July 12, 2021

Tinnitus and Dizziness: The Ultimate Guide

Tinnitus & Dizziness: Unraveling the connection. Important considerations and seeking diagnosis for improved quality of life.
Alexandra Costlow, Au.D.
Written by: 
Alexandra Costlow, Au.D.

Tinnitus and dizziness can occur together, but is there a connection between the two? Whereas tinnitus is defined as sound or noise that is perceived inside the head, dizziness is a broad term that can be used to describe a variety of complaints such the sensation that the room is spinning, feeling off-balance or unsteady, or light-headedness.

There are many reasons why someone with tinnitus may also experience dizziness. Here are important considerations regarding whether your tinnitus and dizziness may be related, and how to take action to get a diagnosis to improve your quality of life.

Types of Dizziness

"Dizziness" is a general term that may be used to describe different types of balance problems. There are actually more specific terms that can be used to describe different types of dizziness:

  • Vertigo makes the person feel as though their surroundings or the room is spinning.
  • Imbalance makes the person feel unsteady, "off-balance," or like they may fall toward one side more than others.
  • Light-headedness refers to the feeling of floating or a disconnect between the head and the rest of the body.

Tinnitus and dizziness, tinnitus and vertigo, tinnitus with dizziness
Vertigo feels like the room is spinning or moving.

Symptoms of Dizziness

People who experience forms of dizziness may notice these symptoms:

  • Tripping or falling
  • Feeling unsteady on unstable while walking or moving
  • Feeling your surroundings or room spin
  • Veering toward one side while intending to walk in a straight line
  • Bumping into things such as furniture or counter tops

Causes of Dizziness

Some causes are referred to as otologic, e.g. a problem affecting the ear or vestibular organs, such as a weakness in the vestibular system.

Other causes are Non-otologic, e.g. not relating to the ear or vestibular system, such as a foot, ankle, or leg problem that affects balance.

Sometimes dizziness can be due to mix of both otologic and non-otologic causes, such as a person who has a numbness in one foot and also a vestibular weakness.

It's also possible for certain medications and substances to cause vertigo. Sometimes vertigo is permanent and sometimes it subsides when the medication is safely discontinued under the guidance of a physician. Some medications suppress the ability of the vestibular system to maintain balance, such as:

  • Meclizine (which may be prescribed in order to suppress dizziness)
  • Decongestants such as Pseudoephedrine or Sudafed
  • Allery medications
  • Certain intravenous antibiotics
  • Certain chemotherapy drugs
  • Alcohol
  • Others

Read more about what causes tinnitus.

Tinnitus And Vertigo

It's important to consult a medical professional for proper evaluation and diagnosis if you have both tinnitus and vertigo. A few disorders that cause both tinnitus and vertigo include but are not limited to:

  • Meniere's Disease - Usually patients report experiencing episodes of reduced hearing, increased tinnitus and dizziness, as well as a feeling of fullness in the ears. Of note, tinnitus tends to be "roaring" when it occurs due to Meniere's Disease.
  • Acoustic Neuroma
  • Otosclerosis
  • Usher Syndrome
  • Labyrinthitis
  • Certain medications can affect both the inner ear and balance organs
  • There are a number of rare conditions that are much less likely to be the cause
  • Having two conditions that independently cause tinnitus and vertigo

Having both tinnitus and vertigo may make you feel anxious or depressed, and you may limit social interactions due to fear of exacerbating symptoms. It's important to find professional tinnitus help in order to optimise odds for success in treating both tinnitus and vertigo.

Tinnitus and dizziness, tinnitus and vertigo, tinnitus with dizziness
Having both tinnitus and dizziness may make you feel anxious, depressed, or avoid social interactions.

