A ringing in your ears is the most common symptom of tinnitus. Other sounds include clicking, roaring, hissing and buzzing.

A health problem such as a jaw joint problem or clenching, ear infections, head and neck injuries, high blood pressure, diabetes or tumors may cause the unwanted noise. Certain medications can also make tinnitus worse.

1. Hearing Loss

While many people with tinnitus have some degree of hearing loss, not all do. In some cases, the tinnitus sounds are in tune with the person’s hearing and a simple correction (like using a hearing aid) alleviates the symptoms.

The noise can sound like a ringing, buzzing, roaring or whistling. It’s usually present all the time but may be louder when a person is listening or focused on something. It’s also possible that the tinnitus changes in pitch and intensity with certain activities or atmospheric pressure.

Seeing your doctor is a good idea to rule out an underlying problem. Your GP can check for an ear infection, foreign object in the ear canal or other problems. You’ll also be asked about your tinnitus, its duration and when it started. They may refer you to an ear, nose and throat specialist or audiologist to test your hearing. They’ll also ask about your medications. In some cases, a CT scan or MRI might be required to determine the cause of your tinnitus.

2. Ear Infections

Unlike hearing loss, tinnitus is not a disease but a sound you hear that isn’t originating from outside your body. These phantom sounds can be a ringing, buzzing, roaring, whistling, clicking, hissing, humming, or pulsatile (rhythmic noise that follows a beat), and they may come and go or be present all the time. Injuries to the head or neck, exposure to loud noise, ototoxic medications, Meniere’s disease, jaw joint problems, and teeth clenching can all cause tinnitus.

Your primary care doctor will try to determine if the sound is related to an infection, earwax build-up, a blocked eustachian tube, a condition that blocks the ear canal, an injury or trauma to the head and neck, jaw and dental problems, or a medication you are taking. If the tinnitus persists, they might refer you to an ear, nose, and throat specialist for further testing and treatment. In some cases, infections in the mastoid air cells or labyrinth that aren’t treated can spread and lead to tinnitus.

3. Headaches

If you have a constant noise in your ears that has no apparent cause, it might be tinnitus. Constant ringing in the ears doesn’t always indicate a major health problem, but it can affect your ability to sleep and concentrate.

Your doctor will ask about your symptoms and do a physical exam, including checking for earwax or other issues. They may also refer you to an ear, nose, and throat specialist for further testing.

They’ll ask about your history and if you’ve noticed any changes in your hearing, especially if you have any tinnitus that occurs only at night or in silence when there are no external sounds to mask it. They’ll also ask you to clench your jaw and move your head in specific ways, because this can help them pinpoint the source of the tinnitus sound. They might also recommend tests for temporomandibular joint disorders, which can cause headaches. They’ll also check for pulsatile tinnitus, which is a sound that follows your heartbeat and can sometimes be heard by clinicians using a stethoscope.

4. TMJ

In a smaller number of cases, tinnitus is linked to temporomandibular joint (TMJ) disorders. People with TMJ may experience ringing in their ears that sounds like humming, buzzing or ringing, which is different from subjective tinnitus.

The temporomandibular joints are found on both sides of your face, right in front of your ears. They connect your jaw bone to the skull and control chewing muscles and movement in the face.

TMJ problems can cause pain, clenching of the jaw or clicking noises. Because the ear is close to the TMJ, afflictions with this joint may create tinnitus. In these cases, a dental health professional may be able to relieve tinnitus symptoms through TMJ treatment or bite realignment. People with TMJ also often experience neck pain, headaches and trouble opening their mouth all the way. Other TMJ signs include jaw popping and clicking, difficulty chewing and a disk that protrudes from the joint.