What Is Tinnitus? Causes, Symptoms, and Treatment Options

A ringing that no one else can hear. A constant hiss in one ear. A buzzing that shows up in quiet rooms and refuses to leave. If this is your experience, you're not imagining it, and you're not alone.

Tinnitus affects an estimated 360,000 Canadians to a significant degree, with many more experiencing it intermittently. It's one of the most common reasons people visit a hearing clinic, and one of the most commonly misunderstood conditions in the field of hearing health.

This guide covers what tinnitus actually is, what causes it, how it's diagnosed, and what treatment options are available, including what's offered at Prairie Hearing Centres in Winnipeg.

What Is Tinnitus?

Tinnitus (pronounced tin-EYE-tus or TIN-it-us; both are correct) is the perception of sound that has no external source. It exists only in your auditory system. The most common description is ringing, but tinnitus can also present as:

• Buzzing or hissing
• Clicking or pulsing
• Roaring or whooshing
• Humming
• High-pitched tones

It can occur in one ear, both ears, or be perceived as coming from inside the head. It can be constant or intermittent, steady or fluctuating in volume.

Tinnitus is not a disease. It's a symptom: a signal that something in the auditory system has changed or been disrupted.

Who Gets Tinnitus?

Tinnitus can affect anyone, but certain groups are at higher risk:

• People with hearing loss (the majority of tinnitus cases involve some degree of hearing loss)
• People with significant noise exposure history (workplace, recreational, or military)
• Adults over 60
• People who take certain medications
• Those with ear infections, wax blockage, or conditions affecting blood flow near the ear
• Individuals with high levels of stress or anxiety (which can worsen existing tinnitus)

What Causes Tinnitus?

The exact mechanism of tinnitus is still an area of active research, but the leading explanation involves the auditory system's response to damage or change.

When hair cells in the inner ear are damaged (through noise, aging, or other causes), they can send abnormal signals to the brain. The brain, interpreting these signals as sound, produces the perception of tinnitus. In other words, tinnitus is often the brain filling in for frequencies it's no longer receiving properly from the ear.

Noise-Induced Hearing Loss

The most common cause. Prolonged or sudden exposure to loud sound damages the hair cells in the cochlea, often producing both hearing loss and tinnitus. A single very loud event (an explosion, a concert at close range) can trigger tinnitus that persists. See our noise-induced hearing loss prevention guide for how to protect yourself.

Age-Related Hearing Loss (Presbycusis)

As hearing declines naturally with age, tinnitus often accompanies it. This is one of the reasons tinnitus becomes more prevalent after 50. Read more on age-related hearing loss.

Earwax Impaction

A buildup of earwax pressing against the eardrum can cause temporary tinnitus and hearing changes. Removing the blockage typically resolves the tinnitus.

Ear Infections and Fluid

Infections in the middle ear or fluid behind the eardrum can cause tinnitus, usually temporary.

Medication Side Effects

A range of medications can cause or worsen tinnitus. These include high doses of aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), certain antibiotics, diuretics, and some chemotherapy drugs. Never stop a prescribed medication based on tinnitus alone; discuss with your prescribing physician.

Cardiovascular Conditions

A pulsing or rhythmic tinnitus that beats in time with your heartbeat, called pulsatile tinnitus, can be linked to blood pressure issues or vascular abnormalities near the ear. This type warrants medical investigation.

Jaw and Neck Issues

Temporomandibular joint (TMJ) dysfunction and cervical spine conditions can sometimes generate or worsen tinnitus through muscular and vascular connections near the ear.

Stress and Anxiety

Stress doesn't cause tinnitus directly, but it significantly affects how noticeable and distressing existing tinnitus feels. Many people report their tinnitus becomes louder or harder to ignore during periods of high stress.

How Is Tinnitus Diagnosed?

There is no test that measures tinnitus directly. Diagnosis involves:

A Comprehensive Hearing Assessment

Most people with tinnitus have some degree of accompanying hearing loss. An audiogram provides essential context.

Case History

Your clinician will ask detailed questions about when the tinnitus started, what it sounds like, whether it fluctuates, what makes it better or worse, and how it affects your daily life.

Tinnitus Matching

In some cases, the clinician will play tones and ask you to identify the pitch and loudness that most closely match your tinnitus. This helps characterize it and tailor treatment.

Medical Referral If Indicated

Pulsatile tinnitus, sudden onset tinnitus, or tinnitus in only one ear may warrant referral to a physician or ENT specialist to rule out medical causes.

How Much Does Tinnitus Affect People?

Tinnitus exists on a spectrum. For some people, it's a minor background noise they barely notice. For others, it significantly disrupts sleep, concentration, emotional wellbeing, and quality of life.

Research suggests that roughly one in five people who have tinnitus find it significantly bothersome. Factors that influence tinnitus severity include: overall hearing health, sleep quality, stress levels, anxiety, and how the person interprets the sound (as threatening versus neutral).

The good news is that tinnitus perception is highly modifiable. Even when the underlying sound cannot be eliminated, how distressing it feels can be substantially reduced through the right approach.

Treatment Options for Tinnitus

There is currently no universal cure for tinnitus. However, there are several evidence-based approaches that meaningfully reduce its impact for most people.

Sound Therapy

Sound therapy uses external sound to reduce the contrast between tinnitus and environmental sound, making the tinnitus less noticeable. White noise and sound maskers, hearing aids with built-in tinnitus masking features, and structured sound programs delivered through devices over months are all effective approaches.

Tinnitus Retraining Therapy (TRT)

TRT combines low-level sound therapy with counselling to help the auditory system habituate to the tinnitus signal. The goal is for the brain to reclassify tinnitus as a neutral, non-threatening signal that can be filtered out, similar to how most people don't consciously hear the hum of an air conditioner. TRT typically takes 12 to 24 months for significant results, but many people notice improvement before then.

Cognitive Behavioural Therapy (CBT)

CBT for tinnitus focuses on changing how a person responds emotionally to the sound. It doesn't reduce the tinnitus itself, but consistently reduces tinnitus-related distress in research trials. It's often delivered alongside sound therapy for people with significant emotional impact.

Treating Underlying Causes

If tinnitus is caused by earwax, medication, a specific medical condition, or another identifiable factor, treating that cause often improves or resolves the tinnitus.

Lifestyle Approaches

Several lifestyle factors influence tinnitus perception:

• Sleep: poor sleep dramatically worsens tinnitus awareness; addressing sleep problems is often important
• Stress reduction: mindfulness, relaxation techniques, and exercise can reduce the stress response that amplifies tinnitus perception
• Caffeine and alcohol: these affect circulation and neural activity; individual response varies
• Protecting remaining hearing: additional noise exposure worsens both hearing loss and tinnitus

Tinnitus Therapy at Prairie Hearing Centres, Winnipeg

Prairie Hearing Centres offers evidence-based tinnitus therapy including sound therapy programs and counselling. Management begins with a comprehensive hearing assessment to understand the full picture, including any accompanying hearing loss and the nature of the tinnitus experience.

If hearing aids are appropriate, we carry current models from leading manufacturers, many of which include built-in tinnitus management programs.

If you've been told there's nothing that can be done for tinnitus, that information is out of date. Effective management is available, and most people with tinnitus experience meaningful improvement with the right approach.