Experiencing a pulsing or thumping sound in one or both ears can be a perplexing sensation. This rhythmic noise often aligns with your heartbeat, creating a distinct awareness of bodily sounds. While unsettling for some, this is a common symptom that can arise from various physiological factors.
Understanding Pulsatile Tinnitus
Pulsatile tinnitus is a rhythmic sound, often described as a whooshing, thumping, or roaring, that synchronizes with your pulse. This differs from other forms of tinnitus, which typically involve constant ringing, buzzing, or hissing noises that do not follow a specific beat. It originates from changes in blood flow within vessels near the ear or an increased awareness of normal blood flow. Unlike other tinnitus types, a doctor might sometimes be able to hear the sound with a stethoscope, classifying it as “objective” tinnitus.
The rhythmic nature of pulsatile tinnitus often makes it feel like hearing your own heartbeat within your ear. This perception stems from the turbulence or changes in blood flow through arteries and veins located close to the auditory system. The sound can vary in intensity and may become more noticeable in quiet environments, particularly when lying down.
Common Causes of Ear Pulsing
An increased awareness of normal blood flow can cause the pulsing sound. This can occur after strenuous exercise, during periods of heightened stress, or due to stimulants like caffeine or nicotine, which transiently increase blood circulation.
Physical blockages within the ear canal, such as accumulated earwax or foreign objects, can amplify normal body sounds, making the subtle sounds of blood flow more prominent. Similarly, fluid buildup or infection in the middle ear, known as otitis media, can alter sound transmission and heighten the perception of internal noises.
Issues with the temporomandibular joint (TMJ), which connects the jawbone to the skull, can also lead to referred sounds in the ear. Dysfunction in this joint can cause muscle spasms or pressure changes that are perceived as a pulsing or clicking sound.
Elevated blood pressure, or hypertension, can make the flow of blood through vessels more forceful and audible. When blood pressure is consistently high, the increased pressure against vessel walls can lead to a more pronounced whooshing sound in the ears. Anemia, a condition characterized by a reduced number of red blood cells, can also increase blood flow velocity and turbulence. This faster, less smooth blood movement can become audible in vessels near the ear.
Atherosclerosis, the hardening and narrowing of arteries due to plaque buildup, creates uneven surfaces within blood vessels. This irregularity causes turbulent blood flow, generating distinct sounds that can be perceived as pulsatile tinnitus.
A “venous hum” is a benign condition where normal blood flow in large veins, particularly the jugular veins in the neck, becomes audible due to specific anatomical configurations or increased flow. Finally, an overactive thyroid gland, or hyperthyroidism, can accelerate the body’s metabolism and heart rate, leading to increased blood flow that may be heard as a pulse in the ear.
When to Seek Medical Advice
A sudden onset of pulsatile tinnitus, especially if it appears without an obvious trigger, warrants prompt evaluation. If the pulsing is accompanied by other concerning symptoms, such as dizziness, vertigo, hearing loss, pain, headaches, vision changes, weakness, or numbness, it is advisable to consult a doctor.
Medical advice should also be sought if the pulsing sound is constant, worsens over time, or significantly interferes with daily activities like sleep or concentration. Pulsatile tinnitus affecting only one ear, known as unilateral pulsatile tinnitus, can also be a significant indicator for further investigation. Individuals with a history of underlying medical conditions, such as heart disease or high blood pressure, should also discuss new occurrences of ear pulsing with their healthcare provider. A medical evaluation is important to identify the underlying cause and rule out any serious conditions.
Diagnosis and Management Approaches
Diagnosis typically begins with a thorough medical history and physical examination. The doctor may listen to the ear and neck with a stethoscope to determine if the sound is objective, meaning they can hear it too. Blood tests might be ordered to check for conditions like anemia or thyroid imbalances.
Depending on the initial findings, imaging studies may be recommended to visualize the blood vessels and structures around the ear and brain. These can include magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), computed tomography (CT) scans, or ultrasound. These scans help identify potential vascular issues or other structural abnormalities.
The management of pulsatile tinnitus is directly dependent on identifying and addressing its underlying cause. If earwax buildup is the culprit, simple removal can resolve the symptom. Medications may be prescribed to manage conditions like high blood pressure or anemia. For issues related to TMJ dysfunction, specific therapies or lifestyle adjustments might be recommended. In rare instances, if a vascular condition like an aneurysm or an arteriovenous malformation is identified, specialized medical or surgical interventions may be considered to correct the problem. Addressing the root cause is central to alleviating the persistent pulsing sensation.