Types of Tinnitus: What You Need to Know

The types of tinnitus can feel as varied as the people who experience them. For some, it’s a faint ringing that fades into the background. For others, it’s a constant roar or pulsing beat that never seems to stop. These sounds may be distracting, frustrating, or even overwhelming — but they always have one thing in common: they are heard without an external source.

Tinnitus is one of the most common hearing-related conditions, affecting millions of Americans. It is not a disease itself but a symptom of something else, such as hearing loss, stress, or circulation changes. Understanding the different Types of Tinnitus helps patients and providers identify causes, choose effective treatments, and regain a sense of control.

This article will explore each major type, what makes them unique, and how they are diagnosed. You’ll also learn about treatments, lifestyle influences, and how hearing care providers can help you manage symptoms more effectively.

What Are the Types of Tinnitus?

Tinnitus can be divided into two broad categories: subjective tinnitus and objective tinnitus. Nearly every patient falls into one of these two groups. Knowing which type you have is the foundation of proper care.

Chart: Subjective vs. Objective Tinnitus

Feature	Subjective Tinnitus	Objective Tinnitus
Who hears it?	Only the patient	Patient and sometimes a clinician
Prevalence	Over 99% of cases	Less than 1% of cases
Common causes	Hearing loss, stress, medications, noise exposure	Vascular changes, muscle contractions
Sound examples	Ringing, buzzing, hissing, roaring	Pulsatile beats, clicking, muscular spasms
Typical treatments	Hearing aids, sound therapy, counseling	Medical evaluation, vascular or muscular treatment

This table highlights the biggest differences. Subjective tinnitus is by far the most common, while objective tinnitus is rare but often medically significant. Both require professional evaluation.

Subjective Tinnitus: The Most Common Type

Subjective tinnitus is the type most people know. It is a sound only you can hear. It may be steady or fluctuate. For some, it comes and goes. For others, it never stops.

Causes and Mechanisms

There are several theories that explain how subjective tinnitus begins:

• Edge theory suggests tinnitus comes from abnormal activity between healthy and damaged hair cells.

• Discordant theory explains tinnitus as a mismatch between damaged outer hair cells and intact inner hair cells.

• Auditory plasticity theory describes how the brain rewires itself after hearing loss and exaggerates missing sound frequencies.

Each of these theories points to altered communication in the auditory system. The brain is trying to fill in gaps, and the result is phantom sound.

How It Sounds

People describe subjective tinnitus in many ways:

• High-pitched ringing

• Hissing or static

• Roaring or rushing water

• Buzzing or electrical hum

Each of these sounds can range in intensity. They may be more noticeable in quiet environments.

Treatments

Treatment for subjective tinnitus often involves improving hearing and reducing stress on the auditory system:

• Hearing aids amplify external sounds, which reduces the brain’s focus on tinnitus. Learn more in Can hearing aids help with tinnitus?

• Sound therapy introduces neutral background noise that competes with tinnitus.

• Counseling helps patients manage the emotional impact.

Together, these approaches make tinnitus less intrusive and easier to live with.

Objective Tinnitus: The Rare Somatosound

Objective tinnitus is rare. In some cases, the sound can actually be heard by another person using a stethoscope near the ear.

Causes and Mechanisms

Objective tinnitus usually comes from physical sources in or near the ear:

• Vascular issues such as turbulent blood flow.

• Muscle contractions in the middle ear or throat.

• Crosstalk between cranial nerves that confuses the brain.

These sources create actual sound, unlike subjective tinnitus, which exists only in perception.

Example: Pulsatile Tinnitus

A common form of objective tinnitus is pulsatile tinnitus, where the sound beats in rhythm with the heartbeat. This often signals a vascular issue and should be evaluated quickly.

Treatments

Objective tinnitus often requires medical treatment rather than hearing aids alone. Approaches may include:

• Addressing vascular abnormalities through medication or surgery.

• Treating muscle spasms with therapy or medication.

• Correcting structural problems in the ear or jaw.

Because this type can indicate serious health conditions, prompt medical care is essential.

Somatic Tinnitus: When Body Movement Changes Sound

Somatic tinnitus is a subtype of subjective tinnitus. The pitch or loudness changes when the patient moves certain parts of the body.

