Are Spikes from Loud Noise Permanent?

[Michael Leigh]

Are spikes from loud noise permanent?

Someone recently asked me, whether a spike in tinnitus caused by loud noise would be permanent? I don't think there is a definitive answer, because tinnitus is a complex condition and if hyperacusis is also present it can complicate matters further. Some people habituate to tinnitus but their hyperacusis hasn't fully cured and this can cause tinnitus to spike.

When a person first develops tinnitus and it was caused by loud noise they have to be careful in future. Tinnitus can and does spike for many people and this is not necessarily caused by loud noise or sounds. After a while it usually returns to baseline or into its normal rhythm. Danger can present itself after a person habituates and the tinnitus has reduced to mild or moderate levels for most of the time. If one isn't careful, it can be easy to forget and slip back into the old lifestyle of: listening to music through headphones. Attending clubs, concerts and the cinema where sound levels can be quite high.

I believe a person with tinnitus should attend clubs, concerts and the cinema if they want to, providing they use noise-reducing earplugs to protect themselves. However, one should remember that nothing is one hundred percent safe. My advice is to stay clear of large standing floor speakers and if you're at a concert don't go to near the front stage where the music is likely to be booming out at high sound levels.

In many instances people will get a warning when visiting these places. If the decibel levels are too high their tinnitus might spike. Usually the tinnitus will return to baseline. However, some people do not pay attention to these warnings and continue to subject their ears to loud sounds and think they are perfectly safe because they are wearing earplugs. Under these circumstances the tinnitus might spike again and this time it might become permanent. I am saying might because nothing is for certain. In my opinion a person with tinnitus needs to follow the warnings their auditory system and tinnitus is telling them.

Regarding headphones. Many people have contacted me after they have habituated to tinnitus and returned to using headphones and listened to music through them at low volume. All of them have noticed an increase in their tinnitus. Some of them noticed their tinnitus spiked but carried on listening to music through headphones and then the tinnitus increased to a higher and more permanent level. It must be said that some people with tinnitus use headphones and have no adverse effects and that is perfectly fine. My opinion on this is, anyone that has tinnitus shouldn't listen to any type of audio through headphones even at low level.

It saddens to say, if a person doesn't heed the warning signs their auditory system and tinnitus is telling them, then they will eventually feel because tinnitus is very unforgiving. It is fine when some people are telling others what they want to hear: "listen to music through headphones because life is for living". "Go to the club as often as possible you're safe with earplugs. If your tinnitus increases you will be the one that will be in the suffering.

I have read many posts in tinnitus talk, where people had habituated and the tinnitus is low. They returned to listening to music through headphones and clubbing during the week and weekends. Some are now regretting this because their tinnitus has increased and they are in distress. Just because a person habituates doesn't mean they can forget everything and carry on in some instances recklessly. You can of course do this but my advice is to do things in moderation and not to excess, because the end result is often returning to ENT for help and visiting tinnitus forums because you are unable to cope.

Michael

 

[Pleasure_Paulie]

Great post - a voice of logical reason! Thanks for your contribution

Use tinnitus as a warming signal that something has gone wrong in your auditory system. Play it safe, be smart and don't forget to carry ear protection with you wherever you go - I carry 2 sets of earplugs on my keyring.

 

[Michael Leigh]

@Pleasure_Paulie, thanks for your kind words they are much appreciated. I like the fact that you carry 2 sets of earplugs on your keyring, a smart thing to do!

 

[Tinniger]

I also have better and worse days. And adopted the term "spike" for it. However, the term tinnitus spike does not appear to exist in scientific literature. Is this an invention of internet forums?

 

[Tinker Bell]

I also have better and worse days. And adopted the term "spike" for it. However, the term tinnitus spike does not appear to exist in scientific literature. Is this an invention of internet forums?

Nice catch. Reactive tinnitus apparently does not exist because it is an invention of internet forums, too. At least according to the author. Oddly anyone who has it says it exists.

 

[Jason37]

What about placing the headphones "over" your ears? I watch movies at night with them sitting on the back side of my ears. I hear them just fine, even at a low level.

 

[Michael Leigh]

What about placing the headphones "over" your ears? I watch movies at night with them sitting on the back side of my ears. I hear them just fine, even at a low level.

Since you have noise-induced tinnitus @Jason37, I don't recommend using any kind of headphones, even at low volume. However, it is your choice. Some people with noise-induced tinnitus are not affected by headphone use and others are. There are plenty posts in this forum from people having noise-induced tinnitus, who resumed using headphones and regretted it. People whose tinnitus wasn't caused by loud noise exposure, are not so much at risk of making it worse using headphones, but I still advise caution.

