Recent Experience with Hyperacusis — Question: Can Everyday Sounds Permanently Worsen Tinnitus?

[Bob den Hartog]

Hey all,

So, I would like to share a recent experience with you I had at the audiologist last week - and ask a question about what should I do now?

First sighting of hyperacusis
I've had hyperacusis for about two months now. It started at the beginning of February, in the form of a warm left ear, burning pain, and a protracted muscle (?) in one instance. I was able to overcome this, by ignoring the pain (I had to during certain phone calls), after each time I noticed I was able to 'block out' the pain after a while and it subsided. It took me a week, but then, I considered myself hyperacusis free, apart from once in a while a little warming of the ear, which subsided again.

Second sighting of hyperacusis
Then, a week and a half after I thought the worst was behind me, hyperacusis came up again. Now also in my right ear. I decided I had to ignore it again, so I did. However, this time this only seemed to make it worse. After a while, I also developed tingling sensations in my face (left), which then developed into painful sections of my face. After a while, it wasn't just sound that did this, but also just any sort of input. For example, MacBook and iPhone screens worsened my conditions, so I had to limit my time working and take breaks (always from home). I've been plugging almost completely for a month.

Recovery...?
Then - the audiologist. Last Thursday we had a meeting, in which he forbade me to wear any plugs. He also refused to whisper. During the conversation, I told him, the left side of my face is going numb. 'Let it go', he said. A friend of mine accompanied me and he noticed my left ear went completely red. It also started burning. Still, 'let it go', he said. I grew increasingly anxious and felt severe stress.

Then... the pain and symptoms stopped getting worse. During the conversation, after a while, I noticed it has reached it's... apex? I don't know. All I know is that I was able to relax a little bit, once I noticed this. I was able to go from a whisper to almost my regular voice, without a worsening. Then - the full duration of the conversation was about 1.5 hour - it started to slowly subside again. When walking home, I hardly plugged and had a conversation with my friend at a normal volume. Since then, I talk again.

Mind you, I only want to list what happened to me. I'm sure this doesn't work for everybody. I'm baffled it worked for me. According to the audiologist, pain in hyperacusis is regulated in the 'lizzard brain', and the only way to access it is not through thought, but in telling your body sound is unharmful through your actions. So, in ignoring the pain, you're 'training' your body.

Ever since, the face tingling / pain is significantly less, the ear pain with sounds is less, and I should keep practicing now with hearing sounds each day. I'm plugging less and less...

The Question
So... now, something I'm extremely anxious about. Because as I'm allowing more and more sound, my tinnitus is raising. It feels like a permanent raise. So as I seem to be recovering from hyperacusis, this same method seems to be raising the volume of my tinnitus. Which terrifies me.

I wanted some kind of schedule to be given by my audiologist. How to build up with sounds? But he said, just turn on your radio, and stop plugging. According to my audiologist, it's impossible to permanently raise your tinnitus with everyday sounds, just as it don't actually hurt your ears, even though you feel pain. Relax, allow sounds. He seemed to be right with the hyperacusis... But I really don't know if I should trust this.

What are your thoughts? Can regular everyday sounds actually permanently raise your tinnitus? Or is this all spikes, and my emotions?

 

[Johan_L]

Fascinating story. Really. I am considering to take "the leap" and stop using plugs at times... but then I hear a sound and feel pain, and decide that its a bad, bad idea.

Also, the first time I recovered by protecting my ears.

Basically, there are "success stories" from those that use protection, AND from those that do not use protection. If you decide to stop using plugs, maybe do it slower and more gradual to see what happens. The stakes are so extremely high, so its better to take a "slow" approach if you go for the "noise exposure" route. And, I think an increase in tinnitus is a warning...

 

[Bob den Hartog]

Basically, there are "success stories" from those that use protection, AND from those that do not use protection. If you decide to stop using plugs, maybe do it slower and more gradual to see what happens.

Yes! And that's the confusing thing! But I also noticed that, the longer I plugged, the less sound I tolerated before I got the "clicking" sound when swallowing in my ears. So the more sounds seemed to "hurt" my ears. That seemed to be a warning sign, to me, that plugging is dangerous. Also, I was listening to my tinnitus each day, which was horrible.

