What Causes Ringing in the Ears?

After a concert or exposure to loud noises, you might have experienced ringing in your ears. Find out the main causes of this medical condition known as tinnitus and when to see a doctor.

If you’ve ever been to a loud concert or bar for a few hours, you might have experienced ringing in your ears afterward. This is a medical condition known as tinnitus and can be extremely frustrating for people if it does not go away.

“Tinnitus is a phantom sound that’s not actually coming from the environment but coming from inside of the person,” says Joni K. Doherty, MD, an otolaryngologist with the USC Caruso Department of Otolaryngology – Head and Neck Surgery, part of Keck Medicine of USC.

People might experience tinnitus in several different ways, Dr. Doherty explains. For some, it feels like ringing in the ears. People also report it as buzzing, whirring, roaring, whistling and pulsating noise, or compare it to the sound of running water, she says. Tinnitus can be difficult to treat, so it’s important to recognize the causes of tinnitus so you can prevent this frustrating condition.

Hearing loss

“While tinnitus is sometimes caused by noise exposure, over 80% of cases are due to some form of hearing loss,” Dr. Doherty says. She notes that there are usually genetic reasons for age-related hearing loss and that some people can live well into their 90s without experiencing any hearing loss.

“Most people don’t realize how loud the world is,” Dr. Doherty says. “Restaurants, for example, are usually around 90 decibels, movie theaters around 120 decibels and a three-hour-long concert has significant noise up to 140 decibels.”

All of these are levels that can damage your hearing and cause hearing loss, especially if you are genetically prone to hearing loss, Dr. Doherty says. Just one single event could cause damage if you are particularly susceptible.

Injuries

“Whiplash injury is known to cause ringing in the ear,” Dr. Doherty says. Head trauma of any kind — and specifically injuries to the ear or the bone encasing the inner ear organs — can also cause ringing in the ears, she adds.

Certain medications

Many medications are ototoxic, meaning they cause damage to the inner ear and both your balance and hearing, Dr. Doherty says.

“The antibiotic medication gentamicin and the entire family of aminoglycosides are extremely ototoxic. We try to avoid giving those to patients now unless there is a special circumstance, such as a resistant bacterium,” Dr. Doherty says. “But in these instances, we monitor the antibiotic level in a patient’s bloodstream so that it helps reduce the toxicity level. We also monitor their hearing to make sure nothing is being affected.”

Certain chemotherapies are also ototoxic, such as platinum-based chemotherapies like carboplatin and cisplatin, she says. “About 60% of people who have cancer and must receive a platinum-based chemotherapy are susceptible to suffering some hearing loss,” she says.

Both chemotherapies and antibiotics cause damage to ear hair cells, but other types of drugs such as loop diuretics can also be ototoxic by damaging the cochlea, which is an organ in the inner ear. “And the first sign of ototoxicity is tinnitus,” Dr. Doherty says.

Allergies

Ringing in your ears caused by allergies is a temporary form of tinnitus that can usually be addressed by relieving your allergies through antihistamines or nasal sprays, Dr. Doherty says.

TMJ syndrome

Temporomandibular joint syndrome — or TMJ syndrome, as it’s commonly called — can also cause ringing in the ears.

“TMJ causes inflammation in the muscles around the ear that are responsible for clenching and grinding the teeth, and that can cause tinnitus,” Dr. Doherty says. “It’s important to treat this condition and doing so can also help reduce the tinnitus.”

High blood pressure

Other conditions such as high blood pressure can also cause tinnitus, Dr. Doherty says.

What to do if you experience ringing in your ears or tinnitus

“If you ever experience tinnitus, you should get a baseline hearing test to see whether there is any hearing loss,” Dr. Doherty says. If there is hearing loss, hearing aids will often help reduce tinnitus. If there isn’t any hearing loss, it’s important to monitor the tinnitus and always wear ear protection when you go to concerts or loud places. “I always counsel patients to wear ear protection, such as high-fidelity earplugs, which allow you to still enjoy the music without damaging your hearing,” she says.

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