Thanks for the response Aleph, I've read one or two of your posts on other threads and it seems like what I'm experiencing is similar to what you experienced in 2015.
Would you be able to summarise in a few points what helped you to get better? Essentially avoiding noise until symptoms reduced and then plugs / stress management?
I copy and paste a fragment of a guide I wrote some months ago. I will have to create a new thread for the whole text.
I don't know exactly how this pain in direct reaction to sounds related by StoneinFocus is. It is probable that is part of the same mechanism and it follows the same logic. But I don't know if it is convenient to manage pain differently.
I had some small sensations of pain, but it was always a consequence of TTTS. And one day, in 2015, I was still using earplugs on the street but I was trying to quit them. I was waiting for the bus without earplugs because it was night a quite. And then, out of the blue, a drunk man threw a big TV against a tree just a couple of meters from me. The sound was incredible strong to me and I startled. The next two days I had a kind-of continuous pain (so it was a delayed and continuous pain, independent of sounds). That was my biggest experience with ear pain.
8- PROTECTION AND OVERPROTECTION
If I have TTTS and this state of "hyperacusis", do I have to protect my ears or use earplugs or cotton balls? In this state, your cochleas are not more sensitive to sounds than when your ears were normal. That is, normal everyday sounds are not going to harm your cochleas and produce hearing loss.
Having said this (and this is something that most doctors and audiologist don't understand), in this state, your tensor tympanis are not normal, and you could have a subjective sensation that sounds are louder than before. So you have to respect your sensations and perceptions. Your purpose is to relax this middle ear mechanism, and as I told you, the best way is to stop being afraid and stop thinking about it. And gradually (or maybe immediately) it will get better.
But if your tensor tympanis are tensed up, you could protect your ears if sounds are too bothersome for you and repeated, or if they are going to be there for a long time. You could use earplugs for that moment and then take them away. Or if it just a brief sound (an ambulance, a dog barking, etc.) you may use your fingers or hands to cover your ears and avoid the inconvenience, or go away from the place if it is necessary. What you have to avoid is that your tensor tympanis get too tensed, or avoid, if possible, specific sounds that bother you (and if symptoms increase after the sounds, it is important to avoid thinking obsessively about the sounds or the temporal discomfort).
Just remember this: if the tensor tympanis are completely relaxed, the experience of hearing is exactly as before. If they are a bit tensed up, certain sounds could be annoying. If you are doing things good, you will recover more or less soon, or you will oscillate between being normal and having a bit of tensor tympani tension once in a while (and gradually thinking less about the problem and getting better).
Using earplugs all the time even if they are not needed will increase your sensation of loudness in general, and of course this is wrong. But also, it is reasonable that if you are in this state of TTTS/hyperacusis and you don't know how to control it, you avoid places with very loud sounds, like rock concerts, parties with loud music, cinema, etc. Unless you know that with earplugs, earmuffs or whatever you are okay and don't get afraid or paranoid about the situation. But if you are unsure, you'd better not do it.
Don't do strange things, like being very annoyed about sounds, and sustain an unbearable situation, trying to negate the discomfort and "be normal again", or get paralyzed about the situation, because of embarrassment or whatever. Just cover your ears or go somewhere else. And remember this is temporary and maybe the next day or week you could listen to the same sounds without any kind of discomfort.
If you are neurotic, obsessive, or anxious, the opposite could also be true. That is, you are in an environment with loud sounds and you are okay, but then for some reason you are surprised or even worried that you are okay, and so you get self-conscious and begin experiencing TTTS. So this is an example where the origin of the problem is not your ears, but your mind.
Another trick for sound intolerance: if there is a specific and short sound that you find too strong, like a bus passing by close to you, or an ambulance siren, you could try humming (doing "Mmm...", a single note, or a melody) during the sound. This adds another sound in the foreground that doesn't bother you, and so the loud sound goes to the background. Of course, you could also cover your ears with your fingers if you consider so.
9- SETBACKS
If for some reason you worsen, the worsening is always temporary. If you dramatize the situation, begin thinking obsessively about it or get depressed, you are just extending the setback and complicating things.
See point 2.
2- PSYCHOLOGIC ATTITUDE
Don't panic. The more you panic and worry the worse. Try to relax and not think about your ears. Once you understand this and check it out by yourself, not because I am telling you, you will know the nature of the problem and you will automatically inhibit any thought that worsens and sustains the problem (unless you don't want to get better).
Ingmar Klockhoff, the man who identified the pathology, described TTTS as "psychosomatic" and due to an "increased psychic tension due to mental stress". This is partially true because the persistence of the problem, as I mentioned before, is more related to the attention or focus the person gives to the problem, than it is related to stress in general. In fact, when someone is worried or stressed about other problems (i.e. the mind is occupied and absorbed by thoughts different from ear issues) TTTS usually gets better. Apart from my experience, I read other anecdotes that confirm this idea.
In this sense, it is important to note that most people with this problem, especially the worst cases, also have mood problems (depression), or they are very obsessive (OCD), or they are very fearful or nervous (anxiety, panic). And these psychological particularities generally, but not always, precede the sound incident and the development of TTTS/"hyperacusis".
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