Tinnitus for 4 Years and (Life Disrupting) Hyperacusis for One Week — A Musician and DJ

[evrmre]

Hi everyone!

I'm a 30-year-old musician and DJ with an occasional dumb habit of losing his earplugs, and as a result I developed mild tinnitus a few years back. It was pretty much the same volume (manageable, only noticeable at night) until last weekend when I DJed my first gig since COVID-19 restrictions were lifted in Canada. I very stupidly forgot my earplugs because I was off my rhythm and I ended up playing for almost 2 hours next to a loudspeaker at half volume (pointed away from me at least). I'll never make that mistake again as long as I live!

I woke up with an increased ringing and pain in the ears. I was really hoping it would go back down, but it's been a week and it hasn't. I can live with the ringing (I'll get used to it) but the hyperacusis, even just for a week, has been very life disrupting. It hurts to listen to almost all music with a kickdrum and snare in the car or my monitors, so I can't work (can kind of manage headphones, though). It hurts to be around friends that talk really loud, so I can't be very social. It hurts to play video games or be in Discord because the game audio and friends yelling hurts my ears. I also get a weird hot sensation in my ears if I listen to white noise for too long as well.

I know there's very little that we know about hyperacusis. I went to the ER and the doctor refused to prescribe me a steroid because I didn't have any extreme hearing loss that he could notice (he didn't do a hearing test he just rubbed his fingers next to my ears haha). He said I was his first patient he'd ever seen with this symptom and to wait for an ENT appointment in a month.

My question is from the veterans who have seen improvement. What's my best bet?

I've seen the following advice:

• Rest your ears for several months with muffs and if you're lucky your ears won't hurt anymore
• Don't remove all noise. Gradually expose yourself to medium to loud noises, if you cut out noise entirely you'll enfeeble yourself and become more sensitive to all noise
• Get checked for TMJ
• Start TRT in the early stages so that the ringing and pain don't impact you as much
• Go keto or carnivore (lol maybe if nothing else works)

Currently my days consist of:

• Wake up, take off white noise sleep mask
• Take NAD+, ALA, Vitamin D, and Ginkgo Biloba on an empty stomach
• Jog for 30 minutes with TRT in headphones
• Breakfast (plain oatmeal with fruit)
• Do HRV training to activate parasympathetic nervous system
• Shine red therapy light into ears (I know, unproven in humans but worth a try!)
• Work (listening to white noise about half the day) & lunch
• Dinner & TV
• Sleep with white noise sleep mask

Am I doing something hilariously wrong that somebody might be able to shine a light on?

Again, I know there's very little actual knowledge in this field but I'd love to hear your thoughts.

Thank you all very much

 

[linearb]

Sorry this happened, my story is somewhat similar (minor tinnitus for years, saw Gang Gang Dance in a tiny concrete box of a venue I should have fled, didn't, eeeeEEEEEEeeEEEEEEEEEvermore since).

For me the ringing never really got better and I manage it with meds at the moment, but it sounds like the hyperacusis is really your problem and you seem like you might be psychologically better prone to adapt to it that me. I say that mostly based on your rationality and lack of panic now; a week post my trauma I was a blithering mess on the floor of various doctor's offices.

So, this is my "good" news for you: I absolutely had all the sensitivity you describe, and for me it did improve, massively, way before I started any meds. I started using earplugs in even moderately loud environments, basically anything that provoked pain I avoided and I also started sleeping in as close to total silence as I could manage, living in an urban condo. I have a friend who likes to yell because he blasted his hearing shooting artillery shells for the Navy, and when I'd be seated next to him for cards, I would wear an earplug on that side.

My sensitivity faded but I think the thing that helped the most was limiting sound overall by moving out of the city into the country. When I go back to the city I am always amazed by how loud it is, but also how generally tolerant I am to city noise, compared to how sensitive to it I was when I left. My last run in to DC I had to remind myself to put earplugs in when the train went underground; I've clocked it and I know it hits 80-90 dB range down there but it didn't make me wince, it just seemed loud and annoying.

Train and truck brake squeals still make me wince but that's been true since I was a toddler.

 

[evrmre]

So, this is my "good" news for you: I absolutely had all the sensitivity you describe, and for me it did improve, massively, way before I started any meds.

