Symptoms
What does your tinnitus sound like?
Find the pattern closest to yours, what it can point to, and the articles that cover it.
None of this is a diagnosis. Where a pattern comes with a sign that means getting checked, the sign is marked, with how soon; the when to see a doctor checklist goes through the signs one at a time. A pattern with no sign marked has not been ruled safe: it simply has none on that list.
What cannot wait
Call your local emergency number or go to an emergency department if:
- I suddenly have weakness, numbness or drooping in my face or an arm, or trouble speaking or seeing Read why: Can Tinnitus Be a Sign of Stroke? Sudden Hearing Loss and Vertigo
- I have sudden, severe vertigo or loss of balance that will not settle Read why: Can Tinnitus Be a Sign of Stroke? Sudden Hearing Loss and Vertigo
- It pulses, and came with a sudden severe headache, sudden neck pain, a drooping eyelid or a change in my vision, or started after a head or neck injury Read why: Carotid Dissection and Pulsatile Tinnitus: An Emergency to Recognise
Seek assessment today if:
- My hearing dropped suddenly, over hours or a few days Read why: Sudden Hearing Loss and Tinnitus: A Real Medical Emergency
What it sounds like
Ringing is the usual word, but tinnitus can hiss, roar, click, pulse or sound like music.
A steady ring, hiss or buzz in both ears
Tinnitus is most often described as ringing. It often comes with hearing loss, sometimes loss nobody had noticed until it was measured, and its pitch often matches the frequencies where hearing is worst.
Arrange an appointment soon if:
“My hearing is noticeably worse in one ear than the other”
Read
- Tinnitus and Hearing Loss: The Connection Explained
- Tinnitus Symptoms: The Sounds, Patterns and Warning Signs
- What Is Tinnitus? Ringing, Buzzing, and Hissing Explained
- Age-Related Hearing Loss and Tinnitus: What the Dementia Link Does and Doesn't Say
- Hidden Hearing Loss: Tinnitus With a Normal Hearing Test
- Online hearing test (a screening check)Tool
A whoosh or thump in time with your heartbeat
With a sudden, severe or unusual headache, loss of vision, sudden neck pain, a drooping eyelid or any other new neurological symptom, or after a head or neck injury, it needs emergency care the same day: with neck pain it can signal a tear in a neck artery. On its own it should be seen within a few weeks. A thorough evaluation finds a cause in more than 70% of patients, and European radiology recommendations say it always needs imaging.
Arrange an appointment soon if:
“It pulses in time with my heartbeat”
Read
- Pulsatile Tinnitus: When Ringing Beats With Your Heart
- Carotid Dissection and Pulsatile Tinnitus: An Emergency to Recognise
- Do You Need a Scan for Tinnitus? What the Radiologists Recommend
- Intracranial Hypertension: When Whooshing Comes With Headaches and Vision Changes
- Tinnitus Worse When Lying Down? What a Change With Position Means
Clicking, fluttering or a staccato tapping
Rhythmic clicking can come from spasms of the tiny middle-ear muscles or the soft palate. Bursts like a typewriter or Morse code, typically in one ear, are a distinct syndrome that most patients respond to a medication for.
Music, singing or voices with nothing playing
Usually a hearing phenomenon, not a psychiatric one. In a review of published cases of musical ear syndrome, most patients had hearing loss.
A low roar, with ear fullness and spells of vertigo
Ménière's disease is recognised by a cluster: vertigo attacks lasting 20 minutes to several hours, fluctuating hearing loss in one ear, tinnitus and ear fullness. Vestibular migraine can produce the same ear symptoms.
Arrange an appointment soon if:
“I get episodes of dizziness or vertigo as well as the tinnitus”
Your own voice, breathing or footsteps sound too loud
A eustachian tube stuck open makes your own voice or breathing boom in the ear. A missing or thin patch of bone over one of the inner ear's balance canals can make you hear your own heartbeat, footsteps and eye movements.
Where you hear it, and what comes with it
One ear or both, and what else is happening, change what is worth checking and how soon.
Only in one ear
With hearing loss that came on suddenly in the past 30 days, UK guidance says to be seen within 24 hours; with sudden neurological symptoms or vertigo that will not settle, immediately. Persistent tinnitus in one ear is a pattern guidelines single out for a prompt, full hearing test and for considering an MRI. Clinicians look first for wax, middle-ear problems and hearing that is worse on that side.
