The Short Answer Educational content only. Any suspected concussion warrants medical evaluation. Persistent sensory symptoms after concussion warrant assessment by the appropriate specialist, an audiologist or ENT for hearing and sound symptoms, a neuro-optometrist or ophthalmologist for visual and eye symptoms, and a physician or neurologist to coordinate care. Consult a concussion-experienced clinician for individualized care. Tinnitus persists after concussion because the injury disrupts the auditory pathway and the brain compensates by increasing neural activity, generating a phantom sound with no external source (Silverberg et al., 2020). Tinnitus is the perception of ringing, buzzing, hissing, or humming that no outside sound is producing. After concussion it arises when damage to the inner ear or auditory nerve from the same trauma, together with increased central auditory gain, leaves the brain generating its own signal to compensate for altered input. Attention, stress, and poor sleep amplify how loud and intrusive it feels. Treatment uses sound therapy, retraining, and nervous system regulation to reduce its loudness and intrusiveness rather than to silence it directly. Tinnitus is a phantom sound with no external source. Auditory pathway disruption drives compensatory neural activity. Treatment reduces its loudness and intrusiveness through retraining. What Tinnitus Is Tinnitus is the perception of sound, most often ringing, buzzing, hissing, humming, or roaring, in the absence of any external source. It can be constant or intermittent, in one or both ears or seeming to come from inside the head, and it ranges from a minor background noise to an intrusive, distressing presence. Tinnitus is common after concussion, frequently alongside hyperacusis and hearing changes, and its loudness and intrusiveness vary with attention, stress, fatigue, and quiet surroundings. How Concussion Generates Tinnitus Tinnitus after concussion arises from a combination of peripheral and central changes. The same trauma that causes the concussion can damage the delicate structures of the inner ear or the auditory nerve, altering the signal the brain receives. In response to this altered or reduced input, the central auditory system increases its gain and neural activity, trying to compensate, and this heightened activity is perceived as sound. In effect, the brain fills in for the disrupted input by generating its own signal. Increased central gain, the same mechanism behind hyperacusis, means the brain is turning up its auditory processing, and in tinnitus this produces a phantom sound. Because both peripheral damage and central compensation contribute, tinnitus often persists even when it began with a specific injury, sustained by the ongoing central activity rather than by continued damage. Why Attention and Distress Amplify It Tinnitus is strongly shaped by attention and emotional state. When the brain focuses on the phantom sound and tags it as threatening or distressing, the limbic and attention networks amplify its perceived loudness and make it harder to ignore, creating a cycle in which distress increases the tinnitus and the tinnitus increases distress. This is why tinnitus feels louder in quiet rooms, at night, and during stress or poor sleep, and quieter when the person is absorbed and calm. Understanding this cycle is central to treatment, because much of the suffering comes from the amplification rather than the raw signal. Symptom Presentation Ringing, buzzing, hissing, humming, or roaring with no external source Constant or intermittent, in one or both ears or inside the head Louder in quiet surroundings, at night, and during stress Worse with fatigue and poor sleep Frequent coexisting hyperacusis and hearing changes Distress, difficulty concentrating, and sleep disturbance Fluctuation with attention and emotional state Assessment An audiologist assesses tinnitus with hearing tests to identify any inner ear or auditory nerve damage and characterizes the tinnitus and its impact. The assessment weighs the distress and sleep disturbance it causes, since these drive much of the suffering, and identifies coexisting hyperacusis. A physician considers the broader picture and excludes other causes. Pulsatile tinnitus, a rhythmic sound synced to the heartbeat, is evaluated differently and warrants specific vascular assessment. Treatment Approach Treatment aims to reduce the loudness and intrusiveness of tinnitus and to break the distress cycle, rather than to silence the signal directly, which is often not possible. Sound therapy provides low-level background sound that reduces the contrast between the tinnitus and silence, making it less prominent, and this is delivered through devices, apps, or environmental sound. Tinnitus retraining therapy combines sound therapy with structured counseling to help the brain reclassify the tinnitus as neutral, reducing the limbic amplification. Managing the amplifiers matters as much as the sound itself. Treating the distress and anxiety, protecting sleep, and regulating the autonomic nervous system with diaphragmatic breathing all lower the amplification that makes tinnitus intrusive. Cognitive behavioral strategies reduce the threat response and the attention paid to the sound. Addressing any hearing loss with amplification can also reduce tinnitus by restoring input. Over time, most people habituate, so the tinnitus fades into the background even if the underlying signal remains. Sensory symptoms after concussion improve faster when the nervous system is regulated and the neck and autonomic system are addressed alongside specialist care. Start your 3-day free trial to build a supportive daily routine. Supporting Mobility Routine JME 155 Diaphragmatic breathing lowers the sympathetic drive that amplifies sensory sensitivity and steadies the nervous system. Ten slow breaths, several times daily. JME 14 Chin tucks reduce upper cervical tension that feeds headache, dizziness, and sensory overload. Ten repetitions with 5-second holds. JME 1 Cervical rotation restores segmental mobility and supports blood flow through the vertebral arteries to the brain. Ten repetitions per direction. JME 15 Cervical lateral flexion addresses side-bending restriction that sustains neck tension and sensory strain. Ten repetitions per side. JME 16 Cervical flexion and extension restore sagittal mobility restricted by suboccipital guarding. Eight slow repetitions. JME 2 Cervical retraction reinforces a neutral head position that reduces the postural strain feeding sensory symptoms. Ten