If you decide to "take the plunge", I would advise to do this through a live conversation with someone. I noticed for example that if I turned on a podcast, or started talking to myself, I was still very much focused on what it would do to my ears, and the pain. Whereas, you need to relay your focus on something else. In a conversation, you need to focus on your partner, and think about what to say, which diverts from the focus on your ears/pain. And maintain the conversation throughout the pain. I think it's like training a dog: if you stop the conversation and let the pain subside on its own, you're basically saying to your body, you're right, that's dangerous. I think? That's my own theory, because all the time, smaller sound exposures worsened the pain in an accumulate manner, whereas, continuing and going through it, alleviated it ultimately.

 

[Bob den Hartog]

The stakes are so extremely high, so its better to take a "slow" approach if you go for the "noise exposure" route. And, I think an increase in tinnitus is a warning...

I believe so too... But there's a fine balance here. If I'm too slow, my hyperacusis is coming back again, and a conversation gives a warmer ear, returning of hyperacusis symptoms, etc. Too fast, and the tinnitus ramps up... Also, the tinnitus FEELS like a warning sign, but so did the pain with the hyperacusis, and that had to be ignored...

This is SUCH a frustrating damned if you do, damned if you don't situation...

 

[Contrast]

According to the audiologist, pain in hyperacusis is regulated in the 'lizzard brain', and the only way to access it is not through thought, but in telling your body sound is unharmful through your actions. So, in ignoring the pain, you're 'training' your body.

That audiologist is a shit for brain idiot and has not read research that suggest pain hyperacusis (noxacusis) is Outer hair cell damage causing temporary noiception and eventually peripheral neuropathy if there is enough damage. Just because the pain has a cap, doesn't mean that loud noise exposure won't make it worse.

Please don't waste your money seeing these people who need their medical license revoked.


https://neurosciencenews.com/inner-ear-neuron-damage-3033/
real science on pain hyperacusis here, linked to outer hair cell and there nerves being damaged.

 

[Contrast]

Imagine this, but inside the ear.
https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061

 

[Rohit Saluja]

Can regular everyday sounds actually permanently raise your tinnitus

Your ears need some rest, don't overdo sound enrichment, it can make the situation worse, do it very slowly, don't rush, otherwise it will make the situation worse. I am going through the same situation with hyperacusis ear pain, and now I'm in a much better place.

 

[Bob den Hartog]

That audiologist is a shit for brain idiot and has not read research that suggest pain hyperacusis (noxacusis) is Outer hair cell damage causing temporary noiception and eventually peripheral neuropathy if there is enough damage. Just because the pain has a cap, doesn't mean that loud noise exposure won't make it worse.

Please don't waste your money seeing these people who need their medical license revoked.


https://neurosciencenews.com/inner-ear-neuron-damage-3033/
real science on pain hyperacusis here, linked to outer hair cell and there nerves being damaged.

Well, yes, there was a lot of resistance against what he said, but since that conversation, which he made me go through... the Hyperacusis has essentially... well, not gone yet, but it's a LOT less, and I truly feel I'm recovering. It went from, not being able to tolerate screens or working for too long, not tolerating sound, to: being able to talk, work, everything. So while I'm sure there's nerve damage, and yes, absolutely, be careful with LOUD noise - but everyday sounds don't seem to be a problem here, and in that regard he seemed right in treating me?

 

[Bob den Hartog]

Your ears need some rest, don't overdo sound enrichment, it can make the situation worse, do it very slowly, don't rush, otherwise it will make the situation worse. I am going through the same situation with hyperacusis ear pain, and now I'm in a much better place.

Hey man! Yeah, giving your ears rest from time to time and going easy seems reasonable . You say you're in the same situation - have you also plugged for a while? Do you also notice regular sounds raise your T? And do you notice T is getting softer again?

I followed the audiologists advice with playing the radio in the background, and that made it a lot worse... Really hoping it's just a long spike... Really hope that everything done with regular sounds isn't permanent...

 

[Rohit Saluja]

I followed the audiologists advice with playing the radio in the background, and that made it a lot worse... Really hoping it's just a long spike... Really hope that everything done with regular sounds isn't permanent...