Need help with your tinnitus?
Learn out to tune out tinnitus and tune back into life with Oto's clinically proven program
Try for free

When to Consult a Professional

Tinnitus and dizziness can significantly interfere with living a safe and productive life, and it's important to be determine the diagnosis in order to treat an underlying problem. Here are some cues that it might be time to consult a professional such as a general practitioner, otolaryngologist (ear, nose, and throat surgeon), or audiologist:

  • If tinnitus and dizziness are persistent
  • If you have fallen or fear that you might fall
  • If dizziness interferes with activities of daily living or working
  • If the tinnitus and dizziness co-inside, it could be a cue that the two conditions may be related to a unifying diagnosis

Evaluating Tinnitus and Dizziness

Evaluation is the first step in determining if the tinnitus and dizziness are related. A case history will help guide the clinician in determining how to investigate the tinnitus and dizziness.

Tinnitus and dizziness, tinnitus and vertigo, tinnitus with dizziness
A case history records details about the history of tinnitus and dizziness.

Evaluating Tinnitus

Tinnitus may be diagnosed based on the patient's subjective report but there are also pitch and loudness-matching tests that can be done to quantify tinnitus characteristics. Additionally, questionnaires such as the Tinnitus Functional Index (TFI) may help quantify tinnitus symptoms and their impact on quality of life. More specialised testing such as Magnetic Resonance Imaging (MRI) may be recommended for some people with tinnitus.

Evaluating Dizziness

Diagnosing dizziness usually entails a case history and potentially some of the following common balance tests. Of note, not everyone who has tinnitus and dizziness needs all of the following tests:

"Bedside" testing such as the Head Shake Test, Dix-Hallpike Test, Romberg Test, Fukuda Step Test, and Halmagyi Head Thrust Test may be done in the office or exam room.

Videonystagmography / Electronystagmography uses special goggles called Frenzel lenses or electrodes placed on the skin to track eye movement.

Caloric Irrigation entails placing air or water into the ear canals to test for a weakness of one or both sides of the vestibular system.

Rotary Chair Testing evaluates the Vestibular Ocular Reflex (VOR), a reflex that keeps vision clear and stable during head movement.

Vestibular Evoked Myogenic Potential (VEMP) tests the inferior vestibular nerve and saccular and utricular pathways.

Computerized Dynamic Posturography evaluates the vestibular, visual, and somatosensory abilities to maintain balance among different conditions (e.g. with and without vision).

Treatment for Tinnitus With Dizziness

The goal of any treatment is to reduce or eliminate symptoms. The good news is that with proper diagnosis and treatment, an improved quality of life is possible.

The particular treatment that is recommended for tinnitus and dizziness will depend on the diagnosis. Common treatments may include:

  • Vestibular rehabilitation
  • Lifestyle modifications and avoiding triggers
  • Medication where indicated
  • Surgery when necessary

Cognitive Behavioral Therapy for Tinnitus can be a helpful tool in reframing thoughts and emotions about tinnitus and improve your quality of life. It may also be useful for improving your ability to cope with dizziness symptoms.

Check out Oto's Complete Guide to Tinnitus Treatments as well as 7 Positive Lifestyle Tips That Will Help Relieve Tinnitus.

Tinnitus and dizziness, tinnitus and vertigo, tinnitus with dizziness
They key to improving tinnitus and dizziness is determining a proper diagnosis in order to determine an effective treatment plan.

Join Oto

In addition to resources for reducing tinnitus intrusion, the Oto app offers techniques for physical wellbeing such as neck and shoulder stretches, neck and shoulder release, jaw release, arm swing, and gentle neck rotation.

Check out Oto's Tinnitus Support Group, a supportive community for individuals with tinnitus or related conditions to receive regular tips and tricks from the expert team at Oto!‍

FAQs

Can tinnitus and dizziness occur simultaneously?

Yes, tinnitus and dizziness can co-exist, and there are a number of different medical conditions where these co-exist. Tinnitus is perceived as an internal sound, while dizziness can manifest in various ways, such as feeling off-balance or experiencing a spinning sensation. If you suffer from tinnitus with dizziness you should speak to your doctor.


What are the different types of dizziness?