That's amazing news, thank you so much! I'm sorry that you had to go through that, and still are to a lesser degree. I firmly believe that every music venue should be required by law to provide earplugs because I probably damaged my ears so much as a teen due to straight up hubris and ignorance. We don't value ear safety enough as a culture.

I say that mostly based on your rationality and lack of panic now; a week post my trauma I was a blithering mess on the floor of various doctor's offices.

I might be misrepresenting how put together I am about this aha. I'm very much panicking internally that my life as a musician is ruined, but I've beat disorders in the past that doctors have told me I'll just need to "manage" and there's no cure for, and I'm strongly hoping that this is the same. I also feel like there's no point in living in extreme panic and anxiety, especially since it will just fracture my relationship with my friends and more importantly my girlfriend. I'm mostly trying to be as proactive as possible given that the damage is recent and nearly all disorders heal best in the first few months.

Your opinion seems to line up with a recent USF study where participants were told to avoid extremely distressing sounds without avoiding all sound as that might have unfavorable results on their mental state, increasing sensitivity. Perhaps that's what I should do. I feel so stupid and I've been beating myself up all week but I'm truly hoping I can return to the state where I can produce music, DJ, and attend festivals (with earplugs of course) again.

Thank you again for giving me some encouragement!

 

[Vincent R]

Hi Emre,

I'm sorry to hear about your situation. Since members of Tinnitustalk deal with their tinnitus in different manners, you should be prepared for different, and perhaps even contradictive, answers. I have suffered from T for eight years. At times, I have been habituated, but additional noise exposures have caused setbacks. The input I provide is based on experience and is anecdotical in nature. Apply the stuff you think makes sense and discard the rest.

I went to the ER and the doctor refused to prescribe me a steroid because I didn't have any extreme hearing loss that he could notice (he didn't do a hearing test he just rubbed his fingers next to my ears haha). He said I was his first patient he'd ever seen with this symptom and to wait for an ENT appointment in a month.

The ENT might want to do a tympanometry and an acoustic reflex test. These tests are often done in combination. The acoustic reflex test is done by emitting beeps into your ear. The ENT will assure you it's safe, but it's not. An acoustic reflex test can cause as well as aggravate pre-existing T. Several cases have been reported by TT members.

Don't let the ENT do an acoustic reflex test. Tell him you can't endure it due to your hyperacusis. If he starts doing it without telling you beforehand, move away your head.

As for tympanometry, I don't have much of an opinion. An ENT did the test on me without causing any noticeable harm, and when he tried to follow up with an acoustic reflex test, I disrupted him.

I've seen the following advice:

• Rest your ears for several months with muffs and if you're lucky your ears won't hurt anymore
• Don't remove all noise. Gradually expose yourself to medium to loud noises, if you cut out noise entirely you'll enfeeble yourself and become more sensitive to all noise

If you start protecting your ears against everyday noise, you should expect them to become more sensitive. But pushing yourself to endure noise that feels uncomfortable won't necesserily work either, and it also goes against common sense.

T is a nerve injury. Once you have severly hurt your ears, no one can tell for sure how much - or little - it takes to make the condition even worse. I would advice caution.

One option is to use foam earplugs for socializing and cutting down on noise exposure that makes you whince. You won't hear everything everyone says with earplugs in, but that's no big deal.

• Get checked for TMJ

There would't be anything wrong with that, but it probably won't be a game changer either. Your T was caused by noise exposure, not tensions around the jaw.

• Start TRT in the early stages so that the ringing and pain don't impact you as much

In my opinion, there is no difference between TRT and just getting used to T on your own.

• Go keto or carnivore (lol maybe if nothing else works)

I haven't tried diets against T, so I have no advice to offer in that particular area.

Currently my days consist of:

• Wake up, take off white noise sleep mask
• Take NAD+, ALA, Vitamin D, and Ginkgo Biloba on an empty stomach
• Jog for 30 minutes with TRT in headphones
• Breakfast (plain oatmeal with fruit)
• Do HRV training to activate parasympathetic nervous system
• Shine red therapy light into ears (I know, unproven in humans but worth a try!)
• Work (listening to white noise about half the day) & lunch
• Dinner & TV
• Sleep with white noise sleep mask

If you fancy laser therapy, then there are tons of posts here on TT about the treatment. Positive results seem scant, but optimists keep trying. The only medical treatment that really appears to work is stem cells, but not everyone who tries it benefits and those who do get reductions rather than a complete cure. Stemcells21 in Bangkok is the clinic I would recommend. Unfortunately, the treatments are very expensive.

