Other Causes of Tinnitus & Linked Conditions

Tinnitus is not a condition in its own right but a symptom, and like most symptoms it can have many different underlying causes. Some are simple and easily dealt with, while others relate to conditions worth understanding and managing. This guide walks through the main causes and the conditions commonly linked to tinnitus, answers some of the questions people most often ask, and explains why more than one factor is frequently involved at once.

What causes tinnitus?

Because tinnitus is a symptom rather than a disease, it can arise anywhere along the hearing pathway, from the ear itself to the way the brain processes sound. The single most common association is with hearing loss, whether that comes with age or from exposure to loud noise over time. But a wide range of other conditions can cause or contribute to tinnitus as well.

This variety is precisely why identifying the cause matters. What lies behind one person's tinnitus can be quite different from another's, and an assessment is the way to tell which applies to you. For the wider picture of the condition as a whole, our guide to understanding tinnitus sets out the broader context.

Some of the main conditions linked to tinnitus

While tinnitus has many possible causes, a handful come up far more often than the rest. These are some of the main conditions and factors associated with it:

• Age-related hearing loss is the most common of all. As hearing naturally changes with age, tinnitus often appears alongside it.
• Noise-induced hearing damage, from loud environments, machinery, or music over time, which harms the delicate structures of the inner ear.
• Ear problems such as a build-up of earwax or an ear infection can block or disturb the ear canal and middle ear, triggering tinnitus that often clears once the underlying problem is treated.
• Meniere's disease, an inner-ear disorder involving changes in inner-ear fluid, typically brings hearing loss and vertigo alongside the tinnitus.
• Otosclerosis, an abnormal growth of bone in the middle ear that can run in families, is a further known cause.

Beyond these, several other factors are worth knowing about. Certain medications can cause or worsen tinnitus, particularly at higher doses. Problems with the jaw joint, known as the temporomandibular joint or TMJ, can also produce it, as can head or neck injuries. Less commonly, a benign growth called an acoustic neuroma can be responsible, which is one reason persistent one-sided tinnitus is always worth having checked.

Can sinusitis cause tinnitus?

Sinusitis is not a typical cause of tinnitus, but it can sometimes lead to it indirectly, through its effect on a small but important structure called the Eustachian tube.

The Eustachian tube connects the middle ear to the back of the throat and is responsible for keeping the pressure in the middle ear balanced. When the sinuses become inflamed or congested, this can affect the Eustachian tube and stop it from working properly. The resulting pressure imbalance or fluid build-up in the middle ear can produce symptoms including tinnitus, often alongside a feeling of fullness or muffled hearing. These symptoms are usually mild and tend to ease as the tube returns to normal function. In most cases, tinnitus linked to a sinus problem settles once the sinusitis clears. If it persists after the sinus symptoms have resolved, it is worth having assessed.

Can tinnitus cause headaches or dizziness?

It is common to notice tinnitus alongside headaches or dizziness, but the relationship is usually not one directly causing the other. More often, they appear together because they share an underlying cause.

Dizziness and tinnitus occurring together are characteristic of inner-ear disorders such as Meniere's disease, where both symptoms arise from the same problem inside the ear. Headaches and tinnitus can occur together through conditions such as migraine, or, less commonly, raised pressure inside the head. So rather than tinnitus causing headaches or dizziness, it is more accurate to think of these symptoms as sometimes linked by a shared root. That is exactly why a combination of tinnitus with headaches or dizziness is worth assessing, so the common cause can be identified.

Is tinnitus hereditary?

For a long time, tinnitus was assumed to be driven almost entirely by environmental factors such as noise. More recent research suggests that genetics play a part too, at least for some people.

A large study of twins found that tinnitus affecting both ears has a meaningful hereditary component, particularly in men, while tinnitus in one ear only showed a much weaker genetic link. This does not mean tinnitus is simply inherited in the way eye colour is. Rather, some people appear to carry an inherited susceptibility that combines with other factors, such as noise exposure and hearing loss, to make tinnitus more likely. In practical terms, a family history of tinnitus may modestly raise your chances of experiencing it, but it is only one part of a larger picture.

Tinnitus often has more than one cause

One of the most useful things to understand about tinnitus is that it frequently does not come down to a single cause at all. For many people it reflects a combination of factors working together.

Someone might have a degree of age-related hearing loss, a history of noise exposure, a stressful period in their life, and a medication that all contribute at once. This is part of why tinnitus can be difficult to pin down to one neat explanation, and why a thorough assessment, one that looks at hearing, health, lifestyle, and history together, tends to be far more useful than searching for a single answer. It is also why the most effective management usually addresses more than one side of tinnitus at once: the auditory side through treating any hearing loss, the emotional side through easing stress and improving sleep, and the attentional side through approaches that help the brain give the sound less notice.

When to get your tinnitus checked

Because tinnitus has so many possible causes, ranging from the simple and easily treated, such as earwax, through to conditions that benefit from proper management, the sensible step is an assessment to work out what is contributing in your particular case.

Two of the most common contributing factors have their own dedicated guides. If you are wondering about the link between blood pressure and tinnitus, or about how stress and tinnitus interact, those are covered in detail separately. For everything else, a hearing assessment is the practical place to begin. If your tinnitus is persistent or on your mind, you can get your hearing checked and start to get to the bottom of it.