What causes ringing in the ear? Related conditions and treatments

People may think of tinnitus with the mention of ringing in the ears. While that is correct, tinnitus is any noise that comes from the ear (rather than the environment) and can also include buzzing, roaring, whistling, or hissing sounds. Tinnitus is a common problem that is often associated with hearing loss. It can occur in one or both ears. It affects up to 50 million people in the United States. Tinnitus can interfere with daily activities, as well as sleep. Although tinnitus sounds can vary, we will refer to the terms “tinnitus” and “ringing in the ears” interchangeably in this article. Continue reading to learn more about ringing in the ear causes and what to do to feel better.

Key takeaways:

• Ringing in the ear is a common symptom due to various causes, such as aging, infection, earwax, loud noises, certain medications, etc.
• Typically, ringing in the ear does not require immediate medical attention. However, a healthcare provider should evaluate tinnitus that persists over a few days. If a sudden hearing loss occurs, that is a medical emergency and requires immediate medical care. 
• Ringing in the ear may or may not require treatment. Depending on the cause, tinnitus can last from day to month or year.
• Treatments for ringing in the ear vary by cause. Read more about treatments for tinnitus here.
• Ringing in the ear can be managed with sound therapy and behavioral therapy.
• Save on prescriptions for ringing in the ear with a SingleCare prescription discount card.

What causes ringing in the ear?

There are many possible causes of ringing in the ear. The American Tinnitus Association notes that over 200 potential conditions may be associated with tinnitus. 

Some common causes of tinnitus include: 

Acute illness or injury, such as:

• Ear infection (middle ear infection or external ear infection)
• Upper respiratory tract infection
• Sinus infection
• Flu 
• COVID-19
• A neck or head injury can cause damage to the ears, nerves, or parts of the brain that are associated with sound

Other ringing in the ear causes may include certain medications, such as:

• Aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) such as Motrin (ibuprofen), Celebrex (celecoxib), or Mobic (meloxicam)
• Certain antibiotics, such as gentamicin or tobramycin
• Loop diuretics (water pills) such as Lasix (furosemide) or Bumex (bumetanide)
• Beta-blockers

Certain medical conditions can also contribute to tinnitus symptoms, such as:

• Temporomandibular joint disorder (TMJ)
• Meniere’s disease (a chronic inner ear disorder that can cause hearing loss and balance problems)
• Acoustic neuroma (also known as vestibular schwannoma; a benign tumor on a nerve that goes from the inner ear to the brain) and other brain, head, and neck tumors
• Allergies (congestion can affect the Eustachian tube, which can affect hearing)
• Migraine
• Excess bone growth in the middle ear
• Eustachian tube problems
• Problems with the blood vessels, including high blood pressure or a buildup of plaque on the walls of the arteries
• Diabetes
• Thyroid conditions
• Anemia
• Lupus
• Multiple sclerosis
• Lyme disease
• Fibromyalgia
• Depression 
• Anxiety 

Other causes of tinnitus may include temporary changes such as:

• A blockage caused by a foreign object in the ear (which can rupture the eardrum) or earwax
• Exposure to loud noise (such as explosions or concerts)
• Changes in air pressure (for example, from diving or snorkeling)

Aging is another common cause. The medical term for age-related hearing loss is called presbycusis. Hearing starts to decline in adults around 60, and the brain fills in missing sounds with tinnitus.

As mentioned above, many potential causes exist, although some people will still experience tinnitus with no identifiable cause.

Should I be worried about ringing in the ear?

Concerning symptoms include tinnitus in only one ear and neurologic symptoms such as difficulty with balance or walking, dizziness, or problems with seeing, speaking, swallowing, and/or talking. See a healthcare provider immediately if any concerning symptoms occur. Sudden hearing loss is a medical emergency and requires immediate medical attention. 

