Tinnitus and Dizziness: Symptoms, Urgent Signs and Who to See

Tinnitus is a ringing, buzzing, hissing or clicking sound inside your head. Healthline says tinnitus is often caused by damage to the middle or inner ear, and the Johns Hopkins Ménière disease page describes a condition that can cause both vertigo and tinnitus. When dizziness comes with ringing, many different conditions can be behind it, so the next step is a routine visit with the right clinician. Some signs need immediate medical help.

If you have any of these now, get immediate medical help: a sudden change in vision or hearing, fainting, chest pain, slurred speech, weakness or numbness on one side, being unable to stand or walk, or dizziness that gets worse or lasts for several hours. The full list is in the section below.

What are the symptoms of tinnitus and vertigo?

Johns Hopkins Medicine’s tinnitus page says people often hear ringing, roaring, buzzing, hissing or clicking inside the head. The sounds may come and go, or they may be ongoing. Its Ménière disease page describes vertigo as a severe spinning feeling, and it lists the symptoms below as the most common ones.

Which symptoms change urgency?

Healthline’s guide to ringing in the ears, dizziness and head pressure lists these signs as ones that may indicate a medical emergency:

• Feeling faint or losing consciousness
• Chest pain or shortness of breath
• A sudden change in vision or hearing
• Dizziness that worsens over time or lasts for several hours
• A headache lasting more than a day that does not respond to over-the-counter pain relievers
• Tingling or numbness in your limbs, especially on one side
• Weakness on one side of your face or body, or slurred speech
• Loss of vision in one eye, or being unable to stand or walk

Ménière symptoms can also come on suddenly, so Johns Hopkins advises finding out ahead of time how to handle an attack and when to get medical care. Cleveland Clinic’s earwax guidance says it is smart to seek medical evaluation if home remedies do not work, your ear hurts or you have trouble hearing. That advice is written for earwax, so it applies when earwax may be the cause.

Why is a hearing test alone not enough?

A hearing test is one part of the work-up, not the whole of it. Harvard Health notes that some people have tinnitus with normal hearing test results, and that a type of damage it calls “hidden” hearing loss is not picked up by conventional tests.

Johns Hopkins describes the diagnosis of tinnitus as a complete health history and physical exam, with an audiological evaluation and other tests depending on the suspected cause. For Ménière disease, it lists balance tests, an MRI to see whether a tumor is present, and electrocochleography, which measures electrical activity of the inner ear.

Cleveland Clinic asks people to have a hearing test in the six months before their visit, and to see an ear, nose and throat doctor first, who will make sure no condition needs medical or surgical treatment. Harvard Health also says that in rare cases the noise can be caused by a tumor or cyst pressing on the auditory nerve, a buildup of earwax, or blood vessel damage. Those causes are found through examination and testing, not by a hearing check alone.

What information is useful without delaying care?

Gather these notes in a few minutes, and do not hold off on booking a visit while you do.

• When it started, and whether the ringing or dizziness is in one ear or both. Johns Hopkins notes tinnitus can be in one or both ears, and Ménière symptoms are most often in one ear. The tinnitus in one ear questions are a useful starting point.
• Whether the sound comes and goes or stays constant, and how often dizziness happens.
• Which other symptoms come with dizziness, such as spinning, nausea, vomiting, sweating, hearing loss or ear pressure.
• The date of your last hearing test, if you have had one.
• Every medicine and supplement you take. Cleveland Clinic’s neurologists review these to see whether tinnitus may be a side effect.
• Your written questions, and someone to come with you. Johns Hopkins recommends both for a useful visit.

Can tinnitus cause dizziness, balance problems or nausea?

Johns Hopkins describes Ménière disease as a balance disorder caused by an abnormality in part of the inner ear. Fluid buildup there can cause a severe spinning feeling (vertigo) and affect hearing. Vertigo can cause falls or trouble driving, and it can come with severe nausea and vomiting. Ménière disease is more common in people in their 40s and 50s, and Johns Hopkins says it is most often caused by more than one factor.

Beyond Ménière disease, a 2022 meta-analysis in the Canadian Journal of Neurological Sciences pooled studies of people with COVID-19 and found tinnitus and dizziness in them. Its limits are covered in the research section below.

