by Neil Bauman, Ph.D.
January 24, 2016
A man wrote,
I am a 29 year old male. 11 days ago, I shot about 60 rounds from an AR-15 (.223) rifle, outdoors, with foam ear plugs in both ears. I might not have had the plugs in as deeply as they could go, but the sound was very much muffled, and I experienced no pain while shooting. I only fired the gun for a few minutes total.
After I took off my ear plugs, my hearing was horribly muffled and distorted in my left ear. It remained that way for several hours before mostly coming back. Tinnitus and a strange feeling remained a couple days later, so I made an appointment with my ENT. He gave me Prednisone and a hearing exam, which revealed ~30 dB hearing loss in my left ear at 4,000 Hz, but mostly normal everywhere else.
It’s been 11 days since I shot the gun. I still have some tinnitus, which is pretty quiet. My tinnitus seems to be low in frequency, maybe around 1,500 Hz. I was wondering if you might be able to explain some of these symptoms I’m having as they are very strange and hard to nail down.
1. A strange feeling of “difference” between my right and left ears, almost like my left ear has something in it, or the pressure is slightly different. Is this a side effect to the hearing loss?
2. My own voice, especially when speaking low, sounds different in my left ear, and seems to buzz or vibrate my left ear while I’m talking.
3. There is a strange, metal-like amplification or echo of sound that seems to occur in my left ear when touching my ear, rubbing my ear, or talking. It almost sounds like my tinnitus is being temporarily exacerbated in short bursts as something impacts my ears. Could this be a function of my low frequency tinnitus? Does low frequency tinnitus produce different sensations than high pitched tinnitus?
I’m really unhappy with the current state of things and can’t believe all this came about just from shooting a gun with ear plugs on. Can you explain what’s going on with my ears?
First, like you, I think you didn’t have your ear protectors inserted properly. Thus they didn’t do their job properly. Hence you had that muffled feeling when you took them out after shooting the rifle. Another possibility is that you didn’t have ear protectors with the correct protection factor.
Ear protectors come in various protection factors ranging from 10 to about 35 dB. For shooting rifles with their sudden sharp sound, you want a protection factor of 30 or so.
The fact that your left ear was damaged more than your right ear indicates to me that you are right handed and shoot right-handed. When you shoot right-handed, your left ear is facing forward and thus gets more of the muzzle blast than your right ear which is more facing back. That’s probably why your left ear got the worst of it. And it could have been acerbated if you did not have the ear protector properly seated in your left ear.
Your ears are most sensitive to sound at 4,000 Hz. Thus, it is not surprising that you now have the typical “noise notch” at 4,000 Hz indicating that you have damaged that ear from exposing it to excessive noise.
In answer to your question No. 1, when you have a sudden hearing loss like the one you experienced from a rifle blast, you have a feeling of pressure in that ear and /or a feeling that everything is muffled. Different people describe this same feeling differently. This is really a temporary hearing loss and is called a temporary threshold shift.
Typically, your hearing returns to normal in a matter of minutes, hours or days depending on the intensity of the sound and how robust your ears are. Sometimes, not all hearing returns and you are left with a permanent threshold shift, meaning you now have some degree of permanent hearing loss.
In answer to question No. 2, the sudden loud noise “bruised” your ear (to use a fancy medical term), and so all sorts of strange things may appear. And just like real bruises, it takes time for your ears to get back to normal. With ears it can be 2 or 3 months or longer, so you have to be patient. Again, the worse the damage, the longer it takes to heal.
Your question No. 3 is very interesting. You wonder why just touching or rubbing your outer ear generates various strange sensations.
Probably what is happening is that other nerves apart from your auditory nerves—called the non-classical pathways—have been super-stimulated and now are also sending messages to your brain.
Here is an excerpt from the 7th edition of my tinnitus book that explains what is happening and why you get such sensations.
So what exactly are the non-classical auditory pathways? The auditory nervous system consists of two parallel pathways. The first is called the classical pathway and the second goes by the name of non-classical pathway (otherwise called the extra-lemniscal pathway). These two pathways process information differently and go to different parts of the brain.
The classical pathway is strictly for auditory information. It is narrowly tuned to sound frequencies. It processes auditory information as this information moves from the cochlea to the primary auditory areas in the brain.
In contrast, the non-classical pathway is more broadly tuned, is more diffusely organized and is more plastic as compared to the classical pathway. The non-classical pathway receives its information not only from the ear, but also from other sensory organs of the somatosensory system such as the tactile (sense of touch/feel) system and the visual system.
The association between the auditory and the non-classical (somatosensory) pathways occurs due to connections in the dorsal cochlear nucleus of the brain. There multitasking neurons receive signals from both the auditory and the somatosensory pathways.
Because there can be this association between the auditory pathways and the non-auditory pathways, when abnormal interactions occur between the various systems connected to these pathways, the result can be somatic tinnitus.
This explains the connection between various forms of “weird” tinnitus that affect the other senses. It also explains how involving another sense can change your existing tinnitus.
I think this is what you are experiencing, and will continue to experience while your ears are still “bruised”. During this time you want to protect your ears from overly-loud sounds. If you expose them to more loud sounds, you are just “whacking the bruise” and its going to take a lot longer for your ear problems to fade away.
The good news is that give it time and most likely your ears will return to normal, but you’ll probably be left with the noise notch hearing loss at 4,000 Hz.
__________________________
You can get your own copy of the new, expanded 7th edition of “When Your Ears Ring”. Just click on the following link. “When Your Ears Ring 7th Edition” .
I have same problem like you explain
What I do?
Hi Tejas:
There are two things you need to do. First, in the future protect your ears from sudden loud sounds like gunshots by wearing a good ear protectors. Second, give your ears a rest for a few weeks while they recover from the noise trauma. This means don’t expose your ears to loud sounds. So if you are around louder sounds, where your protectors at those times.
Cordially,
Neil
I was exposed to on the job gunfire for 20 yrs (protected). Three yrs after retiring, and with very minimal additional protected gunfire, I developed tinnitus without noticeable hrng loss. About 18 months later, I noticed occasionally missing a word or two but no big deal. Volume was still fine.
About two months ago, my tinnitus got a notch worse and my hearing changed so that I had to begin listening to TV on volume setting 38 instead of 25. Audiology exams seem to confirm high frequency loss down to 40(??).
Believe it or not, I had planned to start shooting again but can’t figure out if specially fitted inserts combined with quality muffs (having found out too late, btw, that my govt muffs for 20 yrs were junk) would offer adequate protection. Not being deaf is more important than shooting but I really wanted to shoot again. I even purchased two suppressors to assist in keeping decibels down. I can’t find anything to explain benefits of two levels of protection, combined with a suppressor. Do you, sir, have any advice or thoughts. Any help would be greatly appreciated.
Hi John:
A gun noise suppressor reduces the sound coming out of the muzzle by about 20 to 30 dB, depending on various factors. Thus say your rifle normally produces a 140 dB sound. With a suppressor in place, this dangerous (to your ears) sound will be reduced to 120 dB or so. This is all to the good.
Now if you wear ear protectors, you can drop this another 30 dB or so and you are down to 90 dB which is a LOT safer for your ears.
Wearing both ear plugs and then ear muffs on top of that gives better protection than just one or the other alone, but don’t think wearing the two together dramatically increases the protection. For example, say you have 30 dB protection factor ear plugs and 30 dB ear muffs–which is about the maximum protection factors made. You can’t just add 30 and 30 and get 60 dB sound reduction. That is not how the decibel scale works. Rather, 30 + 30 dB gives you 33 dB protection.
Furthermore, realize that you cannot get unlimited noise protection because the sounds in the air bypass your ears and vibrate your skull. That is why around 30 to 35 dB is the most protection you can give your ears before bone conduction takes over.
That is why using a noise suppressor on your rifle is so important–it can get that initial sound level down 20 or more decibels before that sound reaches your skull or your ears where your double ear protectors can give you another 30 to 33 dB of protection.
Doing this, you should be able to take up shooting again without significantly hurting your ears or making your tinnitus worse–especially if you combine quieter guns with quieter loads at the same time.
So quiet gun, quiet load, gun noise suppressor, ear plugs and ear muffs should give you happy shooting again without further damaging your ears.
Cordially,
Neil
I cant thank you enough for this information. Rookie shooter here and was out on a “testing the water” hunt recently. Failed to wear ear protection while sitting next to the shooter in a blind. He shot a 450 and my left ear is all sorts if weird as described above. Thanks for the info. It was a little panicy feeling to have these severe of symptoms in such a “harmless” outing but, lesson learned and hopefully i can regain the loss by proper care.
Hello,
I went hunting without ear protection one and a half weeks ago. My right ear still feels like something is in it (numb feeling) I can still hear out of it. Will this go away?
Hi Joe:
The numb feeling should go away in time. It can take a number of weeks for your ears to recover from acoustic shock. Each person is different and your ears may be more sensitive than other people’s ears.
You need to protect your ears from loud sounds in the future–and particularly for the coming weeks while your ears recover from the acoustic trauma.
Cordially,
Neil
Hi sir, I shot some guns about a month and in a half ago we were shooting ar 15s, shot guns, and pistols, for about an hour I failed to wear hearing protection the whole time. I did have little soft plugs to put in my ear and had them in some of the time. When I was done I noticed my left ear felt heavy and muzzled but that went away after about a day or so. Throughout the month after shooting I heard slight ringing only at night but dident know what it was and dident think to much of it. A month and half passes I have a stressful event and wasent getting much sleep and woke up one morning and noticed ringing in my left ear and became really aware of it and it was at a higher pitch which was all day I started googling and found out I have tinnitus( never heard of it) I started to panic and put a bit of hydroperoxide in my ear thinking it could’ve been ear wax I then went to the urgent care and they said it looks like I had a slight infection and prescribed me ciprofloxacin ear drops which I only took for about a day because I read online that that can be bad for the ear I went to another doctor who said he didn’t see anything wrong (this was all in the same day) so another day passes by I decided to to go to the the emergency room and he told me that he sees some fluid behind the ear and prescribed me prednisone to take by the mouth for a week and an antibiotic for 5 days I took the prednisone but did not take the antibiotics (azithromycin is the name of the antibiotic) because I read online that that can make it worse I then went to an ent doctor who told me that they did not see any fluid behind the ear and that my hearing is above average (I don’t know what to believe in to many different answers) I’ve noticed now that I have low like ringing that started in my left ear but has spread to my right ear and it’s on and off my ears feel full sometimes and that I’m a bit sensitive to sounds and loud noises I also noticed that if I move my bottom jaw that increases the tinnitus until I stop moving my jaw I’m scared and don’t know what to do I haven’t slept good in weeks sometimes I feel like it’s getting better but I feel my mind is just playing tricks on me. Do you think it can get better?
Hi Ernest:
Stress and noise trauma can certainly bring on tinnitus. You tinnitus started from the noise trauma and was exacerbated by the stress 6 weeks later.
When you go to doctors about ears, they “see” what they think they should see, so one sees a “slight infection” and another sees fluid behind your eardrum and both were wrong. The ENT was right in that you didn’t have any fluid in your middle ear.
When you get a report of hearing above average–if it was above the 0 dB line on the audiogram, that can be indicative of loudness hyperacusis–which is bad, not good.
Moving your jaw which exacerbates your tinnitus just shows that you have both the standard neurophysiologic kind of tinnitus (from noise trauma) PLUS some degree of somatosensory (body) tinnitus from your head, neck, jaw, shoulders, cervical spine out of proper alignment or particularly “tight”. Typically, you can alleviate this kind of tinnitus by chiropractic and massage therapy.
The sound sensitivity is loudness hyperacusis from the noise trauma.
Yes, you can get better. That is not a problem if you work at it. The first thing is to stop being anxious and worrying about your tinnitus/hyperacusis and instead focus on other things (the loves of your life). If you look at the tinnitus/hyperacusis as a threat to your well-being in any way, you cannot habituate to your tinnitus so it will stay and can get worse.
However, if you treat your tinnitus as a useless, unimportant background sound that it is safe to ignore (and then ignore it), your tinnitus and hyperacusis should fade away in time and not bother you. (You can learn more about this in chapters 20 and 21 in my book “Take Control of Your Tinnitus” available at https://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/ .
Cordially,
Neil
Hello Dr.Neil,
I wanted to ask a question about tinnitus and how long it can last. I went shooting just the other day and as I was shooting, my ear muff slipped off and my right ear was exposed as I pulled the trigger of my AR15. It has been 3 days now and the ringing has not yet stopped. Is there anything I can do to try and help my ears heal or is it too late and not likely to recover?
Hi Zachary:
In addition to the magnesium, I’d also take zinc–no more than 30 mg per day.
Also NAC (N-acetyl-cysteine) around 1,800 mg per day for a couple of weeks.
If tinnitus sticks around for a month or more, it may be generally true that it will become permanent, but I’d define a “few days” as at least two weeks, not 2 or 3 days.
If your tinnitus is as faint as you say it is, why worry about it? Just ignore it and most of the time you’ll not even be aware of it. And if in the process it disappears permanently, so much the better. The more you listen for it to see if it is still there, the more your brain will cooperate and make sure it is there and getting louder. That is why you just want to ignore it totally.
That’s about all you can do for now.
Cordially,
Neil
Hello doc, this is Ernest Wilson again. I’ve failed to mention that my ear feels full like they need to pop. They sometimes have little tiny pops through out the day. Sometimes my ear fullness comes and goes. Is that more bad signs?
And also a fan or white noise does not block it out
Hi Ernest:
A feeling of fullness in your ears after exposing them to loud sounds is a common side effect. That fact that it comes and goes is a good sign in my opinion. At least it isn’t there all the time. Over time hopefully in goes more than it comes. In other words you slowly get better.
Fans and white noise are not supposed to BLOCK tinnitus, they are just supposed to reduce the contrast between your tinnitus and silence, which makes it easier to bear the sound and to get to sleep. To actually block out tinnitus, you may have to have a sound so loud that it damages your ears and makes your tinnitus worse.
Cordially,
Neil
Hi Dr Niel!
I have the exact same symptoms as your original story.
I’ve always had trouble with my hearing since being pumped full of antibiotics as a toddler from contracting meningitis. This caused a havoc on my ears with tinnitus and hearing loss in the high frequencies. I’m 36 years old now, and it does feel like my tinnitus is increasing.
However, 5 days ago I used a snowblower on my driveway for about 1-1,5 hours wearing proper ear protection which were approved for – 27db. Everything was fine when I took a break. Then I did some more for 20min and when I removed my ear protection everything was horribly muffled on my right ear. The muffledness somewhat returned to “normal” after 1-2 days but the ear doesn’t “feel right”. Sound feels like it’s shifted left, especially when I hear my self speak. But at the same time, if I cover my ears and hum it sounds right in my head. My tinnitus started to get louder on day 3 on my right ear. So bad I’ve actually woken up at night from it.
Is there any hope things will return to normal, or will I have to deal with this sudden volume increase of tinnitus from now on?
Hi Christoffer:
I suspect that when you used the ear protectors for the 1.5 hours before you took a break, you had them properly fitted so they kept the sound out, but after the break, I’m wondering if you never got the ear protectors fitted properly in your right ear and this thus exposed your right ear to too much sound.
The muffled feeling often indicates you had a temporary threshold shift (temporary hearing loss). Fortunately, most hearing came back as the muffled feeling went away. However, not all came back and that is why you now have louder tinnitus as tinnitus often accompanies hearing loss from the loud sound exposure. It’s interesting that tinnitus doesn’t necessarily appear right away but waits a few days like it did in your case.
Have you had your hearing tested since this episode to see what your hearing status is?
If the tinnitus is due to noise exposure, I don’t see any reason why you can’t habituate to it in time. Basically, don’t focus on your tinnitus. Also, don’t treat it as a threat to your well-being. Rather, treat it as a totally useless background sound that you can safely ignore, then ignore it as much as possible and slowly you will habituate to it as it fades into the background.
Cordially,
Neil
I know this feed is old.
I got a new 12 gauge shotgun Aug. 18, 2020 and took it out in the desert and forgot ear plugs. I’ve always been very careful with my hearing, I though that only a few rounds shouldn’t be to bad. I shot 5 rounds and since then I’ve been having a ringing in my left ear around 16k or a bit higher. It’s almost been 8 weeks now. I’ve habituated it some but I’ll go out for a drive or other things that have never caused an issue and now it makes my Tinnitus loud all over again for a week. Am I past the point where recovery is a realistic hope?
Hi Jake:
It seems that now you have reactive tinnitus where louder sounds because your tinnitus to get louder as a result. Reactive tinnitus is actually a combination of tinnitus and loudness hyperacusis.
No, you are not beyond the point of recovery. It’s just that now you need to follow the treatment protocols for loudness hyperacusis, rather than for tinnitus. As you get your loudness hyperacusis under control, typically your tinnitus will also come under control without any special treatment.
If you want to learn more about hyperacusis and reactive tinnitus, you’d do well to read my book on the subject is just hot off the press this last week. You can get this book at https://hearinglosshelp.com/shop/hypersensitive-to-sound/ . The specific chapters that are applicable to your case are chapters 4 through 13.
Cordially,
Neil
Hello sir, I had fired about 12 rounds from a shot gun without hearing protection and afterwards experienced ringing in my ears and everything sounded muffled. it has been 3 days and the muffled sounds went away and my hearing is normal but I still have a ringing sound in my ear almost like crickets chirping but it’s not too loud. I’m concerned wether this is permanent or if it is only temporary? Thank you and I appreciate your advise
Hi Nathan:
Only time will tell whether your tinnitus goes away totally, however if it fades into the background and doesn’t bother you, then it doesn’t really matter whether it fades away totally or not. In the meantime, the big thing is not to worry about your tinnitus nor focus on it. This gives it permission to go away. Focusing on it does does the opposite.
Cordially,
Neil
HI Dr. Bauman. I went to the shooting range (wearing ear plugs improperly) 8 days ago and have experienced hearing loss in both ears, along with tinnitus in my left. My hearing is very muffled in both ears to the point that conversations are difficult to follow. I can deal with the tinnitus as I’ve had it previously, but I’m concerned about the muffled hearing and how long that will take to go away. I noticed you’ve said it may take 2-3 months and it’s a gradual process, I’m just concerned that I’m over a week removed from the incident and I haven’t noticed any improvement. Thank you for being such a great resource on this subject, your knowledge is appreciated
Hi Kevin:
Have you been to an audiologist and had a complete audiological evaluation. It would be good to do so, so you have a baseline of your hearing now. Then you can learn what your present condition shows and see any improvements/changes in the future.
Sometimes the muffled feeling is because your trigeminal nerve (which controls your Eustachian tubes among other things) is hyperactivated/inflamed and doesn’t let your Eustachian tubes work properly–thus giving the muffled feeling. If this is the case, you haven’t actually lost hearing.
Cordially,
Neil
Hello, I shot a single shot from an AR 15. It’s been 6 days and I feel a fullness or sense of something in my ear. Also along with a loud ring. It’s been 6 days and everything on the internet says it’s permanent. When I hear some noises it makes my ring louder and my ear hurt. Please tell me what this means? Will I have this ring forever?
Hi Reid:
I assume you weren’t wearing ear protectors, were you? Not a smart idea as you have found out.
It is common to have a feeling of fullness and have tinnitus after you ears experience a sudden loud sound.
I doubt “everything” on the Internet says the resulting tinnitus is permanent. Does my website say that? You need to get your information from sites that know, not the many people that “say” it is permanent without having any real knowledge of tinnitus and how to successfully deal with it. Just because theirs seems to be permanent (because they don’t deal with it properly), they like to scare everyone else by telling them it is permanent.
The truth is it may be temporary or it may be permanent–it all depends on you and what you do to successfully deal with your tinnitus.
Your ears have suffered acoustic shock–and common side effects are tinnitus, loudness hyperacusis, ear pain and a feeling of fullness–exactly what you are experiencing. And since louder sounds make your tinnitus louder, you also have reactive tinnitus.
This doesn’t just go away in 6 days–it takes time for you ears to “heal”–more like 6 months or longer so you have to be patient. And during all this time, you need to protect your ears from loud sounds so no listening to loud music, shooting guns, going to loud venues, etc.
And just as importantly, you need to NOT focus on your ears. The more you focus on them, the worse things become. So focus on the loves of your life and thereby basically ignore your ear problems. When you think of your tinnitus/hyperacusis as a threat to your well-being, it becomes permanent. If you treat your tinnitus as “no big deal” and not a threat to your well-being, your tinnitus will begin to fade into the background and not bother you anymore.
Cordially,
Neil
Hello again Neil, it seems nothing has changed except when I get away from noise and turn a low fan on, my tinnitus is not as server as when I’m just standing in public. What does this mean or does this mean nothing at all?
Hi Reid:
When you have a soft constant background sound on like a fan, it reduces the contrast between your tinnitus and silence so you don’t perceive your tinnitus as being as loud.
Cordially,
Neil
Hey doc About 3 and a half weeks ago my gun went off in my closet while I was cleaning it it was 1 shot and the blast caused instant ringing and muffled hearing my right ear is within normal levels of hearing my left ear suffered mid to high frequency hearing loss I saw an ent the very next day and got a steroid injection in the left ear the one that had the hearing loss it showed my 3/4 k frequency was all the way down to 60/65 decibels and my 6/8 k were at 60 and 85 a few days ago I went for another test and my 3/4K frequency were at 25 decibels for both and my 6k went from 60 to 45 and my 8 k from 85 to 70 I’m pretty sure my high frequency is gone but hopefully my mid returns to normal levels also I have ringing in both ears left is worse than the right sounds more like a low toned constant ring while the left is high pitched crickets type of sound was wondering if since the right ear suffered no loss can it be more likely that the ringing subsides in that ear at least and the left ear even though I hope gets better I’m not so sure I heard that these injuries could take up to 6 months to heal since I am at 3 in a half weeks at I doomed?
I also note my doctor prescibed Lopo flavonoid at our last meeting and I was taking magnesium aporatate right after this happened was I taking the wrong magnesium ? I hope that with time this can heal a bit more and the ringin can get a bit softer the right ear which suffered no hearing lose has a low toned constant ring while the left ear the one with damage has a high pitched crickets ring I also have been wearing earplugs at work and anywhere loud I guess my question is am I doomed ? I am at 3 in a half weeks now everywhere I have read says past 2 weeks is permanent smh I don’t know what else to do I hope you reply I hope some more healing can take place over the next few weeks to months THANK YOU DOCTOR
Hi Nathan:
Cleaning a loaded gun is not the brightest thing you’ve ever done, as I’m sure you now realize. You experienced acoustic shock and it was exacerbated by the small size of the closet and the unexpectedness of the loud gunshot.
It’s good you saw an ENT the next day and got Prednisone. What I would have also done is got N-acetyl-cysteine (NAC) and taken close to 2,000 mg a day for the next two weeks. That probably would have done more to protect your hearing than the Prednisone.
Your audiogram revealed only SOME of your hearing loss, but your ears also have developed hidden hearing loss–hearing losses that do not show up on your audiogram. So there was more damage done than the audiogram indicates. You probably have hearing loss in the high frequencies above where they stop testing at 8,000 Hz. You also will have developed Noise-induced hidden hearing loss also called auditory synaptopathy.
If you are interested, you can read more about hidden hearing loss in my article at https://hearinglosshelp.com/blog/hidden-hearing-loss/ .
Normally, I tell people that the hearing they have at 30 days after the incident is probably the hearing they will have going forward. Since you are at about 4 weeks now, I wouldn’t expect much more hearing to return.
Since your 3/4 KHz are now at 25 dB, that is considered normal. It’s actually right no the normal/mild hearing loss line.
The one thing that might still help you is some sessions of Hyperbaric Oxygen Therapy (HBOT) if there is such a clinic near you.
Lipoflavonoids may help, but there are no large scale studies proving they do so. But they won’t hurt, so feel free to take them.
The best (most bioavailable) magnesium is magnesium threonate, but other forms of magnesium ending in “ate” will also work, just not as well.
You definitely are not doomed. Yes, you will have some degree of hearing loss going forward, but you can learn to successfully live with it. Perhaps in a couple of months, you should go to an audiologist and be evaluated for hearing aids if they will help you.
Your tinnitus can fade away into the background so it will not bother you if you treat it as an unimportant noise that is NOT a threat to your well-being in any way, and thus a sound that it is safe to ignore–then ignore it by focusing on the loves of your life.
Cordially,
Neil
Hello I got tinnitus about a month ago and hyperacusis after getting these I started to develop 1 eye floaters in each eye. I am 26, does that mean something serious, could they be related. I also have always felt with anxiety.
Hi Clayton:
As far as I know, floaters in your eyes are not directly related to ear problems such as tinnitus and hyperacusis.
What caused your tinnitus and hyperacusis–attending a loud concert or other loud venue?
Cordially,
Neil
Is Trazodone safe to take with tinnitus, or will it make it worse? I heard that it is ototoxic and that’s bad for tinnitus. What’s your take on it?
Hi Clay:
Trazodone is moderately ototoxic in my opinion. Numbers of people get tinnitus from taking this drug, so I’d be careful. This doesn’t mean it will make your existing tinnitus worse, but there is the risk that it can.
