How is Tinnitus Diagnosed?

By:Damien Cabral

Key takeaways

If you suspect you have tinnitus, book an appointment with your doctor or audiologist rather than self diagnosing, as they can help to determine what type of tinnitus you have and what’s causing it
They’ll ask you about your symptoms and medical history
They may also carry out a variety of tests including hearing tests and movement tests
Once your tinnitus has been diagnosed, your healthcare provider will be able to recommend the best treatment for your specific tinnitus to reduce your symptoms

If you’re experiencing a ringing or buzzing in your ears, you might have tinnitus. For most people, tinnitus can be distressing and debilitating – and although it may not always be possible to cure tinnitus completely, there are lots of tinnitus treatments that can reduce your symptoms and help you to take control of your life. The first step is to get a tinnitus diagnosis – so here’s everything you need to know about getting your condition diagnosed.

How does a doctor diagnose tinnitus?

If you think you might have tinnitus, it’s important to see your doctor or a hearing specialist such as an audiologist or ear, nose and throat specialist (ENT).

Most people have subjective tinnitus, which means that the ringing in their ears can only be heard by them. That means that a doctor will usually diagnose tinnitus based on someone’s description of their symptoms alone.

However, some people have objective tinnitus which means that the ringing or buzzing can be heard by another person, usually by using a stethoscope but in extreme cases it may also be audible without a stethoscope. That means a doctor may also be able to diagnose you based on what they can hear.

Before your doctor tests for tinnitus, they’ll ask for a detailed medical history. They might ask you questions like:

When did your symptoms start?
What does your tinnitus sound like?
Does it happen in one ear or both ears?
Does it come and go or is it permanent?
Do you have any other symptoms?
Do you have any other medical conditions?
Do you take any medications?
Have you noticed any hearing loss?
Have you ever had any previous damage to your hearing?
Do any family members suffer from tinnitus?
Are you highly stressed?
How often are you exposed to loud noises?

It’s important to give the doctor or audiologist as much information as you can, as this can help them to determine what type of tinnitus you have, and what might be causing it.

It’s especially important to be accurate when describing the type of sounds you’re hearing, as it may be the key to determining what’s causing your tinnitus:

Clicking sounds may indicate that muscle contractions in and around your ear are causing your tinnitus
Pulsing, rushing or humming sounds are often caused by issues with your blood vessels such as high blood pressure
Low-pitched ringing could be caused by a blockage in your ear canal, otosclerosis or Meniere’s disease
High-pitched ringing could be caused by exposure to loud noises, hearing loss or medication

Tinnitus is often caused by other conditions, so your healthcare provider may also conduct tinnitus assessments to determine whether you have any underlying conditions that need to be addressed.

Testing for tinnitus

As well as asking you about your symptoms and your medical history, your doctor, audiologist or ENT may carry out some tests. These could include:

Hearing tests

Many people who have tinnitus also have hearing loss. Hearing tests can help your doctor or audiologist to understand whether your tinnitus is occurring in conjunction with hearing loss, or if your tinnitus is caused by another condition. This can help them to determine what treatment is most suitable for you.

You’ll be asked to go into a soundproof room and wear earphones that transmit sounds into one ear at a time. These sounds may be speech or pure tones. You’ll be asked to indicate when you can hear the sound, and your results will be compared against normal ranges for your age to determine whether you have any hearing loss.

You may also be given additional audiological tests to look into how your middle ear, inner ear and auditory pathway is functioning. These can include:

Tympanogram: This measures how well your middle ear functions, looking particularly at the mobility of the eardrum and the conduction bones
Acoustic reflex test: This measures the contraction of the middle ear muscles in response to loud sounds
Otoacoustic emission test: This measures the movement of the hair cells in the middle ear
Speech recognition test: This test is sometimes called speech audiometry and it measures how well a patient hears and his or her capability to repeat certain words
Pure tone audiogram: This is a test of a person’s hearing ability across different frequencies and volumes

Movement tests

Your doctor may want to test your movement, so you might be asked to move your eyes, arms, legs, neck, and clench your jaw. If your symptoms change or get worse when you make a specific movement, it could indicate an underlying medical condition that’s causing your tinnitus.