Vertigo: A sensation that the surroundings, such as the room, is spinning. Imbalance: A feeling of being unsteady or off-balance. Light-headedness: A feeling where people can feel like they may faint.


What symptoms might someone with dizziness experience?

Symptoms can include feeling unsteady while walking, veering to one side when trying to walk straight, or falling over.


What are the potential causes of dizziness?

Dizziness can be otologic (related to the ear or balance organs) or non-otologic (not related to the ear) which could be related to blood pressure or neurology.


Are there specific disorders that cause both tinnitus and vertigo?

Yes, some disorders that can cause both symptoms include Meniere's Disease, Acoustic Neuroma, Labyrinthitis, and certain medications affecting the inner ear and balance organs.


How can tinnitus and dizziness impact one's emotional well-being?

Depending on symptoms and their severity, dizziness and tinnitus can have a substantial effect on a person's quality of life. This can be because their symptoms affect their day-to-day activities or their emotional well-being.


When should one consult a professional about tinnitus and dizziness?

It's essential to seek professional advice if you have tinnitus and dizziness at the same time, if your dizziness puts you at risk of falling, your daily activities are limited or your symptoms. Are affecting your emotional well-being.


How are tinnitus and dizziness investigated?

A professional will review your symptoms by taking a history and completing a thorough examination. They may then complete certain investigations such as certain audiometry tests, radiological scans or specific tests to better understand what may be causing the symptoms.


What treatments are available for tinnitus accompanied by dizziness?

Treatment options depend on the diagnosis. These could include vestibular rehabilitation, lifestyle modifications, certain medications and Cognitive Behavioral Therapy for Tinnitus which can be delivered digitally such as through the Oto app.

References

1. The Tinnitus Functional Index: Development of a new clinical measure for chronic, intrusive tinnitus.

2. Curthoys and Halmagyi Head Impulse test: An analytical device.

Need help with your tinnitus?
Learn out to tune out tinnitus and tune back into life with Oto's clinically proven program
Try for free
Tinnitus & Dizziness: Unraveling the connection. Important considerations and seeking diagnosis for improved quality of life.
Alexandra Costlow, Au.D.

Alexandra Costlow, Au.D.

Medically Reviewed by
Audiologist
July 12, 2021

Tinnitus and Dizziness: The Ultimate Guide

Tinnitus and dizziness can occur together, but is there a connection between the two? Whereas tinnitus is defined as sound or noise that is perceived inside the head, dizziness is a broad term that can be used to describe a variety of complaints such the sensation that the room is spinning, feeling off-balance or unsteady, or light-headedness.

There are many reasons why someone with tinnitus may also experience dizziness. Here are important considerations regarding whether your tinnitus and dizziness may be related, and how to take action to get a diagnosis to improve your quality of life.

Types of Dizziness

"Dizziness" is a general term that may be used to describe different types of balance problems. There are actually more specific terms that can be used to describe different types of dizziness:

  • Vertigo makes the person feel as though their surroundings or the room is spinning.
  • Imbalance makes the person feel unsteady, "off-balance," or like they may fall toward one side more than others.
  • Light-headedness refers to the feeling of floating or a disconnect between the head and the rest of the body.

Tinnitus and dizziness, tinnitus and vertigo, tinnitus with dizziness
Vertigo feels like the room is spinning or moving.

Symptoms of Dizziness

People who experience forms of dizziness may notice these symptoms:

  • Tripping or falling
  • Feeling unsteady on unstable while walking or moving
  • Feeling your surroundings or room spin
  • Veering toward one side while intending to walk in a straight line
  • Bumping into things such as furniture or counter tops

Causes of Dizziness

Some causes are referred to as otologic, e.g. a problem affecting the ear or vestibular organs, such as a weakness in the vestibular system.

Other causes are Non-otologic, e.g. not relating to the ear or vestibular system, such as a foot, ankle, or leg problem that affects balance.

Sometimes dizziness can be due to mix of both otologic and non-otologic causes, such as a person who has a numbness in one foot and also a vestibular weakness.

