What Is Tinnitus? Understanding the Ringing, Buzzing, and Roaring in Your Ears or Head

You’re sitting in a quiet room, yet your ears are anything but silent. A high-pitched ring, a soft whoosh, or a persistent buzz seems to hum from nowhere. You may not even be able to locate where it is coming from.

That sound? It may be tinnitus (pronounced TINN-it-us), a common but often misunderstood condition that affects a significant number of people. According to a comprehensive systematic review published in JAMA Neurology, tinnitus affects an estimated 14.4% of adults worldwide, with rates rising to 23.6% in adults aged 65 and older. While tinnitus isn’t a disease on its own, it’s often a signal that something in your auditory system, or overall health, deserves attention.

In this post, we’ll explore what tinnitus is, why it happens, the different types and severity levels, and what treatments may help you manage it.

What Is Tinnitus?

Tinnitus is the perception of sound in the ears or head when no external sound is present. It’s often described as a ringing but can also sound like buzzing, humming, hissing, clicking, roaring, or even pulsating. These sounds are usually only heard by the person experiencing them.

Tinnitus is a symptom, not a standalone condition. It’s your body’s way of signaling that something may be affecting your auditory system.

Clinically, tinnitus is typically classified into two broad categories:

• Subjective tinnitus: The most common form. Only the person experiencing it can hear the sound.
• Objective tinnitus: Much rarer, this involves sounds that a health care provider might be able to detect with a stethoscope.

What Are the Different Types of Tinnitus?

Beyond clinical classification, tinnitus can take many forms and vary widely from person to person. These variations often fall under subjective tinnitus but may differ based on cause, sound, or how the tinnitus behaves.

Some common types include:

• Pulsatile tinnitus: Sounds like a heartbeat, often linked to blood flow
• Reactive tinnitus: Worsens in response to certain environmental sounds
• Somatic or temporomandibular-joint-related (TMJ) tinnitus: Influenced by movement or tension in the jaw, neck, or shoulders
• Low-frequency or roaring tinnitus: Described as ocean-like, rumbling, or deep humming
• High-pitched tonal tinnitus: A sharp, continuous ringing or whistling
• Intermittent or constant tinnitus: Sounds may come and go or persist continuously

What Causes Tinnitus?

Tinnitus can stem from a wide range of causes, including:

• Hearing loss, especially age-related or noise-induced
• Earwax blockages, which can create pressure in the ear and trigger symptoms
• Exposure to loud sounds like concerts, loud headphones, and machinery
• Head or neck injuries, as trauma can affect auditory pathways
• TMJ disorders, which can cause jaw tension or misalignment
• Medications, as certain antibiotics, chemotherapy drugs, and NSAIDs are ototoxic (meaning they can damage the inner ear and affect hearing or balance)
• Circulatory issues like high blood pressure or vascular abnormalities
• Infections or eustachian tube dysfunction, which can disrupt normal ear pressure and fluid balance, potentially triggering tinnitus
• Chronic stress or anxiety, which can worsen perception and sensitivity

Identifying and addressing the underlying cause is often the first step toward finding relief. The American Family Physician’s clinical guide to tinnitus emphasizes the importance of identifying and treating any underlying causes, such as hearing loss, ototoxic medications, or vascular issues.

What Is Tinnitus a Symptom Of?

Tinnitus is rarely a standalone issue. It’s often a sign of something else going on in your body or hearing system, such as:

• Sensorineural hearing loss, most commonly associated with tinnitus
• Conductive hearing problems, like ear infections or bone abnormalities
• Jaw, neck, or skull-base disorders
• Head injuries or concussions
• Neurological or cardiovascular conditions, including multiple sclerosis or vascular malformations

Because tinnitus can stem from so many different sources, some benign, others more serious, it’s important not to ignore it. A thorough evaluation by a hearing care provider can help pinpoint what’s contributing to the sound you’re hearing. Whether it’s age-related hearing loss, a past injury, or an underlying health condition, identifying the root cause is key to developing an effective management plan.

How Is Tinnitus Diagnosed?