I personally wouldn't bother with white noise at all. It might provide temporary relief, but does not cure the underlying problem. I prefer to bite the bullet and get used to the T noise straight away. Also, I would be very wary about any decive that administrate noise directly into my ear, for example ear buds and ear phones. Especially for lengthy amounts of time. That white noise sleep mask of yours is something I would discard immediately.

Am I doing something hilariously wrong that somebody might be able to shine a light on?

Not hilariously wrong, no. The question is to what extent you will have to adjust your present lifestyle. The nasty thing with T is that if you make a single additional mistake, the consequences might be lifelong. The worst way to make adjustments to T is because aggravated symptoms are forcing you. Better to make the adjustments beforehand. Continuing working as a musician and attending festivals sounds risky. To me at least.

 

[evrmre]

Hi Vincent!

Firstly thank you for the very thorough reply. I will be sure to remain cautious at the ENT as to not cause any unwanted damage. I fully agree that everybody needs to make their own care plan that makes the most sense to them, and that's been my MO since the past weekend trying to make sense of all of this.

T is a nerve injury. Once you have severly hurt your ears, no one can tell for sure how much - or little - it takes to make the condition even worse. I would advice caution.

Tinnitus can be nerve and hair cell injury but it's also a brain reaction to that damage. From what I understand some people develop tinnitus even when no damage to the inner ear is visible at all; on the flip side, plenty of people lose or damage their hearing and don't develop tinnitus - and a lot of it has to do with a stress reaction or ability to mask the hearing loss following damage. Also, most recent research on hyperacusis (which is admittedly lacking) focuses on sound therapy and increasing exposure to everyday noises with a decent result.

In my opinion, there is no difference between TRT and just getting used to T on your own.

I tend to agree with this. I'm using TRT because I am incredibly anxious and prone to health anxiety. Background noise quiets my amygdala and makes me less prone to panic attacks, and I think that's something I need to keep in the routine. I also can hardly sleep without noise currently and I don't think it's doing me any harm, so I don't think I'll cut that out, although I appreciate the suggestion.

Also, I would be very wary about any decive that administrate noise directly into my ear, for example ear buds and ear phones.

Do you have any good science or reasons for this? Most all of the TRT studies I've seen seem to claim that sound therapy and headphones are suitable to be used for up to 8 hours a day if needed. If I can't listen to music or bathe in my usual background noise, I don't want to just be left in silence as I might enfeeble myself.

I truly appreciate this discussion, by the way

 

[Foamearplugssuck]

Chiming in here because I am in a very similar position! About a month ago, I accidentally blasted myself with while playing around with the gain settings on a reverb plug in. That, plus feverishly working on an EP + DJ set, turned my mild tinnitus into pain hyperacusis, reactive tinnitus, and dysacusis.

There's a lot of debate on this forum as to whether headphones are okay to use, even for white noise purposes. Unfortunately, I've seen too many cases of people using headphones and then permanently worsening their tinnitus in order to feel comfortable with using them. Given how fragile your ears are right now, I'd encourage you to stop using headphones for a few weeks/months and see how your ears feel.

The last thing I'll say is that, in my experience, the length of sound exposure is just as important as the level of sound exposure. Having a 45 dB fan on for 8 hours is also not great for your ears and could exacerbate your symptoms, even though the volume is low. So just be mindful of how long you're listening to white noise and how your ears respond to it. If you don't have any negative side effects that's great, but it might be good to take some breaks in silence, especially while you sleep.

 

[Vincent R]

I will be sure to remain cautious at the ENT as to not cause any unwanted damage.

I'm happy to successfully have issued a warning before a potential case of tinnitus-getting-worse-because-an-acoustic-reflex-test occurs. It's much better than reading about yet another poor soul who walked into the disaster after the fact.

Tinnitus can be nerve and hair cell injury but it's also a brain reaction to that damage. From what I understand some people develop tinnitus even when no damage to the inner ear is visible at all; on the flip side, plenty of people lose or damage their hearing and don't develop tinnitus - and a lot of it has to do with a stress reaction or ability to mask the hearing loss following damage. Also, most recent research on hyperacusis (which is admittedly lacking) focuses on sound therapy and increasing exposure to everyday noises with a decent result.