It's also possible for certain medications and substances to cause vertigo. Sometimes vertigo is permanent and sometimes it subsides when the medication is safely discontinued under the guidance of a physician. Some medications suppress the ability of the vestibular system to maintain balance, such as:

  • Meclizine (which may be prescribed in order to suppress dizziness)
  • Decongestants such as Pseudoephedrine or Sudafed
  • Allery medications
  • Certain intravenous antibiotics
  • Certain chemotherapy drugs
  • Alcohol
  • Others

Read more about what causes tinnitus.

Tinnitus And Vertigo

It's important to consult a medical professional for proper evaluation and diagnosis if you have both tinnitus and vertigo. A few disorders that cause both tinnitus and vertigo include but are not limited to:

  • Meniere's Disease - Usually patients report experiencing episodes of reduced hearing, increased tinnitus and dizziness, as well as a feeling of fullness in the ears. Of note, tinnitus tends to be "roaring" when it occurs due to Meniere's Disease.
  • Acoustic Neuroma
  • Otosclerosis
  • Usher Syndrome
  • Labyrinthitis
  • Certain medications can affect both the inner ear and balance organs
  • There are a number of rare conditions that are much less likely to be the cause
  • Having two conditions that independently cause tinnitus and vertigo

Having both tinnitus and vertigo may make you feel anxious or depressed, and you may limit social interactions due to fear of exacerbating symptoms. It's important to find professional tinnitus help in order to optimise odds for success in treating both tinnitus and vertigo.

Tinnitus and dizziness, tinnitus and vertigo, tinnitus with dizziness
Having both tinnitus and dizziness may make you feel anxious, depressed, or avoid social interactions.

Discover how to tune out tinnitus with our free webinar

Thanks for signing up! Please check your inbox to access the course.
Oops! Something went wrong while submitting the form.
You don’t just have to “live with it"
Why we hear tinnitus
How it feels to tune it out
Clinically proven methods that really work

When to Consult a Professional

Tinnitus and dizziness can significantly interfere with living a safe and productive life, and it's important to be determine the diagnosis in order to treat an underlying problem. Here are some cues that it might be time to consult a professional such as a general practitioner, otolaryngologist (ear, nose, and throat surgeon), or audiologist:

  • If tinnitus and dizziness are persistent
  • If you have fallen or fear that you might fall
  • If dizziness interferes with activities of daily living or working
  • If the tinnitus and dizziness co-inside, it could be a cue that the two conditions may be related to a unifying diagnosis

Evaluating Tinnitus and Dizziness

Evaluation is the first step in determining if the tinnitus and dizziness are related. A case history will help guide the clinician in determining how to investigate the tinnitus and dizziness.

Tinnitus and dizziness, tinnitus and vertigo, tinnitus with dizziness
A case history records details about the history of tinnitus and dizziness.

Evaluating Tinnitus

Tinnitus may be diagnosed based on the patient's subjective report but there are also pitch and loudness-matching tests that can be done to quantify tinnitus characteristics. Additionally, questionnaires such as the Tinnitus Functional Index (TFI) may help quantify tinnitus symptoms and their impact on quality of life. More specialised testing such as Magnetic Resonance Imaging (MRI) may be recommended for some people with tinnitus.

Evaluating Dizziness

Diagnosing dizziness usually entails a case history and potentially some of the following common balance tests. Of note, not everyone who has tinnitus and dizziness needs all of the following tests:

"Bedside" testing such as the Head Shake Test, Dix-Hallpike Test, Romberg Test, Fukuda Step Test, and Halmagyi Head Thrust Test may be done in the office or exam room.

Videonystagmography / Electronystagmography uses special goggles called Frenzel lenses or electrodes placed on the skin to track eye movement.

Caloric Irrigation entails placing air or water into the ear canals to test for a weakness of one or both sides of the vestibular system.