Cordially,
Neil
Hey Dr.,
Really hoping for advice and guidance as I am super stressing right now. Any guidance from audiologists or doctor’s in the forum would be so great and much appreciated
Situation:
Recently joined an indoor range. This range is one where you get private shooting rooms, so I’m not shooting with other people, so only exposure to sounds was my own gun fire. Shooting a 9MM handgun for 45 minutes with a private instructor. The room is about 400 square foot in size. I fired about 35-40 rounds in 45 minutes intermittently among dry fire practice with the instructor and used Pro Ears 28 HTBT in-ear protection. After the session, my ears are now stuffy, full and ringing. Been about 36 hours so far with no improvement. My ears feel stuffy like they’re muffled and constant ringing ( heard prominently in quiet environments and barely in busy environments) No pain. I did a hearing test with my AirPods using MiMi hearing test and apparently have no hearing loss. I was at an ENT just 6 months ago who also did a professional hearing test and they said my ears are perfect at that time. Typical that the one part of me that’s never had a health issue now has a health issue from my own stupidity. Most frustrating is the hearing protection I used was an expensive set of protection but I clearly did not use it properly.
Went to Urgent Care who was helpful and prescribed a tapered Prednisone 30 MG tapering down to 5MG over 6 days and gave me a shot of steroids too. Bye said no visible damage to the ear drum or tympanic membrane or canal.
I am going to double up going forward, foamies + high end Sordin Muffs I just bought (Lesson learned!). It being July 4 weekend, I can’t get to a doctor (other than an urgent care or ER which I expect will be a waste of time and money). Should I expect this feeling in my ears to be permanent? I assume it could be permanent but hoping not. If not permanent, how long am I looking at before feeling better? Any guidance or personal stories would help. I see so much negativity about this on other forums. It feels like I’m fresh out of a loud concert right now and panicking.
Thanks everyone!
Hi Tim:
The ear protectors you used have a 28 dB reduction factor if I understand it correctly. Your 9mm produces a sound of 126 to 160 dB (I see both figures listed but don’t know which one is correct for your gun.
If the 160 dB level is what you actually experienced, 160 – 28 = 132 dB that you ears were still exposed to (and that is assuming your inserted them correctly) which is still much too loud for your ears. If the sound level was just 126 dB, then your ear protectors should have given you a maximum of 98 dB and that should not have resulted in any problems. Thus, I think the 160 dB figure is probably more realistic.
Your new Sordin Muffs together with foam ear protectors is what you need in the future in order to prevent more ear damage, or get a silencer for your gun, or both.
When your ears are still feeling stuffed up after 36 hours, I’d say that you have indeed suffered from some hearing loss. Did you test your hearing up to 20 kHz or just up to 8 kHz which is normally done? You could have “perfect” hearing below 8 kHz, and yet have massive hearing loss above that. So unless you check up to 20 kHz, you don’t know that you have hearing loss or not.
In addition, you could have another kind of hidden hearing loss that doesn’t show up on the audiogram that is called auditory neuropathy or cochlear synaptopathy.
You’ve done what you can do now–taking the Prednisone. Now all you can do is wait AND protect your ears from louder sounds for the next couple of weeks to give them a chance to recover. I’d expect the tinnitus to fade away in a couple of weeks or so (if it is going to fade away). It may or may not. A lot depends on your emotional attitude. If you treat your tinnitus as just a useless background sound that is safe to ignore, it will likely fade away in time. However, if you treat your tinnitus as a threat to your well-being, then your limbic system will not let you ignore it and it can become permanent. So a lot depends on you. You need to calm down and not panic. Focus on the loves of your life, not your tinnitus and the feeling of your ears being blocked. In any case, that feeling should fade away in time.
Incidentally, reading all that scary stuff on so many on-line forums just raises your anxiety levels and makes things worse. That is why it is a good idea to stay away from them so you don’t destroy all your hope that you will get better as time goes by.
Cordially,
Neil
Thank you, Dr. Much appreciated. I will absolutely attempt to focus my attention away from the Tinnitus.
My I ask, you mention the tinnitus potentially fading away, is the stuffy ness I feel also temporary or is that likely to be potentially permanent too? It essentially feels as though there is a clog or some water in the ear. Thanks so much!
Hi Tim:
Typically, the stuffy feeling goes away when hearing returns (typically in a few minutes to a few hours to a few days), or as your brain gets used to the new normal. I would not expect it to be there long-term.
Cordially,
Neil
Thank you, Dr. I appreciate your response. I have begun taking my steroid pills today, and will update you on my progress. It is a low-dose of six days. In the interim, should I also be taking some of the supplements that you’ve mentioned on other answers throughout this post? I have ordered NAC I’m currently take a multivitamin that contains several of the Vitmans ABCDNE.
I wanted to seek your recommendation on how long I should stop shooting fall. This morning I woke up and it seems that the fuzziness in the ear is slightly better but the Tinnitus has actually gotten louder. Is it normal for this to happen? The doctor that I saw at the urgent care assured me that this is likely temporary and he suggested I could go back shooting within 7 to 14 days, which seems a little optimistic in my opinion. I am also very nervous about going now. As the expert, could you make a suggestion for me for how long I should postpone? Should they be a time limit on it, or should it be once the tinnitus subsides? Thank you again!
Hi Tim:
To the various vitamins, I’d recommend taking magnesium and zinc–two important minerals your ears need. The most bioavailable forms are magnesium threonate and zinc picolinate. I take both daily just for good health. And of course the NAC–however it would have been best if you had begun taking the NAC right after this happened.
If it were me, I’d stop shooting until my ears get back to normal, or their new normal. That would be at least until the stuffiness/fuzziness goes away. This could be in two weeks or so, but it could be 2 months or so. Each person is different. So much also depends on your emotional makeup. If you are high strung and are worried and anxious, this just makes matters worse. So learning to remain calm makes a lot of difference as to how your tinnitus behaves.
Give your ears two more weeks (and don’t worry about them in them in the meantime by focusing on them). After two weeks, you can look back and see how much improvement you have made. Spend your time focusing on the loves of your life–non on your ears and your tinnitus.
Cordially,
Neil
Hello Dr.,
I am returning for an update on my hearing situation. The last 6 weeks were interesting with some days being worse than others. I specifically chose to ignore my tinnitus and go on about my daily life enjoying things as you described and noticed that it improved, though never subsided. I still listen to white noise at night to mask it. I bought Sordin Supreme Pro X Ear Muffs and went to an audiologist and got custom on ear protection made specifically for my ears that have a an NRR of 24-29. The over ears are 19 NRR but in reality sit around 25 NRR for the frequency of gun shots.
All this said, today I returned to the range and shot the same gun (about 40-50 shots for me and the same for my fiancé) and used my doubled up protection. It was a private range so was just my fiancé and I shooting. My Apple Watch clocked 118 DB while at the range but that was max, though I know handguns can be up to 155-160.
Upon arriving home, I noticed my tinnitus was more noticeable and the right ear was stuffy again. It doesn’t necessarily sound any louder and is still masked by regular background sounds, but it is definitely noticeable in quiet environments. The last few weeks I have sat in silence several times and not been bothered by my ears and sometimes forgotten about them entirely. It was almost as though I had tuned them out, but now it feels like they are back to how they were the day I got home after firing the first time and causing the damage.
What’s strange is prior to me causing the damage I had gone to the range with much less protection and did not get ringing of any kind. Likewise, my fiancé has come with me on every trip and worn over ears only and has not had a single issue with ringing.
Could it just be that my ears are sensitive and I should just give up shooting? Or do you think it’s more likely to do with my mental awareness of the tinnitus and fear of it returning by shooting that has triggered this relapse and awareness of it/volume perception increase? The right ear seems to be the stuffy one again which is the one that is angled towards the firearm when shooting.
It just seems strange to me that even with shooters custom in ears and over ear I am having issues. Yet, my fiancé has no issues at all with far less protection. I wanted to get your thoughts and advice!
Also one other interesting nugget is I have found a YouTube video that if I listen to it, makes my tinnitus vanish completely and just turn to a low level static. It does come back after minutes but sometimes it calms it the rest of the day. Linking below:
https://youtu.be/4LZv3ta13Ws
Thanks so much for your guidance!
Hi Tim:
It is common to have better and worse days. But ignoring your tinnitus was letting you begin to habituate to it so it no longer bothered you. You are doing the right things.
You are also doing well in getting both in-the-ear ear protectors as well as earmuff styles and using them together. Unfortunately, don’t assume that when you have double ear protection that you can just add the two protection factors together–the 29 and 19 and get 48 dB of protection.
This is not the way decibels work. The truth is that 29 and 19 dB equals just 29.4 dB. not 48 dB. And if you assume the 24-29 ear protectors have an average of 26 dB of protection and the 19 dB protectors have a noise rating of 25 for the frequency of the gunshots, adding 26 dB and 25 dB still only equals 28.5 dB.
So you are getting a bit more protection, but not the big difference you were expecting. Thus, you could still be hurting your ears. You are assuming that your dB app was accurate at 118 dB, but this seems low to me. I’d expect it up around 140 to 160 dB. Where were you holding your watch to get this reading? Was it at your ear with the microphone facing forward just like your ear was?
Your ears may be much more sensitive to noise now than they were before you took up shooting. If so, I’d expect them to remain this way in the future as some noise damage has already occurred.
It’s up to you whether you give up shooting or not. You might first try reducing the shots you expose your ears to. For example, don’t be around your fiance when she is shooting. That would reduce the number of shots by half. And you could reduce your shots by half or more too.
Any fear/anxiety could make the resulting tinnitus worse, but it seems more likely that you need more protection–which is hard to do (or better yet, a quieter gun) since your right ear seems stuffy indicating that they noise is still too much for it.
Thanks for the Youtube URL. What you experienced is auditory neuromodulation which can eliminate or reduce high-frequency tinnitus in some people. It doesn’t work for everyone, but it really does work for some people. You are one of them. (I tried it and it just made my tinnitus louder.) Since it works for you, use this auditory neuromodulation file and calm your tinnitus down.
Incidentally, neuromodulation is the darling treatment of the tinnitus industry at the moment. There are several kinds of neuromodulation therapies–acoustic, electric, magnetic, haptic, and bimodal combinations.
Cordially,
Neil
I shot a 357 magnum pistol today. I am right hanged and had a hat over my ears. Yes I know now ear protection is a MUST HAVE but I have very minimal hearing and what feels like something in my ear…it also hurts to hear a somewhat loud noise. What do I do to return to somewhat of a normalcy in terms of my hearing? Should I see a doctor?
Hi Stephen:
What I’d do if I was in your shoes would be to take N-acetyl-cysteine (NAC) NOW–today. You can typically get it at a drug store or health food store. I’d take up to 2,000 mg a day for a week or so. In addition, I’d take Zinc picolinate (the most bioavailable form of zinc) and magnesium threonate (again, the most bio-available form of magnesium) as well as vitamins C and E. That will help mitigate the damage and help your ears recover.
Other than that, I’d be careful not to expose your ears to louder sounds for the next month or more to let them heal. As time goes by, your ears should be able to tolerate louder sounds until they are back to normal. This could take several months–so don’t rush it.
Cordially,
Neil
Hi,
I think I suffered some form of acoustic trauma from the symptoms you’ve described above from attending live music for around 40 minutes. I went to doctors specifically asking if I should take anything to help the healing process and they said there was nothing to do, and steroids were a bad idea. It’s now 4 weeks later, and I still have ringing. My hearing is relatively unaffected although I did not get a hearing test.
What use do these have in mitigating hearing damage and is it completely time sensitive? N-acetyl-cysteine, Zinc, magnesium threonate, vitamins C and E.
In another response you said to avoid loud environments to let your ears heal. Is it ok to attend bars etc with hearing protection, earplugs, in?
Thank you
Hi Mary:
After 30 days, things are pretty much decided in regards to any hearing loss and recovery. As for the tinnitus, it may fade away in time. So I wouldn’t expect the above supplements to make much difference now. Mind you, they are all good for your health and your ears. I take them every day for that.
If you go to loud venues such as bars, you want to wear ear protectors in the future. Your ears take time to heal, but you want to protect them so things don’t get worse in the future. If your ears ring louder after you go to a bar, then you know that your ear protectors aren’t strong enough and you should stay away from the noisy ones.
Cordially,
Neil
Hi Stephen:
Your ears have suffered acoustic shock. What they need most is time to heal and to do that they need relative quiet. You need to protect them from loud sounds while they heal. This could easily take 2 or 3 months or longer, depending on your ears. And in the future don’t forget to protect your ears from all such loud sounds.
Cordially,
Neil
Hi Dr. Neil,
When in acoustic shock I believe I exposed my ears to another loud sound through headphones as I didn’t know what I was experiencing at the time. The db averaged about 45-55. I don’t think it went on more than a couple of seconds but can’t be sure. It felt loud however. In another situation I was stuck in two loud classes for an hour.
How dangerous is this in terms of delaying healing or permanent damage, in your opinion?
My ear protection arrived late that week and I wore it since, and limited noise exposure without protection.
Thank you very much
Hi Mary:
Exposing your ears to 45 to 55 dB shouldn’t hurt your ears. That is in the normal range for human speech.
Being stuck in too loud classes for an hour each could set you back, but unless the sound level was excessive, it shouldn’t cause permanent damage.
As I’m sure you know from reading my posts, it takes time, often several months, for your ears to heal and get back to normal.
Glad you got your ear protectors. Wear them as needed, but don’t wear them unnecessarily or they can make things wore over time.
Cordially,
Neil
Dr. Neil, I hurt my left ear 9 days ago from a gunshot. I have tinnitus from it but when I put sound proof ear plugs in and headphones I can hear my heart beat. Also say when I have these protectors in, when I swallow I can hear the surrounding sounds get louder only in my right ear which is the one that is healthy. What does this mean? Is the eustachian tube dysfunction or inflammation? Can I fix this or what should I do?
Hi Jack:
As far as I’m concerned, this is nothing to worry about. When you block your ears so sounds can’t get in, you become aware of the conductive sounds your body makes such as your heart beating, etc. When you take your ear plugs out, this goes away, doesn’t it? If so, that is perfectly normal.
Cordially,
Neil
I had a sudden balloon explosion near my right ear,it has been 15 days my tinnitus is driving me crazy!is it permanent?it has really depressed me,will i be able to feel silence again?
Hi Rahul:
Rather than dwelling on your tinnitus and how it makes your feel, focus on the loves of your life and let your tinnitus fade into the background. Then, whether it is permanent or not, it won’t bother you.
I don’t think I’ve ever “heard” silence. I can always hear my tinnitus but I choose not to let it bother me–and I’ve had tinnitus for more than 60 years now. You can learn to do the same.
Cordially,
Neil
Did it ever go away? I’ve been suffering from a high pitched tinnitus for about a week now from firing a gun without protection
Hello, I have the same problem except that i didn’t hear a loud sound but was practicing diving in a 5m pool, i did have trouble equalizing my ears and it hurt a little on the bottom of the pool, but the problem only started in my right ear, is it possible that the damage is permanent? What could i do to recover faster if it isn’t?
Hi Mary Jane:
Are you saying your tinnitus began from diving down 5 meters? I don’t think I’ve heard of that. You should feel the pressure on your ears when 15 feet down, but you don’t stay there so when you come up the pressure should go away. Are you also saying that you swallowed while down there to equalize the pressure at that point? If so, why do that? The pressure would be equalized in a few seconds when you come up.
Cordially,
Neil
I shot my handgun without protection for only a few shots, woth no ear protection unfortunately, and now my right ear has been muffled for two days plus now I hear real low volume ringing aswell , will this ringing resolve on its own?
Hi Cory:
It probably will go away eventually. If your hearing is muffled, that indicates you have some hearing loss and until that resolves, you likely will have the tinnitus since tinnitus very often accompanies hearing loss.
Your ears probably experienced acoustic shock and that can bring on other problems, so you should always wear ear protection when exposing your ears to loud sounds–especially sudden loud sounds. Avoid loud sounds for a few weeks to give your ears a chance to heal.
Cordially,
Neil
Thanks Neil, Its been 6 days since my exposure and the muffledness is gone but I still have some tinnitus and sensitivity, since its only been 6 days, is my ears still able to heal more? Also theres alot of misinformation on the web, and these last couple mornings waking up I have no tinnitus, but after im up an hour or two, I slip up and worry it might come back and keep trying to listen for it, and in my case Ive had bad anxiety before this recent noise exposure, so does anxiety and thinking about it make the tinnitus seem actually louder and worse the it actually is? Thanks for all your feedback!
Hi Cory:
The muffledness was a degree of hearing loss–so its great that it is gone. This means your hearing has returned to normal or near-normal levels again. The tinnitus needs more time. So does your sensitivity to sound. See how things are in 2 or 3 more weeks. But don’t try to hear your tinnitus or your limbic system will cooperate and turn up the volume. Just ignore it and let it fade into the background. In the meantime, protect your ears from loud sounds to give the sensitivity time to heal. This takes time and every time you expose your ears to loud sounds during this time, you just set yourself back again.
I agree there is a lot of misinformation on the internet. For example, I just read a research report that showed that 42.7% of the information on Facebook pages about ears is just plain wrong and much about tinnitus is maliciously wrong–they are trying to get you to buy their useless product to get rich at your expense.
You tinnitus is going away if it is gone in the morning when you wake up. But you are undoing the good by 1) worrying about it–this will just make it worse, and 2) by listening for it and straining to hear it. This just sends a message to your limbic system that this sound is important and to turn the volume UP, not down. So, get your anxiety under control because anxiety over your tinnitus and thinking about it does indeed make it worse.
Just answering this comment has raised the level of my tinnitus–and I’ve had tinnitus for more than 60 years so I know how to deal with it. That’s what thinking about it does. But the good news is that I am so habituated to my tinnitus that within 5 minutes of completing this comment, I won’t even be aware I have tinnitus (although it is always there). I choose not to let my tinnitus bother me. You can choose to do the same.
Cordially,
Neil
Dr. Neil, I was at a indoor shooting range yesterday and while I was wearing proper heating protection I still got a ringing in my ears, nothing new here. My ears still feel a bit muffled. Also, I have been wearing heating aids in both ears for a few years now. Should I have taken the heating aids prior to entering the range. Having them on allowed me to hear the instructor clearly. What is your opinion, please.
Hi Luke:
I would never wear my hearing aids and ear protection at the same time. This is because the hearing aids work against the hearing protection by amplifying sound that you want to suppress, thus effectively reducing the protection factor. I think that is why you had muffled hearing and tinnitus as a result. Without your hearing aids, I think you wouldn’t have had these side effects.
What I’d suggest in the future is wear your hearing aids while the instructor is talking, then before any shooting begins, take your hearing aids off and put on the ear protectors.
If your ears are sensitive, you may need to wear double protection–the foam ones that fit in your ear canals and then the big ear muff ear protectors over your ears.
Let your instructor know that when you take your hearing aids off, you are going to be deaf, so he needs to get your attention visually.
Cordially,
Neil
Thank you, Dr. Neil. Do you suggest any supplants, or did I make more permanent damage.
Hi Luke:
Since it is only 3 days later, you could take N-acetyl-cysteine to help your body zap the free radicals that are formed from loud sounds. I’d take around 1,800 mg a day for a week or so. But you have to get started now as most of the free radicals do their damage in the first 3 days or so.
In addition, I always recommend taking zinc and magnesium as these two minerals are very important to your ears working properly and helping in repairs. Personally, I take the most bioavailable forms of these minerals, namely zinc picolinate and magnesium threonate. (I take these two supplements every day–just for good health.)
Cordially,
Neil
A very informative read describing exactly what I seem to be suffering under similar circumstances. My example was hand gun fire in an indoor range with earplugs – the last 3 or 4 shots were noticeable loud. My question is that I spent the next 24 hours with an ear plug into protect from further damage but today on day 2 after I’m not sure if this has helped – so should I keep a plug in for the next few days except at night or allow my ears to breath. Just normal office ambient noise is my daily work environment. How long after no noticeable improvement should I seek a doctors opinion?
Hi Paul:
You shouldn’t be wearing ear protectors unless the sounds are loud damaging sounds. If you wear ear protectors unnecessarily, you can develop hyperacusis and that’s not fun.
But you do want to give your ears a rest by avoiding loud sounds for a few weeks whether you wear ear protectors or not.
Cordially,
Neil
Thanks for the advice Neil. I have indeed left the plugs out unless I go into the workshop. Muffled sound has gone just a ringing now – fingers crossed it starts to ebb away over the next days / weeks – I’m a little concerned I have to admit!
Hello, Paul. How are you?
Were you able to get better? And How long did it take?
I’m in the U.S Army. I shot roughly 40 rounds without ear protection. Its been about a week. I have gained a good amount of hearing back but when touching my left ear (the one that I lost hearing in) just the touching alone feels/sounds different than normal. That ear still hasnt regained all its hearing. Like I said its been about a week now.
Hi Stephen:
When your ears suffer noise trauma, it takes time for them to recover–in could be a few days, or a few weeks or 2 or 3 months, depending on various factors. You need to be patient.
Cordially,
Neil
I just went shooting yesterday with my son at an indoor shooting range I had proper ear protection on but when I took it all off I could barely hear anything out of either ear this morning when I woke up my right ear seems to be doing fine but my left ear is still very muffled and I can barely hear out of it it has to be a bit concerned it feels like there is a slight hum in my ear any suggestions or advice?
Hi Ed:
It seems you suffered noise trauma in spite of the ear protectors. Either you weren’t using the properly–they didn’t fit tight enough–or the protection factor wasn’t high enough for the gunshot volume.
Typically, things will right themselves in a few days. You one ear did that overnight, and your other ear is probably ok now. It just takes time. Give your ears a few days rest from loud sounds.
Cordially,
Neil
Hello, Ed. The same thing happened with me yesterday. I’m worried and taking care of my ears now.
How long did it take for it to go away?? And what did you do?
Best regards.
Reading this guys story is like reading about my life for the past 11 years, i have the exact same type of tinnitus brought on my noise trama, lately it has got worse and normal conversation vibrates through my eardrums, i have become extremely depressed and anxious and see no light at the end of the tunnel
HI Neil,
Do a lot of peoples tinnitus eventually take off like this gentleman’s did ? I think that is something that leads to a lot of my anxiety is that I just wonder how much more time I have before it becomes unbearable. My tinnitus is also from loud noise. Thanks for your input.
Hi Justin:
Tinnitus is largely a psychosomatic condition. That means there is a physical and a psychological component. So you need to treat the psychological component, because left untreated your anxiety is just going to get greater and greater. You’ve got to rein it in and learn how to properly deal with your tinnitus. My book, “Take Control of Your Tinnitus” gives you a lot of information on how to do that. See chapters 16, 17, 18 and 19 for specific help on how to do that. You can get this book in printed or eBook form from http://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/
Cordially,
Neil
I currently have tinnitus from shooting in my left ear. I’ve had it for roughly 5 years now. Hunting is a passion. Can I do more damage to my tinnitus even with wearing double protection (plugs and muffs)? I have done a bit of hunting the past few years and I do feel like it increases the tinnitus for a few weeks and then goes back down but that could be the anxiety about the tinnitus getting worse. I normally wear NNR 33 plugs and NNR 30 muffs.
Hi Justin:
If you are wearing NNR 33 ear plugs AND NNR 30 earmuffs on top of them–and assuming you have installed them properly so they fit tightly, I don’t see that you will harm you hearing or increase your tinnitus, so you can rest easy on that score. However, as you surmise, anxiety can play havoc with your tinnitus. So it is likely your increased tinnitus is more related to your increased anxiety than anything else.
Now that you know you won’t damage your ears, relax and enjoy your next hunt. Bet you tinnitus won’t rise this time.
Cordially,
Neil
Hello Doctor Neil Bauman. I have tinnitus for 1 and a half year. I dont have hearing loss. I was going out to nightclubs from time to time and always had earplugs. Sometimes in the next days I had tinnitus spike for 3-6 days but return to moderate tinnitus after that. However I was very stupid to go in shooting range for just once. I weared both earplugs ( sillicon on right ear and on left some cheap material ) and earmuffs. I shooted maybe 40 rounds and my mother was 2 or 3 meters next to me shooting just like me. I had tinnitus spike like always which lasted for 1 week. After that I was back to normal but after 2 weeks after the shooting now I have hyperacusis. On some moments is moderate but on some moments is severe. Im afraid that my H will last forever just like my tinnitus. Will my hyperacusis ever goes away ? After 15-20 days I still have pain and pressure in my ears from some normal sounds.
Hi Marko:
It sounds like your earplugs weren’t enough and thus your ears suffered acoustic shock. This can include tinnitus, hyperacusis as well as things like ear pain and feelings of pressure.
The proof of this is that your tinnitus spiked. It shouldn’t have done that if you had good earmuffs that were properly-fitted.
Hyperacusis is something that you have control over. You do not have to let it last forever. Hyperacusis has two parts–a physical part and a emotional/psychological component. You need to deal with this latter part while carefully controlling your sound environment while you recover.
It will take time and effort, but you can do it. And in the future, be more careful of your ears so you don’t suffer more grief in the future.
Cordially,
Neil
I fired a confetti shooter by accident and it was a bit too close, when the bang went off my ears were ringing for about 5 seconds and then my right ear was just muffled, this happened yesterday and this morning my ear seems a bit less muffled but still not great and when I speak the bone near my ear vibrates and feels funny? What should I do and will this recover? There is no ringing of tinitus just muffled hearing.
Hi James:
Muffled hearing is typically a temporary threshold shift (temporary hearing loss). Usually it goes away in a few hours to a few days and then things appear to be normal again. So you need to give it a bit more time. However, underlying permanent damage may also occur (the so-called hidden hearing loss) that typically makes it more difficult to understand speech in the presence of louder background noise.
