Tinnitus

Diagnosis

Your doctor will typically diagnose tinnitus based on your symptoms alone. To guide treatment, your doctor will also try to determine whether your tinnitus is linked to another underlying condition. In some cases, a cause cannot be identified.

To help pinpoint the cause, your doctor may review your medical history and examine your ears, head, and neck. Common tests include:

• Hearing (audiological) exam: You sit in a soundproof room wearing earphones that play specific sounds into one ear at a time. You signal when you hear the sound, and your results are compared with normal hearing levels for your age. This helps identify or rule out possible causes of tinnitus.
• Movement tests: Your doctor may ask you to move your eyes, clench your jaw, or move your neck, arms, and legs. If your tinnitus changes with these movements, it may point to an underlying disorder.
• Imaging tests: Depending on the suspected cause, you may need a CT or MRI scan.
• Lab tests: Blood tests may be done to check for anemia, thyroid problems, heart disease, or vitamin deficiencies.

It is helpful to describe the type of noise you hear, as this can offer clues about the underlying cause:

• Clicking: Often linked to muscle contractions in and around the ear.
• Pulsing, rushing, or humming: Usually associated with blood vessel (vascular) issues such as high blood pressure and may be more noticeable during exercise or position changes.
• Low-pitched ringing: May indicate ear canal blockages, Meniere’s disease, or stiff inner ear bones.
• High-pitched ringing: The most common type, often caused by noise exposure, hearing loss, or certain medications. A continuous high-pitched tone in one ear may be linked to an acoustic neuroma.

Treatment

Treatment for tinnitus depends on whether an underlying condition is contributing to your symptoms. When a cause is found, treatment may help reduce or eliminate the noise. Examples include:

• Earwax removal if buildup is contributing to symptoms
• Treatment of blood vessel conditions, which may require medication or surgery
• Hearing aids when tinnitus is related to noise-induced or age-related hearing loss
• Adjusting or changing medications that may be contributing to tinnitus

Noise suppression

Although tinnitus often cannot be cured, several devices can help make symptoms less noticeable.

• White noise machines: These create static-like sounds or natural sounds such as rain or ocean waves. They can be helpful for sleep when paired with pillow speakers. Household items like fans, humidifiers, or air conditioners can also create background noise.
• Masking devices: These ear-worn devices produce continuous, low-level white noise to help suppress symptoms.

Counseling

Behavioral therapies aim to help you manage tinnitus by changing your response to the sound. Over time, the symptoms may become less bothersome.

• Tinnitus retraining therapy (TRT): This combines sound masking with directive counseling and is usually provided by an audiologist or at a tinnitus center. The goal is to train your brain to notice tinnitus less.
• Cognitive behavioral therapy (CBT) and other counseling approaches: A mental health professional can help you develop coping strategies. Counseling can also address related issues such as anxiety and depression. CBT for tinnitus may be offered in-person, in groups, or online.

Medications

While medications cannot cure tinnitus, they may help reduce the severity of symptoms or treat related conditions. Your doctor may prescribe medication for an underlying health issue or to help manage anxiety or depression linked to tinnitus.

Potential future treatments

Researchers continue to explore whether techniques such as magnetic or electrical brain stimulation may offer relief. These include transcranial magnetic stimulation and deep brain stimulation.