About this leaflet

This leaflet answers some of the common questions that people ask about tinnitus. It tells you about:

You can download a portable document format (PDF) version of this leaflet (opens new browser window). 

What tinnitus is

Tinnitus is a medical term for any noise that people hear in one ear, both ears or in their head. These sounds do not come from outside the head, although they may occasionally sound as if they do.

What does tinnitus sound like?

Tinnitus sounds can take a variety of forms such as buzzing, ringing, whistling, hissing or a range of other sounds. For some people it can even sound like music or singing. Sometimes people only notice these sounds when it is very quiet, such as at night. Other people find that they are much louder and can intrude on everyday life. Sometimes tinnitus noise beats in time with your pulse. This is known as pulsatile tinnitus. See our factsheet Pulsatile tinnitus for more information.

How common tinnitus is

Most people have experienced brief periods of tinnitus at some time. It is quite common to have it for a short while after you have been exposed to loud noise – for example, after clubbing. Tinnitus is very common in people of all ages, so you are not alone.

What causes tinnitus

There are many different causes of tinnitus. We know that tinnitus can be linked to:

Many people with tinnitus have never experienced any of the above and don’t have a hearing loss. There are several theories and ongoing research as to what happens when you have tinnitus.

To understand what happens when you have tinnitus, you need to understand how your ear works.

The hearing pathway

The ear is made up of three parts, the outer, middle and inner ear. These parts of the ear change sound waves around you into nerve signals, which then travel up the hearing nerve to the brain. Once the signals reach the hearing part of the brain known as the auditory cortex, you will hear them as sound.

The hearing pathway has a complex filtering system which allows you to ‘tune in’ to sounds that have meaning to you, and ‘filter out’ sounds which are not important to you. For example, you may not notice the background noise of traffic, but you would notice the sound of a baby crying. This system works all the time and stops you being bombarded with sound.

Your brain also has systems that respond to the meaning of sounds and help influence the way that you filter them. For example, if you hear your name at a party you will tune in to hear what is being said about you. This is because the sound of your name has lots of meaning to you. Together, these filters and response systems help to control how you react to sound.

The tinnitus signal

Your hearing pathway, your filters, and your sound response systems are all involved when you hear tinnitus. Firstly, a tinnitus signal is created, usually in your inner ear or the auditory nerve. This is usually very weak and most people don’t notice it. However, if you become aware of tinnitus, this means that your filters have started to pick up this tinnitus signal.

If you become anxious or annoyed by tinnitus, your sound response systems will tune your filters into it and you will start to hear it more.

The aim of tinnitus management is to learn to ignore the tinnitus signal.

Feeling sensitive to sound

Around 40% of people with tinnitus are also more sensitive than normal to everyday sounds. Broadly speaking, there are two forms of sensitivity to sound:

For more information see our factsheet Hyperacusis.

Treatments for tinnitus

There is currently no cure for tinnitus that works in the same way for everyone. But it is sometimes possible to treat the underlying condition that may be causing it. For example, if you have an ear infection, antibiotics may help clear this up, which may in turn improve the tinnitus.

If the tinnitus is linked to a particular medicine you are taking, it may stop if you change or stop taking that medicine. But make sure you ask your GP before you change your medicine, alter your dose or stop taking it altogether. It is also important to let your GP know of any over-the-counter drugs you are taking.

Where to go for help

The first person you need to see is your GP. They will check that your ears are free from wax and infection and may refer you to the ear, nose and throat (ENT) department at your hospital.

Although GPs are trained to a high level in a wide area of medicine, they are not tinnitus experts and their knowledge about treatments for tinnitus may vary. When some people visit their GP about tinnitus they may find it difficult to get a referral to an ENT department. Make sure you tell your doctor that the tinnitus is a problem and how it is affecting you. For example, is it making you feel stressed, or giving you sleep problems? Are you finding it difficult to cope? It may be useful to take along some leaflets or factsheets about tinnitus. Contact RNID Information Line or the British Tinnitus Association (external link, opens new browser window) for free copies.

If you still can't get a referral, try seeing a different doctor in the practice or even changing to a different practice altogether. You have the right to a second opinion. Most GPs are helpful and it is worth seeking their help.

What will happen at the hospital?

