Tinnitus symptoms

Contributed by Paul Dybala, PhD, president, Healthy Hearing
This content was last reviewed on: October 16th, 20152015-10-16 12:23:00

Tinnitus can be frustrating. If you're experiencing constant ringing, buzzing or whistling, contact a hearing healthcare provider for a complete evaluation.


Tinnitus is a feeling of having a buzzing, ringing, hissing or whizzing noise in the ears for an extended period of time. The volume of this irritant can vary over time and the pitch can be in a high or low frequency so that individual experience can range from a squeal to a roar. It's possible to have this issue in one or both ears, and it is possible that is goes in and out on a regular basis. It can get loud enough to interfere with concentration or hearing natural noises. Although tinnitus is most commonly seen in adults, people of all ages may experience this issue. Tinnitus is typically a sign of an underlying condition or disease. 

Tinnitus is subjective

Tinnitus is a phantom sound generated in the brain and only the patient can perceive the irritating noise. When these sounds occur without any other symptoms, tinnitus may be considered a disease by itself. However, it is more commonly a symptom of another disease process. For example, if it accompanied by hearing loss or dizziness, it is likely a symptom of an injury to the sensory organ in the inner ear. 

Tinnitus is experienced on a case by case basis. Even two individuals with the same hearing loss pattern may not describe the same tinnitus loudness and pitch. Each individual may be affected differently by the ailment as well.

How you may feel

Having a constant ringing in your ear is obviously not going to make for a pleasant afternoon, but you may also have issues falling asleep or concentrating at work or in your daily life. The constant discomfort, lack of sleep and inability to live your life as you used to may even cause depression or anxiety. Anxiety is especially common if tinnitus is getting in the way of work or other stressful situations. Many suffers of tinnitus often report additional problems in their daily lives, and some describe a connection between tinnitus perception and stress. Individuals may suffer from depression or thoughts of suicide in response to the persistent buzzing or ringing that feels inescapable.

Contact a mental health professional or call a suicide hotline right away if your tinnitus is leading to extreme feelings of depression, anxiety or suicide.

Underlying medical diagnoses 

Symptoms of tinnitus have been linked to many medical diagnoses, including:

  • Hearing loss: Damage to the sensory cells in the inner ear, especially due to aging or noise exposure can cause tinnitus as well as hearing loss.
  • Meniere's disease: This disorder is characterized by tinnitus, hearing loss and dizziness.
  • Otosclerosis: This disease process may cause tinnitus as the middle ear bones stiffen and freeze.
  • Acoustic neuroma: This tumor on the auditory nerve is also accompanied by facial paralysis, headache, nausea and vomiting.
  • Atherosclerosis of the carotid artery: Putting pressure on the carotid artery should decrease the intensity of the tinnitus.
  • Severe hypertension: These individuals may also experience a throbbing headache, restlessness, nausea, vomiting, blurred vision and seizures.

Other medical issues often associated with tinnitus as a symptom include arthritis of the neck, multiple sclerosis and glomus jugulare tumor. Tinnitus may also be a side effect of ototoxic medications, head or neck trauma, poor dietary habits or impacted ear wax.

Testing and diagnosing tinnitus

The sounds you hear, when you hear them and how often you hear them may be able to help your audiologist or ENT physician determine the best way to treat your tinnitus. A tinnitus evaluation will begin with a series of questions designed to get a clear description of your symptoms. You may encounter questions like:

  • How long has this been going on? 
  • Is it regular or constant? Are the symptoms worse at certain points of the day?
  • Which ear is causing the issue? Both?
  • How loud is the noise? Is the pitch high or low?
  • Is the issue extremely bothersome or a little irritating?
  • Are there certain conditions that make the symptoms worse, such as exposure to noise or caffeine intake?
  • Does the sound ever change?

After discussing your symptoms of tinnitus, your audiologist will conduct a physical examination of the ears and a full hearing evaluation. In addition to the basic hearing tests, a tinnitus evaluation will usually include a pitch matching test and a loudness matching test to quantify the frequency and level of the tinnitus as much as possible. This information is valuable for some tinnitus treatment techniques. If you experience tinnitus in certain physical positions, you may be asked to move your eyes around, clench and unclench your jaw, or move the neck, arms or legs during the exam. 

Get help from an expert

Not all hearing care professionals specialize in tinnitus diagnosis and treatment. Look for a hearing healthcare practitioner in your area who advertises this expertise. Before your first appointment, take note of your specific symptoms, when they occur and what environments make them better or worse. Think about how to describe the sounds you're hearing and whether you hear them in one or both ears. This work ahead of time will prepare you for the first questions asked by the practitioner and ensure you get the most out of your evaluation. 

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