What Causes Tinnitus?

Diagnosis, or finding out the underlying cause of a person’s tinnitus, is an essential step towards implementing effective treatment. It may also uncover important underlying health conditions which need to be treated to alleviate the tinnitus itself and ensure the person’s overall health. Tinnitus is a symptom, similar to pain, and can be triggered by many factors. Some of the most common causes are:

  • excessive noise
  • damage in the ear
  • normal changes in the ear
  • certain medications.

Careful diagnosis is a first step in alleviating the contributing factors to tinnitus.


Our experienced Audiologists examine your ears to look for possible causes of your tinnitus. Tests include:

  • Hearing Test: Our tests encompass ultra-high pitches up to 16kHz because tinnitus often has a high-pitch origin. These pitches beyond the range of speech signal and are not routinely assessed by audiologists. Therefore, it is possible to find an ultra-high pitch (frequency) hearing loss in people who have previously been told they have normal hearing. Further tests would help determine if such a hearing loss is likely to be the underlying cause of the tinnitus.
    It is understandable and common for people to think that their tinnitus stops them hearing well. The opposite is often true – a hearing loss is involved in causing tinnitus most of the time. During a hearing test, your tinnitus may be distracting, reduce your concentration and make it difficult to determine actual hearing levels. Our audiologists are skilled in recognising when this is a problem and modifying the test as needed. We also use other complementary tests to get a comprehensive and accurate picture of your hearing (Link to Oto-acoustic emissions and tympanometry from ‘other tests’, and Electrocochleography from Balance section).
  • Tinnitus Tests: Tinnitus is as individual as a fingerprint. To understand your tinnitus best, we test its pitch, intrusion, associated distress and properties. The results can be important for diagnosis, as well as demonstrating to family and friends what your tinnitus sounds like.
  • Movement: You may be asked to move your eyes, clench your jaw or move your neck, arms and legs to see if your tinnitus changes or worsens with these movements. This may help our Audiologists identify an underlying disorder that may require you to see a Specialist Doctor.
  • Imaging Tests: Sometimes you may be required to have imaging tests such as MRI or CT Scans. Our audiologists work closely with Ear Nose and Throat Specialists, GPs, Physiotherapists, Orofacial Pain Specialists and others in the diagnosis and treatment of your tinnitus.

Some forms of tinnitus are medically important and always need further investigation. These include:

  • Asymmetrical or unilateral tinnitus (tinnitus which is louder in one ear or only heard in one ear)
  • Tinnitus that changes suddenly in quality, site or loudness
  • Pulsatile tinnitus
  • Tinnitus associated with hearing loss, balance disturbance, fullness in the ear or pain
  • Severely distressing tinnitus

Preparing for your appointment

Your audiologist will need information about the following:

  • Signs and symptoms.
    • What type of noises you are hearing?
    • Is it in one ear or both ears?
    • Do the sounds come and go or are they continuous?
    • How loud are the noises?
    • Do you have trouble tolerating other sounds from the world because they appear too loud or painful?
    • Are you or have you ever been exposed to continual loud noises?
  • Medical history, including any health conditions such as hearing loss, high blood pressure, heart disease or blood vessel disease. Please note that numerous other symptoms and health conditions may be relevant.
  • Medication history. Some medications may be a contributing factor to your tinnitus.
  • General wellbeing, sleep patterns
  • Social and emotional support
  • Details of other health professionals who are involved in your care
  • How your tinnitus affects your daily life
  • What makes your tinnitus worse and what makes it better
  • What treatments you have had for your tinnitus in the past

You can view and download our tinnitus questionnaire here. This is a starting point. The audiologist will discuss your responses and may ask a lot of additional questions at your appointment.  

The following are sounds that you may be hearing that can help our audiologists better understand the type of tinnitus you are experiencing and possible causes;

  • Clicking
  • Rushing or humming
  • Heartbeat
  • Low-pitched ringing
  • High-pitched ringing
  • Other sounds
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