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What causes a pounding sound in the ear?

Nov 27, 2025 Source: Cainiu Health
Dr. Lu Cheng
Introduction
Ringing or pounding in the ears may be caused by mental stress, earwax blockage, external otitis, middle ear infection, or neurogenic tinnitus. Symptoms can be improved by emotional regulation, ear canal cleaning, or medication. If the noise persists or is accompanied by hearing loss or pain, prompt medical attention is necessary. Prolonged anxiety and excessive stress can lead to nervous system dysfunction.

　　Pulsatile tinnitus (a pounding or rhythmic sound in the ears) may be caused by mental stress, earwax blockage, external otitis, otitis media, or sensorineural tinnitus. Symptoms can be improved through emotional regulation, ear canal cleaning, and medical treatment. If the noise persists or is accompanied by hearing loss or pain, prompt medical attention is necessary.

　　1. Mental stress: Prolonged anxiety and excessive stress can lead to nervous system dysfunction, causing a pounding sensation in the ears, which often worsens in quiet environments. It is recommended to adjust your mindset, relax, ensure adequate sleep, and relieve stress through physical exercise or listening to soothing music.

　　2. Earwax blockage: Excessive or hardened earwax blocking the ear canal can interfere with sound conduction, resulting in a pounding sound and mild hearing loss. Gently clean the outer edge of the ear canal with a cotton swab, avoiding insertion into the ear canal. Seek professional medical help if needed for safe removal.

　　3. External otitis: Inflammation of the external ear canal caused by ear picking injuries or bacterial infection leads to mucosal congestion and swelling, which stimulates the eardrum and causes a pounding sensation. This condition is often accompanied by ear pain and itching. Under a doctor's guidance, medications such as ofloxacin ear drops, cefradine capsules, and ibuprofen sustained-release capsules may be used to alleviate symptoms.

　　4. Otitis media: Middle ear inflammation triggered by colds or Eustachian tube dysfunction can cause fluid accumulation or congestion in the middle ear, leading to a pounding sound, ear pain, and hearing impairment. Patients may use amoxicillin-clavulanate potassium tablets, levofloxacin hydrochloride ear drops, or phenol-glycerin ear drops under medical supervision to relieve discomfort.

　　5. Sensorineural tinnitus: Abnormal neural discharges or insufficient blood supply to auditory nerves can cause rhythmic, pulsating tinnitus, possibly accompanied by dizziness and difficulty concentrating. As directed by a physician, medications such as mecobalamin tablets, ginkgo biloba extract tablets, and vitamin B1 tablets may help improve symptoms.

　　Maintain clean and dry ear canals; avoid frequent ear picking. Stay away from noisy environments to reduce auditory stimulation. Maintain a regular作息 schedule and balanced diet, consuming more foods rich in vitamins to protect ear health.

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