thorough examination of the issue. Examples of such conditions include high blood pressure, improper diet, allergies, or kidney disorders.
Ear specialists will normally perform strenuous examination of the ears and perform tests to evaluate a patient’s hearing. As the root cause may lie in adjacent areas such as the nose and throat, an otolaryngologist may be brought on as well. An audiologist may be asked to administer a comprehensive hearing test to determine whether the cause is rooted in the acoustic nerve or the inner ear. As unilateral hearing loss damage can imply the existence of a tumor, it is vital that a specialist isolate the cause of the tinnitus quickly to expedite treatment of any underlying disease.
Ringing in ears can develop from issues with either the middle or inner ear. At times, the type of sound can be used as a preliminary diagnosis for underlying diseases. For example, tinnitus with a palpitating, throbbing sound may be a symptom of heart disease. Pulsing sounds are often an indicator of pulsatile tinnitus, in which case a physician may administer an angiogram. An angiogram is a special type of X-ray which is employed after a dye is injected into a patient’s bloodstream. An angiogram can highlight weak spots in the veins or arteries, as well as miniscule tumors that have developed in a patient’s veins. Other common imaging tests such as CT scans or MRIs can allow a physician or specialist to examine the brain and ears.
Tinnitus Prevention and Screening
Preventing ringing in ears begins with avoiding exposure to loud noises. However, in instances where loud noises cannot be avoided, using earplugs can help mitigate the risk of tinnitus and hearing impairment. Cotton balls and other makeshift alternatives, however, do not provide adequate protection and can become ensconced in the ear canal, resulting in further damage. Generally, over the counter earplugs can be found at most drug and sporting goods stores at relatively affordable prices. These earplugs can come in variety of sizes and forms to suit an individual’s preference, including foam, rubber, silicone, and wax.
As tinnitus can result from either a single exposure or continuous streams of noise, it is important to take precautions even in situations where high decibel levels are infrequent. Nevertheless, specialists believe that prolonged exposure to loud noises can make one particularly susceptible to hearing damage. Many of these exposures can occur while performing daily activities. For example, a lawnmower can generate noise of approximately 90 decibels, and continuous exposure at such a level can lead to gradual hearing loss. A jet engine at a distance of 100 feet can induce noise levels around 140 decibels. Those who are exposed to such noises on a regular basis as a result of their occupation should take special care to prevent damage to their hearing. In some cases, over the counter earplugs may not suffice. Individuals who are exposed to high decibel levels frequently should consult a physician with regard to obtaining adequate protection for their given situation.
A Decibel Comparison of Common Noises
- Standard Conversation – 60 to 70 decibels
- Leaf Blower – 70 to 90 decibels
- Ambient Traffic Noise – 85 decibels
- Hair Dryer – 90 decibels
- Subway Train (200 feet) – 95 decibels
- Portable Music Player – 95 decibels
- Jet Engine (100 feet) – 140 decibels
- Rock Concert – 120 to 150 decibels
- Symphonic Orchestra – 130 decibels
Reducing salt and caffeine intake can significantly decrease the risk of tinnitus. Salt lowers overall blood circulation and can result in excess fluid buildup in the inner ear. Caffeine in coffee, soda, and tea can aggravate symptoms, as well as other stimulants such as chocolate and tobacco. Conversely, increasing daily exercise can help counteract these issues by improving circulation and reducing stress. Getting healthy rest and sleep can promote overall health and mitigate the risk for ear problems.
For those who are frequently exposed to loud noise, wearing the proper ear protection can help prevent tinnitus and other forms of hearing impairment. Individuals on certain types of medication may also suffer symptoms of tinnitus, and should consult a physician about dosage and potential alternatives. These medications include common anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen, as well as antibiotics, anti-depressants, and sedatives.
Drugs and Other Therapeutic Measures
A licensed physician should be consulted for any drug related remedies with regard to ringing in the ears. Other therapies, however, can be used to help individuals tolerate the discomfort associated with tinnitus. As the ringing is typically more noticeable in quieter environments, some find that masking the noise with a separate sound provides temporary relief. This competing sound is typically played at a constant but barely audible level and serves to attenuate the tinnitus noise. Such sounds include ticking clocks, music, white noise, or ceiling fans. Electronic devices specifically to mask the ringing are also available, as well as hearing aids that help overcome the impairment that often comes with severe cases of tinnitus. When used together a masker and a hearing aid can amplify external sounds which in turn distracts them from the noise in their head. However, individuals should be cautious when adjusting their hearing aid. Setting the apparatus at too high a decibel level can exacerbate the effects of tinnitus.
As the disease can inflict both physical and psychological pain, those suffering from ringing in the ears may want to seek outside support. Medical professionals, counselors, or support groups can provide individuals with advice on how to reduce the effect of tinnitus symptoms on their daily lives. Online resources also provide a wealth of information regarding the disease. The American Tinnitus Association (www.ata.org) is an excellent location to learn more about tinnitus as well as recent advancements in medical and scientific research.
In recent years, many patients have sought alternative medicines in order to combat the suffering induced by ringing in ears. These techniques include biofeedback and relaxation training. Biofeedback involves taking account of a patient’s response to various stimuli, and then altering that response through relaxation techniques. For example, the mind may react to a certain stimulus by tightening a muscle. Biofeedback trains the mind to control that muscle and the circulation around it in order to govern one’s reaction to that stimulus. When a stimulus is particularly stressful, it may increase the risk or severity of tinnitus. Controlling one’s stress reaction to these external forces therefore reduces the effect of the resulting ear ringing.
Another nascent form of therapy being developed in alternative medicine circles is Tinnitus Retraining Therapy, or TRT. TRT focuses on the method with which the mind reacts to various tinnitus sounds. The primary goal of this therapy is to reduce an individual’s negative reaction to tinnitus-induced noise, thereby decreasing the person’s overall perception of the disease.
Other alternative therapies focus on diet and supplements. While they have not been examined under the rigorous standards of the FDA, some practitioners believe that ingestion of Ginkgo biloba and vitamin A foods and supplements helps reduce the symptoms of tinnitus. Individuals considering altering their diet should consult a physician on any potential dangers or conflicts these can have with prescribed medications.
Prognosis and Follow-Up
With most minor cases of tinnitus, the disease often goes untreated. Mild to moderate cases of tinnitus typically vanish after a few weeks or are limited to a single episode of ringing. In these cases the disease can be tolerated and ignored. In other instances, the tinnitus is caused by an underlying problem, in which case the ringing is eliminated by treatment of the underlying disease. However, for some individuals the cause of tinnitus is unrelated to any separate malady, and is severe enough that it can interfere with daily activities.
Treatments such as relaxation techniques, hypnosis, vitamin therapy, and electronic masking devices are often employed to help individuals cope with these issues. Changes in lifestyle can also reduce tinnitus symptoms, as well as improvements in diet and exercise. In cases where the symptoms are severe, it is important for individuals to seek the advice of a licensed physician, as the hearing problems may be associated with an underlying condition. Once the symptoms are identified, a doctor can monitor and re-evaluate a patient’s prognosis and treatment strategy as their body reacts to various medications. As some drugs can aggravate tinnitus symptoms, it is important for patients to notify and report any side effects they experience while undergoing treatment.Read more: