Noxacusis Got Worse from Neighbor Slamming Their Front Door Three Times Consecutively

[Jenny_S]

Hello everyone,

You might recognize my username from other posts here. This year, I have experienced several noise-related incidents that have affected my noxacusis (trigeminal nerve pain, particularly in my left ear). In January, my neighbor played very loud music for 15 to 30 seconds, which resolved within a week. Then, at the end of February/beginning of March, I experienced discomfort from restaurant bass vibrations, which took much longer to resolve.

However, on Friday, March 31st, I had another noise incident that caused delayed trigeminal nerve pain in my left ear, which has worsened to a level I've never experienced before over the past few days. Fortunately, my tinnitus seems unaffected, but I feel lost despite seeking it multiple times without professional support.

I live in a flat with my partner, and the neighbor directly below us slammed their front door three times consecutively. They had visitors and let the door slam shut since it was on a latch. I was without hearing protection in my flat, about four meters from their door. Last Thursday, my ear felt inflamed intermittently throughout the day, reacting to sound. By Friday, it felt like it was going to cave in. My sound tolerance has dramatically decreased today—typing on the keyboard, taps, and the kettle are causing intermittent nerve pain.

My GP has prescribed oral Prednisolone, but I'm concerned about the side effects and whether taking it now would cause any adverse effects or worsen my ear condition. Additionally, I have been prescribed Amitriptyline for the nerve pain to take before bed, but I haven't taken it yet. Was I naive not to start the medication on Saturday? Is it too late now? Have I missed the opportunity window?

I would greatly appreciate any advice on what to do. I'm feeling overwhelmed and losing hope with this condition.

 

[MindOverMatter]

@Jenny_S, I'm sorry to hear about your issues.

You should try out LDN (go slow and be patient) for your nerve pain. Many have had good effects from it, and there are minimal side effects. The worst side effect, for most, is usually interrupted sleep for a few weeks in the beginning.

 

[Jenny_S]

Thank you for reading and responding, @MindOverMatter.

I have never used any medications for my tinnitus and pain with sound, but after this noise incident, I am looking into it, so thank you for your suggestion. Do you use LDN?

LDN and other medications mentioned on Tinnitus Talk are actually used for neuropathic pain for those with MS, which I, unfortunately, have, too, and I have been reluctant to start treatment due to the side effects of MS drugs. Maybe all this time, I could have felt better if I had started an MS treatment plan a year ago

 

[MindOverMatter]

LDN is a very different type of medication and could effectively reduce inflammation and pain - such as nerve pain. In my opinion, it's worth a try in your case, as the downside is usually minimal. And given you have MS as well, it might give you an even better effect.

It's worth discussing with your GP, preferably a neurologist, @Jenny_S.

 

[Jenny_S]

Thank you again, @MindOverMatter. I will look into your suggestion and talk with an MS nurse.

I am wishing you good health.

 

[kingsfan]

I know it's not Prednisolone, but I've generally had no issue with Prednisone. I take it sometimes for asthma and I've taken it a few times for acoustic trauma. My pulmonologist always has me taper down, so I've done the same when taking it for acoustic trauma.

 

[Jenny_S]

Thank you @kingsfan for sharing your experience.

After taking Prednisone, did it help your acoustic trauma-induced tinnitus? How long after the noise incident did you take it? For me, it will be two weeks this Friday since the door slams...

 

[Hardwell]

I'm sorry to see you back here, @Jenny_S. It's even more frustrating when it's due to others' actions.

I'm not sure if I can offer much advice, but I have taken Prednisone roughly 3-4 days after my own worsening symptoms, I believe. It quieted my tinnitus to almost pre-worsening levels after a few days. Unfortunately, after stopping, it returned to the worsening levels.

For me, the mental side effects were horrific. I experienced intense anxiety and a profound sense of hopelessness while taking it.

Regarding whether you'd benefit from taking it two weeks out, I'm not sure. For acoustic traumas, it's recommended to take Prednisone within the first few days for maximum effect (if any). But then, we don't know what's causing your pain. If inflammation is involved, Prednisone will certainly help.

I became curious about my own ears and bought a camera to examine them after an ear canal completely swelled shut. My ears are very inflamed at present, and I believe that has contributed to my worsened tinnitus.

 

[kingsfan]

Thank you @kingsfan for sharing your experience.

After taking Prednisone, did it help your acoustic trauma-induced tinnitus? How long after the noise incident did you take it? For me, it will be two weeks this Friday since the door slams...

The jury's out on that one. I don't really have any concrete evidence of whether it has helped or not. I've both returned to baseline and had permanent worsening after taking Prednisone. There are too many variables, but I'll give a few examples of my experiences.

1. The first time I took Prednisone was about four days after my initial moderate/severe tinnitus began. I only had to hiss at this point. My GP was worried I had SSHL, gave me a course of Prednisone (I don't remember the exact dosage - I believe it was 50 mg for seven days), and got me into an ENT the next day. ENT confirmed there was no hearing loss and said I could discontinue the medication. I continued to take it and developed new tones while on it - static in both ears and an "EEeeEEee" tone in my right ear. This could have just been the natural progression my tinnitus was just set to take, or maybe it could have been not tapering the prednisone. I'll never know, and I don't bother to worry about it as those tones would become the least of my problems a month later.
   
