Tinnitus is the perception of sound, often described as ringing, buzzing, hissing, or roaring, that does not originate from an external source. While the condition is a symptom of an underlying issue, its severity can fluctuate significantly, leading to periods where the phantom noise becomes louder or more bothersome. These temporary increases in intensity are known as flare-ups or spikes. Understanding what causes these exacerbations is a primary step in managing the condition, and common categories of causes have been widely observed.
Acoustic and Auditory System Triggers
One of the most immediate and common causes of a tinnitus flare-up is exposure to loud noise. This includes both sudden, intense sounds, like a gunshot, and prolonged exposure to moderate noise levels, such as working with loud machinery or attending a concert without ear protection. Noise exposure strains the auditory system, which can cause inner ear damage to become irritated, resulting in a spike in the perceived volume of the ringing.
Physical changes within the ear structure can also directly influence tinnitus perception. Excessive earwax accumulation is a common culprit, as this buildup can press against the eardrum and alter the normal mechanics of hearing. Similarly, rapid shifts in barometric pressure, such as those experienced during air travel or scuba diving, can temporarily intensify symptoms by affecting the pressure balance in the middle ear.
Pharmaceutical and Substance Contributors
Chemical inputs, both medicinal and recreational, are known to affect the auditory system and trigger flare-ups. A significant group are ototoxic medications, which have a toxic effect on the inner ear’s sensory cells. High doses of common over-the-counter drugs, like aspirin and certain nonsteroidal anti-inflammatory drugs (NSAIDs), are known to be ototoxic, as are some antibiotics, chemotherapy agents, and loop diuretics.
These drugs can damage the hair cells in the cochlea or affect blood flow and chemical signaling, thereby intensifying the tinnitus. If a flare-up occurs after starting a new medication, patients should consult their healthcare provider immediately to discuss alternatives, but should never stop a prescribed regimen without medical advice.
Beyond prescription drugs, common dietary stimulants and depressants can also contribute. High intake of caffeine, a stimulant, can increase nervous system activity, making the ringing more noticeable. Alcohol, a depressant, affects circulation and fluid balance in the inner ear, often leading to a temporary worsening of symptoms. Excessive sodium consumption can also affect fluid levels and blood pressure, exacerbating tinnitus.
Systemic Health and Stress-Related Factors
Emotional tension, anxiety, and psychological stress are significant amplifiers of tinnitus, often causing the volume to increase sharply. Stress hormones, such as adrenaline, can heighten the body’s overall awareness and increase muscle tension, particularly in the neck and jaw area. This tension makes the internal sounds much more prominent.
A lack of sufficient rest is another factor, as sleep deprivation makes the brain more sensitive and less capable of filtering out the internal noise. When the brain is fatigued, it struggles to process sensory information effectively, allowing the tinnitus signal to become more intrusive. Physiological conditions can also directly cause or worsen symptoms by affecting the vascular or musculoskeletal system.
High blood pressure (hypertension) can contribute to flare-ups because the increased pressure can alter blood flow in the blood vessels near the inner ear. This change in circulation can make the internal sound more pronounced, sometimes resulting in pulsatile tinnitus that beats in time with the heart. Additionally, disorders of the temporomandibular joint (TMJ), which connects the jawbone to the skull, can cause mechanical pressure or muscle spasms transmitted directly to the auditory system, resulting in a spike in the perceived sound.
Identifying Your Specific Flare-Up Patterns
Because the experience of tinnitus is highly subjective, managing flare-ups effectively requires identifying individual triggers. The practical step for this identification is maintaining a detailed journal or log of your symptoms and daily activities. You should record the time and severity of any spike, along with any relevant preceding factors. This tracking should include specific details about your sleep duration, stress levels, recent food and drink consumption, and any new medications or loud noise exposure. Over a few weeks, patterns will emerge, allowing you to connect a specific action or state of being to the resulting flare-up.