You can read a couple of my articles that deal with what you can take to help alleviate any potential and present damage at http://hearinglosshelp.com/blog/loud-music-and-hearing-loss/ where I talk about the value of N-acetyl-cysteine in the latter part of this article and other vitamins you can take in this following article http://hearinglosshelp.com/blog/vitamins-a-c-e-combined-with-magnesium-help-prevent-noise-induced-hearing-loss/.
Cordially,
Neil
Hi Neil,
Update: my hearing in my right ear is back to normal from what I can tell, however I have tinnitus when I go to bed, I had a read about tinnitus and I understand that it occurs at night because there is less noise but I was wondering if it will go away in maybe the next few weeks or months? Or if not gone in a week should I see a doctor?
Hi James:
Glad your hearing is back to normal. You probably have tinnitus all the time, but you only hear it when it is quiet and your mind is not otherwise engaged. Thus you perceive it at night. It may fade away over time, or it may persist, but it really doesn’t matter if you just ignore it and treat it as a totally useless and unimportant background sound. This gives your brain permission to let it go so it won’t bother you whether you hear it or not.
As for going to a doctor, what do you expect him to do/say–apart from “There is nothing medically I can do. Go home and learn to live with it”.
Cordially,
Neil
Hello my name is Chris and today I was shooting my first ever pistol and completely forgot to cover my ears. Now my left ear very muffled along with lots of ringing. Is there any chance that this could be permanent, if not how long will this last
Hi Chris:
Anything is possible, but it is unlikely that your tinnitus will be permanent. The muffled feeling (really a temporary hearing loss) should go away within the week. Your tinnitus will likely take a bit longer. You should be back to normal in a month or less if you don’t worry about your tinnitus. Just ignore it and let it fade into the background.
And next time wear ear protectors–which I’m sure you will.
Cordially,
Neil
Hey Neil, I’ve had dining for just over 1 month after shooting a 45 outside with bad hearing protection, I’ve seen an ENT and taken ear steroids. Is there a possibility that this will go away? And how long will it take? Thank you.
Hi Armin:
It may go away, or fade into the background in time. It could take a month or it could take 3 years or more. It all depends on how you treat your tinnitus. If you treat it as a sound that is totally unimportant and not a threat to your well-being, it will tend to fade into the background in a few months and not bother you so it doesn’t matter if it goes totally away or not. However, if you worry about it, and thus treat it as a threat to your future well-being, it probably will never go away.
Cordially,
Neil
Hey Neil, Thanks again for the quick response, and I just want to thank you for all the help, your a true blessing. Ive learned more TRUTH from you in the last couple posts then my countless hours of googling, which looking back was a big mistake, soo Please keep doing what your doing, I know your helping lots of people!
Doctor, I went shooting at an indoor range on Dec 29th. I utilized double hearing protection. Orange foam plugs and “slim” over the ear muffs. I had no immediate symptoms. A couple days later maybe January 3rd I had ringing in my right ear. Now it is January 8th and I have a constant high frequency ring in both ears. Internet searches have taught me a about tinnitus. I am wondering if I damaged my hearing by shooting even with hearing protection. I shot a bunch a rounds 45 cal acp and just about 10 rounds of 44 magnum. I have been shooting for years and never had any issues but I have never shot a 44 mag indoors before. Could hearing damage be caused by the sheer percussive impact of the 44 magnum? Do you think the ringing will stop? I am seeing an Ent doctor next week. Any input would greatly appreciated. Thanks.
Hi Steve:
Either your ear protectors weren’t seated properly, or didn’t have a high enough noise rating, or your ears were on their “last legs” so to speak after enduring gunfire from the past and this was the “straw that broke the camel’s back” or your ears are just plain sensitive to sudden sharp sounds.
Normally, you’d expect the tinnitus to appear right away if it was the gunshots and you’d have a muffled feeling from a temporary hearing loss. Since that didn’t happen, I think your ear protectors were adequate. Since your tinnitus only began around 5 days later, I’m wondering if you experienced acoustic shock for some reason.
If the percussive impact were the culprit, you still should have experienced the tinnitus and muffledness right away, not days later as I see it.
Probably the ringing will go away. Give it a couple of weeks and see. But there are no guarantees.
Were you taking any medications in the two weeks before this happened? Some drugs can lower the level at which noise damage appears.
Cordially,
Neil
Hey Neil Cory again, my tinnitus seems to go up and down in volume through out the day, is that fairly common during the healing process of my ear?
Hi Cory:
Everyone is a bit different, so it is hard to say, but I’d say this is a good sign because if it can go down in volume for a while, it can go down for a long time. It shows you are not stuck at a high level of tinnitus.
Cordially,
Neil
Thanks Neil, and last but not least I want to ask you this question because I know you’re very knowledgeable on the subject, is it true that Ears take some time to heal, like maybe up to a few months to recover from gun shot sound like I experienced? Reason I ask is I don’t wanna think that they cant get any more healed, In my case it’s been two weeks and I just want to know if there is still time left that they can still keep getting better/healed?
Hi Cory:
Yes, it’s true. Your ears become sensitive to sounds, and it can take a long time to get this sensitivity back on track–up to 2 years or even more in severe cases. Two weeks is far too little time to start worrying about this.
Cordially,
Neil
Ok good, im just glad my ears can still improve. Thanks Neil
How can someone not worry when earlier in your posts you say it’s permanent after a month?
Hi Reid:
If your tinnitus doesn’t go away or get softer by the end of 30 days, there is a good chance it may become permanent–but that is not a given. And even if it did become permanent, if you correctly deal with you tinnitus, you’ll habituate to it so it won’t bother you. Therefore, whether you hear it or not doesn’t really matter. I’ve had tinnitus for more than 70 years now–but it’s no big deal. I don’t let it bother me. You can do the same.
Cordially,
Neil
Sir: I’ve had diagnosed permant hearing loss from a photo shoot several years ago…. tinnitus along with it. I’m also a competitive shooter nowadays. Hi-power rifles. I’m extremely aware of hearing protection and “double up” with some of the best in the ear and muff that money can buy. However tinnitus and hearing continues to get worse. It’s been suggested that rifle shooting, that requires a solid cheek weld to the gun, is causing more damage thru some Avenue other than thru my protected ears. Help me understand if this could infact be true and how I could reduce the damage other than giving up my passion.
Hi Doug:
How do you get hearing loss and tinnitus from a photo shoot of all things?
On the other hand, I can certainly understand how that could happen since you are a competitive shooter.
Loud sounds damage your ears as you know. Sounds reach your ears in one of two ways–via your ear canals (called air conduction) and via vibrations through your skull (called bone conduction).
You can only protect your ears so much with ear protectors (about 30 dB). So if your rifle is producing say 160 dB blasts, the ear protectors reduce this to around 130 dB–which is still much too loud for your ears. The sound gets to your ears via bone conduction. The tighter the coupling of the rifle to you skull, theoretically, the louder the sound would be via bone conduction.
But holding the rifle loosely would mess up your aim so that is not a good solution either.
I know some rifles (and loads) are louder than others, so finding a quieter rifle and using less powerful loads might be worth trying.
The other thing would be to limit the number of rounds you fire off in a given day since ear damage is related to the volume of the sound times the duration. And stay away from other shooters too so you are not absorbing those blasts on top of your own.
There is no foolproof solution as I see it unless you use guns with silencers on them to get the volume way down.
Cordially,
Neil
Thanks Neil for the quick response. I’m going to look around for a gel cushion that could be used on the cheek rest. Maybe that could help??
BTW- the photo shoot was a teen rave. I stupidly stood right in front of a stack of speakers. No pain so I thought all was ok. Boy was I wrong.
Hello Dr. Neil,
2 days ago someone shot a blank really close to my right ear, and I felt like it was one of those movie scenes when bombs explode. I heard a really loud tinnitus, that lasted about a minute and then faded away, but it has not disappeared yet. I am starting to be really worried this might be something serious, My ear does not hurt or anything but the tinnitus is there. I don’t really know if I hear different or not…
Hope you can help me,
Thank you
Hi Juan:
Sudden loud sounds can certainly cause tinnitus. Typically the tinnitus fades away in a few hours to a few days. However, if there is associated hearing loss, which may include hidden hearing loss, the tinnitus may persist as long as you have a hearing loss.
The big thing is not to obsess over your tinnitus and focus on it all the time. This just makes it worse. It is much better if you focus on the loves of your life and totally ignore your tinnitus and let it fade into the background over time.
Cordially,
Neil
I’m about to be 80 year old female. I have had tinnitus for about 5 years. Seven days ago I was 2 feet from a person in a home when his gun discharged unintentionally. My tinnitus is now louder and one ear still has a little stuffy feeling. I’m trying to decide whether to see my ENT doctor or wait a while. Will flying have any adverse affect on my ears at this time?
Hi Marcella:
I don’t think that flying will bother your ears. Things shouldn’t sound any different than they do now. One thing that can happen is that all or many sounds will now sound too sharp until you ears have time to settle down again. This can take several weeks.
I don’t think that going to an ENT will serve any useful purpose because there’s nothing that he can really do for you.
Cordially,
Neil
Hi Neil, I’m 23 years old and on January 17th 2019 I shot guns without ear protection, I wasn’t able to hear much of anything for two days and I’ve had this constant high pitched ringing in both ears ever since. By Sunday, the 20th, I could hear out of my right ear and not much out of my left but it was muffled. Monday, the 21st, it was the same, Tuesday the ringing in my ears got slightly higher and unbearable but I could hear out of my ears. I went to my family doctor Thursday January 24th, he gave me a steroid pack and anti inflammatorys and told me if the ringing continues to come back after the steroids were done. I went back a week later, on the 31st but I had caught a really bad cold by then so he gave me antibiotics and set an appointment for an ENT. My appointment is coming up this week, February 22nd 2019 and I live in Arkansas where in order to keep my Medicaid Insurance I have to have a work requirement and I’m in between jobs right now. Should I even put up the money for this ENT or should I wait it out? You mentioned previously that they wouldn’t be able to do much for me and I wouldn’t want to wait my time and money. And you said that it might take 2-3 months for my hear to heal? My last question is, Is what I am experiencing normal? I can deal with the ringing for most of the day but by the end I’m so worn out trying to focus my energy on something else that i break down and think “how am I going to live with this for the rest of my life?”. I live with major depressive disorder and I fear this is making me worst.
Hi Christian:
Personally, I wouldn’t waste my money on going to an ENT regarding your tinnitus. Probably it is there due to some hearing loss–whether you can detect it or not. If the noise exposure caused permanent hearing loss, then the tinnitus may prove to be permanent too. So keep on your plan of ignoring your tinnitus as much as possible so it can begin to fade into the background.
If you “wear down” from your tinnitus, try having some background sounds on later in the day and evening to give your brain real sounds to listen to, and to reduce the contrast between your tinnitus and silence. That makes it easier to bear (and ignore). It could be pink noise or environmental sounds, or a fan sound or music. Whatever works best for you.
If you are depressed, tinnitus can be harder to bear. There’s no doubt about it. So you want to work on getting your depression under control as well.
Cordially,
Neil
Hello Neil,
I went to an indoor gun range Saturday for the first time in years. i used ear plugs but i honestly do not think i put them in all the way or properly. some shots from other shooters there were fairly loud. when we left, i could not hear at all. i went to a store and it was silent in there. the only noise i could hear was the sound of the escalator. i could hear the radio on max volume but only muffled, could not make out a single word. the next day, i could make out words better but then came the ringing in the ears. my ears also feel clogged like i came off a plane and they need to pop. like another writer said, when i press on them, they make a weird bouncing sound but it seems to clarify things very temporarily. i can hear better but its still fairly muffled. my own voice seems muffled as well..and the ringing is there as well. its now been 3 days. alot of what i read said 48 hours is usually when the symptoms subside if they’re going to so im kind of getting scared. do you have any insight?
Hi Sarah Jane:
Your ears suffered acoustic trauma at the shooting range and need time to recover. 48 hours is a ballpark figure. It is not a given. Each person is different and your ears may be more sensitive than average. What you are looking for is continued improvement in your hearing–and that seems to be still happening, so that is good.
Tinnitus almost always accompanies sudden hearing loss, and if your hearing all returns, your tinnitus may fade away.
The muffled feeling you have is an indication that not all your hearing has returned yet. However, you probably also caused some permanent damage so you may be left with some degree of hearing loss, and consequently, some degree of tinnitus as well.
It would have been good to take immediate action to help your ears. I would suggest zinc and magnesium supplements to help your ears recover. Also, I would suggest taking higher doses (1,800 mg or so) of N-acetyl-cysteine (NAC) which helps your body produce more glutathione–your body’s most powerful antioxidant. The loud noise produced a lot of free radicals in your inner ears. These free radicals zap your hair cells and cause permanent hearing loss. However, the glutathione zaps the zappers before they can zap your ears so it’s a good strategy. It’s getting a bit late to take NAC now, but you may still want to try it and see if it helps. You can take the zinc and magnesium long term for ear health.
You also want to protect your ears from loud sounds for the next few weeks to allow your ears to recover as much as they can, so stay away from gun ranges, loud sports or musical events, etc., etc.
Cordially,
Neil
Hi Neil , I went and shot my ak 47 yesterday without ear protection . My left ear was very stuffy and I couldn’t hear well. Today the stuffy feeling has subsided a good amount but not completely . But not it’s accompied with a very faint ringing . That I only notice once I am focusing on it. Which is 24/7 because I’ve read so much about T. Do you think the ringing will be permanent or will it subside ?
Hi Tyler:
Probably the ringing will subside and fade away, BUT only if you quit worrying about it and listening for it. The more you try to hear it, the louder and more permanent it will become. So just ignore it and let it fade into the background. Instead, focus on the loves of your life.
And in the future, make sure you ALWAYS wear ear protectors when shooting.
Cordially,
Neil
I went shooting a day ago without hearing protection I shot around 100 rounds of 556 and 40 12g shells my hearing is still muffled with a constant ringing will this ever go away
Hi Eric:
Hopefully, the muffled feeling will go away as your ears recover from all that acoustic trauma. Ditto for the tinnitus. However, there are no guarantees. That is why you ALWAYS want to protect your ears when shooting.
You can help speed the tinnitus in saying good by to you if you totally ignore your tinnitus and focus on the loves of your life–and not on your tinnitus. Hopefully, as the weeks roll by, your tinnitus will fade more and more into the background and not bother you.
Cordially,
Neil
Hello Neil,
I went shooting 6 days ago. I unfortunately did not use ear protection. I was originally shooting a .22, but my boyfriend had me try his SKS. Immediately after, I had ringing in my ears and muffled hearing. By the next day, the ringing and muffledness was gonen in the right ear, but no improvement in the left ear. I went to my doctor who says my eardrums look fine, give it a few more days and if no improvement go to an ENT. Tomorrow will be a week. It is extremely annoying, the muffled hearing and plugged feeling bothers me more than the ringing. When I speak, I sound like a broken speaker. With it being this long is there any hope of hearing returning?
Hi Laurie:
I sure wish everyone that shoots guns would wear proper ear protection. It would save a lot of grief and hearing problems in the future.
Your ears suffered from acoustic shock (trauma) and this takes time to “heal”. It can take 2 or 3 months or more–so don’t rush it. Just protect your ears from loud sounds in the meantime. There is no guarantee that your hearing will ever return to normal, but there is a good chance things will get better. You still have lots of time.
Cordially,
Neil
Hello Dr.Bauman
I went to cut some metal and grind it down with a power tool and it’s been about 7 hours and i’ve still experienced ringing in my ears how long do you think this will last?
Hi Wyatt:
It all depends on how loud the sound was, how long you made the racket, how often you’ve exposed your ears to loud sounds in the past and how sensitive your ears are.
Hopefully, your tinnitus has died down now. If not, let me know.
In the future, you need to wear ear protection when you are going to be around loud noise.
Cordially,
Neil
Hi Neil,
From my ENT exam years ago I have NIHL with a notch at 4K and tinnitus that was measured 12 years ago at 69 dB in RE and 57 LE both at 8K Htz. It took a long time to habituate to it. This came from a loud noise work environment where I guess I didn’t wear my hearing protection as much as I should have. I woke up one morning and the tinnitus was just there. Also, both my brothers lost almost half their hearing by age 30 with no explanation about 40 years ago, so maybe there was some genetic predisposition of sorts for ear problems.
I’ve taken up shooting for the last 4 years and wear double protection such that guys have to scream at me to get my attention when the line is going cold (all hands off guns and secured unloaded).
My earmuff are electronic and 31 NRR. My in-ear protectors are also electronic and 28 NRR.
I’ve not noticed any hearing loss or elevated tinnitus even after shooting and I shoot for an hour or so each week.
Does it seem like I am safely protecting myself from further damage?
Thanks,
James
Hi James:
If you are not getting any tinnitus after shooting for an hour, I’d say your double ear protectors are working just fine for you and it is unlikely that you are damaging your hearing.
Just be aware that with double protection of 31 and 28 dB is not giving you 59 dB of protection. It is more like 33 or 34 dB total. when adding two numbers in dB, you don’t get the arithmetic sum, but the sum is converted from a logarithmic scale. Thus, adding 20 dB and 20 dB for example doesn’t give you 40 dB but 23 dB. Weird, but true.
Cordially,
Neil
Hi Neil; I am a 70 year old who likes shooting rifles and firearms. Recently I went to the range and fired about 50 rounds. I thought the ear plugs were doing their job; but apparently weren’t installed properly or inadequate. I already have a hearing loss from working in a shipyard. My left ear is fine; however the right has a sound similar to a pot ringing low pitch with voices. I wear hearing aids in both ears; they were removed when shooting and plugs inserted. My question to you is should I refrain from wearing the aid in the right ear for a while? It has been a week now and I am getting frustrated. I have tried ear drops and cotton to try to help healing; is that ok? Thanks for anything you can say to help; relieved at some of the posts because they have similarity’s similar to myself. Vr jm
Hi John:
If wearing the hearing aid makes the tinnitus worse, it would be a good idea to stop wearing it for a bit, but if it doesn’t make any difference, then wear it if that is your normal custom.
What I would do is not expose your ears to loud sounds for a few weeks and see if the ringing goes away. At least, it will give your ears time to heal as much as they will.
Then, in the future, when shooting, wear double ear protectors–the foam ones in your ears and then the earmuff style over your ears. If they are seated properly, I don’t think you’ll have problems in the future.
I don’t see that ear drops are going to help tinnitus–the problem is in your inner ears and brain, not your outer/middle ears. Cotton provides such minimal protection, it is not really worth it. Just keep away from loud sounds–but if you have to be around them, then wear the foam ear protectors–and be sure they are seated properly.
Cordially,
Neil
Hi Neil, I’m 16 years old I was outside in a late open field about 8 days ago and I shot a couple round (without hearing protection)and my ears are muffled and ringing slightly sometimes I feel like the ringing has went away but then it juss comes back constant and it’s not that loud but I wanna know if it’s permanent or not I only took about 15 shots total. There were 2 other people shooting 9mm and 22 lr which has never affected my ear but my first time shooting a rifle round went terrible I also had tinnitus for a day prior in my right ear from juss one shot
Hi Javian:
Your ears can only absorb so much acoustic trauma like gunshots before they start to give you grief such as tinnitus and hyperacusis and hearing loss, etc. So in the future, you need to ALWAYS wear ear protectors when shooting so you don’t cause things to get worse.
There is no way to know whether your tinnitus will go away or not. The fact that it went away and then returned is a good sign that maybe it will eventually go away and stay away. But that means not exposing your ears to loud sounds in the future whether gunshots or loud music or other loud sounds. If you are going to be around any loud sounds, wear ear protectors. Otherwise, you may find you end up with permanent LOUD tinnitus.
Cordially,
Neil
Hi Neil.
I’ve had a lot happen in the last few months and I’ve developed ringing in my ears. I do shoot in an indoor range but always wear hearing protection. My ringing began when I went on an anti depressant briefly while also quitting tobacco and using the patch. I also had some vertigo when I quit the medication a week later.
About two months later the ringing became constant.
I’ve quit swimming, taken steroids and am committed to doing whatever it takes to make this go away.
I really believe it was the anti depressant. Will the ringing go away?
Hi Timothy:
Taking antidepressants can certainly cause tinnitus. Which anti-depressant were you taking? I can look it up and see how bad the ototoxic side effects are.
If you’ve done lots of shooting in the past and not had any problems with tinnitus, I’d say your ear protection was adequate and you can’t really blame the tinnitus on the shooting.
There are a number of variables that come into play as to whether your tinnitus will go away or not. First is the drug you took. Some drugs tend to cause temporary tinnitus and others tend to cause more permanent tinnitus. Then there is your own emotional attitude. If you tend to think of your tinnitus as a threat to your well-being, then your tinnitus will tend to be more permanent than if you think of your tinnitus as a useless, environmental sound you can (and DO) safely ignore.
Also, the more you think of your tinnitus the worse it tends to get. So ignore it and focus on the loves of your life and let it fade into the background.
So let me know the drug you were on and we’ll go from there.
Cordially,
Neil
Thank you Neil. I was prescribed Alprazolam and Escitalprolam. I took the canes for 2 days, then quit, but picked it back up about a month ago. Coincidentally that when the real ringing began. The Lexapro I quit after 2 weeks when I had some light ear ringing and vertigo back in January. The vertigo came 5 days after quitting. I had some minor ear issues, but the ringing began full time early March. I’ve just read that the alprazolam can cause it so maybe that makes sense because it coincides with the onset of the permanent ringing.
Thank you so much for any advice or help. I obviously need to ditch the alprazolam.
Hi Timothy:
Of these two drugs, I’d say the Alprazolam is the most likely culprit. There have been between 2 and 3 times as many reports of tinnitus and hearing loss resulting from taking Alprazolam as there are for taking Escitalopram. Also, tinnitus from taking Alprazolam is more likely to be long term, whereas tinnitus from Escitalopram tends to be temporary.
Cordially,
Neil
Hello
I went hunting today and shot a shotgun that was unexpectedly extremely loud. I only took one shot with no hearing protection. The hearing in my left ear is muffled for sure and my ear feels numb to the touch. Will this numbness and muffled hearing ever go away? It’s been 11 hours and i can’t hear well out of this ear and it’s “numb” to the touch. I don’t know what has happened.
Hi Wyatt:
Your ear has suffered acoustic shock. That’s what happened. Even firing one round of 12 gauge is asking for trouble if you don’t wear ear protection.
It can take time for the numbness to go away and your ear to return to more or less normal. Not just hours, but weeks or months. During this time you need to be careful to avoid loud sounds and give your ear a chance to heal. Even so, you may have a certain amount of permanent damage.
Cordially,
Neil
Dr. Bauman
I suffer from frequent migraines and have tried several different meds prescribed by neurologist. After a year now I have constant tinnitus and anxiety. Valium 5mg at morning and night help me tolerate but both seem to be getting worse. Could you suggest something for the migraines that will not cause tinnitus and is there any med that will help with anxiety that does not cause tinnitus. I am 73 and have had migraines most of my life but the tinnitus has gotten much worse in the past year. Thank you for any advice! Martha
Hi Martha:
Diazepam (Valium) is one of the benzodiazepine class of drugs. These drugs may be good in the short term (2 weeks or less) but the longer you take them, typically the less effective they are until they switch and start making things even worse. One of the common side effects of Diazepam is anxiety. So if your anxiety is getting worse, it could be from the drug itself.
Furthermore, hundreds upon hundreds of people have reported to the FDA of getting tinnitus from taking Diazepam. So I’m not surprised that you are experiencing increased tinnitus and anxiety. If I were you, I’d begin a slow taper (over the course of a year or so) to get off this drug.
I’m assuming that over the years your doctors have tried just about all the drugs they know about to try to get rid of your migraines, but with little success. Thus, maybe it’s time to think outside of the box and try something totally different. One of the first things I’d try if I were in your shoes would be to go to an upper cervical chiropractor (not a conventional one) and make sure that your top two vertebrae are in proper alignment. Sometimes migraines are due to this cause, and especially so if your head, neck, shoulders tend to be “tight”.
You can find one of these chiropractors by going to http://www.upcspine.com/ and clicking on Practitioners along the top.
Cordially,
Neil
Hello
Im going through my mandatory military service right now and we had shooting exercise on 25th of April. It lasted about 5 minutes. I think I had my ear plugs inserted incorrectly, because when I took them out my left ear hearing was very muffled alongside with tinnitus. On the same day I got steroid injection which made it better. I also had hearing exam next day which revealed high frequency hearing loss starting from 2000 Hz.
2000 Hz – 40dB
4000 Hz – 60dB
6000 Hz – 55dB
8000 Hz- 50 dB
Ive been taking oral steroids since the first day. Its been 2 weeks now and i had my hearing test again. 2000Hz has pretty much recovered but 3000-8000Hz is pretty much the same alongside with tinnitus.
Is there still time for my ears to recover? Ive been told that I have decent chances because I started taking steroids on the same day.
Im getting little bit worried since its been 2 weeks and only 1 frequency has recovered and I am soon done with my steroids.
Hi Jeff:
Something sure wasn’t right. Too much sound got into your ear and your audiogram shows the typical “noise notch” at 4000 Hz.
