Tinnitus, or ringing in the ears, is the perception of sound when there is no external sound present. It is not a condition by itself but instead a symptom of an underlying cause. Many patients describe the sound as a high-pitched ringing, but it may also be a clicking, buzzing, whooshing, roaring, or hissing. The sound can vary in volume and can be either unilateral or bilateral. In most patients, tinnitus occurs gradually. It can significantly impact the quality of life, causing depression, anxiety, and loss of concentration.
The diagnosis of tinnitus is based on the patient’s history. Questionnaires also help assess how much the tinnitus is impacting the patient’s quality of life. The diagnosis can be supported with a neurological examination, an audiogram, and medical imaging if necessary. In rare cases, the clinician can hear the ringing sound using a stethoscope. (This is known as objective tinnitus.) Prevention of tinnitus involves avoiding loud noises and seeking appropriate treatment to prevent the condition from worsening.
Treatment and management of tinnitus include talk therapy, the use of sound generators, hearing aids, tinnitus counseling, cognitive behavioral therapy, and tinnitus retraining therapy. As of 2013, there is no known effective medication. Most patients are able to tolerate the ringing well, but approximately 1 to 2 percent of patients are significantly impaired by it.
Cause #1: Rheumatoid Arthritis
Rheumatoid arthritis is a condition that affects the entire body, resulting in complications such as heart disease, osteoporosis, gum disease, kidney problems, and hearing loss. With autoimmune diseases such as rheumatoid arthritis, autoimmune inner ear disease (AIED) may develop, worsening hearing loss.
Other associated symptoms of AIED include dizziness and ringing in the ears. Patients with these issues should discuss their options (such as using a hearing aid, reducing loud noise, and wearing ear protection) with a doctor.