What is tinnitus? 

Tinnitus is commonly described as a ringing in the 

ears, but it also can sound like roaring, clicking, 

hissing, or buzzing. It may be soft or loud, high 

pitched or low pitched. You might hear it in either one 

or both ears. In the past year, experts estimate that 

22.7 million adult Americans experienced tinnitus for 

more than three months, which is roughly 10 percent 

of the adult population of the United States.

What causes tinnitus?

Tinnitus (pronounced tin-NY-tus or TIN-u-tus) is not a 

disease. It is a symptom that something is wrong in the 

auditory system, which includes the ear, the auditory 

nerve that connects the inner ear to the brain, and 

the parts of the brain that process sound. Something 

as simple as a piece of earwax blocking the ear canal 

can cause tinnitus. But it can also be the result of a 

number of health conditions, such as: 

• Noise-induced hearing loss

• Ear and sinus infections 

• Diseases of the heart or blood vessels 

• Ménière’s disease 

• Brain tumors 

• Hormonal changes in women 

• Thyroid abnormalities 

Tinnitus is sometimes the first sign of hearing 

loss in older people. It also can be a side effect of 

medications. More than 200 drugs are known to cause 

tinnitus when you start or stop taking them. 

People who work in noisy environments—such as 

factory or construction workers, road crews, or even 

musicians—can develop tinnitus over time when 

ongoing exposure to noise damages tiny sensory hair 

cells in the inner ear that help transmit sound to the 

brain. This is called noise-induced hearing loss.

Soldiers exposed to bomb blasts can develop tinnitus 

if the shock wave of the explosion squeezes the skull 

and damages brain tissue in areas that help process 

sound. In fact, tinnitus is one of the most common 

service-related disabilities among veterans returning 

from Iraq and Afghanistan. 

Pulsatile tinnitus is a rare type of tinnitus that sounds 

like a rhythmic pulsing in the ear, usually in time with 

your heartbeat. A doctor may be able to hear it by 

pressing a stethoscope against your neck or by placing 

a tiny microphone inside the ear canal. This kind of 

tinnitus is most often caused by problems with blood 

flow in the head or neck. Pulsatile tinnitus also may 

be caused by brain tumors or abnormalities in brain 

structure. 

Even with all of these associated conditions and 

causes, some people develop tinnitus for no obvious 

reason. Most of the time, tinnitus isn’t a sign of a 

serious health problem, although if it’s loud or doesn’t 

go away, it can cause fatigue, depression, anxiety, and 

problems with memory and concentration. For some, 

tinnitus can be a source of real mental and emotional 

anguish. 

NIDCD Fact Sheet

Tinnitus

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES ∙ NATIONAL INSTITUTES OF HEALTH ∙ NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS hearing balance
Why do I have this noise in my ears?

Although we hear tinnitus in our ears, its source is 

really in the networks of brain cells (what scientists 

call neural circuits) that make sense of the sounds our 

ears hear. A way to think about tinnitus is that it often 

begins in the ear, but it continues in the brain. 

Scientists still haven’t agreed upon what happens in 

the brain to create the illusion of sound when there 

is none. Some think that tinnitus is similar to chronic 

pain syndrome, in which the pain persists even after a 

wound or broken bone has healed. 

Tinnitus could be the result of the brain’s neural 

circuits trying to adapt to the loss of sensory hair 

cells by turning up the sensitivity to sound. This 

would explain why some people with tinnitus are 

oversensitive to loud noise. 

Tinnitus also could be the result of neural circuits 

thrown out of balance when damage in the inner ear 

changes signaling activity in the auditory cortex, the 

part of the brain that processes sound. Or it could be 

the result of abnormal interactions between neural 

circuits. The neural circuits involved in hearing aren’t 

solely dedicated to processing sound. They also 

communicate with other parts of the brain, such as the 

limbic region, which regulates mood and emotion. 

What should I do if I have tinnitus?

