Should You See A Doctor For Ringing In Your Ears?
Imagine a constant pitch in the background, sometimes drowned out by other noise, but always there and especially bothersome when things get quiet. Maybe you do experience this unpleasant sensation known as tinnitus. The problem is common. But while it is usually harmless and incurable, there are some important considerations.
By definition, tinnitus is the perception of noise without the presence of something making the noise outside of the body. Mostly, tinnitus comes from the brain as a tone or pitch. Rarely, a stimulus from within the head causes the perception of noise. This is usually a pulsing sensation. Tinnitus becomes more common with age, especially after 50.
Causes of Tinnitus
Most all the time, tinnitus that presents as a persistent tone just happens with no identifiable cause. A myriad of lesser common causal conditions also make the list as possibilities in the consideration of tinnitus.
- Hearing Loss: The most common cause is hearing loss, either from noise exposure or advancing age.
- Wax Build Up: Sometimes the cause is simply a blockage of the ear canal with wax. A white, waxy build-up behind the ear drum called a cholesteatoma can usually be seen with a doctor's ear scope.
- Benign Tumor: A benign tumor called a schwannoma is a possibility when the tinnitus is accompanied by facial numbness/weakness, hearing loss and/or vertigo.
- Meniere Disease: Meniere disease is syndrome of vertigo and/or hearing loss associated with tinnitus. Often, the hearing loss is one-sided.
- Migraine: Migraine headaches have been known to cause periodic tinnitus.
- Antibiotics or Aspirin: Certain medications such as antibiotics or high doses of aspirin have been known to cause tinnitus.
- Anemia and High Blood Pressure: While not always the case, anemia and high blood pressure are common among tinnitus sufferers.
- Infection: Lastly, infections (bacterial, viral and fungal) can rarely cause tinnitus.
- Eustachian Tube Abnormality: When the tinnitus is something other than a tone, a cause is much more common. Clicking or snapping is often a problematic eustachian tube. See my recent blog on this topic. Pulsing noises can indicate an arterial or venous problem due to an abnormal twist, plaque formation or an abnormal blood vessel growth.
Should I See A Doctor?
Mostly, tinnitus is an unwanted, harmless symptom with no identifiable cause, though red flags should be considered as a reason for seeing a doctor and perhaps testing. Please see your doctor if you:
- Have Hearing Loss in Both Ears: Hearing loss is a common association with tinnitus. If the hearing loss is gradual and involves both ears, testing and consideration of hearing aids is an option that can be pursued on an individual basis. Everyone has a different threshold for considering hearing loss as a problem, weighing out the option of an assistive device.
- Have Hearing Loss in Just One Ear: If the hearing loss is one-sided or sudden, however, attention should be sought to look in the ear and rule out wax and to consider whether a scan should be done to rule out a schwannoma.
- Also Have Vertigo: In the presence of vertigo a doctors evaluation is necessary to consider the diagnosis of Meniere disease and potentially helpful treatment.
- Have Numbness or Weakness in the Face: If focal neurologic symptoms are present such as numbness or weakness in the facial area, a doctor's evaluation and scan are necessary.
- Just Started a New Medication: If tinnitus is associated with a recently started medication, contact your doctor.
- Hear Pulsing or Clicking: All non-tone tinnitus (pulsing or clicking) should be evaluated by a doctor to rule out serious blood vessel problems. Blood pressure should be checked in persons with tinnitus as should a hemoglobin level (blood count).
Is There Help for This Annoying Problem?
Follow-up studies on adults with tinnitus found the tinnitus present in over 80% at five years after diagnosis. Nearly half reported that the symptoms were the same or worse. Fortunately, however, those with the most annoying symptoms reported to a high degree that symptoms had improved with time.
Uncommonly, fixing the underlying problem (wax removal, improving anemia or treating high blood pressure) can fix the tinnitus. The hope with tinnitus is that the brain will eventually "tune out" the symptoms.
The most annoying aspect of tinnitus for most is the adverse affect on sleep. Adding white noise in the form of crickets chirping or ocean sounds can distract people away from the tinnitus symptoms during initiation of sleep. Unfortunately, correction of hearing loss does not improve the symptoms of tinnitus.