I am giving you my personal advice, what I think is that there are two kinds of hyperacusis, one is head pain related and another is ear pain related. If it's the first case then it can be cured by sound enrichment, but if it's the second case then sound enrichment can make it worse, in that case only expose yourself to those sounds which do not cause any more ear pain, at least few months should be given for the ears to heal themselves before starting any sound enrichment, don't hurry, you can make the situation worse, give it like 6 months.

In my case I used to have ear pain for a full night after I came home from office by car without earplugs, then I started using ear plugs for a few weeks in car, then my pain was gone, then again I started not using earplugs in car, then the pain returned, so now I have decided to give more time to heal my ears for like 6 months.

 

[Bob den Hartog]

I am giving you my personal advice, what I think is that there are two kinds of hyperacusis, one is head pain related and another is ear pain related. If it's the first case then it can be cured by sound enrichment, but if it's the second case then sound enrichment can make it worse, in that case only expose yourself to those sounds which do not cause any more ear pain, at least few months should be given for the ears to heal themselves before starting any sound enrichment, don't hurry, you can make the situation worse, give it like 6 months.

In my case I used to have ear pain for a full night after I came home from office by car without earplugs, then I started using ear plugs for a few weeks in car, then my pain was gone, then again I started not using earplugs in car, then the pain returned, so now I have decided to give more time to heal my ears for like 6 months.

Hmm... I had ear pain, but that was as a reaction to ALL sounds, not just the car after a busy day. And that was elevated with going through a conversation with my audiologist - though not entirely.

Does your tinnitus react to sound? Since you drive your car and go to work, I guess it doesn't?

Mine seems to be getting permanently worse as a reaction to sound...

 

[Rohit Saluja]

Does your tinnitus react to sound?

No the tinnitus spikes a bit when ear pain occurs.

 

[Juan]

Hey all,

So, I would like to share a recent experience with you I had at the audiologist last week - and ask a question about what should I do now?

First sighting of hyperacusis
I've had hyperacusis for about two months now. It started at the beginning of February, in the form of a warm left ear, burning pain, and a protracted muscle (?) in one instance. I was able to overcome this, by ignoring the pain (I had to during certain phone calls), after each time I noticed I was able to 'block out' the pain after a while and it subsided. It took me a week, but then, I considered myself hyperacusis free, apart from once in a while a little warming of the ear, which subsided again.

Second sighting of hyperacusis
Then, a week and a half after I thought the worst was behind me, hyperacusis came up again. Now also in my right ear. I decided I had to ignore it again, so I did. However, this time this only seemed to make it worse. After a while, I also developed tingling sensations in my face (left), which then developed into painful sections of my face. After a while, it wasn't just sound that did this, but also just any sort of input. For example, MacBook and iPhone screens worsened my conditions, so I had to limit my time working and take breaks (always from home). I've been plugging almost completely for a month.

Recovery...?
Then - the audiologist. Last Thursday we had a meeting, in which he forbade me to wear any plugs. He also refused to whisper. During the conversation, I told him, the left side of my face is going numb. 'Let it go', he said. A friend of mine accompanied me and he noticed my left ear went completely red. It also started burning. Still, 'let it go', he said. I grew increasingly anxious and felt severe stress.

Then... the pain and symptoms stopped getting worse. During the conversation, after a while, I noticed it has reached it's... apex? I don't know. All I know is that I was able to relax a little bit, once I noticed this. I was able to go from a whisper to almost my regular voice, without a worsening. Then - the full duration of the conversation was about 1.5 hour - it started to slowly subside again. When walking home, I hardly plugged and had a conversation with my friend at a normal volume. Since then, I talk again.

Mind you, I only want to list what happened to me. I'm sure this doesn't work for everybody. I'm baffled it worked for me. According to the audiologist, pain in hyperacusis is regulated in the 'lizzard brain', and the only way to access it is not through thought, but in telling your body sound is unharmful through your actions. So, in ignoring the pain, you're 'training' your body.

Ever since, the face tingling / pain is significantly less, the ear pain with sounds is less, and I should keep practicing now with hearing sounds each day. I'm plugging less and less...

