Ever wondered why your headaches often come with an annoying ringing in your ears? It's a question that puzzles many.
According to the World Health Organisation (WHO), nearly half of the adult population worldwide suffers from headaches at least once a year. On the other hand, ringing in the ears, medically known as tinnitus, affects between 10% to 30% of adults. But is this overlap a mere coincidence, or is there a deeper connection?
This guide aims to unravel the mystery behind the co-occurrence of headaches and ringing in your ears. We'll sift through scientific evidence, examine prevalence rates, and explore whether a unifying diagnosis exists.
Stay with us to learn how this newfound knowledge can empower you to manage these conditions better and how the Oto app can be your ally in this journey.
Safety Notice: The information provided in this guide is for informational purposes only and is not intended as medical advice. If you have concerns about tinnitus and headaches, or any other medical conditions, it's essential to consult with a healthcare professional or doctor.
Tinnitus manifests as an internal noise that can take various forms, including:
If you are living with tinnitus, the experience can differ widely, making it both puzzling and distressing. The intensity, duration, and quality of the sound can range from transient episodes lasting minutes to persistent conditions extending over months.
Can ringing in the ears cause headaches?
Technically, tinnitus isn't the exact cause of headaches, but the two conditions do often co-exist. The ringing may manifest alongside other auditory symptoms like hearing loss, aural fullness, or otalgia (ear pain), which can exacerbate stress levels and consequently trigger headaches.
Therefore, it's essential to consult a healthcare provider for a comprehensive diagnosis and treatment plan that addresses both conditions effectively.
The encouraging news is that tinnitus often becomes less intrusive with proper management and time. Signs that it is improving include:
- Periods when you don't notice the sound
- A decrease in its volume
- The ability to focus on daily activities without distraction
The link between tinnitus and headaches
Headaches and tinnitus share several similarities. Both conditions are localised to the head, their symptoms can differ widely among individuals, and they are often invisible, making diagnosis and treatment challenging. Let’s explore some other factors that could create a possible link between them.
Anatomical and Physiological Connections
The two ailments are interconnected through a complex network of blood vessels supplying the head and neck, the cranial nerves responsible for sensory information, and the muscles that manage jaw movements. When a headache strikes, these structures undergo changes in blood flow, nerve signalling, and muscle tension. This, in turn, can trigger or worsen tinnitus symptoms.
Both tinnitus and headaches, particularly migraines, have been associated with neurological changes in the brain. Research suggests that disruptions in neural pathways can lead to heightened sensitivity to pain and sound . Additionally, neurotransmitter imbalances, such as serotonin levels, have been implicated in both migraine headaches and tinnitus, further strengthening the neurological link between the two conditions.
Medication Side Effects
Medications like NSAIDs, which are commonly used for headache relief, have been reported to potentially worsen tinnitus in some individuals. Similarly, certain antihistamines and antidepressants used in tinnitus management could lead to headaches or migraines. Therefore, it's crucial to consult with healthcare providers for a comprehensive medication review to minimise the risk of adverse interactions between treatments for these two health issues.
Stress and Lifestyle Factors
Chronic stress can lead to the release of hormones like cortisol, which has been linked to both tension headaches and the severity of tinnitus symptoms. Additionally, unhealthy lifestyle choices such as excessive caffeine or alcohol consumption, poor diet, inadequate sleep, and lack of exercise can exacerbate both ailments. Therefore, adopting stress management techniques and a balanced lifestyle can play a significant role in alleviating symptoms of both headaches and ringing in the ears.
Fluctuations in hormones, particularly in women, can trigger migraines. Conditions like pregnancy, menopause, and menstrual cycles could be common ground. Hormonal imbalances can affect neurotransmitter levels. For example, progesterone fluctuations during the menstrual cycle have been associated with migraine occurrence .
This could, in turn, influence the severity and frequency of tinnitus.
Auditory System Dysfunction
Exposure to loud noises can not only exacerbate tinnitus symptoms but also trigger tension headaches or migraines due to sensory overload. Additionally, inner ear issues like Meniere's disease can manifest with both tinnitus and headaches, suggesting a shared pathway in the auditory system. Therefore, addressing hearing health could be a key factor in managing both conditions effectively.
High blood pressure can be a contributing factor to both headaches and ringing in the ears. It can lead to constriction of blood vessels in the head and neck region, which may exacerbate symptoms. Additionally, disorders like arteriosclerosis, where the blood vessels become less flexible, can also be a contributing factor.
Autoimmune diseases like lupus or rheumatoid arthritis could be an underlying cause. Such disorders often involve systemic inflammation, which can affect various bodily systems, including the auditory and nervous systems. This inflammation can trigger headaches and potentially exacerbate tinnitus symptoms . Moreover, certain autoimmune medications may also have side effects that can worsen either condition, making it crucial to consult healthcare providers for a comprehensive treatment plan.