The first thing is to see your primary care doctor, who 

will check if anything, such as ear wax, is blocking the 

ear canal. Your doctor will ask you about your current 

health, medical conditions, and medications to find 

out if an underlying condition is causing your tinnitus. 

If your doctor cannot find any medical condition 

responsible for your tinnitus, you may be referred to 

an otolaryngologist (commonly called an ear, nose, 

and throat doctor, or an ENT). The ENT will physically 

examine your head, neck, and ears and test your 

hearing to determine whether you have any hearing 

loss along with the tinnitus. You might also be referred 

to an audiologist who can also measure your hearing 

and evaluate your tinnitus. 

What if the sounds in my ear do not 

go away?

Some people find their tinnitus doesn’t go away or it 

gets worse. In some cases it may become so severe 

that you find it difficult to hear, concentrate, or even 

sleep. Your doctor will work with you to help find 

ways to reduce the severity of the noise and its impact 

on your life. 

Are there treatments that can help me?

Tinnitus does not have a cure yet, but treatments that 

help many people cope better with the condition are 

available. Most doctors will offer a combination of the 

treatments below, depending on the severity of your 

tinnitus and the areas of your life it affects the most. 

• Hearing aids often are helpful for people who have 

hearing loss along with tinnitus. Using a hearing aid 

adjusted to carefully control outside sound levels 

may make it easier for you to hear. The better you 

hear, the less you may notice your tinnitus. Read the 

NIDCD fact sheet Hearing Aids at http://www.nidcd.

nih.gov/health/hearing/hearingaid.asp for more 

information.

• Counseling helps you learn how to live with 

your tinnitus. Most counseling programs have an 

educational component to help you understand 

what goes on in the brain to cause tinnitus. Some 

NIDCD Fact Sheet

Tinnitus

hearingbalance
counseling programs also will help you change the 

way you think about and react to your tinnitus. 

You might learn some things to do on your own to 

make the noise less noticeable, to help you relax 

during the day, or to fall asleep at night. 

• Wearable sound generators are small electronic 

devices that fit in the ear and use a soft, pleasant 

sound to help mask the tinnitus. Some people 

want the masking sound to totally cover up their 

tinnitus, but most prefer a masking level that is just 

a bit louder than their tinnitus. The masking sound 

can be a soft “shhhhhhhhhhh,” random tones, or 

music. 

• Tabletop sound generators are used as an aid 

for relaxation or sleep. Placed near your bed, you 

can program a generator to play pleasant sounds 

such as waves, waterfalls, rain, or the sounds of a 

summer night. If your tinnitus is mild, this might be 

all you need to help you fall asleep. 

• Acoustic neural stimulation is a relatively new 

technique for people whose tinnitus is very loud 

or won’t go away. It uses a palm-sized device and 

headphones to deliver a broadband acoustic signal 

embedded in music. The treatment helps stimulate 

change in the neural circuits in the brain, which 

eventually desensitizes you to the tinnitus. The 

device has been shown to be effective in reducing 

or eliminating tinnitus in a significant number of 

study volunteers. 

• Cochlear implants are sometimes used in people 

who have tinnitus along with severe hearing loss. 

A cochlear implant bypasses the damaged portion 

of the inner ear and sends electrical signals that 

directly stimulate the auditory nerve. The device 

brings in outside sounds that help mask tinnitus and 

stimulate change in the neural circuits. Read the 

NIDCD fact sheet Cochlear Implants at http://www.

nidcd.nih.gov/health/hearing/coch.asp for more 

information.

• Antidepressants and antianxiety drugs might 

be prescribed by your doctor to improve your mood 

and help you sleep. 

• Other medications may be available at drugstores 

and on the Internet as an alternative remedy for 

tinnitus, but none of these preparations has been 

proved effective in clinical trials. 

Can I do anything to prevent tinnitus or 

keep it from getting worse?