Taking timely steroids is about all doctors seem to know about. Sometimes they work, sometimes they partially work and sometimes that don’t make a bit of difference. There is no guarantee. What you should also have done right away was take high doses of glutathione (a natural antioxidant) or, since your stomach breaks it down, take high doses of N-acetyl-cysteine (the main building block of glutathione, as well as high doses of vitamin C and the minerals magnesium and zinc. If taken in the first 2 or 3 days, this can help prevent permanent hearing loss. Unfortunately, you are well past that time.
If your hearing isn’t still coming back, that is not a good sign. In any case, my rule of thumb is that the hearing you have after 30 days is what you will have in the future. Not what you were hoping to hear, but I think it is realistic. So you may get a bit more hearing back, but I don’t think much more will come back. Sorry.
Cordially,
Neil
Isn’t there anything I can do to help my recovery? I’ve heard about Hyperbaric Oxygen therapy for example?
Hi Jeff:
The things you need to do to recover from hearing loss typically need to be done right away. Once the hair cells have died, its too late. If your ears are only “sick”, then speed isn’t all that critical–but you don’t know whether they are sick or dead.
You can try hyperbaric oxygen. It may still help some if hair cells are “sick”, but don’t expect miracles. Zinc and magnesium may also still help to some degree.
Cordially,
Neil
I had a 45 handgin go off in a confined space unexpectedly 2 days ago so no ear plugs. Very muffled hearing and ringing in both ears ..will it get better…er gave me a cortisone shot but no relief
Hi Heidi:
Your ears obviously suffered from acoustic shock trauma. I would expect that things will get better with time. You need to give your ears a rest from louder sounds for a month or two in order to give it a chance to heal as much as possible. You may still have some residual damage, but it should be better that it is now.
Cordially,
Neil
Hey man did it ever get better I had the exact same thing happen exact same caliber small space did the ringing at least get softer and how long did it take did u ever get a hearing test done ?
Hello,
I have had minor tinnitus for maybe 3 years and I went outdoor shooting with a friend recently. We shot his 303 caliber lee enfield and did not wear ear protection (I knew I should have but we forgot them and we drove so far). Anyways, I shot around 50 rounds and covered by ears with my fingers while he was shooting. I noticed that my tinnitus has spiked a bit and both ears, especially my left ear as I am right handed is muffled. I don’t think I have hearing loss as I can hear things normally but i know I did do some damage to my ears. Will the muffling or spike in tinitus fade? It has been roughly 30 hrs
Hi Zach:
Those old Lee Enfield 303s are pretty loud. I wouldn’t be surprised if you have some acoustic trauma from firing those 50 rounds. If you had muffled hearing, you know you have a temporary threshold shift–meaning you have some degree of hearing loss. And the tinnitus goes along with hearing loss.
Depending on the damage, it can take a few hours to a few days to a few weeks or longer for things to sound normal again.
Acoustic shock can also result in hidden hearing loss where some of the synapses in your spiral ganglion break. When they do that, you don’t hear certain sounds. They try to repair themselves and if they can, you hear again. If they can’t, then the hair cells they are connected to die and you end up with permanent hearing loss in that frequency.
If I were in your shoes, I’d take zinc, magnesium and N-acetyl-cysteine (NAC). I’d probably take around 1,800 mg of NAC a day for a week or so. You need to start ASAP before cells begin dying. You only have about 3 days before it won’t be effective and half that time is already gone.
Cordially,
Neil
Hello again,
Thank you I am currently loading up on those vitamins. Question for you, will the muffling eventually dissipate?
Hi Zach:
The muffled feeling goes away when your hearing comes back, or if it doesn’t, then fades away as your brain gets used to the new level of “normal” hearing. This can take a few months.
Cordially,
Neil
Hey Neal,
One more question. I am not sure if “muffled” is the right way to describe my ears currently. They feel kind of plugged, as though I have a head cold or I have changed elevationnquickly and pressure has built up. Is this part of the healing process?
Hi Zach:
People use various terms to describe the same thing. As far as I’m concerned, “muffled”, “plugged”, “blocked, feeling of fullness, etc. in a situation such as yours all mean the same thing.
Cordially,
Neil
Hey Neal,
It’s been a week and two days and symptoms have gotten a little better. However my ears are still muffled and the tinitus is still there.. I’ve done a ton of research on this horrible symptom and I hope and pray I won’t have it for life.. does tinitus eventually fade when the muffled ears fade?
Shooting that gun was the worst decision of my life 🙁
I cannot imagine what it is like for those who have severe tinitus.
Thanks,
Zach
Hi Zach:
IF your tinnitus is from muffled hearing, then it should fade as your hearing returns and the muffled feeling goes away. There are no guarantees because you may have caused permanent damage to your inner ear, but I’d be hopeful that things will recover to normal or close to normal in a few months. At least by then you’ll know what it will be.
Cordially,
Neil
Hey Neil,
I went and saw an Audiologist and apparently my hearing is “perfect” – she said there are no signs of any hearing loss and that the ear structure and drum are in good shape.
There is still some slight tinnitus and it has been about 3 months (or close to). Is there any way that it will dissipate overtime?
Thanks,
Zach
Hi Zach:
If you tinnitus is only “slight”, just totally forget about it and ignore it. It’s not bothering you, so whether you have it or not makes no difference. And when you do that, you’ll probably find you are not aware of it most of the time.
Cordially,
Neil
Hi there,
I have had low level ringing in my ears for years as I have played in rock bands all of my life. Around 15 years ago I started wearing molded plugs with a 15db filter and really started looking after them.
Thanks to my own stupidity, I shot a single shot two days ago without protection. I have no idea what I was thinking!
The ringing is back, louder than it has been for years. Plus the left one feels slightly bunged up. In addition some loud sounds are slightly uncomfortable.
Will all of this fade in time do you think? I have learnt an important lesson and will never do this again!
Hi Tim:
If your ears are already damaged from loud sounds, even the report of one shot can cause acoustic trauma such as you are now experiencing. The good news is that your symptoms should fade away in time. Give it a couple of months and see how things are. In the meantime, always remember to protect your ears around loud sounds because each time you expose your ears to these loud sounds the chances are that you will have worse and worse symptoms that will persist for longer and longer and eventually will never go away.
Cordially,
Neil
Hello Dr. Neal Bauman.
Thanks to you this topic is so informative ! If only I could find it earlier …
I have average health , weight is slightly above average ,I’m 42 y.o. ,
I don’t drink/smoke… like at all. Not using any drugs . Maybe only vitamins, from time to time. My senior parents do not have any significant hearing loss.
Yes , in the previous life I had been exposed to some noise (clubs),
in the teenage era . Never had any problems , not even a temporary hearing loss.
On the 24th of July we were celebrating and I went into a room with loud music to make the volume lower . I couldn’t find the remote control and I spent about a minute or so in this environment . There was no pain in the ears , I just felt that it is loud and I left .
I have to say it was quieter than a rock concert , indeed. My friend says it is about 140 watt at the max. volume, and it was set to 71%. Basically everything was OK , so I didn’t go to see a doctor .
Yes , there was a slight muffled feeling in the right ear , right after I left the room , but no big deal – it was only for a short amount of time, 30 mins approx.
The next morning I felt a bit worse , slight discomfort , but yet again , no big deal. I decided to stay at home., just in case. Only on the 3rd day the symptoms got worse .
I had a feeling like I’m having an allergy, or a cold , a slight discomfort while swallowing
and a very high pitched tinnitus (about the upper limit of my hearing – 13000HZ)
I went to a local doctor . They had my hearing checked and there is no loss .
Though they could only check up to 8khz. As of today , I have unbearably high pitched
sound and headaches , trouble sleeping and the muffled feeling is on and off (now both ears , though the left is worse).
Does it mean the ears are trying to heal ?
Please give an advice , I value your opinion to the highest level !
Hi Derek:
I’d say you have experienced acoustic shock syndrome. Obviously the volume was a lot louder than you really thought it was. But, with acoustic shock, it doesn’t have to be enormously loud. You need to protect your ears in louder situations in the future. They are not as robust as they were when you were a teenager.
Now you are experiencing tinnitus (the high-pitched sound you are hearing) and other symptoms of acoustic shock. You need to give your ears a chance to heal. This will take some weeks or months. During this time you want to protect your ears from all those really loud sounds, but don’t wear ear protectors when you don’t really need them or this will just give you hyperacusis and make everything worse. Your ears need to be exposed to a certain amount of sound, just not too much.
Cordially,
Neil
Hello Dr. Neil Bauman !
I’m very grateful for your advice ! I was going to say that I’m sorry for
the posting in the wrong section since my ears were damaged with music …
… but … I guess I was not that wrong after all !
My high pitched tinnitus began to settle down a bit .
Yesterday I was watching an old movie . I turned the volume down to the lowest level.
I had some cotton in my ears , not earplugs , just a small amount of cotton , because I was feeling like I’m having a cold and I was afraid of the air-conditioner’s airflow.
In that movie, they had a scene with several shots . I believe it was .357 S&W Magnum.
And it triggered my tinnitus again, to the maximum ! Also , it triggered an additional “ringing” in the right ear (at approx 3-4khz) for several seconds. The right ear is muffled again . Sorry for repeating, the volume was very low. Isn’t that weird , to say the least ?
I hope this information will be useful/interesting .
P.S.
Today I took an extended hearing test . The result is :
my right ear can’t hear anything after 10khz . Left ear seems better : up to 12.5Khz.
Before that I could hear 14-15Khz with my both ears.
Medications I take.
1) Ginkgo Biloba (3 capsules per day), from the 4th day after.
2) Magne B6 (made in Holland) (6-8 per day) , from the 5th day after.
3)I drink lots of fresh lemon juice with water since day two for toxins.
4) Hyaluronic acid supplement (I took days before , for my knee).
I have to say , the tinnitus matches the same frequencies that I can’t hear.
Is there a hope these frequencies are coming back ?
Should I try oral steroids or is too late ? I read about a guy who had a surgical procedure done after two weeks, which involved placing a grommet and wick in his ear, to deliver steroid drops directly to the inner ear.
Right now I can’t sleep again …
Hope to hear from , have a nice day.
Thank you very much !
Hi Derek:
It’s good you had the volume down low, but even so, sometimes it is the suddenness of the sound (shots) rather than the volume that messes up your ears. This is true in people that experience acoustic shock disorder. So it may be your problem.
I don’t see any problems with the supplements you are taking.
It is very common for your tinnitus to be at a frequency close to your greatest hearing loss. This has nothing to do with hearing coming back. Rather it is because those neurons for the frequencies you no longer hear have nothing to do so they look over their shoulders so to speak and see what adjacent neurons are doing and do the same–thus creating your tinnitus.
Steroids, whether oral or intratympanic only work if given soon enough. That time frame is hopefully within 2 or 3 days. Steroids can still be effective up to two weeks. After that they are less and less effective and after about 30 days or so, taking steroids is basically a waste of time.
Cordially,
Neil
Hi Dr. I was just not thinking and discharged 10
rounds from
a 9mm handgun with no hearing protection last Sunday. It’s close to Thursday and my left ear is still different than my right ear regarding sounds with a little buzzing. It’s better, but doesn’t feel “even”. It also feels as
if it’s plugged, almost like a sinus issue where it won’t pop when I yawn, which I know it is not. Should this subside in over time?
Hi Jon:
your ears are suffering from acoustic shock, and it takes time for them to get back to normal. It may take two months or longer depending on how things go. But one thing you want to do during this time is to avoid exposing your ears to loud sounds. This will just make things worse and take longer to heal.
Unfortunately, you may have some underlying residual damage that may prove to be permanent. Only time will tell.
Cordially,
Neil
I have been shooting small cal handguns for 2 years about 2-4 times per month using 32 db ear muffs & plugs for protection. I am certain the muffs were on properly & worked well. I had experienced a low level of tin in the past before taking up shooting as far back as i can remember but yesterday after a 50 round session at an inside range my tin became greatly elevated & I got the muffled hearing both sides. I read with great interest your advice to one poster to the effect that despite proper protection gunfire can break the camel’s back especially if your hearing is sensitive. Does this mean that once this has happened you should give up shooting?
Hi Adolfo:
What was different this time that you got the tinnitus and muffled hearing since you didn’t have these symptoms in the past shooting episodes? The two obvious ones to me are that either your ear protectors weren’t seated as tightly as they should have been, or you fired more rounds than usual and the protection factor wasn’t enough for the length of time you were exposed to these loud sounds.
I’m assuming that by now your tinnitus and muffled feeling has gone away? You certainly don’t want to expose your ears to cause this again as each time a little more damage to your ears occurs.
I can’t see that your hearing is so sensitive since you have done this before without problems. Try and figure out what was different this time–and don’t let that happen again. If you can do this, I think you should be able to continue shooting–but you are wise to question what is happening so you don’t cause noticeable permanent damage to your ears.
Cordially,
Neil
I was out hunting grouses in the mountain 13 days ago when I shot an accidentally shot. It went into a big rock and I got a big feedback. Fortunately I was wearing plugs (28db). I did not have a immediate reaction in my ears, so I continued hunting that and the following day, shooting maybe 4 shots all together.
Two days later I experienced a faint hizz in my right ear and it kind of interacts with all sound around me. It gets higher when noises are higher etc. Hearing has since been muffled, got a fair amount of pressure in the ears, and experience some kind of strange acoustics, as have been discussed in this thread previously.
When the room is quiet, the ears are almost normal, except for the hizz that comes and goes. Is this a kind of somatic tinnitus, and will the hearing be stabilized given time?
I should also mention that I very recently had an audiogram taken which showed some mild hearing loss (a dip) between 3K and 6K. I had a new hearing test taken after the incident and it revealed the same picture, so no visible hearing lost after the accidental shot.
Thanks so much for any reply!
Hi Kjetil:
When you made that accidental shot that echoed off the rocks, your ears experienced acoustic shock. It was good you were wearing ear protectors or things could have been much worse.
Apart from the hearing loss (muffled hearing) and the feeling of pressure (often described as a blocked feeling) and the tinnitus, you also have hyperacusis which results in reactive tinnitus. That is what you call tinnitus that gets louder as the surrounding sounds increase.
You have reactive tinnitus rather than somatic tinnitus.
Incidentally, your audiogram shows the typical noise notch at 4K which is due to exposing your ears to loud sounds. So you have been damaging your ears with loud sounds–maybe shooting in the past without ear protectors on, or insufficient ear protection.
You need to be more careful to protect your ears from loud sounds in the future so you don’t make your hearing, tinnitus and hyperacusis worse in the future. But be careful not to overprotect your ears or you will make your hyperacusis worse.
Cordially,
Neil
Many thanks for your quick reply – and good advices!
The last couple of days the hearing has been better and less “reactive”. I am still struggling with plugged ears, but it does seem like some if it is due to a cold (my wife goes through the same). Hence I don´t know much of it is due to hearing loss.
The tinnitus is now in both ears, bouncing about, but less excessive.
I know you can´t predict the future, but could I expect the overall condition to improve within the the next 2-3 months?
With best regards,
Kjetil
Hi Kjetil:
I’d expect you’d see improvement–especially if you ears are just clogged as a result of a cold.
Cordially,
Neil
Fingers crossed on that!
I just downloaded and read your paper, Supersensitive to sound. It’s hard to imagine myself having hyperacusis: I don’t have problem listening to music or doing the dishes. But the reactive tinnitus is still there.
Two more questions to you: Even though have some mild hearing loss, is there still a good chance that I will habituate to both sound sensitivity and tinnitus, by making it slip into the background?
When is it safe to take up hunting again?
Your reply means much 🙂
Hi Kjetil:
If you have reactive tinnitus you have a hyperacusis component–but your hyperacusis can be very mild and not noticeable in most situations (and that’s good).
There is a good chance you will habituate to both tinnitus and your hyperacusis will go away. Just don’t rush it. Continue to protect your ears from overly-loud sounds and continue to ignore your tinnitus.
You are ready to take up hunting again when your reactive tinnitus goes away–at least the reactive part. This probably won’t be until next year’s hunting season.
Cordially,
Neil
Thank you so much Dr for your reply. Yes the muffled feeling did go away in 2 days and the tin has gone back down almost back to normal. Also your comment regarding greater exposure to gunfire may be correct since I had begun to go to the range once per week instead of twice per month as I have done for the past 2 years. I forgot to mention that I suffer from strong allergies and my sinuses are often stuffed up. On the day I had the problem I was slightly stuffed up. I wonder if the two factors could have caused the symptoms? I am following up with a hearing test and consultation with an ENT. Meanwhile I don’t plan to go to the range until I am seen. Thank you again for your help. Adolfo
Neil,
The condition in my ears made a turn for the worse during the weekend. I lost my sleep and the reactive tinnitus behaved strangely, winding up with high frequencies. I tried not to focus too much on it, but in the end it got so bad that I saw an ENT.
He didn´t have much of a clue, but after I suggested that I might have hyperacusis, he agreed on that. So they performed a noise treshold test on me and it showed a mild degree of hyperacusis.
Of course this put me in a very tensed mode and the H got steadily worse during yesterday. Feels like I´m full of static electricity. And the tinnitus are very present in both ears.
I am seeing a TRT-spesialist next week, as I cannot function in this condition. What will you advise me to do in the meantime?
Best regards
Hi Kjetil:
My advice doesn’t change. Focus on the loves of your life and thereby ignore your tinnitus as much as possible. Don’t worry about it. This is just making in worse as you can see. It doesn’t hurt to have background sounds “on” all the time to help distract and partially mask your tinnitus so you won’t notice it so much. Keep the volume down to below where your tinnitus reacts to sounds. And of course, protect your ears from louder sounds.
Cordially,
Neil
Hi Neil. Thanks for answering all these questions. While hunting a .300winmag went off about 4’ from my right ear. Hearing loss (muffled) lasted about 2hr, 90% came back within 24hrs but left with high freq loss and tinnitus. Now the tinnitus waxes and wanes throughout the day. Any experience with an injury like this in a 42yo?
Hi Jay:
Your ear suffered acoustic shock and it takes time for it to recover. I’m not surprised you still have some high-frequency hearing loss and tinnitus. It’s a good sign that your tinnitus waxes and wanes–it shows that at least it is not constantly loud. I take this as a sign that it will not be permanent and that your ears are healing. Just give them time–and protect them from loud sounds in the meantime.
Cordially,
Neil
Dr. Neil –
I just wanted to send you a huge THANK YOU for this article, and the time you have taken to reply intelligently and informatively to everyone that was clearly very worried about their hearing situation.
I went to the shooting range 3 days ago with my newly acquired pistol ((which is a .357 Magnum, obviously a very heavy load), and wore a very good headset – but no ear plugs. I also went and shot sporting clays thereafter.
I think part of the issue with the pistol was that the range had an overhang (an awning of sorts), which seemed to have compounded the concussion of the sound.
I am experiencing many of the same problems and worries expressed by many of your readers, and your answers were VERY informative, and frankly very comforting.
THANK YOU for your time in explaining what’s going on to all of us who have been concerned and we’re fortunate enough to find this.
Take care and best wishes!
About 10 years ago, I had some idiot fire a deer gun off, about 10′ of where I was standing. I ended up with what was a loud ringing noise, for probably 10 minutes, before it abated… somewhat. It left, what seemed like a blockage in BOTH my ears, something that I’ve never seemed to of recovered from. Yes, I still have some anger issues around it. It still is blocked to this day. Sounds are distorted and have ringing associated with it. I wondered which type of damage this might be (ear make-up, internally, damage to other parts, healing possibilities, though, I’m pretty much resigned to the notion that my ears are permanently damage as a result of this idiotic action. What seems to clear it up, somewhat is when I’m active, like a bike ride or something, so I’m thinking bloodflow issues? is there a certain name for this condition? Just trying to see if I can lessen this. Most days are fine. I just had a bad dream about it last night, which prompted me to write.
Hi Dave:
Typically, a sudden loud sound like you experienced, especially if it was unexpected, results in acoustic shock syndrome. Some of the symptoms are the ringing you hear, hearing loss, distorted hearing, a feeling of fullness in your ears/ear blocked feeling–all symptoms you are experiencing.
Have you ever had your ears tested since this happened. It would be good to have a complete audiological evaluation to see whether/how much hearing loss you have and if anything else shows up.
I doubt that blood flow is an issue, but it could be. What I think is more likely is that when you are active, you are focused on what you are doing and are not thinking about your ears, so you are not aware of them as much.
And your anger issues can be preventing you from being able to habituate to this so it no longer bothers you. When you have an emotional “attachment” to ear problems, your limbic system keeps them front and center. However, when you deal with your emotional issues regarding your ears, and thus no longer have them, this gives your limbic system permission to let them fade into the background so they are not a problem anymore.
Cordially,
Neil
Hello! I have had faint ringing in my ears for 30 years. I thought everyone was hearing the same ringing I was , so never thought anything of it. One day I mentioned it to my friend and he said he didn’t hear ringing , and that is when I realized it was just me. It never caused me a problem so I let it go. A month and a half ago I went to an outdoor gun range and put in the little plugs they gave us. After the range I took the plugs out and the ringing that was low for all those years was suddenly higher and my ears were muffled. I thought the muffiness would go away…but a month and a half later I still have muffiness in both ears. Also, I don’t hear as well…frequently turning the TV volume higher. Also, noise is very irritating….being in a noisy restaurant is almost intolerable. Fire engine sirens cause my ears to get muffled even more…even loud cars or car honking causes louder ringing and muffles my hearing. I keep thinking I will wake up one morning and my ears will be better, but that hasn’t happened yet . My question is…should I just wait it out and hope that the muffled sound, ringing ears, and irritation to noisy restaurants will dissipate over time? Thank you
Hi Patrick:
My best guess of what happened is that you didn’t have the ear protectors in properly–or they didn’t have a high enough protection factor and thus you exposed your ears to the sudden explosive sounds of guns firing. This resulted in giving you acoustic shock disorder–which includes the ringing (tinnitus) muffled hearing (hearing loss) and hyperacusis (sensitivity to louder and higher-frequency sounds).
There is no specific treatment for acoustic shock disorder. Rather, if they bother you, seek treatment for each separate component. For example, if the hearing sensitivity bothers you, seek treatment for loudness hyperacusis. Quite often, doing this will also get your tinnitus under control.
The muffled feeling may be due to an excessive startle reflex of the tensor tympani muscle and then then the tensor tympani muscle is “stuck” in a state of tonic contraction, thus pulling on the Eustachian tube causing the muffled feeling.
If this is one of your problems, anxiety and worry about it can keep it going. Learning to relax and reduce your anxiety towards your ears is a good area to focus on.
All of these conditions can be tied into a heightened awareness level–think stuck in fight or flight mode. So anything that helps you relax and “get unstuck” is a good step in the right direction.
Cordially,
Neil
I am fairly new to shooting…in the last year or so. I really love the sport. However, I do wear hearing protection but I am concerned that if I continue to shoot over years that I will eventually have some hearing loss. It certainly is debatable if my new found hobby is worth it in the end. I don’t want hearing loss as I have seen it first hand in older family members and it pretty much stinks. My question: In your experience, do most shooters at some point suffer from hearing loss even with hearing protection? I am 52 years old.
Thanks
Hi Alex:
Most people develop hearing loss as they get older, so it is hard to say that if you wear proper ear protectors your hearing won’t deteriorate with age. Most men begin to notice some high-frequency hearing loss when they reach your age.
So if you enjoy shooting, go for it. Wear ear protectors that have a rating factor high enough to protect your ears. You’ll know that it’s not sufficient if you develop tinnitus or a blocked or muffled feeling in your ears after target practice. In that case, you have a three options.
1. Increase the ear protection (but that may not be possible if you are already at the maximum (about 35 dB protection factor).
2. Find a quieter gun to shoot. For example, a 12 gauge shotgun is much nosier than a 22 rifle.
3. If nothing works and you don’t want to risk your hearing, find a different hobby.
Cordially,
Neil
interesting site… I have had a few discussions on guns for defense and contend magnums or even high pressure rounds are not a good idea…I personally dont like magnums because of the muzzle blast and prefer to shoot 38s, 45s, 22s etc…some argue that stress causes auditory exclusion and that the report wont be noticed… I think that is bunk and the blast and consequences will be experienced no matter what. For this reason I keep a handgun with a milder caliber and round for protection. Shooters like to practice with their pet calibers with lots of hearing comfort but I think real life situation may shock them a bit if it occurs.
Hi Neil
I stumbled across your page while researching hearing protection as part of a firearms training manual I am writing.
I am glad I did and hope that you can guide me in my search to correct information.
I am a firearms instructor and also an active sport shooter. Most of my shooting is done with handguns, but I also shoot shotgun and rifle at least once a month.
During competitions I shoot between 200 and 300 rounds over a weekend in competition plus another 500 to 1000 rounds per month during practice.
During training I am standing right behind students and would probably be exposed to around 80 shots per student per range session. Student numbers vary between about 6 and 15 and currently I have range sessions two days per month.
The competitions we shoot does not allow suppressors on any of the firearms.
Currently I do very little shooting indoors.
My questions are:
1. How do I realistically protect myself from NIHL given my work and sport environment?
I currently use MSA Sordin electronic ear muffs with, according to their website, a 30dB noise reduction rating. I am was considering to replace them with electronic ear plugs as the ear muffs are very hot during a day on the range in the South African sun. Your replies above however, now has me wondering if that is the right way to go.
2. If bone conducted noise impact occurs regardless whether or not one is wearing ear muffs, is there a realistic way for shooters to reduce the impact of bone conducted noise, especially on indoor ranges and/or for people who shoot a lot?