Arrange an appointment soon if:
“It is only in one ear, and it has not gone away”
With facial weakness, numbness or another new neurological symptom
Tinnitus with sudden facial weakness, numbness, trouble speaking or any other new neurological symptom needs emergency care: the UK's NICE guideline advises immediate referral, and the NHS list of stroke symptoms leads with face weakness, arm weakness and speech problems.
Call your local emergency number or go to an emergency department if:
“I suddenly have weakness, numbness or drooping in my face or an arm, or trouble speaking or seeing”
With ear pain, discharge, or a blocked, full feeling
These point to something examinable in the ear itself. Blocked, popping ears after a cold, flu or flight often mean the eustachian tube is not equalising; in one study of referred patients, ear infections were the most common ear disorder among those with tinnitus.
Arrange an appointment soon if:
“I have ear pain, discharge, or a feeling of fullness that is not clearing”
When it started, and what changes it
What came just before it, and what makes it louder or quieter, point to different causes.
It started suddenly, with a drop in hearing
A drop in hearing within 72 hours, usually in one ear and often with new tinnitus, needs a same-day assessment rather than a wait-and-see approach. The UK's NICE guideline asks for it to be seen within 24 hours.
Seek assessment today if:
“My hearing dropped suddenly, over hours or a few days”
After a concert, a gunshot or other loud sound
Muffled hearing is the part not to wait out: the UK's NICE guideline makes no exception for noise when it asks for sudden hearing loss to be seen within 24 hours. Ringing after a loud night usually comes with a temporary threshold shift, which NIDCD says disappears 16 to 48 hours later; ringing or muffled hearing still there after two or three days is worth a hearing check.
Seek assessment today if:
“My hearing dropped suddenly, over hours or a few days”
After a head or neck injury
Hearing loss, severe dizziness, a worsening headache, confusion or repeated vomiting after a head injury need immediate medical assessment, whatever the tinnitus is doing, and a pulsing sound that started after a head or neck injury needs same-day care. Concussion, whiplash and other head or neck trauma are well-documented triggers of tinnitus, through several routes.
Arrange an appointment soon if:
“My tinnitus started after a head injury”
After starting or changing a medicine
Tinnitus is often the earliest warning sign of a drug that affects the ear, showing up before any measurable change in hearing. Do not stop a prescription on your own: raise it with whoever prescribed it.
Worth raising with a clinician if:
“It started after beginning or changing a medication”
It changes when you clench, move your jaw or turn your head
Somatic tinnitus changes in pitch, loudness or presence when you move or press on the jaw, neck or shoulders, because nerves from those areas feed into the brainstem's hearing pathways.
Everyday sounds feel too loud, or painful
Hyperacusis is a reduced tolerance for ordinary sound. Studies of tinnitus patients put the share who also have it anywhere from 12.8% to 63%. A strong reaction to specific sounds, such as chewing, at almost any volume is misophonia, a different problem.
Louder at night, or when you lie down
Tinnitus usually does not get louder at night: the daytime sound that competed with it goes, and the contrast makes bedtime hard. A whoosh that gets worse lying down is a different pattern, with its own article.
It comes and goes, with bad days
A change that does not settle within a few days, comes with new hearing loss or dizziness, or is in one ear only needs prompt evaluation. Otherwise a flare-up is a temporary worsening, not a permanent change: most bad stretches reflect poor sleep, stress or recent noise, and settle once that passes.
Worth raising with a clinician if:
“It has changed noticeably in the last few weeks”
If yours is not here, or you are not sure
No pattern on this page rules anything out, and a list only knows what it asks about. If your tinnitus is new, changing, or worrying you, the when to see a doctor checklist takes each sign in turn, and tinnitus symptoms and warning signs sets out the referral tiers the guidelines use.
Whatever it sounds like: if it is affecting your sleep, mood, or ability to function, arrange an appointment soon. CBT is the best-supported treatment for tinnitus distress, and tinnitus and anxiety covers the loop between the sound and the worry.
New to all of this? The first 30 days puts the steps in order, and how tinnitus is diagnosed explains what an assessment involves.