If you are trying to make sense of the sound in your ears, start by describing it clearly. Most people describe tinnitus as ringing, roaring, buzzing, hissing or clicking inside the head, and the sound can come and go or stay constant. A 2023 review found that the characteristics of tinnitus can guide a diagnosis, but they cannot firmly settle what is causing it. Your description is useful, and it is not the whole answer.
Some signs should not wait for a description. If your tinnitus comes with hearing changes or dizziness, contact a healthcare provider about it. Harvard Health’s tinnitus article says that if you have tinnitus despite a normal hearing test, you should report it to your primary care doctor or an ear, nose and throat specialist. For background on dizziness, read tinnitus and dizziness.
Are tinnitus sounds real?
Yes, the sound is real to you, but it has no outside source. A 2023 review indexed by PubMed defines tinnitus as the perception of sound when no external objective noise is present. The same review says it is not defined as an illness, but as a symptom of an underlying process.
Cleveland Clinic’s tinnitus page describes two types:
| Type | What Cleveland Clinic says it is |
|---|---|
| Somatosensory tinnitus | Sounds your brain perceives when you move the muscles in your jaw or neck |
| Subjective tinnitus | Sounds only you can hear |
Cleveland Clinic also says that there might not be a simple answer for why tinnitus is happening.
Can tinnitus sound like buzzing or humming?
Buzzing, yes. The Johns Hopkins Medicine guide to tinnitus lists the sounds people hear in their head as ringing, roaring, buzzing, hissing and clicking. Harvard Health’s article on tinnitus uses similar words and adds whooshing.
If your sound is a hum, describe it in your own words and note how it compares with the words above. Johns Hopkins also says the sounds may have different tones and may happen in one ear or both.
Should I record when sounds occur?
Recording is a practical step. Johns Hopkins advises writing down your questions before a visit, bringing someone along to help you ask them and remember what you hear, and writing down any new diagnosis, medicine, treatment or test your provider mentions. It does not say that a sound log changes the diagnosis.
These are items you could note before a visit:
| What to note | Why it is mentioned in these guides |
|---|---|
| When it starts and stops, or whether it is constant | Johns Hopkins says the sounds may come and go, or be ongoing |
| One ear or both | Johns Hopkins says the sound may happen in one or both ears |
| Whether jaw or neck movement changes it | Cleveland Clinic describes one type of tinnitus as sounds perceived when these muscles move |
| Sleep and stress | Johns Hopkins says people may have trouble sleeping with tinnitus, and Harvard Health says stress may increase both your perception of tinnitus and your reaction to it |
Can the sound description identify the cause?
Not on its own. A 2023 review of 30 publications, dated from 1992 to 2022, concluded that tinnitus characteristics do not have the ability to firmly diagnose the pathology behind them, though they may guide the diagnosis. A 1993 review of cochlear models called the lack of objective measurement the most evident problem in all of them, and said one patient’s situation is hardly attributable to a single model.
Johns Hopkins lists many possible causes of tinnitus:
- Various types of hearing loss
- Damage to the nerve endings in the inner ear
- Exposure to loud noises
- Ear and sinus infections
- High or low blood pressure
- Tumor
- Diabetes
- Thyroid problems
- Head or neck injury
- Reaction to certain medicines
- Wax buildup
- Jaw misalignment
Harvard Health says that in rare cases the noise can be caused by a tumor or cyst pinching the auditory nerve, a buildup of earwax, or blood vessel damage. Cleveland Clinic’s earwax guide lists tinnitus among the symptoms of a clogged ear.
Why do tinnitus sounds change?
Harvard Health reports a study published November 30, 2023, in the journal Scientific Reports. It recruited almost 300 people, ages 18 to 72, who had normal hearing tests and either chronic tinnitus, no tinnitus or intermittent tinnitus. Researchers measured auditory nerve responses and brainstem activity. Compared with people without tinnitus, chronic tinnitus was associated with a loss of auditory nerve fibers and increased brain activity.
Maison, a tinnitus researcher quoted by Harvard Health, says the brain increasing its activity after hearing loss is possibly why you perceive a sound that is not there. The study describes an association, not a cause. Harvard Health also notes that hearing aids are not recommended for people with normal hearing test results, since there are no tests outside research labs to measure this kind of hidden hearing loss.
How many tinnitus sounds are there?
Johns Hopkins names five sound words: ringing, roaring, buzzing, hissing and clicking. Cleveland Clinic describes two types, somatosensory and subjective, as set out above.
What the studies found, and what they cannot tell you
| Study | What it did | What it found | What it cannot tell you |
|---|---|---|---|
| 2023 review in The International Tinnitus Journal | Literature review of 30 publications from 1992 to 2022 | Tinnitus characteristics may guide diagnosis | Cannot firmly diagnose the condition behind the tinnitus |
| 1993 review in European Archives of Oto-Rhino-Laryngology | Reviewed cochlear mechanisms and organised them into three models | Possible molecular and cellular mechanisms in the cochlea | Cannot match one patient to one model without objective measurement |
| 2023 study in Scientific Reports (reported by Harvard Health) | Almost 300 people, ages 18 to 72, with normal hearing tests; measured auditory nerve responses and brainstem activity | Chronic tinnitus associated with loss of auditory nerve fibers and increased brain activity | Shows an association, not a cause; hidden hearing loss cannot be measured outside research labs |
Johns Hopkins says a diagnosis includes a complete health history and physical exam, and that your healthcare provider may request an audiological evaluation.
What should I bring to my appointment?
Harvard Health says that if you have tinnitus despite a normal hearing test, you should report it to your primary care doctor or an ear, nose and throat specialist. Cleveland Clinic’s tinnitus program asks people to have a hearing test during the six months before their appointment and to see an ear, nose and throat doctor first.
Before you go:
- Note when the sound starts, stops or stays constant
- Write down any hearing changes, dizziness or symptoms that are getting worse
- Bring a hearing test result from the past six months if you have one
- Bring someone along to help you remember what you are told
If the sound is in one ear only, tinnitus in one ear covers the questions to ask. If cost is part of your decision, the tinnitus treatment cost page covers what you’ll pay and what’s covered.
Start by noting when the sound starts and stops, which ear it is in, and whether moving your jaw or neck changes it. Bring those notes to your first visit, and let the clinician work out the next step with you.
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.
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