What causes tinnitus and vertigo together?

Johns Hopkins lists these as possible causes of tinnitus, among others: hearing loss, ear and sinus infections, high or low blood pressure, diabetes and thyroid problems.

Ear problems can look alike, so it helps to know what can be mistaken for an ear infection before you decide what to ask.

What should you avoid with Ménière’s disease?

Johns Hopkins says removing caffeine, chocolate, alcohol and salt may reduce how often Ménière symptoms happen and how intense they are. Its page also says reducing stress may lessen how severe the disease is. There is no cure for Ménière disease. Treatment depends on your symptoms, age, general health and how severe the condition is, and your clinician will decide which options fit you.

How do you stop ear ringing?

Johns Hopkins says there is currently no known cure for tinnitus, but it lists several approaches: hearing aids for people with hearing loss, maskers or sound generators, tinnitus retraining therapy, counseling and relaxation. Harvard Health adds white noise or nature sounds, mind-body therapies such as cognitive behavioral therapy, mindfulness-based treatment and biofeedback, and healthier habits such as good sleep, daily exercise and limiting alcohol. Harvard Health also says that treating an underlying condition, such as a tumor pressing on the auditory nerve, earwax buildup or blood vessel damage, can sometimes reduce the noise.

Does your brain eventually ignore tinnitus?

Harvard Health says that more often, the goal is learning to live with tinnitus or reducing it. Johns Hopkins notes that the sounds may come and go, or they may be ongoing. If the ringing is bothering your sleep or daily life, tell your clinician, because Johns Hopkins lists trouble sleeping as a common complaint.

What is the relationship between tinnitus and mental health?

Cleveland Clinic’s tinnitus care says tinnitus can cause, and result from, anxiety and stress. Its program teaches strategies to cope with anxiety and offers mindfulness training. Harvard Health says stress may increase both how much you notice tinnitus and how you react to it, and that cognitive behavioral therapy, mindfulness-based treatment and biofeedback can help redirect the negative thoughts and emotions linked to it.

What mental illness is associated with tinnitus?

Anxiety and stress are the mental health links named for tinnitus. For Ménière disease, Johns Hopkins says that complications such as falls, trouble driving and permanent hearing loss can cause depression and anxiety. If your mood is affected, bring it up at your visit so your clinician can plan care with you.

What is the treatment for tinnitus and dizziness?

Johns Hopkins describes Ménière disease treatment as surgery, medicines to control allergies, reduce fluid buildup, reduce dizziness or improve blood flow in the inner ear, diet changes, behavior therapy and hearing aids. For tinnitus, Cleveland Clinic says a specialist typically treats an underlying medical cause first. When there is no clear cause, its team offers cognitive behavioral therapy, coping strategies, sound therapy and medical management, which can include adjusting medicines or supplements when tinnitus is a side effect.

Are there exercises for tinnitus?

Cleveland Clinic says a physical therapist may design exercises to strengthen the jaw, neck and back, and may teach neck and shoulder stretches, as part of tinnitus care. These are jaw and neck exercises for tinnitus, not exercises for vertigo. For dizziness, ask your clinician whether a balance program fits your symptoms. Harvard Health suggests yoga or tai chi to help manage stress, which it says may make tinnitus worse. Ask your clinician whether exercise fits your situation before you start a routine.

What does the research on tinnitus and dizziness show?

These are small or mixed groups, so read them as limited. The COVID-19 review pooled studies of people with that infection, not people with tinnitus alone. The 1994 trial had 20 people with Ménière disease. Harvard Health says hearing aids are not recommended for people with normal hearing test results, since there are no tests outside research labs to measure hidden hearing loss. It also says that for most tinnitus, “we have only limited ways to cope with the problem.”

Which specialist should you see?

Before you go: your next step

Book a visit with your primary care doctor or an ENT doctor, bring the notes listed above, and use the emergency list if any warning sign appears. Bring these questions with you:

• Which clinician should evaluate my dizziness and ringing first?
• Do I need a hearing test, a balance test or an MRI?
• Could any of my medicines or supplements be contributing?
• What should I do if I have a Ménière attack?

By the Connected Diagnostics Evidence Team

This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.

See also

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