If there are no concerning symptoms but one recently developed tinnitus, make an appointment with a healthcare provider. An appointment should also be made if a sound with each pulse beat (pulsatile tinnitus) is heard. It is a good idea to make an appointment in case the symptoms are associated with another medical condition or if tinnitus has occurred for a while without a doctor visit. 

How is the cause of ringing in the ear diagnosed?

Start with a primary care physician, who can check the ears and take a medical history, which may help determine if a medical condition or medicine is causing tinnitus. 

One can also see an otolaryngologist or ear, nose, and throat (ENT) doctor. An ENT will ask about symptoms and check the ears, head, and neck. They may recommend seeing an audiologist (often in the same office) for a hearing test to evaluate hearing and tinnitus symptoms. 

In some cases, the ENT may order imaging tests, such as an MRI, CT, or ultrasound, to look for structural problems or other medical conditions. 

How long does ringing in the ear last?

It depends on the cause. Depending on what’s causing symptoms, tinnitus can last anywhere from hours to months or even longer. Some examples include:

• If ringing in the ear is due to a buildup of ear wax, having the ear wax removed by a healthcare provider may provide immediate relief. 
• If ringing in the ear after exposure to loud sounds happens, symptoms often go away on their own in a day or so. 
• If a viral or bacterial infection occurs, such as an ear infection, sinus infection, cold, or flu— the onset of tinnitus may be due to fluid accumulation in the ear canal. This type of tinnitus generally disappears once the underlying illness is treated. If it doesn’t, see a healthcare provider. 
• Tinnitus due to aging is more of a permanent type of tinnitus. 
• People constantly being exposed to loud noises, such as live musicians who play in loud concerts, may have permanent tinnitus. 

How to get rid of ringing in the ear/living with ringing in the ear

When coping with tinnitus, learning about ringing in the ear treatments is important. Consult a healthcare provider about how to treat ringing in the ear based on individual symptoms. The best way to feel better is to treat the underlying cause, if possible. For example, if a bacterial infection causes ringing in the ears, a healthcare provider can prescribe an antibiotic to clear the infection, and the tinnitus will go away, too. However, sometimes, tinnitus symptoms may persist for months or years. The good news is that there are some tips to try to lessen the impact of these symptoms, such as:

• Sound therapy: This may help silence or mask tinnitus sounds—or help get used to or ignore them. Examples of sound therapy devices include sound generators (such as a phone app that plays background noise or white noise), hearing aids, wearable sound generators (small devices that fit in the ear and play soft sounds), and combination devices that can both amplify sounds and generate sounds.
• Education: Learning more about tinnitus can help reduce anxiety by helping to become empowered to understand the condition and learn coping strategies. Tinnitus is often not caused by a serious condition, so understanding that can be very reassuring. Learn tips that help prevent aggravating symptoms, such as avoiding caffeine and other stimulants.
• Cognitive-behavioral therapy: Learning coping techniques in cognitive behavioral therapy can help to focus on the positive changes being made to help lessen the impact of tinnitus. 
• Tinnitus retraining therapy is a type of therapy that combines counseling with sound therapy to retrain the brain so that the tinnitus becomes less noticeable. 
• Medications: No medications can specifically treat tinnitus, and vitamins and supplements have not been proven effective in treating tinnitus symptoms. A health care provider may prescribe an antidepressant to increase mood or antianxiety medication for relaxation and sleep. Medication may be needed if tinnitus symptoms are due to another medical condition. For example, the healthcare provider may prescribe medication to prevent and treat migraine attacks if the symptoms are due to migraine. 

Most importantly, see a healthcare provider for diagnosis

There are various ringing in the ear causes, such as aging, infection, or certain medical conditions or medications. The cause of tinnitus may resolve on its own without treatment. However, if ringing in the ear continues, worsens, or is accompanied by other symptoms, it could be a sign of another medical condition and require treatment of the underlying condition. Only a healthcare provider can rule out infection or other serious health conditions. Because there are so many potential causes, patients with tinnitus symptoms should always err on the side of caution and see a healthcare provider for more information and medical advice.