You have always been respectful and therefore, I will try to be more specific and hope my comments will be of some help.
Can you describe this pain in detail and its distribution? Ice pick? Electric? Stabbing? burning? Sore? Needle? Etc. And where it extended to. Also if it was unilateral or bilateral. Thanks.
I can't seem to reconcile:
I hope never to experience the unrelenting piercing pain of hyperacusis again which you have described accurately. It felt just like an ice-pick. Electric, stabbing, ruthlessly unforgiving, bilateral and at times in face. As mentioned, I had to ask people to please lower their voice during conversation because of the severe pain in my ears. I am from an era where the television sets used a cathode-ray-tube. They emitted a ultra high frequency noise above 18 kHz, from the internal scan coils attached to the neck of tube. Most people couldn't hear it or were not troubled by it. Unfortunately I could hear this high pitched signal from a distance of 20ft and it would spike my tinnitus, due to the noise trauma I suffered and impending hyperacusis acute oversensitivity to sound. Going into any store that has a closed circuit TV monitor was a problem, as they used cathode ray-tube technology. I found a way around this.
I quickly learned the benefit of using foam earplugs as they blocked out the high pitched signal from the TV, so I could watch it without my tinnitus spiking but only up to a point. If I watched it longer than an hour or two my tinnitus would spike. I later learned what I often write about in this forum: even though a person wears earplugs sounds can pass through the head and be transferred to the inner ear by bone conduction and spike the tinnitus if they are loud enough.
My noxacusis is probably mild and I can't imagine keeping it hidden. Especially if you didn't wear hearing protection (though granted you would have to make a weird excuse if you were trying to protect and keep your hyperacusis a secret).
Is it possible you are associating loudness discomfort with pain?
Twenty five years ago all I read about was tinnitus and hyperacusis and hadn't heard of noxacusis. I prefer to dispel with such terminology as I believe it can make a person believe their hyperacusis is much worse than it probably is. Tinnitus and hyperacusis both impact on a person's mental and emotional wellbeing profoundly. Therefore, I try not to add undue stress. If noxacusis exists then I'm sure I once had it. Thankfully, I'm completely cured of hyperacusis and all oversensitivity to sound. However, I won't rock the boat or tempt fate. When using my powerful steam cleaner, I use noise reducing earplugs as a precaution.
I assure you that what I experienced when I had hyperacusis was severe pain. When I began TRT and wearing white noise generators, over many months this pain gradually reduced to become loudness discomfort until this went completely away after two years.
Magnesium does help somewhat, especially in liquid form.
I found Magnesium very helpful and took it for 4 years. I can't thank that herbalist enough for her help and advice.
That's the thing though with intracochlear noxacusis (I think mine is more middle ear reflex related), the nerves are traumatized and oversensitive to ATP specifically but noise exposure actually makes them more over sensitive. I could see overprotection possibly making an increased Stapedial reflex or TTTS worse though. That's why even moderate noise exposure can make some people much, much worse.
I was tested at ENT and wasn't told I had problems such as: Stapedial reflex or TTTS. For this reason I have suggested that you try and seek professional help. I advise on tinnitus and hyperacusis. I have corresponded with people that diagnose themselves and are convinced, they have: hyperacusis, noxacusis, TTTS, phonophobia, misophonia and anything else they see fit to throw into the mix. I think it can be psychologically damaging to self diagnose in this way, as one can easily believe no form of treatment will be helpful.
I obviously never practiced human medicine but I was a veterinarian and I can't imagine telling a client that any one treatment always had a "100% cure rate for full recovery ". There are way too many cofactors and comorbidities that could have been missed for starters.
Perhaps there is some truth in what you say. Whether the Audiologist in question tells her patients they will be 100% cured following her treatment plan I don't know but it's what she told me. She has been in practice many years. I have read posts where people are convinced their tinnitus and hyperacusis are so severe they are beyond help and this can be very damaging because tinnitus is intrinsically linked to our mental and emotional wellbeing. It is for this reason I encourage people to focus on the positive things in their life. This does not mean always to be positive, for life is problematic. One must try to keep a balance but it can be all too easy to allow negativity to become all consuming and that just isn't good.
Michael