What Is Tinnitus?

 

Understanding What Tinnitus Is & the Common Causes

Tinnitus is commonly described as a perception of sound without any external source. For many veterans, this experience manifests as ringing, buzzing, or humming in the ears. Tinnitus UK estimates that approximately 1 in 7 adults in the UK experience tinnitus symptoms, underscoring the widespread nature of this condition.

Key Causes of Tinnitus

Cause	Description
Noise-Induced Hearing Loss	Damage to hair cells in the inner ear from loud sounds – a common causation in veterans
Ear and Sinus Infections	Inflammation that affects auditory pathways
Ototoxic Medications	Certain drugs that damage the inner ear
Age-Related Hearing Loss (Presbycusis)	Gradual decline in auditory function with age
Traumatic Brain Injury (TBI)	Disruption to neural circuits involved in hearing

 

How Tinnitus Develops In Veterans

The leading scientific theory is called maladaptive neural plasticity. That simply means the brain is trying to adapt—but in an unhelpful way. Inside the inner ear, the cochlea contains thousands of tiny hair cells that pick up sound vibrations and send them to the brain through the auditory nerve. When these hair cells are damaged (typically by loud noise), the normal signal from the ear is reduced or lost.

The brain doesn’t like missing information. In response, it “turns up the volume” in the auditory system, increasing its own activity to try and compensate. This creates abnormal electrical signals—extra spontaneous firing—that the brain interprets as sound. In other words, the sound isn’t coming from the ear anymore—it’s coming from the brain’s attempt to make sense of silence.

Main mechanisms consist of:

• Loss of inhibition in auditory pathways – normally, the brain filters out unimportant sounds. With tinnitus, that filter breaks down.
• Increased spontaneous neural firing – the brain becomes overactive where hearing signals are weak.
• Involvement of emotion and attention centres – the limbic system and frontal areas (attention) can amplify the distress and focus on the sound

 Together, these brain changes can make tinnitus persistent, especially during stress or fatigue—common after military service. But knowing how it works is the first step to managing it.

How Tinnitus Develops – A Phantom Sound with Real Roots

The leading scientific theory behind tinnitus is known as maladaptive neural plasticity. This means the brain is trying to adapt to changes—but in a way that ends up causing problems. Inside the inner ear, the cochlea contains thousands of tiny hair cells that detect sound vibrations and send those signals along the auditory nerve to the brain. When these delicate hair cells are damaged—usually from loud noise exposure like gunfire, explosions, or aircraft—the normal input to the brain is reduced or lost.

But the brain doesn’t like gaps in its sensory input. In the absence of a clear signal, it tries to compensate by turning up its internal “volume.” This leads to abnormal electrical signals—extra spontaneous neural firing—that the brain mistakenly interprets as sound. In short, the ringing, buzzing, or hissing of tinnitus isn’t coming from the ear anymore. It’s coming from the brain’s attempt to make sense of the silence.

A useful comparison is phantom limb pain—something many veterans may already be familiar with. Just as pain can be felt in a limb that’s no longer there, tinnitus is a phantom sensation created when the brain tries to interpret missing hearing signals. Both conditions are examples of the nervous system adapting to loss, but not always in a helpful way.

Why Understanding the Causes of Tinnitus Can Help Veterans

• Helps target treatments effectively
• Reduces stigma by explaining it is a neurological process
• Supports early intervention strategies

Tinnitus and Hearing Loss from Noise Exposure

Noise exposure is among the leading causes of tinnitus in veterans. Whether it’s prolonged gunfire, explosions, or engine noise, the auditory system often suffers lasting damage, especially when no or improper protective equipment is used or provided. Studies have shown that even a single blast can damage delicate hair cells, which do not regenerate, triggering both hearing loss and persistent tinnitus.

Military personnel face unique risks of acoustic trauma that civilians rarely experience, which is why prevention and monitoring are essential.

Common Sources of Noise-Induced Damage in The Armed Forces

Source	Sound Level (dB)	Risk Factor
Small Arms Fire	140–190 dB	Immediate damage without protection
Artillery and Explosives	170–200 dB	Severe, often permanent hearing loss
Aircraft and Vehicle Engines	100–140 dB	Gradual damage over time
Training Simulations	120–160 dB	Cumulative effect with repeated exposure

The Connection Between Hearing Loss and Tinnitus

Hearing loss and tinnitus often occur together because both result from damage to the cochlear hair cells. When auditory input decreases, the brain attempts to fill in the gaps, creating what are known as phantom sounds. This link is so strong that over 80% of people with tinnitus also show measurable hearing loss.