Diagnosing tinnitus involves more than confirming the presence of sound — it’s about understanding what may be causing it and how it’s affecting your life. A thorough evaluation may include:

• Audiometry: to assess hearing thresholds
• Tympanometry: to evaluate middle-ear function
• Medical history review: including medications and noise exposure
• Physical exam: including the jaw, neck, and head
• Imaging (CT or MRI): in specific cases, to rule out structural issues

To better understand the impact tinnitus has on a person’s quality of life, many audiologists also use the Tinnitus Handicap Inventory (THI), a 25-item self-assessment questionnaire. It measures how tinnitus affects daily function, emotional well-being, and perceived severity, offering valuable insights to guide care decisions. The THI is widely recognized for its strong clinical reliability and validity, and it can be used to track progress over time.

HearingLoss.com^®-Certified providers follow clinical and patient best practices to identify both the presence and potential causes of tinnitus. Many can offer treatment options directly or refer you to trusted specialists for additional care when needed.

What Are the Different Grades or Severity Levels of Tinnitus?

Tinnitus severity varies widely. While some people barely notice it, others find it deeply distressing. Here’s a general guide:

• Mild: noticeable only in quiet environments, not bothersome
• Moderate: can interfere with concentration or sleep
• Severe: disrupts daily activities or emotional well-being
• Debilitating: significantly impacts quality of life, may contribute to depression or anxiety

These severity levels aren’t just about volume; they reflect how much tinnitus interferes with your daily life. That’s why many hearing care professionals use tools like the Tinnitus Handicap Inventory (THI) to better understand your personal experience. By measuring the emotional and functional impact of tinnitus, the THI helps guide treatment decisions and track progress over time. If your tinnitus feels like more than just background noise, it’s worth talking to a provider who can assess its true impact.

Can Tinnitus Go Away on Its Own?

In some cases, yes. Tinnitus may resolve on its own, especially when caused by:

• Temporary noise exposure (e.g., a loud concert)
• Earwax impaction
• Changes in medication
• Acute stress

But if it persists for more than a few days, or worsens, it’s important to consult a hearing care provider. Chronic tinnitus is unlikely to resolve without professional guidance, but many people find meaningful relief through therapy and lifestyle changes.

What Are the Most Effective Tinnitus Therapies?

Medical & Audiological Treatments:

• Hearing aids: amplify sound and may include tinnitus-masking features
• Tinnitus Retraining Therapy (TRT): combines sound therapy with counseling
• Sound therapy: white noise, nature sounds, or music used to mask tinnitus
• Cognitive Behavioral Therapy (CBT): helps reframe emotional responses

Physical & Somatic Therapies:

• TMJ treatment: dental care or physical therapy
• Neck/jaw exercises or manual therapy: especially if somatic tinnitus is suspected

Lifestyle Strategies:

• Avoid silence: keep something you enjoy listening to in the background
• Mindfulness and relaxation: to reduce sensitivity and emotional impact
• Sleep hygiene: using background sounds (like a white-noise sound machine) or sleep masks
• Avoiding triggers: such as caffeine, alcohol, nicotine, and stress

Be cautious of ear candling (sometimes called coning), “miracle” supplements, and unverified home remedies. These are not supported by clinical evidence.

Not All Hearing Providers Treat Tinnitus — Here’s Why

Tinnitus may be difficult to treat, and not every hearing care professional offers tinnitus-specific services. While many providers are experienced in identifying hearing loss (a common cause of tinnitus), tinnitus management itself may not be the focus of many audiology practices. You want to schedule an appointment with a practice who includes tinnitus diagnosis and treatment as part of their clinical services — not every practice does.

This doesn’t reflect a lack of interest but rather the reality that audiology programs must balance many priorities, and tinnitus training may receive less emphasis compared to foundational skills like diagnostics, hearing aid fitting, and pediatric care. Further, tinnitus management can involve complex emotional, neurological, and behavioral elements that require interdisciplinary support.

When booking an appointment with a hearing care professional, ask:

• “Do you work with tinnitus patients?”
• “What kinds of therapy or referrals do you offer?”
• “Are you familiar with tinnitus retraining therapy, sound therapy, or counseling strategies?”

