September 04, 2020

If you have tinnitus (ringing in the ears) you hear a constant or intermittent ringing, buzzing, whooshing, or chirping that has no external source.

The experience of tinnitus is different for everyone, so it’s unsurprising that there are different types and causes of tinnitus.

What Are the Different Types of Tinnitus?

The four main types of tinnitus are subjective, neurological, somatic, and objective tinnitus.

Subjective Tinnitus

This is the most common type of tinnitus.

If you have subjective tinnitus, your symptoms can only be heard by you. Symptoms usually occur as a result of exposure to loud noise.

While this kind of tinnitus can be permanent, it can disappear as suddenly as it appears or last for around three to twelve months at a time.

Neurological Tinnitus

When you have neurological tinnitus your symptoms are generally caused by a disorder, such as Meniere’s disease, affecting the brain’s auditory functions.

Somatic Tinnitus

This form of tinnitus is related to the functioning of the sensory system in that it is caused, worsened, or otherwise related to it. If your tinnitus can be made louder or quieter by moving the head, neck, jaw or eyes, then this is a sign it may be somatic. 

Objective Tinnitus

Involuntary muscle contractions or vascular deformities can lead to a rare form of tinnitus. Unlike the other forms of tinnitus, another doctor with equipment can hear this tinnitus, and many times it can be permanently fixed.

What Can Cause Tinnitus?

Tinnitus can appear to come out of nowhere, so the cause isn’t always entirely obvious, especially if there is no damage to the auditory system. However, in many cases there are root causes to the symptoms.

Some possible causes include:

• Excessive noise exposure
• Certain medications (such as aspirin, some antibiotics, some antidepressants, cancer drugs, and diuretics)
• Earwax buildup
• Ear infection
• Jaw joint dysfunction (TMJ)
• Chronic neck muscle strain
• Cardiovascular disease
• A tumor (usually benign)

Can Anxiety Cause Tinnitus?

Emotional and physical factors have been linked to the onset of tinnitus, including anxiety and stress. 

It isn’t entirely clear whether anxiety and stress can cause the onset of tinnitus, and it can be a point of controversy. Some people find it difficult to believe that their emotions are responsible for such a real and often everpresent auditory sensation. This can be particularly frustrating if you have chronic tinnitus, which is a source of a lot of extra stress and anxiety for you.

It does seem clear, however, that anxiety can worsen your perception of your tinnitus. People often report that when they are stressed, anxious, sad, or overwhelmed, their tinnitus symptoms are either triggered (if the ringing is not already constant) or the noise feels louder. 

For some people, the initial onset of their tinnitus occurs after a period of high stress or a traumatic incident. Of course, there is much debate as to whether these negative emotions really can make tinnitus louder, or whether they lower your threshold for noticing the symptoms, preventing you from ignoring it to the extent that you usually can.

Stress and anxiety certainly play a role in people’s experience of living with tinnitus, so they are generally acknowledged as contributing factors to tinnitus. This can be uniquely problematic due to a ‘vicious cycle’ effect that can occur, when your stress causes your tinnitus to get worse, which can make you more stressed and again, make you less able to cope with your tinnitus.

People might be led to believe that the differences in individual attitudes towards tinnitus can be simply explained by people having different types of tinnitus. However, research doesn’t support this hypothesis and instead proposes that the reason one person can be stressed and another not is because they have different ideas, feelings, and beliefs about tinnitus.

The importance of attitude, attention, and habituation in your experience of tinnitus goes some way in explaining why certain behavioral therapies have proven extremely effective in helping people manage their symptoms.

Can Blood Pressure Cause Tinnitus?

Blood pressure is the pressure of blood in your arteries (vessels that carry your blood from your heart to your brain and the rest of your body). A certain amount of pressure is necessary for blood to move around your body.

It is normal for your blood pressure to fluctuate, for example, it will go up when you’re exercising, and down at night when you’re sleeping. 

Nevertheless, if your blood pressure is consistently high (systolic pressure over 130 or a diastolic pressure over 80), this can be problematic for your health and can lead to tinnitus, amongst many other issues. Your doctor will be able to tell you if you have high blood pressure, and if this is a likely cause of your tinnitus.

Having high or low blood pressure can affect your blood viscosity (the measurement of thickness and stickiness of your blood) with high blood pressure being linked to increased blood viscosity. This results in your inner ear structures receiving less blood flow, and therefore, less oxygen reaching this part of your ear. This is a recipe for hearing loss down the line and can increase your risk of developing hearing issues such as tinnitus. 

Not only this, but common medications used for high blood pressure are loop diuretics and aspirin. Although normal doses should not cause any issues, these are both known to cause tinnitus in high doses, and individual sensitivity to medications varies.

Controlling many factors can help you lower your high blood pressure. Sticking to a healthy plant-based diet, exercising more, drinking less caffeine, eating less salt, and reducing stress and alcohol consumption can help to bring down blood pressure and if you have tinnitus, might reduce your symptoms. 

It is useful to be aware that other blood vessel disorders might trigger tinnitus, such as atherosclerosis (a build-up of cholesterol and other deposits in the vessels), which is problematic as this can cause restrictive, but more forceful blood flow in older people which can be picked up in the ear as tinnitus.

Can Earwax Cause Tinnitus?

Earwax is a natural secretion found in the ear. It plays an important role by keeping the ear canal lubricated, protecting the ear against dust, dirt, and bacteria, and preventing infection.

Earwax is generally best left alone and should clear naturally. Using cotton buds or your fingers to remove wax can push it further into your ears and lead to impaction.

However, for some people, ear wax accumulates more easily and can be problematic. This buildup, left untreated, can cause permanent damage resulting in chronic tinnitus. Also, some people with tinnitus feel that their symptoms are worse when their ears are full of wax. Do not try to remove earwax yourself. If you are concerned, contact your doctor and make an appointment to see a specialist. 

Treating Tinnitus

There is currently no FDA-approved medication or supplement that is clinically proven to be more effective at treating tinnitus than a placebo.

Nevertheless, some very effective strategies can help you manage your tinnitus symptoms. 

Behavioral strategies and sound-generating devices have helped many people to ignore their tinnitus by distracting their attention away from these sounds, and are something to discuss with your doctor if you haven’t already.

If you have been experiencing tinnitus for longer than 48 hours, you should contact your doctor and make an appointment. It’s important to rule out any underlying medical condition that requires urgent treatment. They’ll be able to conduct a medical examination and or refer you to an audiologist.

To read more about tinnitus and hearing loss, see our other blog articles.

The information in this guide has been written using the following reliable sources:

https://www.audiologyandhearing.com/the-4-different-types-of-tinnitus/

https://www.tinnitus.org.uk/tinnitus-and-stress

https://www.specsavers.co.uk/hearing/ear-health/tinnitus/tinnitus-high-blood-pressure

https://www.tinnitus.org.uk/ear-wax