Red flags & when to go in person for Ringing in Ears (Tinnitus)

Audience: adult

Tinnitus, or ringing in the ears, is a common condition that many people experience. It often feels like a buzzing, hissing, or ringing sound without an external source. While tinnitus can be caused by harmless factors like exposure to loud noise or earwax buildup, it can sometimes signal a more serious health issue. Telemedicine can help assess your symptoms, provide advice, and suggest treatments for mild or stable tinnitus. However, some warning signs require prompt in-person evaluation to rule out serious conditions. This guide helps you understand when to seek urgent care, what telemedicine can manage, and how to prepare for your virtual visit. Remember, telemedicine is a helpful tool but not a replacement for emergency or specialized care when needed.

Red flags — go in person / ER

• Sudden hearing loss or noticeable decrease in hearing — seek immediate in-person evaluation.
• New or worsening dizziness, balance problems, or fainting — urgent medical assessment needed.
• Ear pain, discharge, or bleeding from the ear — requires prompt in-person care.

What telemedicine can do

• Initial assessment of mild or stable tinnitus symptoms.
• Reviewing symptom history and medication use.
• Providing advice on noise avoidance and stress management.
• Guidance on earwax removal and general ear care.
• Follow-up for known tinnitus without new concerning symptoms.

What telemedicine cannot do

• Sudden or severe hearing loss.
• Neurological symptoms such as weakness, numbness, or facial drooping.
• Signs of ear infection with pain or discharge needing examination.
• Balance problems or vertigo requiring physical assessment.
• Urgent diagnostic tests like imaging or hearing tests requiring specialized equipment.

What is Tinnitus?

Tinnitus is the perception of noise or ringing in the ears when no external sound is present. It can vary in pitch and loudness and may be constant or intermittent. Many people experience tinnitus temporarily after loud noise exposure, but for some, it becomes a persistent issue affecting daily life.

Common Causes of Tinnitus

Tinnitus often results from exposure to loud sounds, ear infections, earwax buildup, or age-related hearing loss. Other causes include certain medications, stress, or underlying health conditions like high blood pressure. Identifying the cause helps guide appropriate management.

When to Use Telemedicine for Tinnitus

Telemedicine can assist with initial assessment, discussing your symptoms, reviewing your medical history, and suggesting self-care tips. It is useful for mild tinnitus without other concerning symptoms and for follow-up care after initial diagnosis.

Red Flags Requiring In-Person Evaluation

Seek urgent in-person care if you experience sudden hearing loss, dizziness or balance problems, severe or worsening tinnitus, ear pain or discharge, or neurological symptoms like weakness or numbness. These signs may indicate serious conditions needing prompt medical attention.

Preparing for Your Telemedicine Visit

Before your appointment, note when your tinnitus started, how it sounds, and any related symptoms. List current medications and any recent exposures to loud noises or head injuries. Ensure your device has a good internet connection and a quiet environment for the visit.

After Your Telemedicine Visit

Follow any recommendations given, such as lifestyle changes or medication adjustments. Schedule in-person follow-up if advised. Monitor your symptoms and seek immediate care if red flags develop.

How to prepare for your tele-visit

• Write down when your tinnitus started and how it sounds.
• Note any other symptoms like hearing changes or dizziness.
• List all medications and supplements you take.
• Find a quiet, well-lit space for your tele-visit.
• Test your internet connection and device camera/microphone.
• Have a family member or friend available if you need assistance.

After your tele-visit

• Follow recommendations for lifestyle or medication changes.
• Schedule in-person follow-up if advised by your provider.
• Monitor your symptoms closely for any worsening or new red flags.
• Use hearing protection to avoid loud noises.
• Practice stress reduction techniques as suggested.

FAQs

Can telemedicine diagnose the cause of my tinnitus?

Telemedicine can help review your symptoms and medical history to suggest possible causes, but it cannot perform physical exams or hearing tests needed for a definitive diagnosis.

When should I go to the emergency room for tinnitus?

Go to the emergency room if you have sudden hearing loss, severe dizziness, weakness, numbness, or severe ear pain with discharge. These symptoms may indicate serious conditions requiring urgent care.

Are there treatments for tinnitus available through telemedicine?

Yes, telemedicine can provide advice on managing tinnitus, including sound therapy, stress management, and medication review. However, some treatments may require in-person visits.

Is tinnitus always a sign of hearing loss?

Not always. Tinnitus can occur with or without hearing loss. It often relates to ear or nerve issues but can also be influenced by other health factors.

Can stress cause or worsen tinnitus?

Yes, stress and anxiety can make tinnitus more noticeable or bothersome. Managing stress is often part of tinnitus care.

Sources

1. Tinnitus — MedlinePlus, U.S. National Library of Medicine.
2. Tinnitus: Overview — Mayo Clinic.
3. Tinnitus Fact Sheet — World Health Organization.
4. Tinnitus: Diagnosis and Management — National Institute on Deafness and Other Communication Disorders (NIDCD).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If you experience any red flag symptoms or worsening health, seek immediate evaluation by a healthcare professional.