Somatic
The pitch, volume or location shifts when you move your head, neck, jaw or face. Associated with TMJ and dental problems, bruxism, neck and spinal injuries, and plain muscular tension.
800m
People worldwide estimated to experience tinnitus
10–15%
Share of the population affected by bothersome tinnitus
90%
Of people with tinnitus have some degree of hearing loss
1
Dual-mode treatment device granted US FDA approval3
What it is
A sound your brain produces, not one your ears pick up.
Tinnitus is the perception of sound with no external source. Most people describe a ringing, but hissing, buzzing, humming, whistling and thumping are all common. It can sit in one ear, in both, inside the head, or seem to come from just outside it.
For some people it arrives suddenly — after a loud concert, an ear infection, a bad cold or a build-up of wax. For others it creeps in so gradually they cannot name the week it started. Tinnitus lasting under three months is called acute, and much of it resolves on its own. When it persists, it is considered chronic.
It affects people of every age, including children, but it becomes more common with age because it travels alongside hearing loss.
Why it hits some people harder
Two people can hear the same sound and live completely different lives.
Tinnitus is not one condition with one severity. What separates a minor annoyance from a daily ordeal is usually not the loudness of the sound — it is how much attention the brain gives it.
Some brains treat the signal as background and stop flagging it, the way you stop noticing a fridge hum. Others latch onto it, and every time attention lands on the sound the response strengthens. That loop is why tinnitus so often tightens its grip at night, when there is nothing else competing for your attention.
This is also the reason tinnitus is measured by its effect on your life rather than by decibels. A quiet tinnitus that wrecks your sleep is a bigger clinical problem than a louder one you barely register.
The clinical goal for most people is habituation — the brain gradually filtering the sound out — rather than silence.
Types and subtypes
Subjective and objective — and three patterns underneath.
Almost all tinnitus is subjective: only you can hear it. Objective tinnitus, which a clinician can actually detect during an examination, is rare and usually points to a blood vessel or muscle issue. Lenire treats subjective tinnitus.
Cochlear
Something has affected the health of the ear, producing abnormal neural activity in the cochlea. Hearing loss, noise exposure, ototoxic medication, ear disease, diabetes and cardiac conditions are common contributors.
Central
Abnormal spontaneous activity in the brain's auditory centre. It typically develops once tinnitus has become chronic — changes can appear as early as twelve weeks after onset.
Causes
Age-related hearing loss is the most common single cause.
Tinnitus is a symptom rather than a disease, and it has many possible origins. Identifying which one applies to you is a large part of what a tinnitus assessment is for.
If your tinnitus is pulsatile — beating in time with your heartbeat — or arrived suddenly in one ear alongside hearing loss or dizziness, see a doctor promptly rather than booking a device consultation.
- Hearing loss, particularly age-related
- Sudden exposure to loud noise
- Middle ear infection
- Perforated eardrum
- Ménière's disease
- Certain medications
- Head injury
- TMJ disorder and dental issues
- Earwax blockage
- Stress
Neuroplasticity
The same rewiring that lets you learn a language can work against you.
Neuroplasticity is the brain's lifelong ability to reorganise itself by forming new pathways. It is usually helpful — it is how you learn. But it can also be maladaptive.
When hearing loss removes input at particular frequencies, the brain attempts to compensate for the missing signal. The prevailing explanation for tinnitus is that this compensation overshoots: the auditory system generates activity where the input used to be, and you perceive it as sound.
That has a hopeful corollary. If plasticity helped create the problem, plasticity is also the mechanism treatments try to recruit — which is what bimodal neuromodulation is designed to do by pairing sound with a second sensory input.
How it is measured
The Tinnitus Handicap Inventory scores impact, not volume.
The THI is the most widely used measure in tinnitus care. Twenty-five questions produce a score from 0 to 100, where a higher score means a greater effect on quality of life. It is scored in five bands.
0–16SlightHeard only in quiet; no interference.
18–36MildEasily masked by other sound; rarely intrusive.
38–56ModerateNoticed even in noise; daily activities still possible.
58–76SevereNearly always heard; sleep and activity disrupted.
78–100CatastrophicConstant, dominating; unable to carry on normal life.
A clinician administers the THI at assessment to establish your baseline, then repeats it later. That is what makes progress measurable rather than a matter of memory — and memory is unreliable about tinnitus.
What to do about it
There is no cure. There are treatments that reduce its impact.
Both halves of that sentence are true, and anyone selling you only the second half is not being straight with you. Most tinnitus care aims at habituation — getting to the point where the sound is no longer a problem, whether or not it is still there.
Rule out the fixable
Earwax build-up and ear infections are treatable causes, and resolving them can resolve the tinnitus. An audiologist who specialises in tinnitus can assess what is actually driving yours.
Sound, therapy, hearing support
Sound therapy and masking, cognitive behavioural therapy for the distress response, and hearing aids where hearing loss is present — often used in combination.
Dual-mode treatment
Pairing calibrated sound with mild tongue stimulation. Trialled in three large clinical studies and, in trial, more effective than sound alone for moderate or worse tinnitus.3
Tinnitus is not life-threatening, and most people find it eases over time as the brain learns to filter it out. If yours is affecting your mood, your sleep or your ability to work, that is reason enough to have it assessed properly rather than waiting it out.
Identifying the cause is the hard part, and it is what an assessment with a tinnitus specialist is for. Bring how it affects your days, not just how it sounds.
Next step