I don't disagree with any of this, but in your case, noise exposure that caused hair cell injury seems to be trigger. If scientific studies say gradually increased noise exposure to everyday sounds helps against hyperacusis, then you should perhaps go down that route. Still, I think you should try to control how extensive the noise exposure gets (wear earplugs in surroundings with unpredicatble factors, use speakers on moderate volume instead of headphones when playing computer games with friends, and so on and so forth.)

You want to maintain/go back to normal, but you still don't know what adjustment you will have to make. Don't find out by worsening your condition.

I tend to agree with this. I'm using TRT because I am incredibly anxious and prone to health anxiety. Background noise quiets my amygdala and makes me less prone to panic attacks, and I think that's something I need to keep in the routine. I also can hardly sleep without noise currently and I don't think it's doing me any harm, so I don't think I'll cut that out, although I appreciate the suggestion.

I am quite the anxious person myself, but I keep it in check with meditation techniques. Certain techniques can be very effective despite tinnitus ringing in your head. I created a post about it:

Meditation Practice to Deal with Tinnitus

(The post is poorly written, but too old for me to edit. Still, if you want to use meditation as a means to improve your health status, the basic info is there. In my opinion, there is nothing better to ease stress and improve sleep.)

Do you have any good science or reasons for this?

No. I'm very cautious about noise exposure and don't benefit from white noise, so it's an easy sacrifice to make in my case. My worries with regards to white noise devices might be over the top.

I truly appreciate this discussion, by the way

 

[Brian Newman]

Don't worry man. If you did not have a lot of hearing loss, I think you will be ok. You don't even need TRT. You are only a week in. It will most likely get much better with time and fade. Your tinnitus might get better too. Just avoid any noise that bothers you. Don't play anything in your ears at all and see how you do. I don't know who recommended you to do TRT in the early stages but if you never had hyperacusis before, I strongly advise to plug up if any noise bothers you, and don't play anything directly in your ears.

I had moderate hyperacusis from shooting guns before and it never truly went away but following the protocol above I got much better in a year. I truly think you will be fine. Just protect your ears and wait it out.

My hyperacusis this year has gone from moderate to catastrophic. I barely leave the house anymore and and am completely debilitated. I got more noise damage from a car accident, and have other head/ear issues going on that I can't figure out.

You will get better.

 

[evrmre]

Hey Brian, thanks so much for your well wishes.

Yeah I did a mobile hearing test and I'm able to hear all the sounds I used to, so hopefully that bodes well. I mean, obviously I damaged my hearing being exposed to loud noises, but I can still have a quiet conversation with my girlfriend with the AC and TV on no problem.

I don't know who recommended you to do TRT in the early stages but if you never had hyperacusis before, I strongly advise to plug up if any noise bothers you, and don't play anything directly in your ears.

Honestly the vast majority of medical pamphlets...

Enriched acoustic environment rescales auditory sensitivity

NHS: Hyperacusis

...I've seen on the issue and general advice from audiologists I've seen all point to raising the noise floor and avoiding complete silence (especially acutely). I'm not blasting music in my headphones I'm just simply playing low level white noise to calm my amygdala and not associate all sounds with pain.

That said, most people in this thread with experience have told me to discontinue all use of headphones and resign myself to daily silence for several months. I'm more inclined to believe actual sufferers of a condition because they know best, but I just want to have a good reason for something before I do it. I'm avoiding loud and ear-damaging sounds like the plague already, I just want to make sure it would be a smart move to remove all noise or sound therapy. Is there any half-decent evidence for this?

My hyperacusis this year has gone from moderate to catastrophic.

I'm so so sorry you're going through that, man. I truly hope you're able to tolerate more sounds as time passes and you become more resilient.

You will get better.

I needed to hear that bro. Thank you so much.

 

[Traumasux]

How do you feel now?

 

[Matchbox]

How do you feel now?

I hope he didn't go back to DJ life. Permafuck himself. Surprised he even thinks he can still.

Catastrophic tinnitus is no joke. And there's no bottom to how bad this gets.

Audiologists don't know shit about tinnitus. Researchers are the closest thing to experts.

