Hearing clicking noises in your head can be concerning, but is usually nothing to worry about. The clicking is caused by regular bodily functions like muscle contractions or opening and closing of the Eustachian tube. However, clicking can sometimes indicate more serious conditions like tinnitus or temporomandibular joint (TMJ) disorder. Understanding the common causes of clicking noises can help identify if further evaluation is needed.
Quick Summary
Common causes of clicking noises in the head include:
- Eustachian tube opening and closing
- Muscle spasms in the soft palate or middle ear
- TMJ disorders
- Tinnitus
- Earwax buildup
Clicking is typically soft, painless, and intermittent. Persistent, loud, or painful clicking may indicate an underlying condition requiring medical attention. Evaluation by an otolaryngologist can diagnose the cause. Treatments depends on the underlying reason but may include earwax removal, TMJ therapy, or medications.
What causes clicking noises in your head?
Here are some common causes of clicking noises heard in the head:
Eustachian Tube Dysfunction
The most common cause of clicking is dysfunction of the Eustachian tube. The Eustachian tube connects the middle ear to the back of the nose and throat. It helps regulate air pressure and drain fluid from the middle ear space. Swallowing or yawning causes the Eustachian tube to briefly open and close. The tissues rubbing together can create a soft popping or clicking sensation.
Congestion from allergies, respiratory infections, or anatomical variations can make it harder for the Eustachian tube to open. This leads to “blocked” sensations and more noticeable clicking with swallowing as the tube struggles to open up. Eustachian tube dysfunction is usually temporary, but chronic issues can lead to hearing problems or ear infections.
Muscle Contractions
Spasms of muscles in the palate and middle ear can also cause clicking. The tensor tympani muscle and stapedius muscle help dampen sound vibrations to protect the inner ear. Minor twitching or contractions of these muscles stimulates the ear structures, creating a clicking or fluttering sensation.
This muscle activity can be triggered by excessive yawning, chewing, or swallowing. Stress and fatigue may also play a role. The clicking from muscle contractions is typically infrequent and resolves on its own. But recurring spasms may require medical treatment.
TMJ Disorders
Temporomandibular joint (TMJ) disorders cause pain and dysfunction in the jaw joint and muscles used for chewing. Damage to the joint structures allows abnormal bone contact during jaw movements. This creates popping, clicking, and grating noises that can be heard through the ear canal.
TMJ disorders also contribute to muscle spasms in the face which can lead to clicking sensations. TMJ-related clicks tend to be loud, frequent, and accompanied by pain or limited jaw mobility. They may require treatment with bite splints, physical therapy, or surgery to correct structural joint damage.
Tinnitus
Tinnitus involves hearing noises like ringing, roaring, or clicking without an external sound source. The abnormal nerve signals that cause tinnitus sounds are usually generated in the auditory structures of the inner ear but are perceived as coming from inside the head.
Tinnitus can arise from inner ear cell damage, circulatory system changes, certain medications, or other medical conditions. Clicking is an less common tinnitus sound. When present, it may indicate muscular tinnitus caused increased muscle contractions in the palate or middle ear.
Earwax Blockage
Earwax helps protect the ear canal from damage and infection. But too much buildup can harden and plug the opening. As the eardrum moves, clicks may be heard from the wax obstructing the canal. Other symptoms like ear fullness and muffled hearing are also common.
Earwax blockages can be safely removed at home with drops or irrigation. Severe blockages may require professional removal by an otolaryngologist. The clicking will stop once the excess wax is cleared from the ear canal.
When should you be concerned about clicking noises?
Most clicking or popping noises in the head and ears are not concerning. But it is still important to consider the following features that may indicate an underlying problem requiring medical evaluation:
- Persisting for weeks or months
- Occurring frequently throughout the day
- Very loud, strong sensations
- Accompanied by vertigo or dizziness
- Associated with ear pain
- Happening without triggers like swallowing
- Only occurring on one side
- Getting progressively worse over time
- Other new hearing changes or symptoms
Rarely, persistent head clicking may result from nerve dysfunction, muscle disorders, or inner ear conditions like superior canal dehiscence syndrome. Sudden very loud clicking and vertigo may indicate damage to inner ear structures.
Seeking prompt medical attention is recommended if clicking does not have an apparent cause or lingers longer than a week or two. An ear, nose and throat (ENT) doctor can thoroughly assess the head and ears to identify any underlying pathology requiring treatment.
When to see a doctor
You should visit your doctor if you experience any of the following:
- Clicking that arises without an apparent trigger like swallowing or yawning
- Frequent or constant clicking noises that persist for weeks
- Clicking mainly in one ear rather than both
- Sudden onset of very loud clicking sounds
- Clicking accompanied by dizziness or vertigo
- Clicking along with ear pain or pressure
- Other new hearing changes or symptoms
- Clicking that interferes with sleep or daily activities
An ENT specialist can examine your ears with a microscope, perform hearing tests, and evaluate the facial muscles and temporomandibular joint. Imaging like CT or MRI scans may also be recommended to visualize the structures in and around the ears.
Getting an accurate diagnosis for chronic or worsening head clicking is essential for effective treatment and prevention of potential complications like long-term hearing loss.
What causes clicking investigated by doctors?
Doctors may investigate the following possible causes of head clicking:
Eustachian Tube Dysfunction
Chronic Eustachian tube dysfunction can lead to persistent clicking with swallowing, breathing issues, and hearing changes. Evaluation of the throat and nose helps determine if structural issues or allergies are involved. Hearing tests can check for fluid build-up behind the eardrum.