Several underlying conditions could explain the co-occurrence of headaches and ringing in the ears, such as:
- Migraine disorders
- General headache disorders
- Temporomandibular joint (TMJ) dysfunction
- Traumatic brain injury (TBI)
- Carotid artery dissection
It’s also not uncommon to experience anxiety, depression, and sleep disturbances. Notably, one study found that individuals with both tinnitus and migraines have been found to score lower on quality of life and higher on depression inventory rating scales compared to those with only tinnitus .
Pulsatile Tinnitus And Headaches
First, it can be helpful to understand what is pulsatile tinnitus - head noise with a "beating" sensation or sound quality. The pulsing may go along with your heartbeat, and depending on the cause, the pulsatile tinnitus may be inaudible to others (subjective tinnitus) or audible to others such as a medical doctor (objective).
The important thing to know about pulsatile tinnitus, with or without headaches, is that you should seek medical evaluation for this condition as it could be a sign of a medical problem. One condition that may cause pulsatile tinnitus and headaches is benign intracranial hypertension.
Put simply, benign intracranial hypertension, sometimes also referred to as idiopathic intracranial hypertension (IIH), is high pressure in the fluid that surrounds the brain in the skull. It occurs most commonly in women ages 25-40 (but can occur in anyone at any age), in people who are overweight or obese, and in people with chronic kidney failure and certain thyroid disorders.
In addition to pulsatile tinnitus, benign intracranial hypertension / IIH can cause other symptoms such as headache, dizziness, nausea, vomiting, neck stiffness, changes in vision including loss of peripheral vision, trouble walking, depression, and forgetfulness. Some of these symptoms can be worrisome and are similar to symptoms of a brain tumour, so it's important to seek medical evaluation if you notice them.
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Headaches Versus Migraines
Symptoms Of Headaches
- Mild to severe head pain
- Localised to forehead, both sides of the head, the temple, or the back of the head
- Lasting 30 minutes to one week
Symptoms Of Migraines
The English word, "migraine" comes from the Greek words meaning "half" and "skull," attributing to the one-sided nature of head pain that is a defining characteristic of migraine that distinguishes it from a headache. Migraine affects nearly 12% of the population.
Migraine is typically characterised by having symptoms of a headache plus any of the following:
- Pain localised to temples or behind one ear or eye
- Pain is typically one-sided but can affect both sides
- Moderate to severe throbbing pain that interferes with daily activities
- Pain may be severe and cause the sufferer to go to the Emergency Room
- Nausea and/or vomiting
- Vision changes including blurriness, temporary / transient loss of vision, seeing spots or lights
- Photosensitivity (sensitivity to light) or sensitivity to sound
Migraines are further sub-categorized as occurring with or without aura. "Aura" refers to seeing lights or lines, feelings of mental fogginess, and other sensations such as tingling, numbness, smell, taste, or touch approximately 10-30 minutes before the migraine begins.
Central Sensitization In Migraines And Tinnitus
There seems to be a connection between people who suffer from migraines and people who have tinnitus, and the common thread is how the brain neurologically interprets input. In fact, there may be a biochemical reason for this: The trigeminal nerve releases inflammatory peptides which could cause the throbbing pain associated with migraine.
After several migraines, central sensitisation may occur and pave the way for tinnitus to start. Conversely, unilateral tinnitus may sensitise the trigeminal nerve system and trigger migraines on the same side.
Research supports that migraines precede tinnitus (perhaps because they are more prevalent in younger people whereas tinnitus is associated with a change in auditory status which is more common in older adults), but favours a biological connection nonetheless.
People That Suffer From Migraines Are More Likely To Develop Tinnitus
Tinnitus is a commonly reported side effect of migraines, but people who suffer from migraines are also more likely to report having tinnitus. An ode to the age-old question of the chicken and the egg: some may wonder whether having headaches could cause tinnitus or vice versa.
Often, tinnitus can be reported when a migraine occurs but some may wonder whether is there an association between tinnitus and other cochlear disorders with a history of migraines? No matter the chain of effects, it's good to know that:
- Roughly 20% of people who have migraine report tinnitus as a symptom
- 26-47% of people who have tinnitus also report having headaches
Understanding the relationship between headaches, migraines, and ringing in the ears
While tinnitus and headaches often co-occur, one does not necessarily cause the other. They may, however, share underlying triggers or conditions that cause them to appear together, as also highlighted above.
Understanding the types of headaches that may cause ringing in the ears can help you manage these co-occurring issues more effectively. From migraines to sinus headaches, each type has its unique characteristics and potential for appearing alongside tinnitus.
- Migraines: These are not just severe headaches; they come with a range of symptoms like nausea, light sensitivity, and even auditory disturbances.
- Tension headaches: Often described as a dull, bilateral ache, these are the most prevalent type caused by muscle tension in the head and neck regions.
- Cluster headaches: Though rare, cluster headaches are excruciating and occur in cycles.