The Question
So... now, something I'm extremely anxious about. Because as I'm allowing more and more sound, my tinnitus is raising. It feels like a permanent raise. So as I seem to be recovering from hyperacusis, this same method seems to be raising the volume of my tinnitus. Which terrifies me.

I wanted some kind of schedule to be given by my audiologist. How to build up with sounds? But he said, just turn on your radio, and stop plugging. According to my audiologist, it's impossible to permanently raise your tinnitus with everyday sounds, just as it don't actually hurt your ears, even though you feel pain. Relax, allow sounds. He seemed to be right with the hyperacusis... But I really don't know if I should trust this.

What are your thoughts? Can regular everyday sounds actually permanently raise your tinnitus? Or is this all spikes, and my emotions?

I think hyperacusis may be lurking still. If I were you, I would be careful.

I did "take the plunge" and was ok for a while after H came back. It only takes a second of very loud noise to make your ears react, and there is very loud noise in what you call "regular everyday sounds".

You have to find your own balance between not protecting your ears and risking it too much, and it is hard to strike that balance. I think everyone agrees on not to overprotect, but again, there are sounds that just happen and are very loud. You may go to a park and find people celebrating something on a Tuesday afternoon of february and exploding firecrackers. These weird things do happen and they feel a lot worse on ears that have already being damaged or started malcfuntioning.

Basically your ears gave you a warning already, and that's all your symptoms mean. You may be ok for years or may relapse if you are unlucky, who knows!

 

[MindOverMatter]

@Bob den Hartog

How are you doing these days? Did you manage to find your balance in regards to hyperacusis and protecting your ears/not overprotecting?

 

[MindOverMatter]

I do agree with Dr. Neil Bauman on this topic who once wrote:

Stress and anxiety are two triggers of tinnitus. If you are a high-strung, anxious type of person, often you will find that not only do you hear tinnitus, but you also may have hyperacusis—where you hear some/all sounds louder and more intrusive than normal.

I was helping a lady recently that had much the same experiences as you—she was high-strung, anxious and had just gone through a very stressful situation. Her tinnitus was now much louder than normal, and she was worried that it would stay that way. In the past when she would stress over something, her tinnitus would get louder, but subside in a day or two. This time it wasn't—hence her call to me for help.

I explained to her that when we are anxious, this puts our bodies in the "fight or flight" mode. Extra adrenaline surges through our arteries giving us more strength to fight or flee. At the same time, our senses become more acute. Thus we actually hear better than normal during such events—especially fainter sounds.

When you are anxious all the time, your body becomes stuck in this fight or flight mode, which includes the increased acute hearing. The result is that you perceive certain sounds to be annoyingly loud such as your phonograph needle. At the same time, loud sounds are then much too loud (such as fireworks).

The usual reaction to this increased sensitivity to sound is to avoid all noisy places and wear ear protectors most of the time. This actually proves counterproductive because when you wear ear protectors all the time, you brain becomes "starved" for normal sounds. As a result, it cranks up its internal volume control. This just makes the situation even worse—because when you take the noise protectors off, sounds are louder and even more annoying than before.

On top of this, your tinnitus is also louder because, with the increased internal volume, your brain is now hearing more of the random firings of the neurons in your auditory system—which some researchers think we hear as tinnitus.

The way to resolve this problem is not to overprotect your ears. Yes, clap your hands to your ears if there is a sudden loud sound around you (a siren going past you, or a truck blasting his air horn), but otherwise do not overprotect your ears so your auditory system will always have adequate stimulation. This will cause your brain to turn down the internal volume.

At the same time, you need to learn how not to be so anxious. You need to learn to be calm and "hang loose". That will get you out of the "fight or flight" mode. This alone will let your brain turn down its internal volume.

When you do this, you will find that your tinnitus often becomes less intrusive and fades into the background. You will also find hat those sounds you found annoying before now don't bother you much, or at all.

I'm not saying this is easy to accomplish, but it is necessary. There are a number of books available that teach you how to relax and calm down. If you need further help, see a therapist that specializes in helping people work through their anxiety problems without using drugs.

The end result will be reduced tinnitus, reduced hyperacusis and more enjoyment in your life. That makes it all worthwhile, doesn't it?