Ringing in the ears: These causes can be behind tinnitus

Humming, whistling, hissing or cracking – ringing in the ears can occur suddenly. They are often over after a few seconds, but sometimes they persist. They all share that they can only be heard by the person concerned or (more rarely) by others as part of a medical measurement. According to the definition, the perception of a noise that cannot be attributed to an external acoustic stimulus is referred to as tinnitus – tinnitus does not only express itself as a beeping, as is often wrongly assumed. Depending on the volume and duration of such tinnitus, the noise in the ear is perceived by those affected as having different stress levels. If the ringing in the ears lasts longer than three months, it is called chronic tinnitus.

There are many possible causes of ringing in the ears. From problems with the cervical spine to medications to psychological components such as stress and anxiety, many factors can be behind tinnitus. In the following, we present typical causes of tinnitus and show how to identify possible triggers.

However, this article cannot replace a medical diagnosis. You should, therefore, always seek medical advice if you are impaired by ringing in your ears, mainly since tinnitus can often occur as an accompanying symptom of illness.

Tinnitus from stress?

If you suffer from a lot of stress privately and professionally, this is accompanied by ringing in many people’s ears. Other stressful emotions, such as anger or fear, are also suspected of promoting tinnitus in the long term.

It has not yet been scientifically clarified whether psychological stress, such as stress, can trigger tinnitus. For example, it is assumed that a permanently high level of the stress hormone cortisol could bring about changes in the auditory system or that interference signals in the auditory pathway are perceived more clearly under stress. In addition, stress can promote sudden hearing loss (i.e., sudden or even complete hearing loss), which can trigger tinnitus. In any case, one thing is sure: Stress can intensify existing tinnitus, and tinnitus can, in turn, promote negative feelings.

tinnitus and depression

Tinnitus and depression often occur together. There are different reasons for this. Existing tinnitus is associated with highly negative feelings in many affected people – depending on the degree of stress. In the long run, tinnitus can, therefore, also promote the development of depression. Conversely, the same applies: the typical symptoms of depression, such as listlessness, a negative mood or inner restlessness, are suspected of triggering ringing in the ears.

(Unilateral) ringing in the ears due to problems with the cervical spine

Problems with the cervical spine (cervical spine) and incredible blockages in the area of ​​the upper vertebrae are discussed as possible triggers of tinnitus. The ringing in the ears caused in this way is often one-sided, and the noise itself is humming or hissing. Therefore, a medical examination of the spine can help search for the causes of tinnitus.

Neck pain, tension and tinnitus

Like problems with the cervical spine, tense neck muscles can also contribute to the development of tinnitus. The triggers are tension in specific muscles that press on nerves or blood vessels in the neck.

Tinnitus from jaw problems

There are numerous connections between the jaw, cervical spine and ears via muscles and nerves. Problems with the jaw, for example, due to misalignment, grinding teeth, or surgical procedures, can also cause ringing in the ears.

What medications can cause ringing in the ears?

Certain medications’ possible side effects include damage to the sensory cells in the ear or the associated cranial nerve. The technical term for such an effect is ototoxicity. Examples of ototoxic drugs are:

• special psychotropic drugs
• higher concentrated acetylsalicylic acid (ASA)
• some antibiotics
• Diuretics (water pills)

Tinnitus after a cold or middle ear infection

Tinnitus can also occur with a cold. The triggers are viral inflammation of the nasal mucosa. This also lines the connection between the middle ear and the pharynx so that viruses can get into the middle ear via this route in the event of an infection.

Inflammation of the middle ear or ventilation disorders in the middle ear, which can arise as a result, are also possible causes of ear ringing. If the condition is treated and eventually resolves, the ear ringing usually disappears over a few weeks.

Ringing in the ears has a variety of causes.

A brief cracking or clicking sound in the ear, for example, when swallowing, indicates pressure equalization between the inner ear and the outside air. The ear trumpet (Eustachian tube) opens briefly, which can be associated with a noise. For example, many people know this from pressure changes on an aeroplane or a mountain trip.

Another common cause of cracking noises is poor middle ear or auditory tube ventilation. These disorders often occur due to swollen nasal mucous membranes since the paranasal sinuses are connected to the middle ear.

Muscle twitching of the middle ear muscles or the soft palate can also trigger a cracking sound. In rare cases, inflammation or damage to the eardrum can also be responsible for the cracking.

Causes of Pulse Synchronous Tinnitus

If the noise in the ear is pounding or throbbing and its rhythm corresponds to the pulse, it is a so-called pulse-synchronous tinnitus. Constrictions in the bloodstream often trigger this. If the sound is more of a clicking sound, muscular twitching of the palate or middle ear may be behind it.

In contrast to many other forms of tinnitus, pulse-synchronous tinnitus can be heard by others or measured using medical devices. This is then referred to as objective tinnitus.

ringing in the ears and blood pressure

If the blood pressure, i.e. the pressure with which the blood flows through the veins, is permanently increased, this increased pressure can be perceived as a noise in the ear. But blood pressure that is too low can also make itself felt as a frequent short-term noise in the ear, for example, when there is a drop in blood pressure when you sit up quickly after bending or lying down.

Tinnitus due to magnesium deficiency?

Magnesium dilates blood vessels, improving blood flow. It also improves blood flow. Since too high or too low blood pressure can cause ringing in the ears, it has been suggested that a magnesium deficiency could be linked to tinnitus.

Hearing loss or acoustic trauma as a trigger for tinnitus

Suddenly occurring, one-sided hearing problems up to complete hearing loss are called sudden hearing loss or “ear infarction”. The causes of sudden hearing loss are not yet fully understood. The disease is probably triggered by circulatory disorders in the ear, metabolic disorders or stress. In any case, there is damage to the sensory cells (hair cells) in the ear, which can also occur with acoustic trauma (e.g., acoustic trauma).

In addition to dizziness and (often unilateral) hearing loss, ringing in the ears is a typical symptom of sudden hearing loss. A doctor should treat a sudden hearing loss as soon as possible to get rid of the tinnitus and avoid permanent damage to the ear.

Tinnitus in hearing loss

Hearing loss is usually caused by damage to the hair cells in the ear, which means that sound waves can no longer be adequately processed. Hearing loss is, often accompanied by ringing in the ears, which can worsen the hearing problems.

Ringing in the ears and Meniere’s disease

In Menière’s disease, also known colloquially as rotary vertigo disease, the production of inner ear fluid is disrupted. As a result, too much fluid accumulates in the inner ear. Dizziness and hearing loss occur, often accompanied by a one-sided, low-pitched tinnitus and a feeling of pressure in the ear. Nausea and vomiting can also occur.

tinnitus and alcohol

Alcohol is suspected of damaging the hair cells in the ear and thus being able to trigger tinnitus. Whether such damage occurs and how persistent it occurs is probably related to the amount or concentration of alcohol consumed.

Tinnitus in pregnancy

Ringing in the ears is not uncommon during pregnancy. In principle, favourable factors such as stress or high blood pressure can also be considered as triggers. Problems with the cervical spine are also a common cause, especially in late pregnancy.