Noise-induced hearing loss, the result of damage to 

the sensory hair cells of the inner ear, is one of the 

most common causes of tinnitus. Anything you can do 

to limit your exposure to loud noise—by moving away 

from the sound, turning down the volume, or wearing 

earplugs or earmuffs—will help prevent tinnitus or 

keep it from getting worse. 

What are researchers doing to better 

understand tinnitus?

Along the path a hearing signal travels to get from the 

inner ear to the brain, there are many places where 

things can go wrong to cause tinnitus. If scientists can 

understand what goes on in the brain to start tinnitus 

and cause it to persist, they can look for those places 

in the system where a therapeutic intervention could 

stop tinnitus in its tracks. 

In 2009, the National Institute on Deafness and Other 

Communication Disorders (NIDCD) sponsored a 

workshop that brought together tinnitus researchers 

to talk about the condition and develop fresh ideas for 

potential cures. During the course of the workshop, 

participants discussed a number of promising research 

directions, including:
NIDCD supports and conducts research and research training on the 

normal and disordered processes of hearing, balance, smell, taste, 

voice, speech, and language and provides health information, based 

upon scientific discovery, to the public.

hearing, balancesmell, tastevoice, speech, language

NIDCD Fact Sheet: Tinnitus

Publication No. 10-4896

Updated April 2010

For more information, contact:

NIDCD Information Clearinghouse

1 Communication Avenue

Bethesda, MD 20892-3456

Toll-free Voice: (800) 241–1044

Toll-free TTY: (800) 241–1055

Fax: (301) 770–8977

E-mail: nidcdinfo@nidcd.nih.gov

Internet: http://www.nidcd.nih.gov

The NIDCD Information Clearinghouse is a service of the 

National Institute on Deafness and Other Communication 

Disorders, National Institutes of Health, U.S. Department 

of Health and Human Services.

• Electrical or magnetic stimulation of brain 

areas involved in hearing. Implantable devices 

already exist to reduce the trembling of Parkinson’s 

disease and the anxieties of obsessive-compulsive 

disorder. Similar devices could be developed to 

normalize the neural circuits involved in tinnitus.

• Repetitive transcranial magnetic stimulation 

(rTMS). This technique, which uses a small device 

placed on the scalp to generate short magnetic 

pulses, is already being used to normalize electrical 

activity in the brains of people with epilepsy. 

Preliminary trials of rTMS in humans, funded by the 

NIDCD, are helping researchers pinpoint the best 

places in the brain to stimulate in order to suppress 

tinnitus. Researchers are also looking for ways to 

identify which people are most likely to respond 

well to stimulation devices.

• Hyperactivity and deep brain stimulation. 

Researchers have observed hyperactivity in neural 

networks after exposing the ear to intense noise. 

Understanding specifically where in the brain this 

hyperactivity begins and how it spreads to other 

areas could lead to treatments that use deep brain 

stimulation to calm the neural networks and reduce 

tinnitus.

• Resetting the tonotopic map. Researchers are 

exploring how to take advantage of the tonotopic 

map, which organizes neurons in the auditory 

cortex according to the frequency of the sound to 

which they respond. Previous research has shown 

a change in the organization of the tonotopic 

map after exposing the ear to intense noise. 

By understanding how these changes happen, 

researchers could develop techniques to bring the 

map back to normal and relieve tinnitus. 

Where can I find more information?

The NIDCD maintains a directory of organizations 

that provide information on the normal and 

disordered processes of hearing, balance, smell, taste, 

voice, speech, and language. Please see the list of 

organizations at http://www.nidcd.nih.gov/directory.

Use the following keywords to help you search for 

organizations that can answer questions and provide 

printed or electronic information on tinnitus:

• Tinnitus

• Noise-induced hearing loss

For more information, additional addresses and phone 

numbers, or a printed list of organizations, contact:

NIDCD Information Clearinghouse

1 Communication Avenue

Bethesda, MD 20892-3456

Toll-free Voice: (800) 241-1044

Toll-free TTY: (800) 241-1055

Fax: (301) 770-8977

E-mail: nidcdinfo@nidcd.nih.gov