Snorting Ketamine or getting Dexamethasone shots would've been a better plan over sound enrichment. Works for very mild hyperacusis only.

 

[evrmre]

How do you feel now?

I'm doing a lot better.

I can listen to music in speakers at medium volume. Voices don't hurt anymore, others or my own. I'm not back to DJing and I'm not sure if I'll be able to for a while, but it's definitely a goal (with extreme hearing protection, of course).

TMJ massage, self percussive massage, and ball-rolling the neck and face helped a lot. Complete silence for the first 2 weeks felt like it made me worse and increased my phonophobia. I stared listening to gently EQed noise in the myNoise app and it helped a lot and I had a significantly reduced "clenching" reflex to sound which was directly worsening my pain hyperacusis, particularly the "stabbing" pain deep in the ear (almost non existent now)

Plans for the future are working with an upper cervical chiro to fix some long standing neck pain that might be innervating the TMJ and inner ear pressure (could have been a big part of how I got hyperacusis and not just hearing loss). Working with a concussion doctor to help with my dizziness, brain fog, headache, and mild visual snow that have come from this.

I would say I'm about 40% better in 2 months. I'm being very careful without allowing stress to control my life and cause more pain. Wish me luck on the next few months!

 

[Traumasux]

I'm doing a lot better.

I can listen to music in speakers at medium volume. Voices don't hurt anymore, others or my own. I'm not back to DJing and I'm not sure if I'll be able to for a while, but it's definitely a goal (with extreme hearing protection, of course).

TMJ massage, self percussive massage, and ball-rolling the neck and face helped a lot. Complete silence for the first 2 weeks felt like it made me worse and increased my phonophobia. I stared listening to gently EQed noise in the myNoise app and it helped a lot and I had a significantly reduced "clenching" reflex to sound which was directly worsening my pain hyperacusis, particularly the "stabbing" pain deep in the ear (almost non existent now)

Plans for the future are working with an upper cervical chiro to fix some long standing neck pain that might be innervating the TMJ and inner ear pressure (could have been a big part of how I got hyperacusis and not just hearing loss). Working with a concussion doctor to help with my dizziness, brain fog, headache, and mild visual snow that have come from this.

I would say I'm about 40% better in 2 months. I'm being very careful without allowing stress to control my life and cause more pain. Wish me luck on the next few months!

I am glad to hear that.

That sounds a lot like my case!

I have some weird sensations in hands/fingers so I suspect a pinched nerve in my neck.
My hyperacusis is almost gone as well, things like my newborn screaming is unpleasant but i can listen to music no problem, however, certain sounds like high pitched ones is unpleasant.

My neck is also VERY stiff...

 

[Simon85]

I would say I'm about 40% better in 2 months. I'm being very careful without allowing stress to control my life and cause more pain. Wish me luck on the next few months!

Great news. Things should continue to improve.

 

[Leila]

I would say I'm about 40% better in 2 months. I'm being very careful without allowing stress to control my life and cause more pain. Wish me luck on the next few months!

I'm happy to hear that your hyperacusis improved so much over the last two months. Hopefully it will get even better with a little more time.

I woke up with pain hyperacusis and reactive tinnitus in the beginning of the year myself and it's been a pain in the neck ever since - though I have to admit, that the hyperacusis gradually lessened a little, which I''m more than thankful for.

At the moment, I still do as @Brian Newman suggested and plug up whenever a noise is bothering me which allows for a certain degree of normality.

From what you're saying and the way you're saying it I feel that you've got a good handle on your tinnitus and hyperacusis. Stay positive and let us know how things are going for you in the future!

 

[Freerunner]

@evrmre, did the tinnitus also improve after your hyperacusis started subsiding?

 

[evrmre]

@Freerunner, yep. Still not as low as it was pre-accident, but way lower than the day of. Working on my posture, TMJ issues, and neck stability has helped a lot. Never knew it was a problem until this happened to me and I noticed I've been tight for years.

 

[FreckledEars]

Similar situation.

Musician's earplugs changed my life. After getting a referral from a doctor to see an audiologist... the audiologist told me about musician's earplugs.

So they have an ambient filter so you are able to hear a full spectrum of sound while still having ear protection.

Look into it.

I have tinnitus, hyperacusis and use the musicians plugs to manage when I'm working on headphones or in a loud space.

Changed my life.