3. What is the mechanism of hearing loss through bone conducted noise? Does it also impact the nerve hair in the cochlea?
4. What would you recommend to shotgun and rifle shooters as the best available hearing protection taking into consideration that fact that most of us complain about ear muffs interfering with a proper gun mount?
I am very interested to hear from you as I find that there is a whole lot of nonsensical information on the Net and/or people are just generally ill informed in the subject.
I would also like to get your permission to use your reply in my manual and therefore request all relevant details of how you would like to be referenced in the manual.
I look forward to hear from you.
Warm South African regards .
Andre
Hi Andre:
Glad to help you out. Here’s my thoughts on your questions.
1. Realistically, you can’t protect from all loud gunshot sounds, so what you do is lower the odds as much as you can of damaging your ears.
Note that some people have very sensitive ears and others have what I call “cast iron” ears. If you have sensitive ears, you are at much more risk from lower level gun blasts than those with cast iron ears. For example, I have just fired 1 round of 12 gauge in my life. That was enough for me. However, a competition skeet shooter told me he had fired more than 1,000,000 rounds of 12 gauge. I asked him whether he used ear protection. He said–“Not for the first 400,000 rounds”! That’s an example of cast iron ears. But he still suffered noise damage, even after wearing ear protectors for the remaining 600,000 rounds.
So one rule is that if your ears ring or feel plugged or muffled after a shooting session, obviously your ear protectors aren’t good enough. Thus, you need to beef up your ear protection. Make sure any ear protectors are seated properly. If necessary, wear double protection–both ear plugs and ear muffs. (You may find that ear plugs may be all you need–but be careful to insert them properly so you get a good seal.) Use the highest ear protection factor you can find–somewhere around 30 to 35 dB. You can try electronic ear plugs and see whether they work for you.
Try to reduce the noise level. Obviously outdoors lets the sound escape better than indoors, so that gives the edge to outdoor shooting as a step in protecting your ears.
You can also reduce the noise level by firearms that are not as loud as others. And don’t use high-power loads. In other words ditch the magnums. Use low power rounds that are quieter–consistent with what your competition rules are. For example, you could do most of your practicing with low-power rounds and then do your final practicing with whatever rounds you need for competition.
Another factor is time. Since noise damage is a product of sound levels times time of exposure. Thus, if you spread out the sessions so your ears don’t adsorb too much noise too fast, that could help reduce your risk. Thus it would be easier on your ears if you spread a shooting session over longer periods. For example, instead of shooting for 1 hour straight, break it down into 4 15 minute sessions with a half hour rest between sessions–and in that time get well away from any other shooters/loud sounds so your ears CAN rest.
2. Sounds travel though air to your ear canals and then down them. That is why you wear ear plugs–to prevent the loud sounds from reaching your eardrums/middle ear/inner ear. But sound also travels though your body–so sound hitting your skin when the bone is directly underneath such as your skull also transmit sounds to your inner ears. Because sounds don’t travel as well though body tissues as via air conduction in your ear canals, sounds via bone conduction are typically about 30 dB or so softer than through your ear canals.
The problem is that after 30 to 35 dB of reduction via ear plugs, you reach the same level as bone conduction. Thus, you can’t use better ear protection as the sound just goes through your skull and damages your ears. This is why using guns and rounds that don’t produce as much sound are better. The sound then reaching your inner ears is reduced by the 30 dB or so bone conduction and also by the difference between a loud and a soft gunshot.
I’ve never seen it mentioned in relation to shooting but if you have to stand behind your students while they practice. If you held a plexiglass shield between yourself and your student, you’d have an additional sound barrier limiting the shock wave from hitting your body thus reducing the bone conduction and air conduction sound level. You see these clear plexiglass shields used in orchestras to protect various musicians standing in front of the “noisy” instrument.
3. The only difference between bone conduction and air conduction is the path the sound takes to reach your inner ears. With air conduction, you vibrate your eardrum, which in turn vibrates the 3 tiny bones which then pushes on the oval window causing a wave action in the fluid in your inner ear. With bone conduction the sound waves vibrate your skull producing the same wave action in your inner ears–just at a 30 or so dB lower sound level. This varies by frequency, but I’m not getting into that aspect here. So the bottom line is how loud is the sound that reaches your inner ears in terms of preventing/limiting damage resulting in hearing loss and tinnitus.
4. I’d recommend double protection–but if the ear muffs get in the way, then try all kinds of ear plugs and see which works the best for you. I’m no expert on the differences in ear plugs. But also practice all the above tips at the same time. If each tip helps reduce the ultimate ear damage, doing several at a times may put you in the damage-free zone.
Feel free to use this reply, and my other numerous replies to this article and parts of the original article itself to make up your manual.
Just credit it, “Neil Bauman, Ph.D. Center for Hearing Loss Help. Used by permission. See https://hearinglosshelp.com/blog/tinnitus-and-other-ear-damage-from-shooting-rifles/
Cordially,
Neil
About five years ago I was evaluating handguns for a police department. Seven of us were on an indoor range. We continued to shoot for about 2.5-3 hours. I started to get very sensitive to the noise and could feel the rounds going off. I was using properly inserted ear plugs and earmuffs. For the next three months my ears were very painful to any amount of noise, even doors closing. I finally went in to the doctor who told me I have hyperacusis. Even today I have pain from wind noise, music, the vacuum, etc. I was told there was nothing the doctor could do.
Hi Terry:
Your doctor is right, that there is nothing he knows to do to help you, but that does not mean that there are no treatments for loudness hyperacusis. There are. Typically, the place to go for help with hyperacusis is a tinnitus and hyperacusis clinic. These clinics are commonly run by audiologists that specialize in helping people with these conditions.
Loudness hyperacusis is basically a psychosomatic condition, typically brought on by noise trauma such as you experienced and by your emotional response to this. What happens is that your ears now have a reduced tolerance to sound, so louder (and typically higher-frequency) sounds now sound too loud and hurt. The solution is to slowly rebuild your tolerance to sounds so you can once more tolerate normal sounds without pain, etc.
You want to protect your ears from truly loud sounds with ear protectors, but not to normal sounds. At the same time, you want to surround yourself with low-level background sound 24/7 and slowly increase the level of this sound as your ears can take it. This is a slow process and you don’t want to rush it. Most people who persevere with proper hyperacusis treatment improve with time.
Cordially,
Neil
Hello Dr. Neil,
Thank you for continuing to provide help on this page since 2016! You are amazing!
Three years ago on a flight I experienced very sharp pain in my ears while descending. After landing I could hardly hear anything for 3-4 weeks. My GP said the hearing may or may not come back and the cause was because I flew with a cold/sinus issues. I have since flown with “Earplanes” and haven’t had issues. Apparently they release pressure? He also mentioned water behind my eardrum but claimed that’s common. Could that cause any hearing loss? Not all of my hearing returned and I have experienced hearing loss in my left ear and the light ringing persists. I’ve learned to live with it but I’m not sure what damage was caused and if I’m more susceptible now to further damage from loud noise.
Several days ago, I went to the shooting range with a buddy and wore earplugs, so did he. As you might guess, after firing 100 rounds of 9mm ammo my hearing was muffled and ringing for several days after. My buddys hearing was fine he claims. He was in the lane next to me so I could also hear every shot he made too. The shots seemed sufficiently muffled.
My question is whether or not the damage from the plane trip could get worse even with the best ear protection? Am I at a disadvantage with an existing hearing issue? I’d like to use the best earplugs and ear muffs to continue my hobby but don’t want to make things worse.
Thanks again!
Hi Gary:
You should never fly if your ears are clogged up/have a cold, etc. If you have to fly, then take a decongestant about an hour before you take off and again about an hour before you are scheduled to land. And pop your ears regularly when ascending and descending.
Wearing earplanes are good too. They slowly allow the pressure to change, not stop it from changing, but this really helps many people as you have found out for yourself.
Not “water” behind your eardrums, but fluid. I call it “gunk” as it is more like mucous. This gets forced up your Eustachian tubes if your ears are congested with a cold.
Normally, when the cold is over and the gunk drains out, your hearing returns to normal. However, sometimes the cold virus gets into your inner ears and can cause permanent hearing loss.
If shooting lets your ears ring, then you know you didn’t have ear plugs with a high enough protection factor, or you didn’t have them inserted properly.
If you need even more ear protection, wear ear muffs on top of the foam ear protectors. That should work for handguns. With rifles, the ear muffs can interfere with holding the rifle properly.
If your ears seem muffled after a shooting session and you are wearing double protection and that is still not enough, here are some things you can try. 1. Don’t shoot so many rounds non-stop. Maybe shoot 10 or 20 then go to the lobby or away from the noise and give your ears a rest for 15 minutes or so. Then go back and shoot some more. See if that helps.
Another thing to consider is the sound level your gun makes. I think a 9 mm is pretty noisy, isn’t it? Get a handgun that is as quiet as you can find, or buy loads that are not as powerful to try to reduce the noise.
Obviously a silencer would be the way to go if that is legal where you are.
Once you ears are damaged, succeeding noise can cause them to be more susceptible to damage so you need to take even better care of your ears.
Cordially,
Neil
Hi Neil.
I am 20 years old. I have tinnitus in both ears because of headphones (music), but the audiogram only shows damage in right (6000 kHz – 55 dB). My question is:
I want to be a cop, but at the police academy i have to go through firing a 9mm pistol and an AK-47. Is this safe with foam earplugs 37 dB and earmuffs 30 dB (double protection) without worsening tinnitus. I am writing from europe, thank you.
Hi Tony:
I’d think that should be enough. Just be aware that adding the additional 30 dB earmuffs only adds 0.8 dB more protection. (37 dB + 30 dB = 37.8 dB) but it can still be worth it in case your foam ear protectors aren’t sealing properly, then the earmuffs will give added protection.
I hear from too many people that have used foam ear protectors but they didn’t give the needed protection for shooting guns, presumably because they weren’t inserted properly, or worked themselves out a bit.
Although your ears likely are a bit “weaker” due to the previous noise damage resulting in tinnitus, with adequate hearing protection, I don’t think shooting will necessarily make your tinnitus worse. The only way to know for sure is to try it and see.
Cordially,
Neil
Thanks for the answer.
Can you tell me what you would recommend as a replacement for foam earplugs for better protection (+ classic earmuffs)? And should I be worried when more cadets have to shoot at the same time?
Hi Tony:
If your foam ear plugs are rated with a protection factor of 30, that’s about all you can expect. The secret in how well you insert the ear plugs in your ear that makes the difference. If they are not inserted properly, they won’t give you that protection factor in actual use.
I don’t know which ones are better than others as long as the protection factor is the same.
The more noise there is around you should not significantly affect your ears as long as you have your ears properly protected.
Cordially,
Neil
Hi Neil! So yesterday I went and shot my gun and I’m feeling pressure in my ear and a very loud ringing sensation but also I wasn’t wearing protection but when I shot the gun I heard my ear pop not like a normal elevation pop like an actual small pop which I think was caused by the Shockwave what should I do
Hi Jon:
What symptoms have you had besides tinnitus and the feeling of pressure? Any balance problems? Any hearing loss? etc.
If it were me, I’d take zinc and magnesium supplements and take NAC (N-acetyl-cysteine) for a couple of weeks. I’d take the NAC at a rate of about 1,800 to 2,000 mg per day. To be effective, the sooner you begin the better–like today.
And give your ears a rest from loud sounds for a few weeks.
Cordially,
Neil
Hi Neil!
I have tinnitus in my right ear (6000 kHz – 40 dB) because of fireworks. Yesterday I got an inflammation of the auditory canal (otits externa) and my general practitioner prescribed me ear drops containing dexamethasonum, neomycinum and polymyxinum B and he also prescribed me ear drops containing boric acid. Is there a risk of exacerbation of tinnitus due to ototoxicity? If dangerous is there any other therapy for otitis externa?
Hi Antonio:
You need to remember to wear ear protectors when you are around fireworks. They can be very noisy–particularly some kinds of fireworks.
If you have otitis externa, doctors commonly prescribe the combination drug you mention. Personally, I wouldn’t take this combination because it has Neomycin in it–and that is a very ototoxic drug to be putting in your ear canal. Dexamethasone and Polymyxin B are only mildly ototoxic so I wouldn’t worry about them.
If I had otitis externa, I’d use more natural means that are not ototoxic. You can read these solutions in my article at https://hearinglosshelp.com/blog/seven-safe-treatments-for-ear-infections/ . I’d particularly see numbers 6 and 7–using acetic acid (vinegar) and hydrogen peroxide.
Cordially,
Neil
Thank you very much for your reply. I will start treatment with hydrogen peroxide and vitamin c. I only have one question left, is boric acid (3%) safe for otitis externa with the use of hydrogen peroxide?
Hi Antonio:
Never mix different treatments together. You never know what might happen. You could do one treatment one day and the other the next day–that kind of thing if you want to try both treatments–that should be fine.
I don’t know whether mixing them together would be safe or not, so better to err on the side of safety and do as I mentioned above.
Cordially,
Neil
Hi Dr. Neil,
2 days ago I was shooting a 9mm at an indoor facility with 30db plugs in. I guess the right one didn’t fit flush in my Left ear. Immediately my hearing was muffled and ringing. I only shot about 15 rounds. Yesterday i began a round of 60 mg prednisone for 2 weeks and the day today i started 1800 mg of NCA. I guess I’m wondering what is the likelihood of the muffing/ringing going away. I should add the left ear is somewhat bruise feeling as well.
Is there any chance of my hearing returning to normal?
Thank you for actively responding to everyone on here. I appreciate what you do.
Hi Corey:
I’d expect the muffled feeling to go away in a few days at the most, but that is not a given. Everyone’s ears react differently. The ringing should get less as the days go by. Typically, hearing (at least some of it) will return–but maybe not all of it.
In addition to the NAC, you might also want to add two mineral supplements that your ears need–zinc and magnesium. The most bioavailable forms of these minerals are zinc picolinate and magnesium threonate.
Your ears could return to normal (but probably would still have some hidden hearing loss), but most likely you’ll notice a bit of hearing loss (and accompanying tinnitus). Only time will tell in each case.
Cordially,
Neil
Hi Dr. Neil,
When i was younger, approx 23 (now i am 35) i suffered from tinnitus. It started as a minor thing and discovered by chance one evening, and developed into a more serious sympthom that drove me crazy for months (both years, with some peaks, sometimes localized in the middle of my head). Eventually, after a couple of years, it disappeared or simply i got used to it, but to the point that i not ever noticed also sleeping with eaplugs.
Then i started to shoot with firearms; always doubling ear protection and without having any problems for my hears (no hearing loss nor tinnitus). One day, approx 5 years ago, it happened that at the range i forgot earplugs at home and shot one single round of 9mm with earmuffs down (double unfortunate event). My ears immediatly stopped to hear, very huge tinnitus started, and had pain… After few hours the pain had gone and i started to hear again with no other effect apart from tinnitus and extreme sensibility to sounds for some days. I didn’t suffer any ear loss (i went to do some test several days after), but tinnitus didn’t stop, retuned as it was years before, and it took other 2-3 years to pass.
Eventually it completely disappeared and i started to wear earplugs again at night without detecting any noise. I think that much was related to the fact that i avoided to think about it, if i concentrated maybe i could hear something, but i categorically tried not to do it for any reason once i stated to feel better.
In any case, i really felt better and without any tinnitus for several time, since what happened next.
Approx 10 days ago, i was shooting at home with an air handgun, CO2 powered (not firearm) in a semi closed space. Considering that this is not a firearm i did not wear any ear protection (i know that this is not a rule, just explaining why i was not careful).
I shot more than 150 rounds without problems, pain or nouissances, but when i stopped and returned at home, i felt some ringing. I instantly panicked and felt the tinnitus all night.
The next day i shooted again with earplugs, and in few days the tinnitus disappeared (something still present at night, but marginal).
After another couple of days, i shooted again wearing earmuffs (approx 35 dB SNR attenuation, the one i use with actual firearms), approx 200 shots. I wear also safety glasses.. i don’t know it those could have affected the sealing of the earmuffs.
At the end the same as the first time, i started feeling tinnitus and it got worse day by day. Initially i heard it only during the night, now i also experience it all the day long, and it seems to worsen…
It makes very difficul to sleep (and i also need earplugs to sleep in general, i have very light sleep, but i also experience it without earplugs) and i’m really worried that i’m living this experience for the 3rd time in my life. I experience it in both ears, something shifting from the two, and at night becoming very loud at in the center of my head. I also have the sensation to be woke up by the tinnitus itself.
I hope that it will end like the other two times, at a certain point..
Considering that the gun shot develops approx 96 dBA at my ear (measured with several iPhone apps, but another gave me 114 dBA peak), in your opinion is it possibile that i have damaged my ears without using actual firearms? Can tinnitus be related to this or in your opinion is can be only psychological/anxiety related? Can i expect it to pass again?
I also tested my hearing with several apps during these days and it appears on the same levels of what measured years ago with the same method (slightly better, actually) without any significant loss.
Thank you very much,
Best regards
P.S. sorry for my english, it’s not my first language, i hope everything is clear
Hi Rick:
When you shot that one time 5 years ago, your ears suffered acoustic trauma, from which they largely recovered, but you would have had some underlying permanent hearing damage–what they now call “hidden hearing loss” since it doesn’t show up on audiograms.
If you had a tight seal with the air gun, then you shouldn’t have had any tinnitus as I see it. But if there was a leak, the loud sounds could get in and hurt your ears–obviously the sounds were enough to cause tinnitus. And then your anxiety didn’t help, but could have made the tinnitus worse.
When measuring the volume, always use the peak reading as that is what causes the damage, not the average sound level.
You can damage your ears with any sudden loud sound. Your ears don’t care whether the sound was generated by a gun or by a crash or a piece of sheet metal falling down. It’s how much and how fast the sound makes your eardrum move. You could do similar damage if you suddenly squirted water into your ear canal–again, it’s how far and how fast your ear drum moves.
Given your history, I’d expect that your tinnitus will eventually fade into the background like it did before.
But there is a limit. Each time you do this, you are causing more damage, albeit hidden, and eventually, the tinnitus may not go away and you may develop hyperacusis where sounds begin to sound too loud.
So treat your ears carefully–ear plugs and ear muffs (double protection) when you are shooting using any kind of gun. And make sure both are seated properly. For example, if you wear eye protectors, then the muffs may not seal as well as they should, but the foam ear protectors still should seat properly.
And give your ears a rest between all the shooting. Perhaps shoot 50 rounds or whatever number seems appropriate, then give your ears a half hour rest away from all the racket. Then shoot some more.
Also, don’t get so worried and anxious when you develop tinnitus. It is not the end of the world. The more you worry and focus on your tinnitus, the worse it tends to become. So it is always good to forget about it and get on with your life. (But at the same time, note what caused your tinnitus and don’t do that again in the same way. Find a way that doesn’t damage your ears.
One more thing. It is not a good idea to wear ear plugs to bed as that can cause your brain to turn up its internal volume to try to hear more, and the result is that eventually everything can sound much too loud, and it can make your tinnitus worse at the same time.
Better to partially mask the external sounds with some soothing sound–perhaps a fan running in your bedroom, or environmental sounds–water sounds are excellent–waves on a beach, babbling brook, rainfall, waterfalls sounds, etc.. This partially hides your tinnitus so you can sleep and gives your brain real sounds so it doesn’t feel the need to crank up its internal volume.
Water sounds are also relaxing which will help soothe your anxiety.
Cordially,
Neil
Dear Dr. Neil,
thank you very much for your precious response.
I have some more questions:
1) Can the tinnitus increase for days after the last exposure? I went from noticing it just after shooting and only with ear plugs at night (tuesday 2nd June), to noticing it also without earplugs at night, to noticing it all the day long after approx a week… and also becoming more noisy.
In addition, now i also notice a constant/fixed sound on the left ear when i go to bed, very annoying and hard to cover also with ambient sounds… in your opinion, is this related to my brain having increased the volume in the last days ’cause of the plugs, or is a normal evolution of it? If it is related to the volume, can i expect my brain to turn it down again or is it irreversible?
In these days i feel really bad (and guilty) and i fell like i’ve never been so bad relevant to tinnitus. I read other of your answers suggesting that tinnitus may heal after few weeks or months…. of couse there is no guarantee and you are basing everything on what i am writing without visiting me, but is there something that might suggest that this damage could be more durable?
2) I tried to follow your advice and sleep without earplugs and with ambient sounds on the background for the last two nights. I slept more than the previous nights, but i am always very tired when i wake up; i mean, VERY tired. Can the tinnitus affect the quality of the sleep also while sleeping?
Also, are there any risks of sleeping with a quite “high” volume of ambients sounds (i measure approx 50 dBA at my bed)?
3) Relevant to shooting, i could have caused tinnitus while shooting with an airgun with max 96 (or 114 dBA, depending on the app used… let’s say that it is 114 in order to consider the worst scenario); mi firearm, 9 mm handgun, develops 160 dBA (at my ear it can be less, but let’s just consider the worst scenario as before). Doubling the protection, if i’m not wrong, can reduce it of max. 37 dBA, that means that there are still more than 120 dBA left on my ear.
Is it safe (also considering the pause between few shots that yous suggested me)? I mean.. is it safer to hear 120 dBA with ear protection than 114 dBA without?
Thank you very much,
Best regards
Hi Rick:
Yes, your tinnitus can increase for some days after an event as your brain tries to reset itself after the excessive noise exposure.
And your tinnitus can be made worse by worrying about it. The more you worry, the worse your tinnitus becomes. That is why you need to get your worry and anxiety under control. When you are anxious about your tinnitus, you are treating your tinnitus as a threat to your well-being. When this happens, your brain HAS to listen to it and warn you about it.
However, if you treat your tinnitus as a totally unimportant, background sound that is NOT a threat to your well being, then your brain can let it fade into the background and thus it will not bother you.
Wearing ear plugs essentially starves your brain for sound, so it turns its internal gain up so you can hear better and this just makes your tinnitus even louder.
Your brain can learn to turn down the volume, it is not irreversible. That’s the good news. But you have to do your part as I explained above in order for that to happen.
In answer to your second question, if your tinnitus prevents you getting a restful sleep, then you could indeed feel very tired in the morning. It’s not the tinnitus bothering you while you sleep, but getting to sleep and staying asleep that is the big problem so yoeu get the required number of hours of uninterrupted sleep.
Obviously, you want your bedroom to be as quiet as possible, but wearing ear protectors for 50 dB of ambient sound can be counter-productive. Personally, I wouldn’t sleep with them in.
3. I think that 114 dB could have caused your tinnitus to worsen. Especially when you shot multiple times. I believe that short, sharp, sudden sounds can cause more damage than continuous loud background sounds–in the short term. But continuous loud background sounds will cause more damage in the long term.
If your 9 mm has a muzzle report of 160 dB, it will be somewhat less at your ears since you are pointing the gun ahead of you and away from your ears so the sound will be louder ahead of you. I don’t know how loud it would be at your ears. Wearing ear protectors and then ear muffs will give you around 35 or so dB of protection. So you will want to give your ears periodic rest periods as the sound will still be pretty loud in your ears.
To answer you last question, loudness is loudness–so 114 dB is always safer for your ears than 120 dB, but whenever you shoot, you should always wear ear protection because sudden loud gunshots can cause ear damage.
The idea when it comes to shooting is to protect your ears as much as you can no matter what gun you are using.
Cordially,
Neil
Dear Dr. Neil,
Thank you very much for your reply. I see that you put a lot of effort in answering everyone, I think that this is really admirable.
I have a few updates: after a few weeks (approx. 14 days ago), I started to feel better and I decided to shoot again. I shoot my BB gun again with DOUBLE hearing protection, meaning both ear plugs and muffles. I shoot approx. 150 rounds giving a rest of approx. 10-15 min after each 50 rounds.
I could hardly hear what people say with such protection, I still heard the sound of shots but really muffled.
Ditto, when I finished shooting, after a few time, I began to hear tinnitus and I became worse the day after, and kept worsening to the point that I know hear it often the whole day. At this point, although the first time that I shoot without protection I might have damaged something, I begin to think that my anxiety and mi mind play a huge role in this thing. I mean, maybe you can tell me that I am wrong, but I think it’s very had that shooting a bb gun with double protection (properly fit, I took a lot of care also wearing safety glasses with band instead of arms), can lead to some damage.. also if there are some surfaces that can reflect the sound, but the sound level with such protection should be quite safe also for hours of continuous exposure… Maybe It’s the fear or the recall of past experiences.
I also took n-acetyl cycteine for days at high dosage, just in case, and some magnesium, but tinnitus keeps worsening.
I think that I’ll stop shooting for several months in any case, no matter what gun or what protection.
I have some additional answer from this last weeks:
1) When I go to bed, also after days that I experienced few tinnitus, I always woke up at approx. the same time (something aroung 2-2.30 a.m.) with huge tinnitus. Is it possible that thinking about it during the day influences the behaviour of tinnitus/mind at the night? It happens also if I feel quite positive when laying down.
I’m sleeping without plugs, with background sounds at approx.. 40 dBA, but somehow tinnitus finds the way to be heard no matter the volume (it seems to “adapt” to the volume of the outside) and the type of sound. I have to use high frequency sounds (crickets, birds.. that are not relaxing, to me) instead of water or white/brown/pink noise because they are not able to mask it.
I can hear it on my left hear, on the right or in the centre of the head.. Sometimes is more “concentrated”, and sometimes is more diffused… does this mean something?
