@Aaron91, I notice that you immediately jump to physical causes in your search for understanding. However, there doesn't always need to be a physical explanation. For instance, fibromyalgia can often have no physical explanation for why a patient is experiencing pain in their right arm one day, and then in their left leg the following day. I'm not sure if you are familiar with the work of Dr. Howard Schubiner, but he believes that a vast amount of chronic conditions do not have any physical underlying cause, and the majority of humans have physical abnormalities in their bodies without experiencing chronic conditions. I think he found around 80% of people over age 50 have degenerate disks or other structural problems.
After reviewing some of Dr. Schubiner's work, it got me thinking a lot about whether my hyperacusis is actually a physical problem or whether it is something else. In my case, it follows a lot of the behavioural patterns which Dr. Schubiner would consider to be signs of what he refers to as mind-body syndrome.
Some points which made me really consider whether my hyperacusis could be a structural problem, ear damage or something else entirely:
- If hyperacusis is due to ear damage, why did I get it in both my ears at the exact same time? The odds of both ears becoming damaged at the same time are surely extremely low.
- Why does my pain hyperacusis switch from one side to another? I find it unlikely to be structural as I can actively feel it change side when I am literally just sitting there.
- Nearly every success story I've read emphasises the point about disestablishing the brain's hypervigilance response to sound. Are personality traits and mental state a predominant factor in determining whether their hyperacusis will be acute or chronic? It is now understood that people with certain personality traits are more likely to experience chronic conditions. Furthermore, people who suffer abuse are significantly more likely to experience chronic conditions. Personally, I have the primary personality traits which make you more likely to experience chronic conditions. I can't remember them all, but they are typically perfectionists, strong inner critics, people pleasers etc. There are many reasons as to why doctors believe people with these personality traits are more likely to experience chronic conditions but I can't remember them off the top of my head.
What's interesting is that if you seek to answer these questions from the perspective of hyperacusis research, you will not find any answers. However, a paradigm shift to the perspective of central sensitisation allows these questions to be answered fairly easily.
I suppose my point is that trying to find physical explanations for the nature of hyperacusis could lead you down a frustrating rabbit hole and it may be worth considering different medical paradigms. However, I know most people on these forums hate the idea of central sensitisation even though it is now really becoming established in the medical world. I actually recently saw a success story from someone who had never seen any improvement until they treated their hyperacusis as a nervous system problem rather than an ear problem. Definitely food for thought.