The Symptoms, Causes, and Different Types of Tinnitus

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Contrary to popular belief, tinnitus doesn't exclusively take the form of a high-pitched ringing in the ears. There are many different ways tinnitus can manifest. We'll review some of the most common types of tinnitus, their symptoms, and their causes. You can find answers and useful tips here.

Acute, Subacute, and Chronic Tinnitus
The Many Causes of Tinnitus

General Symptoms of Tinnitus

The one thing that every type of tinnitus shares in common is the presence of phantom noise, which can take several forms depending on the underlying cause.

Ringing, whistling, or buzzing

The most common type of tinnitus also has the largest range of possible causes.
High-pitched ringing might be linked to hearing loss, acoustic trauma, or acoustic neuroma. Low-pitched ringing, meanwhile, most often indicates a physical blockage or deformity. This may include otosclerosis, a blockage in the ear canal, or a medical condition such as Meniere's Disease.
An ear or sinus infection can also occasionally cause tinnitus.
Certain medications are also particularly prone to causing tinnitus, as well:

Diuretics
Aspirin
Nonsteroidal anti-inflammatory drugs
Antidepressants
Cancer medication
Quinine-based medications
Some antibiotics

Clicking. grinding, crunching, or rushing

A continual, aggravating clicking sound could be linked to abnormal muscle contractions or joint issues caused by conditions like temporomandibular jaw disorder (TMJ). On the other hand, a rushing sound could indicate a damaged Eustachian tube.

Roaring, humming, or pulsing

This entire group of sounds typically stems from vascular issues such as high blood pressure or vasoconstriction. If the tinnitus occurs rhythmically and appears to coincide with your heartbeat, it is known as pulsatile tinnitus.

Tinnitus may occur equally in both ears, exclusively in one ear, or at a different level in each ear. It also may be intermittent or continuous.

Compensated vs. Decompensated Tinnitus

In addition to being classified by the nature of the phantom noise, medical professionals also categorize tinnitus based on its intrusiveness and the degree to which it impedes the patient's quality of life.

Compensated tinnitus

Compensated tinnitus isn't particularly intrusive. Most people can generally block out or ignore the noise without much effort.

Decompensated tinnitus

Decompensated tinnitus may not be physically dangerous but can cause severe psychological strain. It's ever-present, incredibly intrusive, and extremely difficult to ignore. The side effects of decompensated tinnitus may include insomnia, chronic stress, depression, social isolation, anxiety, problems with interpersonal relationships, and issues at work.

Acute, Subacute, and Chronic Tinnitus

Medical professionals also classify tinnitus on how long it lasts.

Acute tinnitus as you might expect, is the least severe. It typically persists for less than three months and often stops spontaneously. Acute compensated tinnitus rarely requires medical intervention.

Subacute tinnitus lasts longer, generally recurring over 3-12 months. As with acute tinnitus, there's a good chance subacute tinnitus will resolve independently.
Chronic tinnitus is the most debilitating and severe, persisting for over twelve months and rarely subsiding without direct therapeutic or pharmaceutical intervention.

The Many Causes of Tinnitus

No, tinnitus is not "all in your head." At least, we don't think it is. The truth is that medical professionals still aren't entirely clear on how the condition develops.
What they have determined, however, is that tinnitus can be divided into two broad categories.

Subjective tinnitus

The most common form of tinnitus is also the most difficult to diagnose. Subjective tinnitus, as it's known, cannot be measured externally. It also has the broadest range of possible causes.

Acoustic trauma, presbycusis, or acute hearing loss. Scientists suspect that after damage occurs to the sensory cells in the cochlea (stereocilia), certain sounds are either only faintly transmitted to the brain or fail to transmit at all. The brain then attempts to overcompensate by 'turning up the volume.'
Neurological issues. Brain damage or damage to the auditory nerve may also cause tinnitus.

Objective tinnitus

Unlike subjective tinnitus, the symptoms of objective tinnitus can be measured via specialized equipment. It typically has a direct physical cause. This could include, but is not limited to:

Vascular constriction
Otosclerosis
Blockages or inflammation in the ear canal
Musculoskeletal issues
A disorder such as [Ménière’s disease]

Additional Articles

Hearing Loss – Hearing Impairment

Preventing and treating tinnitus

Getting a Hearing Test