repetitions per set. JME 150 Thoracic rotation restores mid-back motion needed for full diaphragmatic breathing and relaxed upright posture. Eight repetitions per direction. JME 227 Overhead reach opens the thoracic spine and rib cage, supporting the deep breathing that calms an overloaded nervous system. Ten repetitions with controlled tempo. Start your 3-day free trial for joint-specific mobility programming that supports the nervous system regulation behind sensory recovery after concussion. Common Mistakes Seeking silence, which increases the contrast that makes tinnitus prominent Focusing on eliminating the sound rather than reducing its intrusiveness Leaving distress, anxiety, and poor sleep untreated as amplifiers Ignoring coexisting hearing loss that maintains the tinnitus Overlooking pulsatile tinnitus, which needs different, vascular evaluation Progression Assessment characterizes the tinnitus, identifies any hearing damage, and weighs its distress and sleep impact. Treatment uses sound therapy and tinnitus retraining to reduce intrusiveness, while managing distress, sleep, and autonomic arousal to lower amplification. Most people habituate over weeks to months, so the tinnitus recedes into the background even when the signal persists. Why do I hear ringing after a concussion? The trauma can damage the inner ear or auditory nerve, and the brain compensates for the altered input by increasing its auditory activity and gain, which is perceived as a phantom sound. The ringing is generated by the brain filling in for disrupted input rather than by an external source. Will my concussion tinnitus ever go away? The underlying signal may persist, but most people habituate over weeks to months, so the tinnitus fades into the background and stops being distressing. Sound therapy, tinnitus retraining, and managing distress and sleep speed habituation. The goal is to reduce its loudness and intrusiveness rather than to guarantee silence. Why is my tinnitus louder at night? In quiet surroundings there is less external sound to mask the tinnitus, so the contrast makes it more prominent, and at night fatigue and reduced distraction increase attention to it. Stress and poor sleep amplify it further. Low-level background sound at night reduces the contrast and makes it less intrusive. How is tinnitus treated after a concussion? Treatment uses sound therapy to reduce the contrast between tinnitus and silence, tinnitus retraining therapy to help the brain reclassify the sound as neutral, and management of distress, sleep, and autonomic arousal to lower amplification. Addressing any hearing loss with amplification can also help by restoring input. When is tinnitus after a concussion concerning? Pulsatile tinnitus, a rhythmic whooshing synced to the heartbeat, needs different, vascular evaluation and should be assessed promptly. Sudden hearing loss, one-sided tinnitus with other neurological symptoms, and rapidly worsening tinnitus also warrant prompt assessment rather than routine management. Why Sensory Symptoms Happen After Concussion Sensory symptoms after concussion arise from disrupted sensory processing rather than damage to the sense organs alone. Concussion strains the connections between brain regions, alters the balance of excitation and inhibition, and leaves the nervous system in a sensitized, hyperexcitable state (Silverberg et al., 2020). In this state the brain turns up the gain on incoming signals, so ordinary light, sound, smell, taste, and touch are amplified, distorted, or perceived when absent. Some symptoms also reflect direct injury to sensory nerves. Most sensory symptoms improve over weeks to months as the brain recovers and the gain settles, and structured management speeds the process. Graded Exposure and Avoiding Overprotection A common trap in sensory recovery is total avoidance. Completely shielding from light, sound, or activity feels protective, but sustained avoidance makes the nervous system more sensitive over time, narrowing tolerance further. The better approach is graded exposure: staying within a tolerable range while gradually and deliberately increasing exposure as tolerance grows, never pushing far past the point where symptoms flare. This retrains the nervous system to accept normal sensory input. Extreme protection, such as constant dark glasses indoors or continuous earplug use, tends to worsen sensitivity and is used sparingly and strategically rather than continuously. Managing Sensory Overload Reduce competing sensory input by handling one channel at a time Take planned breaks in a calm, low-stimulation environment before overload builds Use diaphragmatic breathing to lower the arousal that amplifies sensitivity Pace demanding sensory environments rather than avoiding them entirely Protect sleep, since fatigue lowers sensory tolerance Treat coexisting headache, since pain and sensory sensitivity feed each other When to Seek Specialist Assessment Persistent or worsening sensory symptoms, symptoms that interfere with work or daily life, and any symptom with concerning features warrant specialist assessment. Hearing and sound symptoms are evaluated by an audiologist or ENT, who can test hearing and guide sound therapy. Visual and eye symptoms are evaluated by a neuro-optometrist or ophthalmologist. Smell and taste symptoms are evaluated by an ENT. A physician or neurologist coordinates care and excludes other causes. Pulsatile tinnitus, sudden vision or hearing loss, and rapidly worsening symptoms need prompt evaluation rather than watchful waiting. The Autonomic and Cervical Contribution Sensory symptoms rarely stand alone after concussion. Autonomic dysregulation keeps the nervous system in a heightened, sympathetic-dominant state that amplifies sensitivity, and cervical dysfunction feeds headache, dizziness, and sensory strain through shared brainstem pathways. Regulating the autonomic nervous system with diaphragmatic breathing and graded activity, and addressing the neck with mobility and manual therapy, lower the background arousal on which sensory symptoms ride. This is why calming the nervous system as a whole often eases sensory symptoms that specialist treatment alone does not fully resolve. References Patricios, J. S., et al. (2023). Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022. British Journal of Sports Medicine, 57(11), 695-711. PubMed Silverberg, N. D., et al. (2020). Management of concussion and mild traumatic brain injury: a synthesis of practice guidelines. Archives of Physical Medicine and Rehabilitation, 101(2), 382-393. PubMed