TMJ Disorders
Imaging like CT or MRI can show damage, dislocation, or arthritis in the temporomandibular joints. Specialists will assess jaw alignment and function to help diagnose TMJ disorders.
Meniere’s Disease
This inner ear disorder causes severe vertigo episodes along with roaring, clicking, or other noises in the ears. Hearing tests reveal progressive loss, and balance assessments also help make the diagnosis.
Muscle Spasms
Spasms of muscles in the palate, mouth, and ear can sometimes create persistent clicking. Neurological testing and EMG may be used to evaluate muscle function.
Tinnitus
Hearing and neurological exams help diagnose tinnitus. Clicking sounds suggest palatal myoclonus or stapedial muscle spasms rather than typical tinnitus causes.
What are the treatment options?
Treatments for clicking noises in the head depend on the underlying cause but may include:
Medications
Nasal sprays or antihistamines can reduce congestion and Eustachian tube dysfunction. Muscle relaxants or anti-anxiety drugs sometimes alleviate clicking from muscle spasms or TMJ disorders. Specific medications like anticonvulsants may help certain forms of tinnitus.
Earwax Removal
Blocked ear canals can be cleared by flushing with warm water or using dissolving drops. Severe blockages may need professional removal by an ENT doctor.
Physical Therapy
PT aimed at jaw, head, and neck muscles helps retrain muscles and reduce spasms, tightness, and TMJ joint issues contributing to clicking.
Dental Devices
Night guards, bite splints, and other oral devices correct bite alignment and reduce damage that creates clicking related to TMJ disorders.
Counseling
Cognitive behavioral therapy and tinnitus retraining therapy can improve coping strategies for persistent clicking or tinnitus sounds.
Surgery
Procedures to reposition or repair damaged TMJ structures, ear bones, or auditory nerves may be necessary in some cases.
What tests do doctors use to diagnose the cause?
Doctors use the following tests to help diagnose clicking in the head/ears:
Physical exam
Check ears, nose, throat, jaw, and facial nerves for abnormalities contributing to clicking.
Hearing test
Assess for changes in hearing thresholds, fluid in middle ear, or auditory nerve damage.
Tympanometry
Measures eardrum movement and middle ear pressure associated with Eustachian tube dysfunction.
Videonystagmography
Records eye movements to identify balance issues suggesting inner ear disorders.
Imaging
CT and MRI visualizes ear structures, nerves, TMJ, and other areas for abnormalities.
Blood work
Help rule out inflammatory diseases like rheumatoid arthritis causing TMJ changes.
When should someone get an MRI or CT scan?
Here are some guidelines on when to get an MRI or CT scan for clicking noises:
- Persistent clicking lasting weeks to months, especially with worsening or asymmetric hearing
- Associated symptoms like vertigo, tinnitus, or ear pain
- Signs of altered facial sensation or muscle weakness
- Abnormal findings on exam like redness, discharge, or asymmetric ear canal size
- Failed trial of conservative treatments like decongestants or muscle relaxants
- Need to visualize subtle bone defects, tumors, or structural changes not seen on a physical exam
An MRI is ideal for a detailed look at soft tissue structures like nerves, blood vessels, and muscles around the ear. CT highlights bony abnormalities better such as those involving the skull base or TMJ.
Imaging is often one of the later options if initial hearing tests, a trial of medication, or evaluating risk factors does not reveal an obvious cause.
What is the outlook for chronic clicking noises?
The prognosis for head clicking depends on the underlying cause:
- Eustachian tube dysfunction – Usually resolves once congestion or inflammation in the throat and nose clears.
- Muscle spasms – Clicking frequently stops if spasms were due to a minor trigger. Physical therapy and muscle relaxants can help.
- TMJ disorders – Varies depending on severity. Mild cases can improve with conservative treatment. Severe TMJ damage may cause chronic symptoms.
- Earwax impaction – Resolves immediately after excess wax is removed and canal opens up.
- Tinnitus – No cure exists but cognitive behavioral therapy helps manage symptoms in around 60% of chronic cases.
- Otosclerosis – Progressive condition eventually leading to total hearing loss. Surgery may restore hearing.
- Meniere’s disease – Involves periods of symptom flares and remission. Long-term outlook is highly variable.
Catching underlying conditions early and appropriate treatment helps prevent complications of chronic clicking like worsening hearing loss, pain, or recurrent infections.
When should you see an ENT doctor?
Here are some signs that warrant seeing an ear, nose and throat specialist:
- Clicking persists longer than 1-2 weeks
- Occurs frequently throughout the day
- Associated with other symptoms like pain, vertigo, or hearing changes
- Disrupts sleep or interferes with work/activities
- Related to chronic nasal congestion or sinus issues
- Associated with jaw pain or catching of the jaw
- Loud clicking that you can feel as well as hear
- Happening without a trigger like swallowing or yawning
- Hearing loss, ringing, or a feeling of fullness in the ears
ENTs specialize in diagnosing ear, nose and throat conditions. They have specialized equipment to examine the ears and nasal cavity. This allows them to identify any anatomical, inflammatory, or structural issues causing clicking or associated symptoms.
Conclusion
In most cases, brief clicking or popping noises from the ears and head are harmless events that resolve on their own. Causes like Eustachian tube opening, muscle contraction, and joint movements produce soft clicking due to contact of tissues.
However, persistent, frequent, or progressively worsening head clicking should be evaluated by a doctor. Imaging like CT or MRI scans may be needed to identify any pathological conditions involving the ears, nerves, joints, or muscles.
Treatments will target the specific underlying disorder contributing to head clicking. Prompt diagnosis from ENT specialists allows appropriate therapy to relieve clicking and prevent complications like long-term hearing changes or impairments.
