Pete Townshend, of the legendary British rock group The Who, has talked often of his struggles with hearing loss and tinnitus—a common problem affecting 15-20% of people. Townshend attributes his tinnitus to the use of headphones in the recording studio. For people like Townshend, tinnitus can be an occupational hazard. While sustained exposure to loud noise can cause tinnitus, this “ringing in the ears” condition, which is comorbid with migraine, is generally triggered by an underlying condition such as:
- age-related hearing loss
- ear, head, or neck injury
- circulatory systems problems
- temporomandibular joint disorder (TMI).
Symptoms include buzzing, roaring, clicking, hissing, and humming. Occurring in one or both ears, the pitch can vary from low to very high. Tinnitus can be present all the time, or it can come and go. For some people, tinnitus is just an annoyance. However, as with migraine and other comorbidities, for many the condition can significantly affect quality of life resulting in:
- Anxiety and depression
- Sleep disturbances
- Concentration and memory issues
- Difficulties with work and family life
Establishing a Connection
Numerous studies have documented the comorbid connection between migraine and tinnitus. One study found a strong association between headaches and tinnitus in young adults. Tinnitus was reported by 8.9% of participants with migraine, 7.3% of patients with migraine without aura, and 10.8% of participants with migraine with aura.
A 2018 study found people with migraine have more than a three times higher risk of developing tinnitus and other cochlear disorders. As with migraine, there is no cure for tinnitus, just disease management, and researchers aren’t entirely sure why there is a comorbid association between migraine and tinnitus. It could be due to something called central sensitization, which happens when the brain and spinal cord develop a heightened sensitivity to stimuli that both should (a pin prick) and shouldn’t (a light touch) hurt. Repeated migraine attacks can result in central sensitization, triggering tinnitus.
Although uncommon, there are some serious causes of headache with tinnitus such as a tumor or carotid artery dissection (tear in the wall of your artery)  If you have symptoms including sudden onset of ringing (especially in one ear), dizziness, or hearing loss, seek medical attention immediately.
Physicians will begin your treatment by trying to determine an underlying cause (if there is one). This will include a hearing exam, imaging tests and lab work. If an underlying cause is established, treatments could include:
- Earwax removal
- Hearing aids:
- Changing medications: Some medications are thought to cause tinnitus, in which case a lower dose or switching to something else might be recommended.
- Noise suppression: Electronic devices such as a white noise machine or a masking device can mitigate tinnitus noise.
- Tinnitus retraining therapy
- Medications: Drugs can’t cure tinnitus, but in some cases they may help reduce the severity of symptoms or complications. Prescription medications can treat an underlying condition, or the anxiety/depression often present with tinnitus.
- Counseling: Mental health professionals can teach coping techniques that may help with the psychological aspect of tinnitus. 
Research also shows that having a headache disorder, like migraine, can play a big role in how tinnitus impairs your quality of life. So even if treating your migraines doesn’t improve the physical symptoms of your tinnitus, it may lessen the psychological toll. That is, treating one may help the other. 
If you have comorbid tinnitus with migraine, several tactics can help mitigate the symptoms of both:
- Limit exposure to loud noise and/or use noise-canceling devices when necessary.
- Get regular sleep and exercise.
- Make healthy food choices.
- Limit alcohol, caffeine, and nicotine.
- Seek support from and with others dealing with similar issues.
- Consider alternative therapies such as acupuncture and meditation.
Don’t despair! Many people can manage comorbid tinnitus quite well. Research on both migraine and tinnitus continues, with new insights and treatments coming into play regularly.
Tell us! Do you live with comorbid migraine and tinnitus? What are your best coping strategies? Which treatments have worked for you?
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