I also feel the ears quite “full” and muffled sometimes, and this also doesn’t make sense to me apart the fact that maybe I’m putting a lot of attention to it considering that I’m not exposing myself to any loud sound.
2) The thing that lets me hope, is the fact that from the first day of shooting (the only one with not protected ears) I experienced several days (but not nights) with no tinnitus… is it a good sign or the fact that these events are becoming more rare could mean that tinnitus can simply worsen?
3) I’ve been suggested to try some meditation. Is it a good thing in your opinion (acceptance, less anxiety etc.) or I can worsen the symptom considered that during meditation you have to put a lot of attention to your body and anything you feel?
Sorry for the quantity of answers, at present time I feel like I won’t be able to return to normal life again.
Thank you very much,
Rick
Hi Rick:
Shooting a BB gun with double ear protection shouldn’t hurt your ears nor cause your tinnitus to get worse.
I have to agree with you that worrying about your tinnitus and past experiences could be the most likely culprit in your tinnitus worsening.
Giving your ears a rest from shooting for a few months seems like a good idea.
It’s possible that your tinnitus gets worse in the early morning and wakes you up due to your thinking about it during the day. It seems you fall asleep easily, but after you get some hours of deep sleep, then you wake up with bad tinnitus.
Perhaps you should try some sound therapy at night to give your ears more real sounds to listen to. You want continuous background sounds that you find relaxing and not annoying. You do NOT want to mask your tinnitus–those sounds would have to be too loud to do that, and besides, that would not help you get rid of your tinnitus. You want the sounds to always be well below your tinnitus level. The idea is to reduce the contrast between your tinnitus and silence–not that your bedroom is silent anyway as you have previously explained.
Your ears feeling full and muffled can be from the initial shooting episode resulting in acoustic trauma. Those two are symptoms of acoustic trauma. Hopefully, they will fade away in time.
It’s always a good sign when you can go for hours without hearing your tinnitus like you are during the day. Tinnitus at night is always harder to stand since you are trying to sleep and since you aren’t actively doing something, its so easy to focus on your tinnitus.
Meditation can be a good therapy, but not if you focus on your tinnitus unless you are doing something like mindfulness therapy where you hear your tinnitus, but let it go and not form a judgement about it. It’s when you focus on thoughts like it will never go away, or it will always bother me–that kind of thing–that you make your tinnitus worse.
Cordially,
Neil
I went shooting last sat. Without ear protection.. Tomorrow will be a week and my ears r sfill ringing and deel muffled. Im really stressed about it all. How long could it take for my ears to.go back to normal?
Hi Alicia:
How are things going now–still just as muffled and the ringing still just as loud, or are things slowly getting back to normal?
There is no way to say how long it will take as that depends on a number of factors such as how many rounds you fired, how loud the gunshot was, how robust your ears are, how much and what kind of damage the excessive noise caused, and your level of anxiety over this event and how you treat your tinnitus. For example, if you treat your tinnitus as a threat to your well-being, then it will stick around, whereas if you treat it as a totally unimportant sound that is safe to ignore, then it will tend to fade away in a few weeks or months.
Cordially,
Neil
Hello Dr. Neil,
I am a 14 year old male. I just went to the shooting range and shot a .40, but I was also exposed to other weapons. I failed to correctly put on my ear muff for my right ear, and now I feel like it is clogged. It is not very severe, but it is uncomfortable. I can still hear out of it. The strange part is that when I rub it or squish it, my ear temporarily returns to normal, before going back to the muffled, clogged, sensation. What should I do?
Hi Daniel:
How is your ear doing now? Is the muffledness going away? If so, I wouldn’t do anything and just let your ear “heal”. And stay away from loud sounds while your ear heals.
Cordially,
Neil
I went shooting outdoor with a 380 and an AR sat June 6th without ear protection. There was other people shooting as well without ear protection. And everyone else is fine. I have a consistent ringing in my ears. I went to the ent and had a hearing test done and I have hearing loss high frequency 6000hz-8000hz at 70-75db in both ears severe. Could my hearing and the ringing eventually go away
Hi Alicia:
Your hearing loss probably won’t come back. The high frequencies are the first to go which is what has happened to you. Since tinnitus very often accompanies hearing loss, your tinnitus may prove to be permanent as well. But you can learn to habituate to your tinnitus so it won’t bother you, and indeed, you may not even be aware you have tinnitus for hours on end.
You NEED to wear ear protectors when you are shooting guns. Those gunshot sounds are just too loud not to damage our ears.
Cordially,
Neil
I do hair for a living and I’m around blow dryers and I eye vac which is loud should I wear ear plugs the whole time I’m at work or is this bad to do.
I feel like the ringing is making it harder to hear.
Hi Alicia:
I don’t know how loud your hair dryers, etc are. An easy way to tell is to download one of the many sound meter apps to your cell phone and hold it up near your ear and hold and use the blow drier as you normally would and see what the readings are on the sound meter. You might have to get someone to read the meter as you want the microphone to be by your ear canal in order to get an accurate reading.
Then let me know what the readings are and I’ll give you an answer.
Tinnitus can make it seem hard to hear. When I was young, I likened mine to trying to hear through a fog. But the truth is, you hear just as well as if it disappeared, but the tinnitus sounds can make it seem harder to understand speech.
Cordially,
Neil
Is there any chance the tinnitus will go away in a few weeks or months? I’m so freaked out about it im having tfouble coping with it and doing everyday normal things.
Hi Alicia:
Since you have a pretty severe high-frequency hearing loss, I doubt your tinnitus will go away completely, but you can become habituated to your tinnitus so it essentially fades into the background and no longer bothers you.
But in order for that to happen you have to quit freaking out about your tinnitus. You have to treat it as a totally unimportant background sound that you never give a thought to–in other words it is NOT a threat to your well-being.
The way you are treating it, it is a very important sound or else why would you freak out about it. By doing this, you are telling your brain to always let you hear it because it IS a threat to your well-being.
You need to change your attitude towards your tinnitus if you want to let it fade into the background.
Cordially,
Neil
I’m in the army and I was shooting. My earplug fell out and I kept shooting. It’s been about a week. Initially I couldn’t hear out of my right ear. Now I can hear but my ear is always ringing and noises like flushing the toilet or turning the sink on make the ringing worse. Will this ever go away? Should I be trying to avoid noises that irritate it?
Hi Jesus:
You have suffered acoustic shock and it has resulted in hearing loss, tinnitus and loudness hyperacusis.
What your ear really needs is a rest from loud sounds while it recover–but this can take a couple of months and I guess you don’t have that option. But you want to protect that ear from loud sounds in the future. But you don’t want to overprotect your ears by wearing ear protectors unnecessarily or you will make things worse.
Avoiding sounds that irritate it is a good initial strategy, and then as your ear can handle it, slowly introduce those sounds into your environment again.
There are no guarantees that your tinnitus will go away completely since you now have a hearing loss and typically tinnitus accompanies hearing loss. But if you treat your tinnitus as a totally unimportant background sound, and thus NOT a threat to your well-being, it will tend to fade into the background where it will no longer be a problem.
Cordially,
Neil
Hello Dr. Neil,
I have tinnitus in both ears for 7 years (but only damage in right ear (6000 KHz – 55 dB)) because of mobile earphones.
1. Is it safe to shoot from a 9mm gun with earplugs (37 dB) + earmuffs (35 dB) without the risk of worsening tinnitus
2. Sometimes I get a weird feeling in my ears like a sound trauma, that every sound around me makes my tinnitus worse. This feeling lasts for about 30/45 minutes and then disappears. What could be the cause of this?
3. If I don’t have a hearing loss in my left ear why is my tinnitus noise more loud in left ear?
4. What would you recommend for occasional panic attacks when tinnitus is a little louder than usual?
ENT prescribed me B-complex vitamins, melatonin (as needed), zinc / magnesium and recommended physical activity.
Can it help reduce tinnitus a bit?
Will there ever be a cure for tinnitus? 🙂
Sorry for my language english is not my first.
With gratitude
Hi Anthony:
Here’s my answers to your questions.
1. It should be, but everyone is different. I’d cautiously try shooting a round or two and see what happens. But don’t go shooting steadily all afternoon without breaks. Your ears need breaks even with ear protectors. So take half an hour off between shooting a number of rounds. Your ears should tell you when you’ve done enough.
2. That is called reactive tinnitus. Reactive tinnitus is a combination of tinnitus and loudness hyperacusis. Typically hyperacusis is a result of exposing your ears to excessively loud sounds.
3. Who says you don’t have a hearing loss in your left ear? There are hidden hearing losses that obviously don’t show up on normal tests. For example, they test to 8,000 Hz, yet normal hearing goes up to 20,000 Hz. If you have a lot of hearing loss up there, you could have tinnitus as a result even though “they” say you have perfect hearing (below 8,000 Hz). You could also have hidden hearing loss due to loud sounds but in the underlying supporting cells in the spiral ganglion where synapses are damaged or broken. This will prevent a sound signal being sent to your brain.
And tinnitus seems to move around. For example, you can sometimes hear tinnitus in one ear, the other ear, both ears at once, or just inside your head. So I wouldn’t worry much about why it seems louder in your good ear.
4. Why would you panic just because your tinnitus is a little louder. Just accept it. Do you try breathing exercises to put the brakes on the panic when you feel an attack coming on? This is a simple and easy way to stop them. Also, learn to totally relax and do that when you feel an attack coming on and see if you can prevent it becoming a full blown panic attack. I don’t recommend using drugs except as a last resort.
5. Your ears need zinc and magnesium so if you are low on either of these minerals, taking supplements is a good idea. Physical exercise gets the blood flowing to your inner ears and if a lack of adequate oxygen in your inner ears exacerbates your tinnitus, this is all to the good. Vitamin B3 is a vasodilator and also can increase blood flow–so likewise it is a good idea. And exercise can help you keep your mind off your tinnitus–also a very good idea. The more you focus away from your tinnitus, the easier it is for your tinnitus to fade into the background.
6. Finally, no, I don’t think there will ever be a cure for tinnitus for the simple reason that there are several kinds of tinnitus–and each kind requires different treatments. So there will never be one drug that will “cure” tinnitus. But even today,there are “cures” for certain kinds of tinnitus. For example, if your tinnitus is a result of your temporomandibular joint being out of place, getting that taken care of can get rid of your tinnitus.
Cordially,
Neil
Hello Dr. Bauman;
8 days ago I shot at an indoor range for an hours, with 35 rounds from a 12 gauge shotgun and a lot of 9 mm. I was wearing hearing protection (over the ear) and used the foam inserts in the ear. Anyhow, I have had my ears ringing since with some muffled sensation.
I did see an ENT today and reported mostly normal hearing, with some loss on higher-pitches. I do feel like it was kind of a waste of money.
Anyhow, is it possible my ringing could improve over time?
It is not not really noticeable when I’m outside but very “loud” in quite settings, including bedtime-I use a box fan to help.
I won’t go shooting for a few months, may choose an outdoor range with weapon mufflers. I already bought new hearing protectors since I think the one I used did not properly seal.
Thanks in advance for your reply, Aric.
Hi Aric:
Obviously, the ear protection you wore was not enough for the volume of the guns you were using. Perhaps your ears are more sensitive that the average person’s ears so you notice it more–and get the tinnitus.
Giving your ears a few months rest is an excellent idea–given them time to recover as much as they can.
Be aware that 9 mm and 12 gauge guns have a muzzle blast of around 160 dB. Since ear protectors only give about 35 dB protection, you are still hearing the blasts at around 125 dB and that is too loud for most ears. Mind you, your ears are not at the muzzle so what your ear hear is less than that, but still plenty loud. So you may want to limit your shooting to a few rounds each day to avoid having hearing and tinnitus problems.
Cordially,
Neil
Dear Neil,
On December 22nd 2019 I shot 15 rounds from a 40 caliber pistol. I used foam earplugs and had faint ringing in my right ear after. The noise was faint I didnt think about a trauma. I went to an ent 18 days after the shooting and had injections in the ears. Also oral presidone. Wish I would have went right after. Anyways, I my audiogram is between 20 and 30 db from 750 to 8k. However it was found I have a 60 decibal notch at 250 and 500 Hertz. Does firearm noise affect the low frequencies? I have piercing low roaring and high pitched ringing all the time. How do I habitatuate to these sounds?
Hi Joshua:
I’ve never heard of firearm noise causing a low frequency loss such as your explain. It seems your audiogram shows a reverse slope hearing loss rather than a noise notch.
Do you have an earlier audiogram for comparison purposes? Maybe all the hearing loss wasn’t from the gunshots, but from some other cause. I rather suspect that is the case.
Your low frequency roaring is likely due to the low frequency loss, and the high frequency ringing from the high frequency loss.
You habituate to your tinnitus by first accepting that tinnitus is NOT a threat to your well-being and then act that way. Consider it the same as you do any other unimportant background sound such as traffic noise, or the sounds your fridge makes which you basically totally ignore. As you do this, you’ll find that your tinnitus begins to fade into the background and in time won’t be a problem at all.
If your tinnitus is intrusive so you find it difficult to ignore it, then you should use some sort of sound therapy to partially mask your tinnitus to help this process along. You don’t want to totally mask your tinnitus as that only helps in the short term, but doesn’t help you habituate to your tinnitus.
Cordially,
Neil
Thanks for the reply;
In your experience, is it typical my ringing could improve over the next few months of ear rest or is this volume likely permanent?
Still very noticeable in quiet settings and has affected my sleep, although so far I have not let it give me anxiety primarily by staying active/busy.
Frankly, it’s the hope there may be some improvement in the tinnitus that keeps me going, but it can be hard at times.
My hearing has historically been sensitive, had a similar issue after a concert in ’91 and at the range in ’98-if memory serves it took some time for an improvement.
Again thanks, I am very grateful for this resource as there is a lot of misinformation out there.
Hi Aric:
Yes, your tinnitus can improve with time. If you learn to ignore it and let it fade into the background, it will become less and less intrusive. So you have hope. You’ve done it before–even though it took some months each time, so you can do it again. You have to give it time.
When you sleep, it wouldn’t hurt to have some soft sounds on–white or pink noise, water sounds, music, etc–something constant and at a low level to give your ears/brain some real sounds to hear–something real, but at the same time totally unimportant sounds so you only passively listen to them and basically then ignore them–and with them you also ignore your tinnitus.
Cordially,
Neil
Dear Neil,
I recently had an encounter with fireworks, and one went off very close to me, causing an instant ringing in my right ear which faded after around 10 seconds or so. afterwards, my hearing in my right ear was slightly muffled. it has been 3 days, there’s still a mild muffled and plugged up feeling in my ear, and a buzzing sort of tinnitus. I’m getting extremely worried that this is permanent and that i wont be able to properly sleep and hear again. is there any chance of recovery for me?
Alyssa
Hi Alyssa:
You need to calm down. It’s only been three days since this happened. You need to give it time. I’ll bet in two months, you’ll have forgotten all about it as your ears heal.
If you want to help the process along, I’d take zinc and magnesium supplements which are two minerals your ears need to stay healthy and also the precursor of glutathione, the body’s most powerful anti-oxidant, commonly referred to as NAC (N-acetyl-cysteine). This helps zap the free radicals that are produced by the noise trauma. You can take up to 1,800 mg a day of NAC for a couple of weeks to help your ears. The sooner you begin taking these, the more you can help your ears. Time is of essence when it comes to zapping free radicals.
Cordially,
Neil
Hi Dr. Bauman;
What are your thoughts on prednisone in my situation, per my prior posts?
To recap, it has been 14 days since onset of tinnitus after indoor range shooting. I appreciate your recommendations thus far in dealing with this and am I not even close to panic/anxiety, but I am curious about this steroid as it applies to my symptoms as well as its risks (could prednisone possibly worsen tinnitus symptoms?).
Should I be surprised my ENT on my visit on 7/2 did not even mention it?
I did some research and discovered studies using this with good effect (National Institutes of Health 2011 and the Elyns Publishing Group 2015).
I have also inquired of my ENT this option today and await their reply.
Thanks again, Aric Walsh
Hi Aric:
Some doctors think Prednisone is the solution for most ear problems. Others don’t. The truth is, sometimes it works and sometimes it doesn’t. There’s no way to tell ahead of time. So if you choose to accept the risks of Prednisone side effects, you may choose to try it and see whether it helps your tinnitus.
Although Prednisone helps people with ear conditions, it can also cause them or make them worse–including tinnitus. So you have to weigh the pros and cons.
If you choose to take the Prednisone, you need to do it asap as the longer you wait, the less chances it will help. By 30 days, it is basically a waste of time and you are fast getting there.
Probably the most effective would be an intratympanic injection rather than oral pills.
Cordially,
Neil
OK-I began taking oral Prednisone last night-technically day 15.
As of 16 hours of taking the med, it seemed to aggravate tinnitus but today maybe a littler better but basically about the same.
Hi. A week ago I shot a 9mm hand gun and since I noticed the sound of running water or if I open a plastic bag it sounds lower or muffled. I have no ringing or anything.
I can hear out of my ear but different sounds do sound different than the right ear. Will this go away and did I damaged my ear?
Thank you
Hi Rebekah:
I’m sure you suffered acoustic shock. It can take 2 to 4 weeks for various symptoms to show up. They typically don’t show up right away.
If you don’t expose your ears to more loud sounds, hopefully your symptoms will fade away in time. You probably did cause some hidden damage to your inner ears.
Cordially,
Neil
Hello Dr. Bauman;
Just an update-been 31 days of T since range shooting (with hearing protection) and prednisone day 15 to 30 did not benefit my tinnitus.
Still the same volume and causing difficulty in sleeping and life. Very well read on and implementing coping strategies and not overtly giving into anxiety, but the symptoms for me the same and very real.
Hopefully this can still improve, with time, but concerned that symptoms have not improved at all.
As mentioned, saw an audiologist 7/2 with mild hearing loss high pitch. ENT’s office today asked for my conditions update and requested an ENT evaluation. Not sure what benefit that would do for me.
Thanks, Aric.
Another update: My tinnitus all of the sudden improving-still there but lower volume-sleep all the sudden returning to normal. Again, always had T but seems this was worse but now improving-hope I recover back to where I was but relieved to finally see improvement this week.
Thanks Dr. Bauman for your advice.
Hey Aric, i’m dealing with a similar issue. Can you please give an update?
thanks
Hi Jay; no significant improvement since my last post about 3 months in. I have personally habituated better to it, but still very noticeable in quiet settings and at bedtime. It still affects my quality of life.
Hello Arick. i have the same problem from the 13 september 2020. plz tell me How Are you? i’m very scared and in deep depression a cant work and sleep. Very loud T
Hi Boris; personally I am fine surprisingly I have had no anxiety/depression BUT have very loud T. No improvement. I still work and sleep, but T always there. Not sure how/why I am able to function normally unlike others with T, I just am.
My medical services have not helped, I essentially concluded I am on my own with this one.
Appointments for care for this were a waste of time/money.
The medical profession does not offer cures or improvements for most conditions these days, instead they offer meds that probably will not work for T and anecdotes.
The focus is on “managing symptoms” rather than real improvement of symptoms, finding any solutions is asking the impossible of them.
Hey Dr.Bauman
9 days ago I was out on the back part of my property to shoot. I was alone and only had a little time away. I stupidly forgot to put my hearing protection on as it was so quite out. I shot one round of .38spl from a snub nose revolver. … instant regret. Both ears pretty bad for two days . Then my right got better but left not so much. Went to Gp and they put me on prednisone 7 day. I wasn’t content with that and went to an ent two days later or 4 days ago. They gave me a hearing test right ear normal left ear typical notch. Prednisone 7 day but start at 60 and taper . I wore an earplug for the first 5 days as the sensitivity was so high. I see from tour posts not to do that too much.
I’m wondering if it’s normal for the symptoms to fluctuate. Muffled not or less , same with tinnitus. Still feel like I have water in my ear, now starting to have some aches show up as well in and around the ear.
Did my simple 1 shot mistake damage my hearing permanently?? Why is my left sooo much worse than my right. I know as a right handed shooter the left ear takes more of the impact. However, it’s been 6 days since my right ear got better.
Hi Jay:
It’s hard to believe one shot did that to you, but everyone’s ears are different–some are “fragile” and some seem to be made out of cast iron! You did what you could by getting the prednisone ASAP.
Fluctuating symptoms is a good sign–shows they are not constant and permanent. So I wouldn’t be surprised if they eventually fade away.
You probably caused some permanent hidden hearing loss, hopefully relatively minor.
You answered your own question as to why your left ear got the brunt of it and thus still has more symptoms. But hopefully, things are much better now that another week has gone by.
Cordially,
Neil
About 20 years ago I accidentally shot a gun without putting the ear protection back on my ears. Ever since I have been experiencing dizziness sensations and sensitivity to loud noises. Multiple docs across multiple specialities can not figure out what is happening. Do you have any suggestions?
Hi Erica:
If the dizziness and sound sensitivity has stayed the same throughout all these years, the only thing that comes to mind that makes any sense is that the loud sound blew a third (pathologic) window in your inner ears on the vestibular side. This means that sound signals can reach the balance (vestibular) side of you inner ear where your brain interprets these sounds signals as balance signals. These bogus balance signals then confuse your brain as they don’t agree with the signals from your balance organs. This confuses your brain and you end up with dizziness (and vertigo in some people).
This pathologic third window (besides the normal oval and round windows) can also result is sound hypersensitivity. Have any of your doctors specifically checked you out for superior canal dehiscence, or any dehiscence in the other two semicircular canals and related structures. That seems the most likely areas to investigate first.
Cordially,
Neil
Hello Dr. Bauman,
I am a 30 yr old male. On Saturday 8/1 at ~7:30pm I went to an open area on my property with the plan to target shoot. I had hearing protection …. but forgot to put it on before the first shot. I was shooting a .38spl snub nose revolver. I only shot one time and i had immediate ringing and muffled hearing ( under water sound) in both ears. That quickly made me deiced to not shoot anymore. The next morning my right was better , not maybe 50% but my left was still very muffled. By Monday night my right was 90% but my left was still ringing , muffled and now very sensitive (started wearing an ear plug in my left ear) . I made an appt with my GP and they prescribed a taper does of prednisone. and if the symptoms did not go away i would need to schedule a follow up with an ENT.. i did not want to wait so i went to the ENT on Thursday. Went to the ent and had a hearing test. presented with “Typical Notch” in left but basically normal hearing in my right. They prescribed a higher starting does but another taper 60mg-5mg over 7 days.
I stopped wearing an earplug last friday.( day after the ent) As i have seen where that could hurt healing.
Today is 7 days and i took my last dose of prednisone. My left ear is less sensitive. But i still have the muffled hearing ( like listening through a wall or i have water in my ear) Actually numb feeling to the touch and ringing.
The ringing seems to fluctuate. not in the sense that its louder and quieter per say. More that its pitch goes up and down like dialing in an old radio.
My question is, does this tell you i’m still healing … or is this what i will be left with…. after just one shot, from a pistol … out side …. I have a follow up on 9.3 with the ent for another audiogram. I have also been taking b12 magneesium and a multi with 125% zinc. to try to get this resolved.
It feels just like my ear needs to “pop” like when on a plane or driving through the mountains. but without the discomfort.
Hi Jay:
When you subject your ears to acoustic trauma from sudden loud sounds like gunshots you can get a number of symptoms like the muffled hearing feeling you have. Also, the numb feeling is one of the symptoms. And it is very common to have that feeling that your ear is blocked and needs to pop–but you can’t pop it. That’s all part and parcel of failing to protect your ears from loud sounds as you now know.
Now you need to give your ears a rest from louder sounds for a couple of months at least and see how things are then.
Cordially,
Neil
You are still in early days of recovering. Don’t expect to recover in a week or so. Depending on the “damage”, recovery can take months, not just days or weeks.
Hello thanks for the reply . Now at exactly 3 weeks the fullness feeling subsided greatly two days ago . However I fee that the tinnitus has not changed. It does seem to fluctuate but when it’s loud it’s greatly affecting my mood/daily life. When it’s bad I feel like if I mess with my ear ( press on the Tragus , pull or cup with my hand ) seems to relieve it momentarily.
I’ve seen online (YouTube ) pink noise and other tinnitus relief sounds … idk how legitimate those are. This has got to get better I have two little boys under 3 and I am a grumpy mess right now . Filled with anger at myself for such a dumb mistake . I’ve been taking b12, magnesium, d3 and a daily since 3 days after injury. I added NAC two days ago.
Could I have done more harm by wearing an earplug to much for the first few days after this happened ?
I feel like on the good days it’s manageable but like today (bad day) I just can’t imagine living this way.
Hi Jay:
When some symptoms go away, that is always a good sign. It is normal to have good days and bad days. As time goes by, hopefully you’ll have more and more good days and fewer and fewer bad days. Don’t let the bad days through you. Just press on. The good days will come again.
Pink noise and other tinnitus-relieving sounds are good to have playing in the background–especially on the bad days. You don’t want them so loud they drown out your tinnitus–just loud enough that they take the edge off it. Water sounds are very good and relaxing too–waves lapping on the beach, waterfalls, rainfall, babbling brook, etc.
I don’t think you did much if any harm in wearing the ear plugs for a few days, but you need to minimize their use to situations where you really need them while your ears recover. (Screaming kinds in one situation that comes to mind.)
Cordially,
Neil
Dr. Bauman,
First I want to thank you for the blog and for your compassion and understanding. It’s really amazing that you answer and engage the posters. If there is a way to donate to your blog and assist you in continuing to help others l’d like to do so.
