If you often experience a ringing in your ears or hear sounds that no one else can, you're not alone. According to the U.S. National Institute on Deafness and Other Communication Disorders, between 10% and 25% of adults experience what's medically termed tinnitus. 

That means some 34 to 85 million Americans can relate on some level to hearing noises that don't have an external source — though these sounds have to persist for three months or longer for it to be considered chronic tinnitus. It's also worth noting that, "while millions of people have tinnitus, only a small percentage are significantly bothered by it," says Dr. Tina Huang, an otolaryngologist who treats patients with tinnitus and other hearing issues at the University of Minnesota Medical School. 

Here's what tinnitus is, what causes it and its most common treatments. 


What does it mean when your ears ring? What is tinnitus?

Tinnitus is defined as "sound that a person hears when there is no external source of the sound," says Huang. Such noises are often described as a "ringing" in the ear, but a multitude of other sounds can also apply. These include pulsing, buzzing, squealing, clicking, chirping, roaring, humming, whistling, hissing and rushing. "Some people even describe the noise they hear as musical," says Sarah Sydlowski, the audiology director of the Hearing Implant Program at Cleveland Clinic.

For some people, such sounds can be so loud the individual can't focus on anything else. For others, the noise can be so soft or subtle that it could be easily missed. Sounds can also be high-pitched or very low and can come and go or maintain a more constant presence. 

Tinnitus can happen to anyone, but it occurs more frequently in adults than children, and is especially common in adults 40 years or older. People with tinnitus may experience frustration, problems sleeping, relationship troubles, difficulty concentrating heightened anxiety and irritability and mental health issues.

What causes tinnitus? 

All causes of tinnitus are not universally understood. "It's complex because the actual pathway for the creation of tinnitus is not fully mapped in the brain," says Huang. "But we do know there is no genetic component to tinnitus." Instead, environmental factors and getting older play the biggest parts. For instance, age-related hearing loss can affect the brain's auditory nerve and is thereby one of the most common causes of tinnitus. 

Another common factor is damage related to repeated exposure to loud noises such as deafening music, work environments with loud machinery or frequently attending especially raucous sporting events. "When the 18,000 or so sensory cells in the inner ear are damaged by loud sounds, the ear is less capable of sending signals to the hearing nerve and ultimately to the brain," says Sydlowski. Damaged sensory nerves are thought to be why tinnitus is especially common among veterans — as active military members are sometimes exposed to bursts of gunfire or bomb blasts.

Blockage of the ear canal due to earwax or other substances can also cause tinnitus, as can suffering from an ear infection or head or neck injury. "Head trauma in general can cause tinnitus even when it doesn't cause noticeable changes in hearing since tinnitus is brain-generated," says Huang. High doses of certain medications can also contribute to tinnitus. Some of these include antidepressants, NSAIDS, certain antibiotics and anti-malaria medicines. 

Less commonly, tinnitus is sometimes related to brain tumors, jaw-joint problems or chronic conditions such as thyroid disorders, diabetes or autoimmune disorders. 

What is the best way to treat tinnitus?

Treatment options for tinnitus vary depending on what's causing the problem. Sometimes stopping the behavior that causes tinnitus or changing one's medication are all that is needed. Other times, the root cause of the problem needs to be fixed such as treating the underlying injury or condition. Wearing a sound generator or hearing aid can also treat symptoms associated with tinnitus.

Sound therapies can be helpful as well, as can tinnitus retraining therapy. "Another of the main treatments for tinnitus is cognitive behavioral therapy (CBT) as the main goal of treatment is to make the tinnitus less bothersome," says Huang. She adds that stress reduction techniques and improved sleep can also help.

White noise machines can also be useful in masking frustrating or distracting noises. "A fan running or sounds like rain or a thunderstorm playing can help because tinnitus is most noticeable in quiet places where there isn't other sound," says Sydlowski. "Anything that can take your brain's attention off the sound can be helpful," echoes Huang.

"Whether tinnitus is barely noticeable to debilitating," adds Sydlowski, "it's important to know that it can be treated and managed."