Tinnitus Explained: When the Sound Comes from Within

Most of us think of hearing as something that happens out there — a sound wave enters the ear, travels to the brain, and voilà: we hear.

But what happens when the sound isn’t coming from the outside world at all?

That’s what people with tinnitus experience: a perception of sound generated internally — in the ear, or more often, in the brain — without any external source.

It might sound like ringing, buzzing, hissing, or even pulsing. Sometimes it’s high-pitched, sometimes low, and sometimes it’s there one day and gone the next.

 

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Tinnitus Isn’t One Thing

Tinnitus isn’t a disease in itself; it’s a symptom, and it can arise from many different causes. In the UK, more than 16 million people are estimated to experience tinnitus at some point — that’s roughly one in four adults.

Thankfully, the vast majority don’t suffer from it severely. Many notice it occasionally, and some have lived with it since childhood without realising others don’t hear the same background sound.

Tinnitus only becomes a problem when it starts to interfere with concentration, sleep, or emotional wellbeing. That’s when it deserves proper assessment and management.

 

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Objective vs. Subjective Tinnitus

The most common form is subjective tinnitus — only the person experiencing it can hear it.

But there’s also a much rarer form called objective tinnitus, where a clinician can actually hear the sound using a stethoscope or sensitive microphone. This is usually caused by a physical source inside the body — for instance, a rhythmic pulsing sound in sync with the heartbeat (known as pulsatile tinnitus).

If tinnitus is unilateral (only on one side), pulsatile, or sudden and severe, it’s important to seek medical assessment promptly. These are the few situations where we look for — and can sometimes treat — an underlying physical cause.

 

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Is Tinnitus Dangerous?

In most cases, no.

Tinnitus doesn’t mean something sinister is happening in your ears or brain. It’s often associated with temporary or permanent changes in hearing, and/or with some sort of unusual stress that affects how the brain processes sound. Stress patterns also make the brain ‘noisy’ and therefore, there’s more to hear within. 

Think of tinnitus as your brain generating its own “background noise” — often after it stops receiving certain sounds from the outside world. In a light-hearted way, I sometimes tell my patients:

“If you hear tinnitus, take it as proof that your brain is active and working — nothing more, nothing less.”

Still, the distress tinnitus can cause is very real and should never be dismissed. It deserves a proper evaluation — both to rule out any underlying causes and to offer evidence-based management strategies.

 

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What Helps with Tinnitus?

Modern audiology offers several tools and therapies that can help reduce tinnitus awareness and distress. The most effective approach depends on each individual’s history, hearing profile, and coping patterns.

Evidence-based tinnitus management options include:

• Sound therapy and sound enrichment – using low-level, pleasant sounds to reduce contrast between tinnitus and silence.
• Informational counselling – understanding tinnitus reduces anxiety and helps regain a sense of control.
• Cognitive Behavioural Therapy (CBT) – reframing unhelpful thought patterns around tinnitus.
• Mindfulness-based techniques – reducing emotional reactivity and improving focus.
• Neuromodulation therapies, such as bimodal stimulation (e.g. the Lenire®️ device), which retrain how the brain processes sound.

Your audiologist will determine which approach—or combination—is most suitable after a detailed tinnitus and hearing assessment. It’s not only okay but also is important  to ask for your tinnitus professional’s qualification, experience and expertise level. Unfortunately, it is a niche area of audiology (shouldn’t be- we want it to be a part of mainstream audiology) and not everyone is equally trained to deal with tinnitus patterns. 

 

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Why Assessment Matters?

Tinnitus can be influenced by many factors: hearing changes, jaw and neck tension, ear conditions, medications, stress, and even cardiovascular health.

That’s why it’s vital to begin with a comprehensive audiological evaluation, not just a hearing screen.

A proper assessment will help identify:

• Any associated hearing loss,
• Ear or middle ear conditions,
• Red flags requiring ENT referral, and
• Which management pathway is most likely to help you.

Don’t feel worried if your tinnitus expert makes an onward referral. Tinnitus can be a result of complex medical and psychological mix and often a multidisciplinary approach is more helpful in managing it. What you need is a trustworthy, qualified advisor, who has your best interest at heart and is secure enough to understand your and their own limitations in carving out the best management plan for you.

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In Summary

Most tinnitus is not dangerous — but it is meaningful. It’s your body and brain’s way of saying that something in your auditory system and/or your lifestyle needs attention, care, or recalibration. All three systems – physical emotional and mental health need to be evaluated to design the best path forward. 

With modern tools & techniques and the right professional guidance, tinnitus can be managed very successfully. You don’t have to “just live with it.”

At Audiology Planet, our tinnitus specialists provide evidence-based assessment, sound therapy, and counselling techniques designed to help you regain calm, clarity, and confidence in your hearing world.