In the realm of medicine, instant results are a rarity. More often than not, we prescribe treatments with the understanding that time and patience are necessary, focusing more on managing symptoms rather than offering a definitive cure.
However, there are occasions when a problem can be swiftly and effectively addressed, providing a profound sense of accomplishment for both the patient and the healthcare professional. Such was the case with Jo, a patient who recently sought my help after experiencing a sudden onset of tinnitus.
Jo arrived in my office, visibly anxious, after what seemed like an overnight transformation. She was familiar with stories of individuals whose lives had been dramatically altered by this condition—a persistent ringing, buzzing, or hissing sound that only the sufferer can hear, with no apparent external cause and no way to turn it off. The fear that her life might similarly be impacted was palpable.
Few people realize just how prevalent tinnitus is, affecting approximately one in ten individuals. The condition can be incredibly debilitating, interfering with sleep, concentration, and mental health, often leading to increased anxiety and depression.
The manifestations of tinnitus are varied: some hear a ringing, others a buzzing, whooshing, clicking, or whistling. For some, it comes and goes, while for others, it is a constant presence. In Jo’s case, she was troubled by a persistent ringing in both ears.
The sounds vary: ringing, buzzing, whooshing, clicking, whistling, a constant tone. For some people it comes and goes; for others it never stops. Jo’s was a ringing in both ears.
She had also noticed her hearing wasn’t as sharp as it used to be – her husband complained she was shouting and had the television up too loud, while she was convinced, he was mumbling.
When I looked in her ears, I found the answer almost immediately: Both ear canals were packed with dark, hard, dry wax.
Ear wax lubricates and protects the ear, but when it builds up and hardens, it causes hearing loss and irritates the eardrum. That irritation, in turn, can produce tinnitus
Wax has a purpose: it lubricates and protects the ear.
But when it builds up and hardens, it blocks the ear canal, causes hearing loss and irritates the eardrum. That irritation, in turn, can produce tinnitus.
I prescribed a week of daily olive oil ear drops to soften the wax. Following this routine, the wax should slowly dislodge, opening the eardrum and reducing the tinnitus.
I explained to Jo, as I do to all my patients, that cotton ear buds are never the solution to ear wax build–ups.
This is because the sticks can push the wax further in, further worsening hearing or tinnitus problems.
Jo also decided to pay to have her ears microsuctioned – where the wax is removed by a healthcare professional using a small suction device.
However, for most patients, olive oil drops should do the job.
Once the wax was removed, Jo’s recovery was miraculous. Her hearing returned to normal and the ringing stopped. Now she thinks it is her husband who is shouting.
It is such a simple fix, and yet I am constantly surprised by how many tinnitus sufferers have never been told to check their ears for wax.
Moreover, in this situation, while I prescribed the olive oil drops, these products are available over the counter in most pharmacies.
Unfortunately, microsuction is generally no longer offered at most GP surgeries – due to NHS cost–cutting – meaning patients will typically have to pay around £60 for it. But, for many, it can be transformative.
Of course, ear wax is not the cause of every case of tinnitus. Another is a little-known condition called temporomandibular joint syndrome – or TMJ.
The temporomandibular joint is the hinge that connects your jawbone to your skull, and when it is not working properly, this can trigger tinnitus.
The TMJ sits in very close proximity to the ear, and the two share nerve pathways. Dysfunction in this joint, whether caused by teeth grinding, jaw clenching, arthritis or poor bite alignment, can produce tinnitus alongside the more obvious symptoms of jaw pain, clicking, painful chewing, headaches and earache.
This is why I always routinely ask tinnitus patients whether they have any of these symptoms now.
And the good news is that treating TMJ dysfunction can bring real relief for tinnitus. This usually starts with jaw exercises and a custom-fitted mouth guard worn at night to reduce grinding and clenching, combined with anti-inflammatory medication.
Presenter Zoe Ball, 55, revealed in 2024 that she suffers from temporomandibular joint syndrome – or TMJ – which can be a cause of tinnitus
Where those measures are not enough, Botox injections into the jaw muscles can reduce clenching very effectively, and steroid injections directly into the joint are another option.
As the joint settles, tinnitus often improves alongside it.
Certain medications can also cause tinnitus as a side effect, including anti-inflammatories, aspirin and some antibiotics.
In some cases, this is reversible when the medication is stopped or changed, but patients should never alter or stop any prescribed medicine without speaking to their doctor first.
For some patients, tinnitus can be linked to later-life hearing loss.
Hearing degrades over time and, in some cases, this can lead to tinnitus. The same issue can occur in patients who have had their hearing damaged by long term exposure to loud noises.
For these patients, hearing aids can often help reduce tinnitus symptoms. In fact, more than half of people report meaningful improvement in their tinnitus when wearing hearing aids, though it typically returns when the aids come out.
Some devices now include built-in white noise generators for additional tinnitus relief.
White noise is a constant sound that doesn’t change in pitch or volume – typically, something that sounds a bit like static coming from the un-tuned radio, or a fan.
For tinnitus relief, it works as sound therapy to provide a steady, neutral background noise, which helps reduce the contrast between the internal ‘ringing’ and the quiet environment.
GP, author and broadcaster Dr Philippa Kaye
However, the truth is that, for many patients, the underlying cause of the tinnitus will never be identified. For many, it can occur out of nowhere. But that does not mean, for these patients, it can’t be resolved.
Cognitive behavioural therapy – a form of talking therapy – has strong evidence behind it for tinnitus: it does not silence the sound, but it changes your relationship with it, helping you identify unhelpful thought patterns, improve sleep and reduce the spike of anxiety that the ringing can trigger.
Sound therapy includes standalone white noise machines, tinnitus apps, or simply a radio tuned to static at night – all make it easier for the brain to ‘tune out’ the tinnitus.
Fascinatingly, there is also a new treatment that could revolutionise treatment. It’s called the Lenire device and it uses a combination of sound therapy and mild electrical stimulation of the tongue.
The science behind it is complex, but a recent study of over 200 patients reported more than a 90 per cent improvement rate at 12 weeks. It’s currently only available privately, often at prohibitive costs of around £4,000. However, it is possible that it may be adopted on the NHS in the future.
Tinnitus is more than just a sound in your ear, it can really have an impact on your life. But, at the same time, it is invisible to doctors who are often too quick to dismiss it as a minor issue.
That’s why it’s so important that patients ask to be checked for the most common causes, including ear wax build-up, TMJ syndrome and hearing loss.
Finding the cause could be the way to find a life-changing solution.