   
2. The second time I took Prednisone was after going to Venice Beach with my daughter. I got caught in all sorts of traumatizing volumes - Loud music from stereos and buskers, a marching drumline, and an ambulance passing us while we were walking to our car on the street. My ears felt brutal at the end of that day. I started Prednisone the next day. Again, I can't remember the dosage. I had to combine the Prednisone the urgent care gave me and what I had leftover from my asthma, but I made sure to taper this time. I didn't end up having any permanent worsening.
   
   
3. The third time was last December after an auto mechanic used an impact drill several times while I was in the garage with him. This time, I opted for 1800 mg NAC for several days afterward. After a week of no improvement, I went on Prednisone again, but I still had permanent worsening.
   
   
4. I'm on it again right now. This is my final time trying it if my spike becomes permanent. I'm pairing it with 1800 mg of NAC and the RDA of Magnesium for ten days, and I'm also about to leave for the store to get Vitamins A, C, and E and hopefully get in my system before the 48-hour post-trauma window up.

That was a little long-winded but hopefully thorough enough.

 

[Michael Leigh]

I would greatly appreciate any advice on what to do. I'm feeling overwhelmed and losing hope with this condition.

I am sorry to hear about the difficulties you are going through @Jenny_S. The symptoms you are experiencing are severe. Since you have asked for advice, I suggest asking your GP to refer you to ENT so tests can be carried out on your auditory system. Suppose ENT finds nothing untoward is wrong with your hearing, and there are no underlying medical problems with your auditory system. In that case, they will likely refer you to Audiology to see an audiologist for treatment for hyperacusis, which is what I think you need, as it's likely that your acute oversensitivity to sound will remain and not reduce if it's not treated.

I prefer not to use terminology such as noxacusis and think it would help others who are troubled with acute oversensitivity to sound to do the same psychologically and keep things simple by saying they have hyperacusis. This condition comes in different levels of severity, and no two people will experience it the same, although they will share some similarities. When I had severe hyperacusis with pain 28 years ago, there was no mention of noxacusis in the many tinnitus and hyperacusis books that I read. Neither was it mentioned by the doctors or audiologists who examined me. I believe the more complex one makes tinnitus and hyperacusis by using terms like reactive tinnitus, noxacusis, etc., the more it reinforces the severity of their symptoms and could make them believe they will not improve with treatment. Tinnitus and, to some extent, hyperacusis are primarily mental. I do not mean these conditions can be controlled by mere thought, but they can increase stress the more one focuses on them and, thus, can often hurt the tinnitus and hyperacusis.

I believe you need professional medical help. Talk to your GP and ask to be referred to ENT.

Best of luck,
Michael

Keeping Things Simple with Tinnitus | Tinnitus Talk Support Forum

 

[da-gan]

Hi @Jenny_S,

I read through some of your earlier posts; you seem to suffer from pain hyperacusis without any loudness at all during any stage of your journey with acoustic traumas, which is quite uncommon. Most hyperacusis sufferers experience loudness during some stage. It's a small and exclusive club that you, myself, and others are part of.

ENTs and audiologists should be avoided for everything besides diagnosing this condition; they have nothing to offer except dangerous advice and testing that may worsen you. But you already know this since they already harmed you once with an Acoustic Reflex Test. Some people with pain hyperacusis can't even do low-volume audiograms without setbacks. This is obvious, but under no circumstances let them talk you into getting an MRI if you suffer from noise-induced pain,

There is little information regarding treatments. The number one priority remains to avoid setbacks, especially stacking setbacks on top of each other. Stay within your sound limits and avoid pain. Use protection if needed and double-protect when necessary. Check for any issues with your neck and jaw, like TMJD, that may exacerbate your condition.

Some noxacusis sufferers get pain relief with Ambroxol, a prescription-free cough medication if the noxacusis is in the middle ear. Other experimental treatments, like botoxing the Tensor Veli Palatini, are being explored by adventurous sufferers, but this must be regarded as high risk with unknown benefits. The round oval window reinforcement surgery seems to have poor results with noxacusis; the best results are with mild loudness hyperacusis.

Steroids like Prednisolone only have one indication: Sudden sensorineural hearing loss, and from what I understand, you don't have one. There is no evidence it works against tinnitus and hyperacusis. Anecdotal evidence is mixed like everything else in this game; some people worsen, some see no benefit, and some claim benefit. It should be taken within 24 hours of acoustic trauma or, at the very latest, within a week. I would probably not use steroids today unless I had noticeable hearing loss with the setback/trauma; I don't see how the benefits outweigh the risks. Amitriptyline can work excellently with nerve pain but can also worsen tinnitus, so be careful.

Keep your faith; people can recover even from severe setbacks with pain hyperacusis, but healing is very slow with this condition. I had a major setback with dropping a power adapter on a surface that gave a loud bang; it took six months to get back to baseline.

I hope to see you recover soon.

 

[ECP]

@Jenny_S, how are you doing today? Did you decide on a medication to try?

@da-gan, how would one know whether noxacusis is coming from the middle ear or some other part of the ear or brain? I'm asking because your suggestion to take Ambroxol for middle ear noxacusis piqued my interest.

 

[Zigs]

Hi @Jenny_S, how are you doing now?