I am a 50 yr old male and experienced acoustic trauma at an outdoor gun range on 8/21/20 in the late afternoon, discharging a .223 rifle while using 3M ear plugs rated at 25db NRR. This was my first time firing a rifle and my last. I did not feel or sense any abnormal “loudness” from the gunshots, compared to pistol rounds which I have fired in the past. Several hours later when I was home the voices of my family members began to sound different.
Almost electronic in nature, as if they were using a vocal box, or if they were speaking in front of a fan. Kind of Alvin and the Chipmunks tone of voice, sounds like a harmonica if that makes sense..like an extra vibration is being produced in the voice. And my voice sounds like this inside my head as well. Is this a kind of tinnitus? I don’t hear ringing, buzzing, or hissing noises when alone and quiet as others seem to describe their tinnitus.
Funny enough, when I or others speak in a whisper the voices are not distorted. I can hear all other sounds fine with no muffling or distortion. Birds and crickets outside, the tick of the second hand on my kitchen clock..all sound normal. I went the ENT on 8/25/20 in the morning and had an audiogram performed and had my ears examined. ENT told me he sees no physical damage inside my ears and that the audiogram suggests hearing loss at frequencies and decibels normal for age related hearing loss, but without a baseline audiogram to work from he can’t say more.
Some voices sound normal and others are distorted as I describe above, seems as if male voices are not as distorted as women. This occurs intermittently as well. A conversation can begin sounding distorted and then “switch” to normal sounding voice. Two people can talk and one sounds normal and the other distorted. ENT put me on Prednisone 60 mg to be tapered and suggested we could follow up with tympanic injection after the oral prednisone if my hearing hasn’t improved.
I began the prednisone that day of the consult, 8/25/20. I have taken Chelated Zinc (23mg) and Chelated Magnesium (400mg) supplements daily prior the incident, but just discovered NAC from your writing and began taking the 1800 MG dosage on 8/26/20.
The ENT informed me I only have about 3 weeks to try the prednisone treatment and after that it’s not efficacious. I have a follow up on 8/31/2020 and I’m considering requesting simultaneous injections while continuing the current oral prednisone treatment. Am I being to aggressive with this? The time frame for the steroids effectiveness has me concerned. If I wait for the oral regimen to be completed before the injections that will put me in the beginning of the third week since the acoustic trauma. Studies I’ve read about oral vs injection say they have similar results. Your thoughts and comments are appreciated.
Christopher
Hi Christopher:
Thanks for your kind words.
I try to help as many people as I can, but I can’t help them all. If you want to donate towards helping me keep doing what I do, that’s great. I don’t have any donate buttons on the website, but feel free to donate via PayPal. My email address at the bottom of any page in the website is the one registered with PayPal. I’m always appreciative of any donations I receive.
I don’t understand why your ears are acting up. A 223 isn’t a loud rifle is it? And you were wearing ear protectors? And it didn’t seem loud to you at the time. So unless the ear protectors weren’t inserted properly, you shouldn’t have experienced acoustic trauma–but you did for some reason.
Distorted hearing is one of the hallmarks of acoustic trauma. It seems that the sounds that bother you the most are louder higher-frequency sounds, correct? I’d expect this due to the way our ears are made. That is why you hear female voices as more distorted–they are higher-pitched.
Hearing loss from acoustic trauma doesn’t necessarily show up on audiograms. Rather, it is hidden–hence the name “hidden hearing loss”. The damage is in the synapses. Sometimes they heal themselves and other times they don’t and the associated hair cells then die as well.
I am optimistic that your ears will heal as you have intermittent good and bad times.
The Prednisone may be helping. As your doctor said, prednisone is best taken right away–and certainly within two weeks. After that it doesn’t do as much, and by the end of 30 days, taking it is largely a waste of time and money. If it were me, I’d finish the taper you are on and then that would be it for the prednisone–unless you can see good things happening due to the prednisone. Then it might be worth trying another course, or an intratympanic injection or two.
Acoustic trauma takes time to heal. It’s not so much hearing loss as distorted hearing.
The big difference between using pills and intratympanic injections is that the pills affect your whole body, whereas the injections get the Prednisone where it is needed without first going through your whole body.
I don’t think I’d take both pills and injection at the same time. But your doctor would know more about that. Just remember, there are no guarantees that the prednisone will do anything. Sometimes it does and sometimes it doesn’t. You try it out and see. Sometimes hearing, etc. comes back on its own without any treatment–so taking prednisone is basically a “let’s try this and see if it helps or not.”
Cordially,
Neil
Hey Dr.Bauman,
Thank you for your continued guidance. I am now right at 30 days and my follow up is in two days. I still have hearing loss at the > 4000 hz, still some fullness, numbness and tinnitus with Hyperacuses ( I actually think that its recruitment as its not uncomfortable but rather annoying, sounds like water running or certain pitches in music) I am still taking the supplements. I have requested that I get Dexamethasone injections starting Thursday . What are your thoughts on this? Is there anything else i can do to try to recover some hearing? My Audio gram is above average in my right ear and below 3000hz in my left. I don’t think i would be a candidate for a hearing aid, what are your thoughts on that? I’m feeling very down about this and i wish i could turn back time…… what an idiot.
My last symptom that i had not mentioned yet is hard to explain. If i cup my ear or put my finger in it as though im going to itch it. I feel like there is fluid in my ear. I get a weird crackling like crinkling paper, if i modulate by “Itching” i almost get a bit of dizziness not really spinning just feel like my entire head is moving. it does not happen with my right ear, only the bad (LEFT) one . Thank you again for your guidance during this and i look forward to your response.
regards
Jay
Hey hey man did it ever get any better I am at 4 weeks now did the ringing at least become manageable and Soften up a bit with time. ???!
How’s everything now days Jay?
Hello Dr. Bauman
Can martial arts worsen tinnitus?
(blows to the ears, blows to the jaw, pressure on the ears …)
and
can a person with tinnitus attend concerts and nightclubs with earplugs (30 or 35 dB)?
Hi Ivan:
Any head trauma–so yes, blows to the ears, jaw, etc. can result in tinnitus–and could cause other ear problems too.
Sure you can attend loud events–but it may not be wise to do so–even with ear protectors. It all depends on how “robust” your ears are, how loud the venue is where you are sitting/standing and how long you stay there.
If the sound entering your ears behind the ear protectors is down to 85 dB or so, you shouldn’t have a problem.
If your ears begin ringing at any time, or are ringing when you leave, then you (belatedly) know that the sound was too loud for your ears.
Cordially,
Neil
Hi, I love your site. I stumbled upon it after an accidental over exposure to my ears. I hope you can offer some advice.
So…I live in a very rural area in the mountains (literally can’t see a light from my house – we’re out there). Outside of the city it is allowed to shoot a gun on our property – we even have our own personal shooting range. My point is we openly shoot on our property so we’re usually taking all kinds of precautions, including for our ears. My husband has seen an audiologist for years for annual checkups because of a viral infection when he was a child that caused slight hearing loss in one hear. Therefore we are reasonably informed and make sure we take care to protect his hears – he never shoots without hearing protection, even using the pressure washer and etc, he uses protection. On the other hand I am incredibly sensitive to any sounds. I hear things sometimes literally a mile away and around other people I am always the one more annoyed by a sound that anyone else and the first one who hears even the slightest sounds. Good hearing is not always a blessing in a very loud world.
So here is what happened to me. My husband, wearing his ear protection, was standing just outside the garage door with his back to the house door. He was shooting a rodent (legal at our house). With the most terrible timing ever, I opened the house door and stepped out almost at the very moment he pulled the trigger – my fault. He told me he was going to shoot but I wasn’t really paying attention to him and in less than 2 min I pretty much spaced it out. He was probably 20 feet away from me, facing away from me and he was standing outside the garage threshold but only by a few inches. The sound echoed through the garage and since I had just stepped out – I was putting the recycling in the bin that is next to the door (…guess that is what I get for recycling :). Anyway, I have (rarely) heard gun shots without ear protection before but normally it just really annoys me and I am fine but this time was different. It’s been an hour and my left ear actually hurts near the jaw bone joint – the idea of a ‘bruise’ actually fits with what I am feeling. It hurts. I never had ringing and the pain was rather immediate, but hasn’t subsided at all on the left. I’ve been sitting in the house and the only sound in the house is the fridge running and me typing. I assume it is only my left ear because my right ear was facing the door going back in to the house. If you can picture a garage, I stepped out of the house, to face the bin immediately next to the door. I turned so my right ear was facing the house, my left ear was facing the rest of the garage, so I am guessing the echo hit my left ear first causing more damage and therefore explaining why that ear has pain, whereas the right ear feels fine. There was no muffled sounds in the left, I feel like I can hear fine but it does hurt that ear when I talk and even when I let the fridge door slam shut the sound caused me pain.
Can you offer any advice regarding what I should do to help my ear “heal”? Maybe arnica pills since arnica cream helps actual bruising?
Would you suggest an evaluation by an audiologist?
Do you have any thoughts on why this exposure would cause pain/damage, whereas other times when I’ve been around gun fire without ear protection my ears were seemingly fine (such as when duck hunting and rarely not taking time to protect my ears before firing my shotgun) – the loud noise was always incredibly annoying but not painful, and certainly never caused lasting pain. I wonder why is this exposure different?
Finally, would be able to hazard to guess, if this pain is an indication that I will have permanent damage to that ear? I have cursed my “bionic” hearing for years but I also am only 40 so not really interested in being hard of hearing either.
We have no kids or pets so it’s very quite in my house, would you be surprised if the pain continued in to the next day?
I should also include, he was shooting a 20g pump action browning shotgun with dove loads, I think. I know they’re small rodent loads…it was actually my shot gun he was using.
If my ears do start to feel ‘full’ does “popping” them cause more damage or would it help, or does it make no different at all?
Thanks for any thoughts and advice you have to offer. Great site!
Hi Sara:
What you suffered was acoustic shock. This can occur when you hear a sudden, unexpected, loud noise. The reason it hasn’t happened before is because you were expecting the gunshots (and had your protectors on). Because it was so sudden and unexpected, your acoustic reflexes didn’t have time to kick in and protect your ears.
Acoustic shock can give rise to a number of different symptoms including ear pain, feeling of fullness like the need to pop your ears, hearing loss, tinnitus, ear fluttering sensation, sometimes balance issues, headaches, etc.
In your case, you have been supersensitive to sounds all your life. So this just exacerbated the situation.
The pain is neuropathic pain and is most likely related to irritation of your trigeminal nerve more than anything.
You are right about your right ear being somewhat protected by your head and thus didn’t experience the brunt of the gunshot. So it was not “damaged” like your left ear was.
Pain from acoustic shock can last a considerable time, just like the other symptoms. So don’t be discouraged if it still hurts today when you wake up.
One thing that will hinder recovering from acoustic shock is negative emotions such as anxiety and worry.This can just make the supersensitivity to sound even worse. This is called loudness hyperacusis by the way. Therefore, you want to remain calm and not focus unduly on your ear problems.
I don’t see arnica working in that this isn’t a bruise, but an irritated nerve. So anything that helps calm nerves may help. For example, you may find supplementing with GABA (gamma-amino-butyric acid) helpful.
And for the next couple of months you want to protect your ears from louder sounds–but still give them plenty of exposure to softer and medium sounds. Being in totally quiet situations is not good–so you may want to supplement your quiet house with background music or pink noise at a low level while they heal.
Popping your ears may make you feel better, but if they don’t pop, continuing trying to pop them isn’t going to help and if you use too much backpressure, can cause problems. The problem is that your trigeminal nerve enervates your Eustachian tube and if it is irritated, you get this feeling of fullness. So better to concentrate on getting your nerves calmed down.
It’s too early to know whether you will have permanent damage, but I think you have a good chance of things all returning to normal in the next couple of months or sooner.
Cordially,
Neil
Thanks so much! I did read many parts of your website. I took note of the mention of steroids. As a steroid dependent asthmatic I as used to oral prednisone. I reached out to my GP. What are your thoughts about oral steroids a few days after an acoustic shock? Also, if steroids are used there must be inflammation? What is inflamed- does the loud sound cause the organs of hearing to get inflamed?
That same day, a few hours after the shock and after reading your site, I started magnesium glycinate and 1200 of n-acetylcysteine with 1000 vitamin C along with my normal 2000 of vit D. Other than GABA do you have any suggestions? I read that magnesium has prevented hearing loss in soldiers, do you know if that is accurate? Plus, how can they say that if they can’t measure hidden loss?
I’ve read you refer to acoustic trauma and acoustic shock. Can you explain the difference? Thoughts I am very curious of the difference I admit, I am hoping shock is less likely to cause damage:)
Given that I am 40, do my ears still have time to heal and fully recover all my hearing before age related hearing loss begins?
Finally, I am incredibly interested in the ear reflexes….how do our ears protect our hearing when a loud sound is expected? I am a trained as a RRT so I have a good understanding of basic A&P but sadly hearing and ears in general were not focused on at all in my day – airways and lungs were obviously our focus but it seems the details of hearing is really glossed over for all but those specifically focused on the topic.
So can bone conductive sounds also cause hearing loss/damage? What about internal sounds such as chewing or when nervousness causes ones heart to pound “loudly”…will I hurt my ears chomping away on almonds? 🙂
I did notice pain and tension along my left side – neck, jaw, etc. Other than relaxing, is there anything to be done to calm inflamed/irritated nerves in this case? I do notice today, 48 hours later, I can tolerate normal sounds without pain in that hear (Saturday letting the fridge door slam caused pain, today I can tolerate the car door slamming). I still have no ringing or other symptoms but they are still sensitive. I used a few app to measure sounds and it seems like around 75-80 I start to notice some tenderness feeling. I put in an ear plug when I dried my hair or anything that is louder than that 75-80 area…though I did forget about it for most of the day so hopefully that’s a good sign. I just wish there was a way to test if I have any damage. For all our advanced medicine we seem to be lacking for options here.
Thanks again!
Hi Sara:
You sure do ask a lot of questions. That’s my job.
I’ve only heard of steroids being effective for hearing loss, but some doctors seem to think they should use them for any ear problems. Even with hearing loss, there are some doctors that don’t give them because they don’t believe steroids work.
The truth is, sometimes hearing comes back on its own. Sometimes hearing never comes back. And sometimes giving steroids seems to help.
I don’t know exactly what they think is inflamed. However, if you’re going to take steroids, the sooner the better.
Off hand I can’t remember how much magnesium helps prevent hearing loss, but it is certainly needed by our ears for proper functioning.
There are different kinds of hidden hearing loss. They can measure it if they have the right equipment and the desire to do so. Typically, almost no one seems to bother so it remains hidden.
It’s easy to use the terms acoustic shock and acoustic trauma interchangeably, but there is a technical difference. Acoustic trauma is the incident itself whereas acoustic shock disorder or acoustic shock syndrome, often just shortened to acoustic shock, are the symptoms that persist after the incident is past. So if there are no persisting symptoms, you just have an acoustic trauma, but if you have resulting hearing loss, tinnitus, ear pain, ear fullness for example that persist for a few days or weeks–that is acoustic shock.
Your ears have plenty of time to heal. For women, hearing loss due to aging (presbycusis) kicks in about 10 years later than it does for men. So you have maybe 20 still.
Ear reflexes are fascinating. You have the tensor tympani muscle that attaches to the hammer (maleus) which is attached to your eardrum. When there is a sudden loud sound (basically a sound that startles you), your tympani tympani muscle pulls on the hammer bone which pulls the ear drum slightly inward so that all the sound energy hitting the eardrum isn’t transmitted as efficiently from the eardrum to the hammer. Hence, the sound is dampened so it is not as loud.
At the other end of the 3 bones is the stirrup (stapes). It is attached to the oval window. The stapes muscle, in response to louder sounds pulls the stapes away from the oval window, again making it more difficult for sounds to be transmitted from the stapes to the oval window and hence to the inner ear. The result is that a very loud sound is now only a loud sound by the time it reaches your inner ear.
These muscles also work when you speak, cough or laugh so you don’t deafen yourself. Ditto when you chew you food. Thus you won’t damage your hearing by chomping on your almonds.
Bone conducted sounds are already dampened by about 30 dB so they shouldn’t hurt your hearing, but there are exceptions. If you chomp down on a “jawbreaker” candy and it suddenly cracks, that sound is pretty loud and when I did that as a boy, my hearing would be muffled for a few minutes afterwards indicating that it was too loud.
If you have pain and tension along your face, jaw, neck and shoulders, often that is because of tension that tightens your muscles which pull on your vertebrae which pinch certain nerves and you feel the pain. Relaxation is one way to avoid this. But if you already have it, then going to a chiropractor to get your vertebrae properly aligned, and then going to a massage therapist to relax the muscles so they don’t just pull your vertebrae out again is a good way to do it.
Cordially,
Neil
Hello Dr. Bauman,
Is it possible to have unilateral hearing loss in the right ear ( right-handed) when firing an M-16 in the prone position? I was using triple flange ear plugs and wearing a combat helmet.
Thank you
Hi Rhian:
Anything is possible. For example, you may not have had the ear plug in your right ear seated properly allowing too much sound in. Your right ear could have been more sensitive to sound due to having been exposed to excessive sound in the previous weeks and had not had time to recover completely. There could be several factors at play that caused that.
Cordially,
Neil
Hi. I have also just stumbled onto your site and found it to be most informative.
In a similar vein to the posts above, I have moderate hearing loss and I wear hearing aids. Initially, the loss was in all probability caused by being a drummer in a band that played in nightclubs. I used to use a technique called a ‘rim-shot’ continually to ensure that my snare drum cut through the venues loudly and clearly. A rim-shot is when you strike the drum skin/vellum and the metal outer rim/hoop simultaneously with a single strike. The effect was that the sound went off like a pistol shot. The ear that was facing the drum was damaged the most while the other ear which generally faced away was affected less.
After a few years and into my thirties, my GP at the time inspected my ears at a routine check-up, and commented that my ear-drums had been ‘insulted’. There seemed (as I remember) to be a ‘hardening’ of the eardrum as a result of the abuse that it was taking.
Many years later, in my 50’s, I found that my hearing got worse (all of my 6 siblings and both parents need/needed hearing aids) and so I got tested and started wearing hearing aids. At that time, hearing problems were largely in the sibilant sounds which made it difficult to follow conversations. The lack of sibilant punctuation made conversation closer to a dull blur of medium to low frequencies.
My hearing aids compensate by lifting the higher frequencies but this is partly a solution, and partly a curse. In large rooms/halls with a lot of hard surfaces, the high frequencies bounce around and so my hearing aids are amplifying an already excessive level of high frequencies making it very difficult to hear.
I am still a performing musician (using in-ear-monitors, with better volume control). If I listen to music with good headphones, I enjoy the richness of the music and often remove my hearing aids because they are making the sound to sharp or strident, and so this makes me wonder if my hearing loss is more caused by a hardening of the eardrum as suggested by my GP a long time ago, or by a loss of higher frequencies. Is it possibly more a question of sound pressure level required to activate the ‘insulted’ ear-drum, rather than increasing specific frequencies? With a direct sound source (higher spl?) I enjoy reasonable hearing.
Am I diagnosing accurately, or should I not question my audiologist and accept her diagnosis?
Thank you for a great blog.
Hi Brian:
Most people with hearing loss (90% or so) have a high-frequency hearing loss. This means that you don’t hear the high-frequency speech sounds. As a result, speech sounds muffled and unclear. You can hear people talking because you hear relatively well in the low frequencies, but you miss the high frequency sounds that give speech most of its intelligibility.
Hearing aids help give back these high frequencies so you understand speech better. However, this really only works well when you are A) close to the speaker and B) are in a relatively quiet room.
When the background noise increases, basically you are lost and as you have experienced, all those high-frequency amplified sounds just take the top of your head off. This is the most common complaint of hearing aid wearers.
I think this is your situation and in this you are perfectly normal and in line with the rest of us hard of hearing people.
I doubt your “insulted” eardrums (whatever your GP really meant) have much or anything to do with it.
Cordially,
Neil
Age 35 years, height 182 cm, weight 90 kg.
Hello there! On September 13, at 11: 00 am, I was in a shooting range in a field shooting 28 rounds with a saiga 12 rifle without headphones in an open field. Initially, for 3-4 hours, my ears were strongly blocked, after I heard a constant “ringing” (squeak) of a high key. At the moment, the congestion is almost gone, remained a little in the left ear. The ringing also remained, mainly in the left ear, which does not go away(the left ear was closer to the muzzle of the rifle). strong tinnitus Is my biggest concern! Jane keeps me awake.
On Tuesday, September 15, he was admitted to the ENT Department of the city hospital.
Immediately on the same day(September 15) after 17: 00, I was prescribed 24 mg of dexamethosone through a dropper,+ b vitamins, as well as cerraxone 500 mg with a dropper, as well as Cavinton 10 mg per day with a dropper.
On Wednesday morning, September 16, all the same droppers but only 16 mg of dexamethosone through the dropper(reduced the dose of dexamethasone),
on Thursday morning, September 17, dexamethosone was still reduced to 8 mg via a dropper, and I realized(thanks to the tinnitus club website) that I need to increase the dose because I think I can’t beat the disease and I told the doctor that I was switching to prednisol in tablets and after lunch at 15 30 I used 200 mg of prednisone in tablets.
On September 18, 19, I took 250 mg of prednisone in tablets( divided 2-3 doses per day). the rest of the drugs (ceraxone 500, cocarnit, Cavinton) are not missed and used in the day hospital every morning through injections and droppers for the 6th day (in PM today).
Please answer pozh-STA, whether I managed to apply hormones especially on the first day of treatment? After all, after an acoustic injury, it was about 60 hours since I took the first dose of Dexamethosone.(I counted everything) was I treated correctly, did I get a dose of Dexamethosone on the first day? Will the ear whistle go away? I haven’t been able to sleep for a week because the ringing in my ear doesn’t go away. How much more should I drink and should I reduce prednisone per day? Thank you in advance for your response. My doctor says we should make it. After all, less than 5 days have passed at the time of the first introduction of the hormone into the blood.
Help im scaring
Hi Boris:
You had timely treatment with Dexamethasone. Over here they typically use Prednisone but they are the same class of drugs so I don’t think it makes all that much difference which one you use.
I’m not a medical doctor, but 250 mg of Prednisone seem high to me. Over here, doctors typically start at 80 or 60 mg or even 40 mg and reduce the dose from there over a period of 7 to 10 days.
There is no guaranteed way to get rid of tinnitus. One herbal that helps is Ginkgo biloba, but you have to take the proper therapeutic dose which is 480 mg per day standardized to contain a minimum of 24% flavone glycosides, 6% terpene lactones and 2.6% bilobalide. Even so, you may have to take this for up to 3 months.
Don’t be afraid or anxious. These things take time to settle down. The more you focus on your tinnitus and worry about it, the worse it gets and this prevents you from habituating to it so it no longer bothers you.
If you can’t sleep, put a fan on or other soft continuous sound to reduce the difference between the level of your tinnitus and silence. This helps many people.
Cordially,
Neil
thank you Neil for the answer on this site. I’m from Kazakhstan, found in you in this site! God bless you!
Hello, I’m bothering you again, after a course of prednisone tablets of 250 mg for 5-6 days, I did not get better and we again switched to intravenous Dexamethasone 24.28, 21 mg, and there are no improvements at all, I got worse at night and absolutely unbearable ringing in both ears does not allow me to sleep at least two or three hours a day. I think I’m going crazy. I don’t understand anything anymore. The ringing in the ears is the strongest. The hospital doctor asked me if I have too many nerves in my ear(I am a sensitive person) and therefore it is worse for me than for other people to tolerate this ringing? Today, the attending ENT said that you need to try intratimpanalnye hormone injections in the ears, but he refused to do this because of fear of damaging the drum(small experience) said to look for such an ENT. Today, before lunch, 25-09-2020, I found a private old Soviet military doctor ENT, he listened to my isotria and about hospitalization in a day hospital and about its 0-th effectiveness and made me an injection of the hormone hydrocartisone+dioxin in my ears. analgesic and 10 minutes later pierced, filled the composition, dizzy and I lay on his couch for half an hour.
Now, while the drum is not overgrown, the doctor said to periodically add a little mixture of hydrocartisone+dioxidine, in order to enhance the effect. This ENT doctor said I drip dexametasona not needed, because through the ear we pour enough of the hormone is he right?
And the main question is, can the ringing still remain at such a wild level, or will it definitely decrease when the nerve calms down from an acoustic injury? I remember on September 13, 2020, I unsuccessfully shot 25 rounds of ammunition with a rifle(defective powerful) and received a wild acoustic injury because I was not wearing headphones.
Thank you in advance. I’m Desperate
Hi Boris:
I doubt any steroid shots or pills are going to help your tinnitus. Over here they don’t give steroids (at least not much) for tinnitus. I’ve not heard of steroids working for tinnitus. If steroids really worked, everyone with tinnitus would take them and get rid of their tinnitus, so that should tell you something.
Probably the best thing to do is embark on a good course of tinnitus treatment such as Tinnitus Retraining Therapy or Neuromonics if they have such clinics in your country. Another thing that can really help is taking Cognitive Behavioral Therapy that is specifically modified to work for people with tinnitus.
