Hi, it's a delicate balance.
Several years ago, I was outside, and a truck backfired from at least 300 feet away. It knocked the sh** out of my tinnitus, and the spike was at least 6 months, I almost ended up in chronic psych ward.
My colleague said don't take chances. Since then I always wear Bose QC25 noise-cancelling headphones, this is a light form of protection that will prevent you from getting a spike for - loud overhead paging, shopping carts crashing, illegal/no car muffler, etc etc etc. Mostly in the house I don't wear them, and I have a quiet office, I may or may not wear them, but if I am wearing them, I have a FLAC player with restful rain soundtrack set on low. Raiinfall is pink noise, which is good for hyperacusis.
I have low frequency hypersensitivity, hyperacusis, and generalized sound hypersensitivity, just about as bad as it can go. I have a good stock of Bose QC25, they do eventually break/wear out, such as the internal wire will break and then disposable cheap Ch***** garbage sold for high profit, to you, at high price, which I resent, but what can you do?
If I'm in a noisy part of the building (still considered safe by occupational health, no one wears hearing protection there), I will wear sponge hearing protection plus the Bose. If someone says something to me, I pick up the Bose, so I can hear them. They all know I have tinnitus, a chronic neuropathic pain disorder, so everyone respects that. If I did not do the above, I would be a total wreck. My dentist is also aware, she is extremely considerate, drill for second, off for a second, only do as conservative procedure as possible. I'm missing a front tooth, I can't risk the tinnitus spike from getting an implant, I can afford it from the finance point of view, but not from the tinnitus spike point of view, so I just go around with a missing tooth. My colleague just says it makes me look bad-ass. A lot of people around here have missing teeth, just not at the place I work - they can afford dental care, so everyone's teeth are great, I mean dental problems are common, missing teeth are common, and you do apparently lose lifespan from missing teeth, but it's all a compromise for me.
The main thing that deep-sixed me, was years ago I used to wear sponge hearing protection 24/7 including sleep. Overuse of hearing protection gave me hyperacusis and tinnitus. I was admitted to hospital with it. After being discharged from hospital, no one knew anything, and no one told me to not wear hearing protection at night. That is the totally worst. You have to have very quiet music or restful rain soundtrack all night, that will keep your hearing healthy. I actually am gradually slowly slowly getting better. And it is slow, such as snail's pace, you are talking neural rehabilitation, such as rehab from a stroke, it is painfully slow. You have to prevent it from getting worse by using appropriate hearing protection, and help it to get better with proper diet, exercise, and give your ears constant low level stimulation. Just like you would treat any chronic pain condition. Bad back? Don't lift heavy things, and keep your back straight and lift with your legs. You may need some pain killers, maybe even long term. That's just part of life. I enjoy my life. I'm not going to get into an end it all thread here, that's not the good answer, it may be the case for some very rare person, and mine has been about as bad as can be imagined, crying for hours, until there aren't any tears left, realizing crying did nothing except lose my supply of tears. I just keep going, I don't know how, but I certainly wear hearing protection as required, and outside, with trucks and harleys, hearing protection outside is mandatory. Just light protection, such as noise-cancelling headphones. Overprotection leads to worse complications.