Causes and Mechanisms

Somatic tinnitus is usually connected to musculoskeletal problems such as:

• Temporomandibular joint (TMJ) disorder.

• Neck strain or spinal misalignment.

• Bruxism, or teeth grinding.

• Posture-related tension.

The dorsal cochlear nucleus processes both sound and somatic input. When those pathways interact abnormally, tinnitus can fluctuate with movement.

Treatments

Somatic tinnitus is best addressed by treating the body systems involved:

• Physical therapy for neck and jaw muscles.

• Dental care or splints for TMJ issues.

• Massage and stretching for muscular relief.

• Posture correction to reduce pressure.

For more strategies, see Ways to address tinnitus.

With proper care, somatic tinnitus often improves significantly.

Pulsatile Tinnitus: Hearing Your Heartbeat

Pulsatile tinnitus is a unique condition where the sound matches the rhythm of your heartbeat.

Causes and Mechanisms

The most common causes include:

• High blood pressure.

• Vascular abnormalities near the ear.

• Increased awareness of normal blood flow.

This type of tinnitus often needs cardiovascular testing.

Symptoms

Patients describe pulsatile tinnitus as:

• A rhythmic whooshing or thumping.

• Stronger in quiet rooms.

• More noticeable when lying down.

Treatments

Treatment depends on the underlying cause:

• Blood pressure management.

• Imaging and medical evaluation.

• Surgical repair in rare vascular cases.

Chart: Pulsatile vs. Non-Pulsatile Tinnitus

Feature	Pulsatile Tinnitus	Non-Pulsatile Tinnitus
Sound	Rhythmic, heartbeat-like	Constant or variable tones/noises
Common causes	Blood flow, vascular changes	Hearing loss, stress, noise damage
Risk level	May signal medical condition needing care	Often linked to chronic hearing loss
Treatment approach	Cardiovascular or surgical evaluation	Hearing aids, sound therapy, counseling

This chart shows why pulsatile tinnitus always deserves medical attention, while non-pulsatile tinnitus is often linked to hearing changes.

Musical and Auditory Hallucination Tinnitus

In rare cases, people hear music, singing, or voices. This is sometimes called musical tinnitus.

Causes and Mechanisms

• More common in older adults.

• Linked to significant hearing loss.

• Caused by neural loops in the auditory cortex that replay stored patterns.

Treatments

Helpful treatments include:

• Counseling to reduce distress.

• Hearing aids to restore missing sound input.

• Sound enrichment to break neural loops.

• In some cases, medication to reduce abnormal brain activity.

This type can be unsettling, but it is not a sign of mental illness.

Noise-Induced Tinnitus: A Common Trigger

Noise-induced tinnitus is one of the leading causes of ringing in the ears.

Causes and Mechanisms

Noise exposure damages hair cells in the inner ear. This damage creates mismatches between inner and outer hair cells, leading to phantom sounds.

Patterns

• Acute tinnitus: temporary ringing after a concert or loud noise exposure.

• Chronic tinnitus: persistent tinnitus after repeated loud sound exposure.

Treatments

• Hearing protection to prevent further damage.

• Hearing aids to restore audibility.

• Sound therapy to mask ongoing tinnitus.

Find more treatment guidance in The Ultimate Guide to Hearing Aids in Kansas City.

Age-Related Tinnitus: Linked to Presbycusis

Presbycusis, or age-related hearing loss, often causes tinnitus.

Causes and Mechanisms

• Gradual hair cell loss over time.

• Reduced auditory input triggers phantom sounds.

Symptoms

• More common after age 60.

• Often bilateral.

• Typically high-frequency ringing.

Treatments

• Hearing aids for amplification.

• Communication strategies for daily life.

• Counseling for emotional support.

See how treatment differs in Costco Hearing Aids vs. American Hearing + Audiology Hearing Aids.

Medication and Disease-Related Tinnitus

Tinnitus can also be caused by medications or medical conditions.

Ototoxic Medications

Common culprits include:

• Non-steroidal anti-inflammatory drugs (NSAIDs).

• Chemotherapy drugs.

• Certain antibiotics.

• Diuretics.

These drugs can cause either temporary or permanent tinnitus. Always consult your physician before stopping any prescription.

