Tinnitus is the name given to sounds that you hear but that don’t exist in the external world – and no one is quite sure why it happens. The sound may be in one or both ears, low or high pitch, loud or soft, continuous or intermittent. It’s rarely a sign of serious underlying disease, but 10% of adults and 3% of children in the UK experience tinnitus, and 1% of the population suffers significant distress as a result. Some common possible causes are age-related hearing loss, ear wax and infections. Rarer causes are Ménière’s disease or an inherited ear condition called otosclerosis. “There’s no cure for tinnitus so prevention is key,” says Nic Wray of the British Tinnitus Association (BTA).
If you’re exposed to high levels of noise at work, your employer is legally obliged to protect you from noise damage. The near universal use of earphones is a particular concern; it’s best to keep the volume of any device to 60% of the maximum and take them out every 60 minutes. Parents and caregivers should check children’s earphone usage. Wray says children who develop tinnitus may not complain of ringing or abnormal sounds in the ears, but just seem anxious, sleep-deprived and unusually sensitive to loud noise or silence.
A hearing check every two years from the age of 50 is a good idea, says Wray. Correcting hearing loss with a hearing aid may reduce the risk of tinnitus.
Most commonly prescribed drugs don’t cause long-term tinnitus, but intravenous antibiotics (gentamicin) and some chemotherapy drugs can. Aspirin, ibuprofen and the diuretic furosemide can cause temporary tinnitus, but permanent inner-ear damage and tinnitus are extremely rare at normal doses.
People who shove fingers, pencils or earplugs deep into their ear canal can get an impacted plug of wax that presses on the eardrum and may contribute to tinnitus. Olive oil ear-drops soften the wax and gentle suction (better than syringing) can be arranged by your GP.
Long-term tinnitus is distressing and stress-inducing. The good news is that it often improves over time as the brain filters out the intrusive sound, a process known as habituation. Recent research suggests that mindfulness is a useful psychological tool to help manage it. Antidepressant drugs and ones that act on the inner ear (betahistine) are sometimes prescribed, but Wray says the BTA doesn’t recommend any drug treatment. All aspects of diagnosis and management of tinnitus are currently being reviewed by Nice and a guideline should be published in May 2020.
External sounds such as audiobooks or music on the radio can distract the brain from tinnitus and mask the symptoms. Hearing aids and tinnitus-reprogramming devices can help. There are also some excellent apps such as Tinnitus Alleviator.