Imaging tests

Your doctor may want to conduct imaging tests like CT scans, MRI scans or ultrasounds, depending on what they think is causing your tinnitus.

These types of tests show your doctor what is happening inside your body, and it’s likely they’ll look at your brain, the nerves surrounding your ear, and your inner ear to see if they can see what’s causing your tinnitus.

Lab tests

Your doctor may also want to do blood tests to check for issues that may be causing your tinnitus, such as anemia, heart disease, a vitamin B12 deficiency, or thyroid problems.

Tests for tinnitus to diagnose sound perception

Determining the gaps in a person’s hearing is important because this often corresponds to the type and quality of their tinnitus. When evaluating tinnitus cases, hearing professionals often work with additional tests. There are currently no objective tests for tinnitus because of its subjective nature. It is, however, possible to test the perception, pitch and volume of the tinnitus.

When diagnosing tinnitus, potential sound perception tests could include:

Tinnitus sound matching

Demonstrating common tinnitus sounds to patients can help them identify their specific perception. Multiple sounds can be layered or adjusted to create an exact audio recreation of the patient’s tinnitus. These recreations help customize the patient’s tinnitus management therapies.

Minimum masking level

By determining the volume at which an external noise covers the perception of the patient’s tinnitus, doctors measure the sound level. The result can be used in both tinnitus masking and sound therapies.

Loudness discomfort level

This test is important for patients who are extremely sensitive to noise. It determines the volume at which an external sound becomes uncomfortable or even painful.

Is tinnitus self diagnosable?

If you’re hearing a ringing or buzzing sound in your ears, you may suspect that you have tinnitus – and you’re probably correct. But it’s best to see a healthcare professional rather than self-diagnosing.

A doctor, audiologist or ENT will be able to diagnose tinnitus, determine what type of tinnitus you have, what’s causing it, and what type of treatment is best suited to your particular condition.

Even if you’re not particularly bothered by the tinnitus yourself, it’s best to get it checked out by a doctor. That’s because tinnitus can be indicative of hearing loss, so the sooner you get your symptoms checked, the sooner you’ll be able to prevent further damage to your hearing.

Treatments for tinnitus

Once your tinnitus has been diagnosed, your healthcare provider will be able to recommend the best treatment for you.

Depending on the cause of your tinnitus, it may not be possible to cure it completely. However, even if treatment doesn’t cure your tinnitus, for many people, treatment can help to reduce the impact of your symptoms.

Some common treatments for tinnitus include:

Hearing aids to correct hearing loss
Tinnitus retraining therapy (TRT) to help you tune out the ringing sounds and become less bothered by the noise over time
Sound therapy, which exposes you to background noise to help train your brain to tune it out
Cognitive behavioral therapy, which helps you to change your thought patterns so you no longer think of tinnitus in a negative way

As well as treating your tinnitus, your doctor may advise you to protect your ears to avoid hearing loss, or to prevent existing hearing loss from getting worse.

It’s important to protect your ears when you’re exposed to loud noises, whether you’re working in a noisy environment or watching live music. Earplugs like Loop Experience offer up to 18 decibels of noise reduction and filter sounds equally across all frequencies, so you can still hear everything perfectly, but at a reduced volume.

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Life after a tinnitus assessment

Once you’ve had a tinnitus diagnosis, what happens next? Hopefully your treatment will help to reduce the impact your symptoms have on your life, but it’s important not to expect a quick fix. Some treatments may take weeks or even months to work.

In the meantime, it’s important to try to stay positive, even if you find that your symptoms affect your day-to-day life. Speak up to your friends, family and colleagues about how you’re feeling. You could even find some online or in-person support groups in your local community to find like minded people who understand how you’re feeling.

If your tinnitus is making you feel anxious or depressed, let your doctor know. They may be able to advise you of some support groups or signpost you to resources that can help you boost your mood and confidence.

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