The choice is yours. Just remember, if your tinnitus gets worse it is unlikely to return to its previous level and could be more difficult to cope with.

Sorry to sound so sobering.

Michael

 

[Jason37]

They are not "in" my ear, only wedged behind them.

 

[Michael Leigh]

They are not "in" my ear, only wedged behind them.

It doesn't matter whether they are in your ear or over them. You are playing with fire. I hope and pray you do not get tinnitus the right way, for if you do then you will l know, what loud intrusive tinnitus can do to a person. It is something I wouldn't wish on my worst enemy.

You have been warned.

I wish you well,
Michael

 

[Tinker Bell]

They are not "in" my ear, only wedged behind them.

I am unsure how this would be different than wearing wearable WNGs.

Regarding whether your tinnitus is noise induced, that actually does not matter in terms of future damage. Ear hair cells damaged by ototoxic medications are just as susceptible to noise damage as those with tinnitus from acoustic trauma and vice versa.

And apologies for Michael claiming you do not have the right kind of tinnitus, as if one cause of tinnitus is superior. He is making assumptions about the volume of your tinnitus and that is not very welcoming on a support forum.

 

[Tinniger]

The problem with the term spike is that it seems to be used for every temporary worsening of symptoms, whether it is 10 minutes, 10 hours, 10 days, 10 weeks or 10 months. That spoils the concept then...

 

[Michael Leigh]

The problem with the term spike is that it seems to be used for every temporary worsening of symptoms, whether it is 10 minutes, 10 hours, 10 days, 10 weeks or 10 months. That spoils the concept then...

As long as the tinnitus reduces to baseline, it doesn't really matter. The problem is the anxiety and fear that people associate with the spike and this can prolong it. Most spikes (not all) are caused by hyperacusis which many people get (not all) because of exposure to loud noise. If the hyperacusis is not cured or at least treated and improved, spikes will often remain a problem.

Michael

 

[VickiD]

@Michael Leigh, a car went past, with a loud scream - gear box issue I think. My ears spiked and there has been a hissing ever since. It feels like it's worsening too Can this get better?

 

[Michael Leigh]

@Michael Leigh, a car went past, with a loud scream - gear box issue I think. My ears spiked and there has been a hissing ever since. It feels like it's worsening too Can this get better?

Hi @VickiD.

I am sorry to know of the discomfort that you are going through at the moment caused by a spike that has resulted in you hearing persistent hissing. I cannot say for certain when things will return to normal for you but usually spikes reduce with time. However, this depends on what the underlying cause of your tinnitus is, because you have had this condition for quite a few years.

Spikes in tinnitus are usually (but not always) an indication that a person has noise-induced tinnitus which was caused by exposure to loud noise and their auditory system has developed an oversensitivity to sound. This oversensitivity is often known as hyperacusis. Hyperacusis can manifest itself in many ways and no two people will experience it the same. Like tinnitus, hyperacusis can be mild, moderate and severe. It can improve by itself but if it doesn't and treatment is not sought, the affected person can develop long-term problems with spikes, even though they may have habituated to their tinnitus. Therefore, it's important hyperacusis is treated. One of the best treatments is using sound therapy by wearing white noise generators to desensitise the auditory system. This treatment is best done under the care of an audiologist that specialises in tinnitus and hyperacusis management as counselling and medication may be required.

I note from you previous posts that for many years you wore earplugs when sleeping; this may have contributed you having an oversensitive auditory system. Overusing earplugs and other forms of hearing protection risks lowering the loudness threshold of the auditory system which can make it more sensitive to sound. This is the reason most hearing therapists and audiologists advise tinnitus patients not to sleep in a quiet room. It is much better to sleep with a sound machine by the bedside or connect it to a pillow speaker to play low-level sound enrichment. I have covered this in many posts on my started threads.

I also note that your ENT doctor has diagnosed you with turbinates. You have probably been advised this condition can cause ear fullness, earache, tinnitus and some hearing impairment. Turbinates can be treated so it's important that you are under the care of an ENT doctor.

If the spike you are currently having is caused by external sound and not related to an underlying medical condition such as turbinates, my advice is to start using low-level sound enrichment and to see an audiologist that specialises in tinnitus and hyperacusis management. I strongly advise that you don't listen to audio through any type of headphones, even at low volume.

I hope you start to feel better soon,
Michael