Muscular tinnitus is a very rare type of tinnitus where you hear sounds caused by muscle spasms in your middle ear.

Tinnitus is a condition where you hear sounds like ringing or buzzing that are not from an outside source. It affects about 10–25% of adults, and children may also get it.

There are generally two types of tinnitus:

  • Subjective or non-rhythmic: Only the person with tinnitus hears the sound. This is the most common type.
  • Objective or rhythmic: With objective tinnitus, the sound may be heard by someone else. This type includes tinnitus caused by conditions that affect your muscles or blood vessels. It affects only 1% of people with tinnitus.

If the cause of muscular tinnitus is diagnosed and treated, it may be resolved.

The sound that muscular tinnitus creates is usually a clicking noise.

The symptoms may vary by person but may include sounds that:

  • are always present or only there occasionally
  • fluctuate in volume and pitch
  • are in one or both ears
  • increase in volume at night or when there is less outside noise
  • get louder if there are external noises
  • seem to be inside your head rather than in your ears

Muscular tinnitus is associated with involuntary spasms or twitching of the tiny stapedius and tensor tympani muscles in your middle ear, which is the area between your eardrum and inner ear.

These two muscles control the movement of the bones that carry sound from the air to your inner ear. The muscles contract to reduce the volume of loud noises. If they contract rhythmically, you may hear clicking or other repetitious sounds.

Some of the following conditions may cause muscular tinnitus:

Since muscular tinnitus is a symptom rather than a condition, the complications depend on the underlying cause.

According to the National Institute on Deafness and Other Communication Disorders, tinnitus is rarely associated with a serious medical problem.

You should see a doctor if your tinnitus:

  • lasts longer than 1 week
  • disrupts your sleep or concentration
  • makes you anxious or depressed
  • if the tinnitus sounds match your heartbeat (pulsatile tinnitus)

It’s important to see a doctor if your tinnitus symptoms begin suddenly or affect your ability to hear other sounds. These are some of the muscular tinnitus red flags that may indicate a more serious underlying cause.

Tinnitus is a symptom of an underlying condition, so the goal of a diagnosis is to determine the cause.

A doctor may first check for something that could be blocking your ear canal, such as earwax or an infection.

If that’s not the cause, they may ask about your medical history to identify any conditions or medications that could lead to tinnitus.

They may then refer you to an otolaryngologist, also called an ear, nose, and throat (ENT) doctor, or to an audiologist who will test your hearing.

An otolaryngologist will examine your ears, neck, and head. They may ask you to clench your jaw or move your neck or eyes to see if it affects your tinnitus.

If the otolaryngologist suspects you may have muscular tinnitus, they will usually order imaging tests like the following that may show the underlying cause:

The treatment for muscular tinnitus depends on its underlying cause. This type of tinnitus may go away on its own without treatment.

If the cause of muscular tinnitus can’t be determined or it continues after treatment, a doctor may prescribe muscle relaxer drugs.

Other treatments and remedies for tinnitus include:

  • Sound-masking devices: Worn like hearing aids, these devices provide white noise that drown out tinnitus sounds.
  • Tinnitus retraining therapy (TRT): With TRT, you wear adjustable hearing-aid-like devices that gradually lower your awareness of tinnitus noises.
  • Background noise: Listening to pleasant sounds like ocean waves or falling rain may help relieve tinnitus symptoms.
  • Stretching exercises: Performing neck stretches regularly may help relax your neck muscles.

It may take 3 months to a year to experience relief with treatments such as TRT, according to the American Tinnitus Association.

Surgery is infrequently necessary if no other strategies are effective.

It may not be possible to prevent muscular tinnitus since its causes vary.

To help prevent tinnitus in general, you can try doing the following:

  • wearing ear protection in loud environments like concerts
  • setting the volume in headphones or earbuds to a safe level
  • taking breaks if possible to get away from loud noise in noisy areas
  • trying to reduce stress with activities like meditation or journaling
  • using your jaw less, such as cutting back on chewing gum

Unlike most other types of tinnitus, muscular tinnitus may go away after its underlying cause is identified and treated. The causes may range from tension in your neck to degenerative conditions like ALS.

If your tinnitus symptoms begin suddenly or if the noise blocks out other sounds, it’s important to see a doctor to rule out any serious underlying conditions.