Why Veterans are at Higher Risk of Hearing Loss & Tinnitus

• Repeated unprotected exposure
• Lack of immediate treatment after acoustic trauma
• Stigma around reporting hearing issues during service
• Delayed onset after discharge

Important Reminder: If you served in environments with chronic noise, contact a hearing loss specialist who is veteran-friendly to undergo a comprehensive hearing assessment, even if your hearing seems fine.

Diagnosis & Monitoring Tinnitus in Veterans

Diagnosing tinnitus is often more complex than identifying hearing loss alone. Since tinnitus is a subjective experience, clinicians rely heavily on veterans’ descriptions of their symptoms. ENT specialists and audiologists use a combination of clinical interviews, hearing tests, and validated questionnaires to capture the impact of tinnitus on daily life.

A thorough evaluation not only measures hearing thresholds but also assesses how tinnitus affects concentration, sleep, and emotional well-being.

Standard Tools Used in Tinnitus Assessment

Assessment Tool	Purpose
Pure Tone Audiometry	Measures hearing sensitivity across frequencies
Tinnitus Handicap Inventory	Evaluates perceived severity and impact
Otoacoustic Emissions	Assesses cochlear hair cell function
Tympanometry	Checks the middle ear health
Psychoacoustic Matching	Estimates pitch and loudness of tinnitus

The Importance of Early Monitoring

For veterans, early diagnosis is critical. Not only does it validate their experience, but it also creates a baseline to monitor changes. This is especially important because tinnitus can worsen over time or fluctuate depending on stress levels, PTSD symptoms, and exposure to further noise.

Latest Medical and Audiological Treatments For Tinnitus

Although there is no universal cure for tinnitus, a range of evidence-based treatments can help reduce its impact. Over the last decade, research has advanced significantly, giving veterans more options for relief and improved function.

New Tinnitus Treatments

Treatment	How It Helps
Sound Therapy	Uses background noise or customised sounds to mask tinnitus
Cognitive Behavioural Therapy (CBT)	Reduces distress and improves coping skills
Hearing Aids	Amplifies environmental sounds to reduce tinnitus awareness
Tinnitus Retraining Therapy (TRT)	Combining counselling and sound therapy to retrain perception
Pharmacological Support	Addresses anxiety, depression, or sleep disruption

ENT specialists and audiologists often tailor treatment plans to each individual, considering the severity of tinnitus, co-occurring conditions like PTSD, and the degree of hearing loss.

Modern tinnitus management combines counselling, sound therapy, and medical devices to retrain the brain’s response to phantom sounds.

Innovations in Tinnitus Care

Recent advances have introduced neuromodulation devices and digital apps that help regulate neural activity linked to tinnitus. Clinical trials are exploring:

• Transcranial Magnetic Stimulation (TMS): Non-invasive brain stimulation to disrupt tinnitus signals.
• Bimodal Stimulation Devices: Combine sound with mild electrical pulses to retrain the auditory system.
• Personalised Mobile Apps: Guide relaxation and deliver customised sound therapy.

Co-Occurring Conditions: PTSD and Traumatic Brain Injury (TBI)

Tinnitus rarely occurs in isolation among veterans. Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) often complicate both diagnosis and treatment. Research indicates that these conditions can exacerbate tinnitus symptoms, creating a cycle of distress that impacts daily functioning.

Veterans with PTSD are more likely to experience severe tinnitus, highlighting the need for integrated treatment approaches.

How Co-Occurring Conditions Affect Tinnitus

The limbic system, which is responsible for emotional regulation, interacts closely with the auditory pathways. This is why veterans with PTSD often describe tinnitus as intrusive and inescapable. TBI, particularly blast-related injuries, can damage both the ear and the brain areas that process sound.

Signs That Tinnitus May Be Linked to PTSD or TBI

• Flashbacks or hypervigilance when tinnitus is prominent
• Memory or concentration difficulties
• Severe irritability or emotional swings triggered by noise
• History of blast exposure or concussions

We understand how challenging it can be to manage multiple conditions at once. We believe that integrated care, which addresses mental health, hearing, and neurological health simultaneously, offers the best chance for veterans to recover.

Getting Help and Support

If you are living with tinnitus, you are not alone. Our team at Veterans Welfare Group is dedicated to supporting veterans through comprehensive tinnitus and hearing loss assessments, targeted treatment referrals, and practical assistance with resettlement, employment, and rehabilitation. Our team includes veterans with lived experience who understand firsthand the challenges tinnitus can bring.

Accessing help early can improve your quality of life and reduce the impact tinnitus has on daily activities.

How We Can Assist

Our specialists at Veteran Welfare Group can guide you through the process of getting help, from arranging expert appointments to providing resources about hearing protection and treatment options. If you have questions about the medical discharge process, our experienced team can walk you through every step.

You deserve support that respects your service and your health needs. Whether you’re newly discharged or have lived with tinnitus, help is available.