Medical Conditions

Tinnitus is also linked to:

• Ménière’s disease.

• High blood pressure.

• Autoimmune disorders.

• Acoustic neuroma or other tumors.

Treating the root cause often improves symptoms.

Tinnitus and Mental Health

Tinnitus does not exist in isolation. It often interacts with mental health conditions.

Emotional Impact

Many patients report:

• Anxiety when tinnitus becomes louder.

• Depression from persistent symptoms.

• Sleep problems linked to nighttime awareness.

Why It Matters

The limbic system and autonomic nervous system play a major role. Stress amplifies tinnitus perception, and tinnitus increases stress in return. This cycle can be broken with proper support.

Treatment Strategies

• Cognitive behavioral therapy to change thought patterns.

• Relaxation training to reduce stress.

• Support groups for shared experience.

Addressing mental health is an essential part of tinnitus management.

How Lifestyle Influences Tinnitus

Lifestyle choices often affect the severity of tinnitus. Patients who recognize triggers can better manage symptoms.

Common Lifestyle Triggers

• Loud noise exposure at work or play.

• Stress and lack of sleep.

• Poor diet or high caffeine intake.

• Alcohol and tobacco use.

• Prolonged silence with no background sound.

Each of these factors can make tinnitus worse. Recognizing them allows patients to make healthier choices.

Chart: Lifestyle Triggers of Tinnitus

Lifestyle Factor	Effect on Tinnitus	Management Strategy
Noise exposure	Damages hearing, increases tinnitus risk	Use hearing protection
Stress	Amplifies perception of tinnitus	Relaxation, mindfulness, exercise
Poor sleep	Increases fatigue and symptom awareness	Consistent sleep schedule
Caffeine or alcohol	Can intensify ringing for some people	Limit intake, track symptoms
Silence	Makes tinnitus more noticeable	Use background sound

Managing lifestyle factors does not cure tinnitus, but it can make it far less intrusive. Patients who take small, steady steps often see major improvements in comfort and quality of life.

How Hearing Care Providers Evaluate Tinnitus

A thorough evaluation is key to proper treatment.

Hearing Tests

Providers use several tests to understand hearing status:

• Pure tone audiogram measures thresholds across different frequencies.

• Speech recognition tests evaluate word understanding.

• Tympanometry checks middle ear function.

• Otoacoustic emissions measure hair cell activity.

Tinnitus-Specific Tests

Additional assessments help define tinnitus:

• Sound matching recreates the perceived pitch.

• Minimum masking levels determine loudness.

• Loudness discomfort levels reveal sensitivity.

Measuring Impact

Providers may also use the Tinnitus Handicap Inventory. This questionnaire helps measure how tinnitus affects daily life.

Accurate evaluation ensures treatment plans match each patient’s needs.

Everyday Management and Lifestyle Tips

Beyond medical care, patients can use daily strategies to improve comfort.

Helpful Approaches

• Reduce stress through exercise, meditation, or deep breathing.

• Improve sleep hygiene by keeping a routine and avoiding screens at night.

• Avoid complete silence by using fans, soft music, or nature sounds.

• Protect hearing at concerts, events, or work with earplugs.

These steps will not eliminate tinnitus, but they make life easier. When paired with professional care, they provide meaningful relief.

FAQs About the Types of Tinnitus

What are the two main types of tinnitus?
Subjective tinnitus and objective tinnitus.

What is the rarest type of tinnitus?
Objective tinnitus, sometimes called somatosound.

Can tinnitus sound like music?
Yes, some people hear musical patterns or voices.

Which type of tinnitus is linked to hearing loss?
Subjective tinnitus is most often tied to hearing loss.

Does tinnitus always mean permanent damage?
No, temporary conditions like earwax or sinus pressure can also cause it.

Can treatment differ by type?
Yes, each type requires a different approach based on its cause.

Taking the Next Step Toward Relief

Tinnitus can feel overwhelming, but you do not need to face it alone. A hearing care provider can identify your tinnitus type, guide you through testing, and design a plan that fits your needs.

American Hearing + Audiology provides advanced hearing aid technology, personalized treatment plans, and caring professionals who understand the impact of tinnitus.

Find your nearest American Hearing + Audiology location and take the first step toward lasting relief today.