- Sinus headaches: Caused by sinus inflammation or infection, these headaches result in facial pain and pressure. The inflammation can also affect the auditory system.
The term "migraine" originates from the Greek words meaning "half" and "skull," highlighting its one-sided nature. Unlike other types of headaches, migraines come with additional symptoms and affect nearly 12% of the population.
The neurological link: Central sensitisation in migraines and tinnitus
The common thread between migraines and tinnitus is how the brain interprets sensory input. The trigeminal nerve releases inflammatory peptides, potentially causing migraine-associated throbbing pain. Over time, this can lead to central sensitisation, making you more susceptible to tinnitus or vice versa.
Prevalence and connection: Migraines and tinnitus
Research indicates a biological connection between the two conditions:
- About 20% of people with migraines report tinnitus
- Between 26-47% of people with tinnitus also have headaches
Chronic headaches and persistent tinnitus
If you experience headaches more than 15 days per month for at least three months, it's considered chronic. The co-occurrence of tinnitus could signify an underlying migraine condition. Both ailments can significantly impact daily life, but treatments are available.
Tinnitus And Constant Headache
A headache is considered to be chronic if it occurs more than 15 days per month and lasts for at least three months. When tinnitus also occurs, it could be a sign of a migraine.
Persistent headaches accompanied by tinnitus can seriously disrupt daily living and have a significant impact on quality of life. Most people find relief knowing that there are ways to treat headaches, migraines, and tinnitus.
How to treat headaches and ringing in the ears
Below is a comprehensive table that categorises and outlines various aspects related to headaches and tinnitus. Each section provides actionable advice or information to help you better understand and manage these co-occurring conditions.
When to seek medical advice
If lifestyle modifications and over-the-counter treatments aren't effective, it may be time to consult your general practitioner for a referral to a neurologist. This is especially important to rule out other medical causes for your symptoms.
Discover Oto: Your digital ally in managing headaches and ringing in the ears
Struggling with the incessant ringing in your ears and frequent headaches? Meet Oto, a revolutionary digital platform designed to help you regain control over your life. Created by a team of experts who have both personal and professional experience with tinnitus, Oto offers a comprehensive strategy to help you soothe this condition effectively.
Why choose Oto?
- Expert-crafted content: This digital program is like having a therapist in your pocket. It offers guided audio sessions that cover various aspects of life impacted by tinnitus, from helping minimise distractions to falling asleep faster.
- Instant accessibility: Being a mobile app, Oto is available whenever you need it, wherever you are. This ensures you have the support you need right at your fingertips.
- Personalised approach: The 1-1 program combines expert video coaching with the app's features, offering a tailored experience that adapts to your specific needs. Our specialists understand the condition intimately, offering a trustworthy path to tuning out tinnitus.
- Cognitive Behavioral Therapy (CBT): Unlike other solutions that focus on hardware or retraining therapies, Oto leverages the proven effectiveness of CBT to help you tackle tinnitus symptoms, including stress and anxiety.
- Community and expert insights: Benefit from regular webinars, Q&As with top tinnitus experts, and success stories from users who have walked in your shoes.
- Easy to Use: Oto is designed with user-friendliness in mind, making it accessible even for those who are not tech-savvy. Plus, subscribers can take advantage of a free consultation with a tinnitus expert.
Take the first step today
The intricate relationship between headaches and tinnitus is one that impacts various facets of daily life, from sleep quality to emotional well-being. While these conditions may seem overwhelming, understanding their interconnectedness and underlying causes can empower you to seek effective management strategies.
Various types of headaches, from migraines to tension headaches, have been associated with tinnitus, and both ailments can be exacerbated by factors like stress, hormonal changes, and certain medications. Fortunately, there are comprehensive solutions like Oto that offer a multi-faceted approach to dealing with these conditions.
Designed by specialists who have personal experience with tinnitus, the mobile platform combines the power of CBT, expert guidance, and personalised support to help you reclaim your life. Don't let tinnitus and headaches hold you back any longer. Discover Oto today and take the first step toward a better quality of life.
- Shore, S. E., Roberts, L. E., & Langguth, B. (2016). Maladaptive plasticity in tinnitus—triggers, mechanisms and treatment. Nature Reviews Neurology, 12(3), 150–160. https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC4895692&blobtype=pdf
- Somerville, B. W. (1971). The role of progesterone in menstrual migraine. Neurology, 21(8), 853. https://doi.org/10.1212/WNL.21.8.853
- Langguth, B., Hund, V., Landgrebe, M., Schecklmann, M., & Kreuzer, P. M. (2015). Tinnitus and headache. Neurological Sciences, 36(1), 37-44. https://doi.org/10.1007/s10072-015-2146-9
- Langguth, B., Hund, V., Busch, V., Jürgens, T. P., Lainez, J. M., Landgrebe, M., ... & Tass, P. A. (2017). Tinnitus and Headache. BioMed Research International, 2017, Article ID 7974167. https://doi.org/10.1155/2017/7974167