Rotary Chair Testing evaluates the Vestibular Ocular Reflex (VOR), a reflex that keeps vision clear and stable during head movement.

Vestibular Evoked Myogenic Potential (VEMP) tests the inferior vestibular nerve and saccular and utricular pathways.

Computerized Dynamic Posturography evaluates the vestibular, visual, and somatosensory abilities to maintain balance among different conditions (e.g. with and without vision).

Treatment for Tinnitus With Dizziness

The goal of any treatment is to reduce or eliminate symptoms. The good news is that with proper diagnosis and treatment, an improved quality of life is possible.

The particular treatment that is recommended for tinnitus and dizziness will depend on the diagnosis. Common treatments may include:

  • Vestibular rehabilitation
  • Lifestyle modifications and avoiding triggers
  • Medication where indicated
  • Surgery when necessary

Cognitive Behavioral Therapy for Tinnitus can be a helpful tool in reframing thoughts and emotions about tinnitus and improve your quality of life. It may also be useful for improving your ability to cope with dizziness symptoms.

Check out Oto's Complete Guide to Tinnitus Treatments as well as 7 Positive Lifestyle Tips That Will Help Relieve Tinnitus.

Tinnitus and dizziness, tinnitus and vertigo, tinnitus with dizziness
They key to improving tinnitus and dizziness is determining a proper diagnosis in order to determine an effective treatment plan.

Join Oto

In addition to resources for reducing tinnitus intrusion, the Oto app offers techniques for physical wellbeing such as neck and shoulder stretches, neck and shoulder release, jaw release, arm swing, and gentle neck rotation.

Check out Oto's Tinnitus Support Group, a supportive community for individuals with tinnitus or related conditions to receive regular tips and tricks from the expert team at Oto!‍

FAQs

Can tinnitus and dizziness occur simultaneously?

Yes, tinnitus and dizziness can co-exist, and there are a number of different medical conditions where these co-exist. Tinnitus is perceived as an internal sound, while dizziness can manifest in various ways, such as feeling off-balance or experiencing a spinning sensation. If you suffer from tinnitus with dizziness you should speak to your doctor.


What are the different types of dizziness?

Vertigo: A sensation that the surroundings, such as the room, is spinning. Imbalance: A feeling of being unsteady or off-balance. Light-headedness: A feeling where people can feel like they may faint.


What symptoms might someone with dizziness experience?

Symptoms can include feeling unsteady while walking, veering to one side when trying to walk straight, or falling over.


What are the potential causes of dizziness?

Dizziness can be otologic (related to the ear or balance organs) or non-otologic (not related to the ear) which could be related to blood pressure or neurology.


Are there specific disorders that cause both tinnitus and vertigo?

Yes, some disorders that can cause both symptoms include Meniere's Disease, Acoustic Neuroma, Labyrinthitis, and certain medications affecting the inner ear and balance organs.


How can tinnitus and dizziness impact one's emotional well-being?

Depending on symptoms and their severity, dizziness and tinnitus can have a substantial effect on a person's quality of life. This can be because their symptoms affect their day-to-day activities or their emotional well-being.


When should one consult a professional about tinnitus and dizziness?

It's essential to seek professional advice if you have tinnitus and dizziness at the same time, if your dizziness puts you at risk of falling, your daily activities are limited or your symptoms. Are affecting your emotional well-being.


How are tinnitus and dizziness investigated?

A professional will review your symptoms by taking a history and completing a thorough examination. They may then complete certain investigations such as certain audiometry tests, radiological scans or specific tests to better understand what may be causing the symptoms.


What treatments are available for tinnitus accompanied by dizziness?

Treatment options depend on the diagnosis. These could include vestibular rehabilitation, lifestyle modifications, certain medications and Cognitive Behavioral Therapy for Tinnitus which can be delivered digitally such as through the Oto app.

References

1. The Tinnitus Functional Index: Development of a new clinical measure for chronic, intrusive tinnitus.

2. Curthoys and Halmagyi Head Impulse test: An analytical device.

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