For the best outcomes with tinnitus treatment, seek professionals who not only understand hearing loss but are equipped to help patients cope with the effects of tinnitus, or who collaborate with teams that do.

Quick Answers About Tinnitus

What is Tinnitus?

Tinnitus is the perception of sound — such as ringing, buzzing, or humming — when no external noise is present. It’s not a disease itself but a symptom of an underlying issue in your hearing or health.

What Does Tinnitus Sound Like?

Tinnitus can sound like ringing, buzzing, hissing, clicking, roaring, or even pulsing in your ears or head. The exact sound and intensity vary from person to person.

What Causes Tinnitus?

Tinnitus has many possible causes, including hearing loss, earwax buildup, exposure to loud noise, head or neck injuries, TMJ disorders, certain medications, and stress. It may also be linked to circulatory or neurological conditions.

Is Tinnitus Permanent?

Tinnitus may be temporary or permanent, depending on its cause. In some cases, such as after a loud concert or with a medication change, it may go away on its own. Chronic tinnitus may require treatment or long-term management.

Can Hearing Loss Cause Tinnitus?

Yes. Hearing loss is one of the most common causes of tinnitus. When the brain receives less auditory input, it may create phantom sounds to fill in the gaps resulting in tinnitus.

How Do I Know if I Have Tinnitus?

If you notice sounds like ringing or buzzing that no one else hears, especially in quiet environments, you may have tinnitus. A hearing care provider can perform tests to diagnose it and uncover potential causes.

How is Tinnitus Diagnosed?

Tinnitus is typically diagnosed through a combination of hearing tests, physical exams, and a review of your medical history. Some providers use tools like the Tinnitus Handicap Inventory (THI) to assess how it affects your daily life.

Is There a Cure for Tinnitus?

There’s no universal cure for tinnitus, but many people find relief through hearing aids, sound therapy, cognitive behavioral therapy, tinnitus retraining therapy, or lifestyle changes. The right treatment depends on the cause and severity.

Should I See a Medical Doctor or Hearing Care Professional for Tinnitus?

If you have persistent tinnitus, it’s important to see a hearing care professional. They can help identify underlying causes and recommend appropriate next steps or refer you to a specialist if needed.

What Should I Avoid if I Have Tinnitus?

Avoid loud noise exposure, stress, caffeine, nicotine, and alcohol all of which may worsen tinnitus symptoms. Managing stress and maintaining healthy hearing habits can help reduce the impact.

Take the First Step Toward Tinnitus Relief

Tinnitus can feel isolating, but you’re not alone and help is available. The first step is understanding your hearing health.

Start by taking our free three-minute online hearing screener — it can help you identify potential hearing loss, one of the most common causes of tinnitus. For a more complete evaluation, find a certified provider near you who can evaluate your symptoms and guide you through possible next steps. Just be sure to ask if they offer tinnitus support, as not all hearing care professionals specialize in tinnitus management.

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References

• Dalrymple, S. N., Lewis, S. H., & Philman, S. (2021). Tinnitus: Diagnosis and Management. American Family Physician, 103(11), 663–671. https://www.aafp.org/pubs/afp/issues/2021/0601/p663.html. Accessed July 1, 2025.
• Jarach, C. M., Lugo, A., Scala, M., van den Brandt, P. A., Cederroth, C. R., Odone, A., Garavello, W., Schlee, W., Langguth, B., & Gallus, S. (2022). Global Prevalence and Incidence of Tinnitus. JAMA Neurology, 79(9), 888. https://doi.org/10.1001/jamaneurol.2022.2189. Accessed July 1, 2025.
• Newman, C. W., Jacobson, G. P., & Spitzer, J. B. (1996). Development of the Tinnitus Handicap Inventory. Archives of Otolaryngology – Head and Neck Surgery, 122(2), 143–148. https://doi.org/10.1001/archotol.1996.01890140029007. Accessed July 1, 2025.
• Ototoxicity: Symptoms, Causes & Treatment. (2023, March). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/24769-ototoxicity‌. Accessed July 1, 2025.