A concussion is a mild traumatic brain injury (mTBI) caused by a bump or blow to the head that makes the brain move rapidly inside the skull, temporarily disrupting normal function. Tinnitus is the perception of sound, commonly described as ringing, buzzing, or hissing, when no external sound is present. It is a symptom of an underlying issue within the auditory system. A clear correlation exists between experiencing a concussion and the onset of this phantom noise.
The Confirmed Link Between Concussion and Tinnitus
Concussions frequently lead to the development of tinnitus, a symptom so common that medical checklists for mild traumatic brain injury often include “ringing in the ears.” Studies indicate a significant percentage of individuals who sustain a traumatic brain injury report new or worsened tinnitus symptoms. This is often referred to as post-concussion tinnitus (PCT).
The majority of cases linked to head trauma are subjective tinnitus, meaning the sound is only audible to the affected person. This noise can manifest in one or both ears, and can be constant or intermittent. PCT is distinct from other forms because its direct cause is the mechanical force of the injury or the resulting neurobiological changes.
How Traumatic Brain Injury Disrupts Auditory Pathways
The force of a concussion can disrupt the auditory system through two main pathways: direct physical damage and central nervous system changes. Physical trauma causes peripheral damage by affecting the structures of the middle and inner ear. The violent movement of the head can injure the delicate hair cells within the cochlea or disrupt the alignment of the tiny bones in the middle ear (the ossicular chain).
This mechanical disruption can also impact the vestibulocochlear nerve, which transmits sound signals to the brain. When this nerve or the inner ear is damaged, the brain receives less input. This causes the central auditory system to become hyperactive as it attempts to compensate. This maladaptive neural activity in the brainstem and auditory cortex is believed to generate the phantom sound.
Another consequence of concussive force is the development of somatic tinnitus, strongly associated with accompanying neck and jaw injuries. The muscles and nerves in the neck (cervical spine) and the temporomandibular joint (TMJ) are anatomically linked to the auditory system. Tension or dysfunction in these areas following trauma can influence tinnitus perception, often making the sound worsen with specific head or jaw movements.
Management Strategies and Long-Term Outlook
For many people, post-concussion tinnitus is a temporary symptom that resolves as the brain heals within a few weeks or months. If the symptom persists beyond three to six months, it may be classified as chronic and require a structured management approach. The goal of treatment is not necessarily a cure, but rather to help the person habituate to the sound and reduce distress.
Sound therapy is a common strategy involving external sounds, such as white noise or nature sounds, to make the tinnitus less noticeable. Devices like ear-level sound generators or hearing aids that amplify ambient sound can help reduce the brain’s focus on the internal noise, especially if hearing loss is present. Tinnitus Retraining Therapy (TRT) is a formal habituation protocol combining sound therapy with psychological counseling.
Cognitive Behavioral Therapy (CBT) is an effective component of management, focusing on retraining the patient’s emotional response to the tinnitus. CBT helps patients reframe their thoughts and anxieties related to the sound, reducing distress and impact on daily life. Patients should seek specialized medical help immediately if their tinnitus is pulsatile—a rhythmic whooshing or throbbing sound synchronized with the heartbeat—as this may indicate a vascular issue requiring urgent investigation.