First, you will see a specialist at the ENT department. It is important to have a thorough check-up to see if there are any obvious causes for your tinnitus. You may then be referred to a tinnitus clinic if there is one in your area. These are usually run by staff from the audiology department.

Some hospitals have specialist tinnitus centres or clinics, but it varies depending on where you live. Some areas may offer a limited tinnitus service or in some cases no tinnitus service at all. Getting an NHS appointment may sometimes involve delays and waiting lists, so be prepared to wait.

Contact the RNID Tinnitus Helpline to find out where your nearest clinic is.

How do ENT departments help?

Your specialist may suggest you try habituation therapy. This changes your sound response systems so that you gradually become less aware of the tinnitus. Habituation therapy can involve:

How can counselling help?

Counselling is a very important part of tinnitus management. It can help you understand your tinnitus better. Talking about tinnitus and sharing how it makes you feel can also be very helpful.

How can hearing aids help?

If you have a hearing loss, a hearing aid can help with tinnitus management by:

All these will help distract you from paying attention to tinnitus.

What is sound therapy?

Sound therapy is also known as sound enrichment. Many people find that they are more aware of tinnitus in a quiet environment. Sound therapy works by filling the silence with therapeutic sounds. These distract you from listening to your tinnitus making it less noticeable and therefore less intrusive. This helps your filters to tune out tinnitus. Sound therapy involves listening to a range of sounds that you find pleasant, such as recordings of nature sounds, or by using a sound generator, or a sound enricher.

See our factsheet, Equipment, sound therapy and tinnitus.

How do sound generators work?

A sound generator produces a gentle, soft ‘rush’ (white noise) which sounds like an off-tune, or off-station, radio. This can help retrain your brain to ignore tinnitus. The volume should be set at just below the level of the tinnitus. You can get different styles of sound generator. Sound generators that you wear in your ear look like hearing aids. You may not be offered all styles on the NHS as availability varies throughout the country. It will also depend on what is most appropriate for your needs.

What other sounds can help?

Some people find everyday sounds helpful, such as the television, radio, an electric fan or music. You may have to experiment until you find the sort of music that works best for you. Ideally the music shouldn’t be too stimulating or emotional. Some people find natural sounds helpful, such as the sea, the rainforest or birds, either on their own or combined with pleasant music.

Be careful not to cover the sound of the tinnitus by playing any of these sounds too loudly. However, at night you may find it useful to use background sound to help you get to sleep.

We sell desktop sound generators and a range of relaxation CDs and cassettes. They have all been recommended by people with tinnitus. Contact the Tinnitus Helpline for more information.

We also have a book called Understanding tinnitus – managing the noises in your ears or in your head. This essential book on tinnitus has been written by audiology specialists. It tells you about:

Is relaxation important?

A regular relaxation routine can help you manage the stress that is often associated with tinnitus. Many people notice their tinnitus more when they are worried or tired, and this in turn increases their levels of anxiety and stress.

You can learn to control your responses to stress by using relaxation techniques. These are taught in many tinnitus clinics and audiology departments, or try local adult education classes in relaxation techniques, or classes in meditation or yoga.

See our factsheet Tinnitus and relaxation for more information.

Children and tinnitus

Children and young people can also get tinnitus and hyperacusis. Children may be born with tinnitus or develop it in the same way that adults do. Children born with tinnitus or who develop it at a very young age may not realise it is unusual. They often do not have the words to describe their tinnitus until they reach school age. As with any childhood ear problem, get specialist help as soon as possible by contacting your child’s GP.

For more information, see our factsheet Tinnitus and children.

How can I find out more?

RNID Tinnitus Helpline

We can provide the following information for people with tinnitus and their friends and families:

British Tinnitus Association (BTA)

Contact the BTA Helpline for information, advice and support. The BTA:

British Tinnitus Association, Ground Floor, Unit 5,
Acorn Business Park, Woodseats Close,
Sheffield S8 0TB.
Telephone 0800 018 0527 Fax 0114 258 7059
Email: info@tinnitus.org.uk
Website: British Tinnitus Assocation website (external link, opens new browser window)

Medical disclaimer

The information given in this leaflet is not medical advice and by providing it RNID undertakes no responsibility for your medical care nor accepts you as a patient. Before acting on any of the information contained in this leaflet or deciding upon a course of treatment you should discuss the matter with your GP or other medical professional who is treating you.