Tinnitus — often described as ringing, buzzing, clicking, or hissing in the ears — affects a significant number of individuals following a concussion or mild traumatic brain injury. While it’s commonly associated with direct ear trauma or loud noise exposure, many patients report tinnitus after head injuries without any obvious damage to the ear itself.
This can make the symptom incredibly frustrating and difficult to understand — especially when it becomes chronic.
📍 Find a Certified Concussion Clinic for a comprehensive assessment.
Note: This article is a compressed version of the full piece by Steven Murray.
The exact mechanisms remain complex, but several theories have strong support:
The inner ear (which houses both the cochlea and vestibular system) may be affected by concussion, leading to dysregulation of sound and balance processing. Even without direct trauma, sudden shifts in cerebrospinal fluid pressure and inflammation may impair auditory nerve function.
Neck injuries often co-occur with concussions and can contribute to tinnitus. This is thought to occur due to somatosensory dysfunction and altered cervical input to brainstem centers involved in auditory processing(1).
Heightened sympathetic activity (fight-or-flight) following concussion may exacerbate tinnitus. Increased nervous system arousal is often seen in patients with persistent symptoms, including ringing in the ears(2).
Anxiety, stress, and hypervigilance — all common post-injury — can heighten awareness of tinnitus and increase its perceived intensity. Sleep disruption and fatigue can worsen this cycle.
Neuroinflammatory changes following concussion may affect auditory pathways. Research suggests altered neurotransmitter levels (e.g., glutamate, GABA) may contribute to the perception of phantom sounds(3).
🎓 For a full breakdown of how concussion can affect multiple systems — including the neck, vestibular system, and autonomics — join our Free 90-Minute Patient Workshop to learn how to get rid of symptoms like tinnitus once and for all.
If tinnitus is worsened by head or neck movement, or accompanied by neck pain or dizziness, a cervical spine evaluation is essential. Treatment may include:
📖 Related: Top 5 Evidence-Based Treatments for Concussion
Breathing exercises, mindfulness, and nervous system regulation strategies (such as vagus nerve stimulation and graded exercise) can help down-regulate sympathetic tone and improve tolerance to tinnitus.
Patients with tinnitus and dizziness or motion sensitivity should undergo vestibular testing. Vestibular therapy can help regulate sensory processing and reduce tinnitus severity in select patients.
Although tinnitus may be neurological in origin, patients should be screened for hearing loss or auditory damage. Audiological testing ensures no peripheral deficit is missed.
Background noise (white noise machines), reducing screen exposure before bed, and sleep hygiene practices can all reduce tinnitus severity at night.
Tinnitus should not be ignored — especially if:
📍 Find a Certified Clinic to identify and treat the root cause.
Find a Clinic
Near You.
Baseline Testing, Treatment, and Rehabilitation to get you back to work and play
Browse our network of trained multidisciplinary healthcare practitioners that collaborate with physicians to co-manage concussion injuries.