You can also help yourself successfully deal with your tinnitus. My book “Take Control of Your Tinnitus” covers many different treatments that can help you and ones you can do yourself. The eBook version is the only practical way to get this book as the postage costs for the printed version are more than the book itself costs.
You can get the book at https://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/ .
Cordially,
Neil
Hello Neil! Thank you for being there! Almost two months after the acoustic injury, I stopped taking hormones and vasodilators, and as soon as I stopped taking them, my tinnitus returned to a tolerable level, and the tinnitus in my right ear became quiet. In the left, the power of tinnitus is about 5 points out of 10. Apparently, medications and hormones were making the situation worse. Now you can sleep and it’s good. Some days there is a slight hyperacusis. Now I’d like to ask you some advice: My hobby is firearms since my youth I was fond of weapons and read books about weapons. I want to ask you, can I practice shooting with headphones and earplugs in my ears, or should I sell my gun and forget about my hobby? Are there any shooters in the US who shoot weapons despite tinnitus? It’s a pity to sell your gun. But I’m afraid to shoot. Silencers are not sold in our country, I have never seen them in stores in the country.With respect, Boris
Hi Boris:
I’m glad your tinnitus has settled down to a reasonable level. So many drugs make tinnitus worse as you have found.
If you have properly fitting ear plugs and ear muffs over them, it should probably be ok, but remember you ears probably haven’t fully recovered so you still want to be careful.
If it were me, I’d try shooting a round or two with both the ear plugs and ear muffs on and see what happens. Wait a few days as symptoms may not appear right away. If your tinnitus and hyperacusis stay the same and sounds don’t seem muffled, then you should be ok and can do more shooting. However, if any of these three symptoms occur/change, then you know it’s not time yet. I’d wait another couple of months and try the same thing again. If you get the same results, then you know either you have to get better ear protectors, get a gun or loads that are quieter, or give up shooting. Hopefully, you’ll find something that will work for you so you don’t have to give up shooting.
Cordially,
Neil
Hey Neil, I’m a 20 y/o male. About 3 days ago I shot 2 rounds out of a .500 s&w revolver outdoors without hearing protection unfortunately. Only my right ear is muffled accompanied by tinnitus and hear whooshing sounds when the shower is on or I’m when I’m driving. I’ve taken 2000 mg of NAC starting on the 3rd day since exposure along with 50mg zinc tables. Do you think these symptoms could be permanent? I have had some anxiety about it since it’s so loud. Thanks
Hi Jake:
How are things going now with your ears? It’s been a month since this happened. If things are continuing to improve you can assume that they will go away eventually. However, you need to get your anxiety under control because worrying about your tinnitus is a sure way to make it worse. Instead, treated as an unimportant environmental sound that you hear all the time and totally ignore. That’s the way to treat tinnitus so it can fade into the background and not bother you anymore.
Cordially,
Neil
Hey Neil,
I’m a 20 year old male and 4 days ago I shot 2 rounds out of a .500 s&w outdoors without hearing protection. Since then I’ve had constant ringing in my right ear along with muffling and a screeching or whooshing like noise that I can only hear when I’m either driving or showering or the ac’s blowing next to me, it goes away when it’s completely quiet, how long would you think it would take for something like this to recover? Thanks
Hi Jake:
I’d think you would be well on your way to recovering since I’m so late in answering you. If you’re not, let me know how things are progressing and what your symptoms are now.
Cordially,
Neil
Hi, I’m a 21 year old in my senior year of college. Before I went off for school my friend wanted to show me his new skeet shotgun. He was walking me through the steps to shoot it. I was then going to ask about ear protection before he shot it, but out of no where he decides to shoot it. I had a ringing in my ear and the typical temporary hearing loss. It really pissed me off to be quite frank. That was around the end of August. I have made sure to avoid any loud noises since then. I still feel like there is some hearing loss. Is it too late to see if there is anything I can do to help heal or strengthen the hearing in that ear? I have always really enjoyed music and I have even been told I have perfect pitch. Ever since then I have had a hard time enjoying the music as much and I don’t feel like I hear it the same way as I did. I am so frustrated because I was trying to be responsible and avoid anything like this, but my friend was stupid and shot the gun just to be funny. I haven’t heard him mention anything about it so I’m sure his hearing is fine. Even though he didn’t have ear protection on either. I’ve read so many things that say this sort of thing leads to permanent damage that is irreversible. I would be open to any and all sorts of suggestions. Even to help heal or repair it a little bit would make a difference. It’s worth noting that the loss doesn’t seem to be dramatic. I’ve tried to test how different my hearing is between the two ears. On hearing tests I still can hear the quietest noises, but I can tell there is a difference between my two ears. In normal day conversations it is almost impossible, if not impossible, to tell there is even a problem. When I really want to listen to something like music I’m so used to knowing what things sound like that it ruins the experience for me a little. If there is nothing that can be done to heal or repair my earing , then is there something I can do to help ignore the existence of it? It’s obviously been almost two months since this happened so I imagine there isn’t much that can be done at this point, but I would love to get answers/suggestions to some of my worrying questions. Based on what I’ve read the odds don’t seem great, but anything that might make even a small difference I’m open to hearing.
Hi Grant:
Some people seem to have “cast-iron” ears like your “idiot” friend apparently has. Other people have much more sensitive ears like probably you have. As you know, you need to protect your ears from loud sounds like gun blasts.
Since it is about three months now since this happened, it’s unlikely that anything can be done to improve your hearing as such. Fortunately, you didn’t seem to lose much hearing, but you likely have some hidden hearing loss, and that is why you perceive this distortion in the sounds you hear, or at least the music component.
Does listening to music at a lower level reduce the distortion so that you can enjoy it more? Have you tried that? Does the distortion show up more in the high frequencies or is the distortion generally through all frequencies? If it’s frequency dependent, maybe adjusting the tone control might help make the distortion less noticeable.
Cordially,
Neil
How are your ears nowadays Grant?
Thank you Neil for your response. I’ll wait a few months then, or maybe even until next spring, and then try to shoot a couple of shots. Thank you again for being there, God bless you
hello Doctor Neil, good morning I want to ask, 2 weeks ago I attended a party with a loud song, after I came home, my ears were ringing badly, the next day I went to the ENT doctor, and the doctor prescribed nerve and pain medication and vitamin B complex, but days go by. My tinnitus is like the same, after passing a week my tinnitus starts to sound less but not specific, like a number from 10 down to 8. will my ears be normal again? thanks Doc. my warm greetings from Indonesia.
Hi Calvin:
If it has already lessened, then you can expect your tinnitus to continue to lessen in severity as the weeks go by as long as you don’t become anxious and worry about it. And you want to protect your ears from loud sounds and give them time to heal. This process can take 2 months or longer. So don’t expect immediate changes. At the end of 2 months, you can assess how your ears are doing.
Cordially,
Neil
thank you doctor for the reply i really appreciate it. I need more advice from a doctor, what foods or drinks can maintain or accelerate the healing of my tinnitus, and what things should be avoided. ohh one more doc, my tinnitus sounded loud when I closed my ears, and when I opened it only heard a hissing sound but very small. thank you doctor Neil, I hope the doctor is always blessed
Hi Calvin:
Supplements such as zinc and magnesium are always good for your ears. So are vasodilators such as vitamin B3 and Ginkgo biloba (taken in therapeutic doses–480 mg per day–can increased blood flow to your inner ears and can help with tinnitus for some people.
The basic thing to be avoided is louder sounds while you give your ears time to heal.
Cordially,
Neil
thanks for the answer doctor, I will try to keep my ears. and keep praying to get well soon in order to improve my quality of life.
hello Doctor Bauman, good evening. I want to ask you something about tinnitus. i go to a music concert, and after i come home i have constant ringing in both my ears. I was panicked and anxious for a few days and was sleep deprived. but on day 6, my tinnitus seemed to disappear (but there was still a little bit) but when I put my palms to both ears, the tinnitus ringing sound was still big. is it normal to recover?
Hi Randy:
You were lucky that your tinnitus went away in only six days. That doesn’t always happen.
Are you saying that when you put your palms over your ears your tinnitus comes back and gets loud again, and when you take your hands away from your ears your tinnitus disappears or drops to a very low level?
I know that putting your hands over your ears can affect your tinnitus, or at least the perception of your tinnitus. So that is nothing to be worried about.
Cordially,
Neil
Hi Dr. Bauman,
Exactly a week ago, I had a pretty traumatic event with my ears with a gunshot. I always wear ear protection at the range, but when hunting I typically do not. I build a new rifle with a very aggressive muzzle brake, and the sound from 1 gunshot was bad enough to make me unable to hear for 5-10 minutes, lose some sense of balance, and now have high pitched ringing in my left ear a week later which is relatively mild.
I am a composer, work in the music industry. This is extremely scary for me, and I’m going to be getting tests done here soon. What should I expect in the coming weeks in terms of the high pitched ringing?
I’m in my early 20’s, so hopefully I can recover from this and have it not damage my career. Moving forward, I will of course be wearing hearing protection while hunting. I’m very careful with my ears due to my profession, but it has always been the norm to hunt without ear protection. Never even crossed my mind somehow. The muzzle brake on the new gun that caused this event is excessive, and other people have mentioned how loud and concussive the muzzle brake is.
I’ll add to this now, by saying that I am finding frequencies that I cannot hear in my left ear now. I matched the ringing frequency to ~15,700hz, and I cannot hear that frequency when playing a sine wave in my left ear. I can hear it in my right ear just fine. I fear that this indicates that the damage is permanent, and that is incredibly scary for my career.
I’ll add to this now, by saying that I am finding frequencies that I cannot hear in my left ear now. I matched the ringing frequency to ~15,700hz, and I cannot hear that frequency when playing a sine wave in my left ear. I can hear it in my right ear just fine. I fear that this indicates that the damage is permanent, and that is incredibly scary for my career.
Hi Mitchell:
The sound/shock from the gun brake gave you acoustic shock, hence the hearing loss, tinnitus and balance problems. You also, no doubt, have some degree of hidden hearing loss (that don’t show up on your audiogram) in the conventionally-tested frequencies, and of course hearing loss in the high frequencies don’t show up on the audiogram because they don’t test those frequencies.
Both of these sources of hearing loss can result in tinnitus. I suspect you have some degree of permanent loss in both these ranges, so your tinnitus may prove to be permanent.
How are your ears doing now as it is now more than a month later?
Cordially,
Neil
Hello Dr. Bauman,
I did a really stupid thing last friday and shot about 40 rounds of an AR15 with no hearing protection at all. I felt ringing on the first shot but just kept shooting because I figured it would go away after a day or two. But I am on Day 4 now and I still have trouble hearing noises. Everything sounds different and listening to music for example sounds muffled. I also have tinnitus constantly. Will it go back to normal after some time or will I be stuck with permanent hearing loss at this level (about 65-70% of what it was before). I am 21 and this is the first time I’ve hurt my ears like this.
Hi William:
How are things sounding now after a month or so later. I’m still trying to get caught up on my comments.
Has your tinnitus gone away? Ditto for the muffled feeling? These things usually take some time, but if you have protected your ears from loud sounds in the meantime, you should be ok now.
Cordially,
Neil
Hi Dr. Bauman,
I had a hearing test done shortly after this post and initially had a 40db loss at 8k hz sloping downwards. I was prescribed a 2 weeks course of prednisone. Now about a month later I was tested again and am back to within 5-10 hz of normal range. However I still have the tinnitus, but it has gone done in severity. Hopefully it clears up eventually, as I’ve read it could be 6-12 months before it fully goes away. That being said, if it were to stick around I’m sure it wouldn’t affect me in any serious way considering how much it has dissipated compared to where I was a month ago. I also supplemented NAC, Gingko, magnesium, and zinc for about 2 weeks after. Hopefully this information can comfort anyone else dealing with this problem. If you can get past the first month it will only get better from there!
Hey William,
Hope all is well. I have the same scenario as you mentioned and I’m 3 weeks in. How is your hearing now that it’s been past one year?
Hello Doctor, I had a question about my current condition with my ears. I was hunting about 2 weeks prior to me writing this post, and I fired about 10 rounds out of my hunting rifle without any protection. Normally I’m very protective of my hearing and always wear ear muffs when I shoot at a range or outdoors, but I slipped up this one time. Currently, my overall hearing has shown signs of improvement, I still have intermediate tinnitus in my left ear (I’m a right handed shooter), I have been taking NAC for the last week or so and have not seen substantial improvement with my left ear. I also notice that my ear still feels bruised and has a congested feeling accompanied by hyperacusis. My question I mainly have for you is that is there any other recommendations for treatment you may suggest aside from rest and avoiding loud noises, and also if you were to guesstimate how long would you say I may expect for my ear to fully recover from the acoustic trauma I have experienced? Thank you so much for your time!
Hi Casey:
It takes time for your ears to recover from acoustic shocks like they received from shooting a rifle without ear protectors. So staying away from louder sounds for some weeks is definitely a good idea.
Taking NAC is a good idea for the first couple of weeks. You need to be taking a therapeutic dose of around 1,800 mg per day to do much good. Your ears also need magnesium and zinc so supplementing with those may also help.
I suggest giving it at least 2 months and then evaluate how your ears are doing. You should see substantial improvement during that time.
Cordially,
Neil
Dear Neil,
Thank you for responding to my question back in July regarding the gun trauma and low frequency hearing loss. I have seen several ent docs and been given a diagnosis of cochlear hydrops or cochlear meneires. I am still have debilitating tinnitus and intense pain and fullness in the right ear. Everything normal with no tinnitus in left. Have you ever come across any other individuals with symptoms like mine in the past? I have been taking diuretics with no improvement. I am also starting to lose my high frequencies now and have had no other noise exposures since last December. What a frustrating condition this is!
Hi Joshua:
If you really have Meniere’s or cochlear hydrops, then I suggest that your neck is out of proper alignment. It’s always possible that the recoil from the shots put your C1 and C2 vertebrae out of proper alignment–and that is the cause of Meniere’s (although doctors don’t know this). I’d go to an upper cervical chiropractor and make sure everything is properly aligned. You’d do well to read my article on the subject. It also tell you were to find such specialized chiropractors. The link to this article is https://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/ .
Thank you for posting that. I have started seeing a chiropractor who believes I have a pinched trigeminal nerve. The ringing has calmed down a lot but the roaring is so bad with intense pain constantly deep in the ear. I am also able to make the tinnitus much louder by moving my neck, bending down, or swallowing. I hope this can be remedied. Last question I promise, do you know if dexamethasone is harmful to the inner ear? I had very mild high frequency hearing loss when this started and went from a 25db loss to a 70db loss at 6 &8k. The ent wants me to do these every 90 days being it usually helps with the fullness and tinnitus intensity. Could this be ruining my inner ear being I have no other noise exposures since the pistol incident over a year ago?
Thank you for your time.
Hi Joshua:
If you can make your tinnitus louder (or softer) by various body movements/positions, then chiropractic treatment should be largely be able to fix that. Once you are in proper alignment, this kind of tinnitus should go away.
Dexamethasone is ototoxic for sure. In fact, hundreds upon hundreds of people have reported to the FDAs database of losing hearing after taking this drug. Did your mild hearing loss progress to severe AFTER you began taking the Dexamethasone? How long have you been taking it in relation to the pistol incident?
Cordially,
Neil
Hi Neil,
It seems that the high frequency loss has gotten worse sense I started getting the injections. The last hearing test I had done the audiologist said it was the same as my audiogram in February. However 6k is a 50db loss and 8k is a 70db loss. I was at 45k loss at 8k in may and 6k was 30. It seems the drugs are ruining my ears. I wish I could get rid of this roaring it’s so loud and unbearable. Have you ever heard of success with the eustachian tube balloon? My ear is so stopped up and wont pop.
Hi Joshua:
Taking steroid injections months after the incident is a waste of time in my estimation. After about 30 days, steroids don’t seem to do anything positive. I sure wouldn’t keep on when all that is happening is your hearing is getting worse.
As I understand it, Unless your Eustachian tube is filled with gunk so your ears won’t pop, the reason is that the nerve (trigeminal) controlling the Eustachian tube is damaged/pinched. You previously mentioned that your chiropractor said your trigeminal nerve was pinched so that is where I suspect the basic, underlying problem lies or somewhere along the mandibular branch of this nerve.
If that is your real problem, then balloons aren’t going to cure the problem.
Cordially,
Neil
Dr. Bauman,
I recently was in an enclosed room where an abnormally high pitched calibered pistol went off one time. I did not have hearing protection whatsoever and it was quiet up until the point of the shot. Instantly my ears were full, but there was very little pain. I didn’t even hear the shot really. I have a slight ringing in my ears, more so in my left ear than my right. Higher sounds like a faucet running do not sound normal and almost sounds electronic but in an annoying way. When I talk my left ear has an internal ring that gets louder the louder I speak and forces me to speak quietly. I had to wear earplugs the first two days because every little sound was very unpleasant, but I will refrain from doing so after I read your take on hyperacusis. I am on day 4 since the shot and I have a fullness in my ears, mild aches that come and go, and a low ring and white noise but it also drowns out the unpleasant sounds. Ive taken a bunch of online hearing test and pitch recognition tests as I play and study music. The tests all indicate my hearing is good but listening to music is harder when trying to pickup the fainter sounds of a song although I can still hear them if I listen extra close. I intend to refrain from all loud noises in the next coming months. My question is very similar to others but based on the circumstances of the incident what are the odds I will get back to almost normal? Also, what effect will this have on my music ability? Can months of healing make a substantial difference? Thanks in advance.
Hi Nicholas:
Your ears have suffered an acoustic shock. It takes time to heal. Protecting your ears from louder sounds for some weeks should help. You may be left with some residual damage to your hearing, but I think you have a good chance of having your ears return to normal or close to normal.
Cordially,
Neil
Thank you for such a quick reply. It is day six since the shot took place. My ears are definitely better today compared to earlier days. When listening to music ( on low of course) I can’t seem to pick up the bass like I used to, but my pitch comprehension is still pretty solid. My ears ache but the tinnitus has seemed to subside to almost non existent. I will give an update on my further progress. Thanks so much for providing such awesome incite!
Dr. Bauman,
It’s been about a month and two weeks. Tinnitus can only be heard when I plug my ears and its somewhat faint. My biggest concern is my hearing. I still get aching in the ear after being at work where sound is much more present than at home. I don’t expose myself to loud damaging sounds but certain higher pitched sounds bother me a lot. I should reiterate that the gun that was fired was a 7.62×25 in a small enclosed room without ear protection. Ive been taking magnesium and zinc since my accident. Is a month and a half still early in the healing process? I understand that my hearing is permanently damaged but is there still a possibility that some will come back past this point? Ive talked to a few people who have had extreme noise exposures and some have said it took up to four months for it to come back. Do these claims make sense or are they misinterpreting their experience? Thanks in advance.
Hi Nicholas:
It’s great that your tinnitus has faded so much that it is no longer an issue. Just ignore it and it may even totally disappear.
Your ears are still healing so giving them too much sustained sound at this point is causing the ear pain. It can take some months for this to “heal”. You have only had it for 6 weeks. Probably by the end of 3 months you’ll notice a lot more improvement in the amount of sound your ears can stand before they begin to ache. Just be careful not to expose you ears to loud sounds so you don’t cause yourself any setbacks.
I personally doubt that any more of your hearing will come back now. There is always a possibility, but I feel it is VERY slight.
I think they are mixing up actual hearing coming back with the fact that as their ears heal, they can stand more noise which they interpret as hearing better rather than standing more sounds without problems.
Cordially,
Neil
Dr. Bauman,
Thank you for your generous help for those seeking help with tinnitus from rifle fire. I’ve had tinnitus since I was in my teens but a couple of months ago experienced acoustic shock ago at an outdoor firing range when my 23 db ear muffs were woefully inadequate protection against noise from a rifle firing Nato 7.62 x 51mm rounds next to me.
I’m on the mend and back close to baseline. I’m paying attention to always having adequate protection though I’ve had a couple of times where I’ve “whacked the bruise” (smoke alarm, lawn mower even with protection) and had setbacks to healing.
Your advice has been a great comfort and I’ve learned a lot from your tinnitus ebook.
Thank you, I greatly appreciate it,
Joe
Hi Joe:
Thanks for the kind words.
You are going to do well in the future regarding your tinnitus. You know what to do and are doing it. The big key is to not treat your tinnitus as a threat to your well-being, but as a totally unimportant background sound that you can safely ignore.
Cordially,
Neil
Dr Baumen,
I started BP meds HCTZ on Thursday 14th for Blood Pressure, coincidently, on Sunday 17th I was wood working, and exposed my ears to loud screeching noise that only lasted for 5 secs. I didn’t feel any ringing or hearing loss. Come Monday, my ears started to get extra sensitive to loud noises (such as plates clanging, birds chirping, i didn’t think of it much) Tuesday I started experiencing ringing in my ears (tinnitus), and then found your website and read up on the octotoxity from HCTZ meds as a real side affect. I was 6 days into my med taking, and i have stopped as of yesterday, wednesday.. The sensitivity wasn’t as bad as yesterday but it is still there along with the constant ringing in my ears as of today . I’m not sure if this is a side effect of HCTZ, which seems like it, or a result of the noise induced tinnitus, i hear everything fine, just feels like sound is dialed up, and the constantly ringing in my ears.
I’m praying it will go away over time, but what do you think is the root cause? and prognosis? how long would i know whether i’ve caused permanent damage.
Hi Tony:
It seems the tinnitus from taking HCTZ is generally temporary, or quickly reduces to a low level when you stop taking it. It can also cause hyperacusis where sounds are now too loud and often “sharp”, especially high-frequency sounds such as you mention.
If the loud screeching sound was sudden, loud and unexpected, even 5 seconds could have resulted in acoustic shock. And the results could be tinnitus and hyperacusis too. So it is hard to know which to blame–or maybe partially both. I tend to think it was the loud screeching that is your main culprit at this point.
Over time, if you avoid more loud sounds for 2 or 3 months, I think you’ll find things settle down to a reasonable level or disappear entirely.
Cordially,
Neil
Thanks Dr Neil. Would you say CBT Therapy may help me habituate faster? (to both the tinnitus, as well as the hyperacusis). I only hear the ringing when room is more quiet, but on contrast when room is loud my ears get sensitive. Such as those plates or my kids. I’m torn between whether i should habituate as best as i can in loud rooms for shorter periods, or just wear ear plugs which i read kinda defeats the purpose.
I wish i knew where this condition is temporary or permanent. thanks for writing back so soon, the last several days have been difficult.
HI Dr. Neil.. Going back to my previous question. I just ready page 395,396 of your Hyperacusis book, seems like what you’re saying is if i don’t have pain hyperacusis .. but instead have loudness hyperacusis I probably should try not to wear ear plugs in the kitchen, or around my kids. Does that sound right?
and i should find zones in my house to move away from the noise if i need a break., and that the loud noise that I perceive won’t damage my ear any further if the other people in the room does not require hearing protection So far the sensitivity is to high frequency noises, like plates, utensils, pots, kids talking loud.
Referring back to the book you mentioned TRT as a good source of treatment, how is that different from CBT (seems like both have sound masking and low levels as guide for rehabituation)
Hi Tony:
That is correct, but you don’t want to expose your ears to louder sounds such that it makes things worse. So you might want to move to a quieter spot in the house when it gets too noisy in the kitchen–just far enough away that the sounds don’t exacerbate your hyperacusis, but close enough that you can slowly “push the envelope” to a bit louder sounds.
And yes, you want a “safe” room or safe place if you need it for a few minutes while your ears calm down. Go there when you need to, and stay there just as long as your need to.
You got it–perceived loud sounds don’t damage your ears or auditory system unless they are also truly loud real sounds such as a person with normal hearing should also avoid them or take precautions so they don’t damage their ears.
High frequency sounds are the most annoying because your dynamic range is most collapsed in the high frequencies.
TRT focuses on both the sound therapy aspect of tinnitus AND on the emotional component. CBT typically focuses more on the emotional component. Furthermore, CBT is typically just of a short duration (2 or 3 months) while TRT is a long-term treatment that can last up to 3 years.
Choose the one that works best for you, and where you have easy access to your therapist. Depending on how severe you view your tinnitus/hyperacusis you may find that just CBT will do the job.
Cordially,
Neil
Hi Tony:
CBT therapy done by a therapist experienced in working with people with tinnitus and hyperacusis can be an excellent choice if you can find one. Since your hyperacusis is your major problem, you need a therapist that understands hyperacusis so they don’t treat you inappropriately by assuming hyperacusis can be treated like tinnitus, which can just make it worse.
Instead of trying to treat your hyperacusis by being in a “loud” room for shorter periods, you’d be much better off being in a less noisy room for longer periods and slowly work up to noisier rooms.
And you are right–you don’t want to wear ear plugs unless you really have to, and then just for the shortest time you need to wear them.
This should be temporary if you follow the right treatments and you keep your emotions under control. You could be left with a bit of residual hyperacusis/tinnitus, but nothing to even bother you.
Cordially,
Neil
I’m already feeling a bit of doom and gloom here.. Since my onset has been a week, is there any hope that this is just temporary.. ?
Hi Tony:
You need to give it time. You are in the early days at this point. You need to give it time. Acoustic trauma incidents often take a matter of months to resolve. So it’s not time to worry about whether it is temporary or permanent. That is something that has to wait and see how things progress in the coming months.
Cordially,
Neil
Thanks Dr Bauman. I appreciate you answering on Sundays..
At what point do you think i should see an audiologists that treats tinnitis and hyperacusis through TRT or CBT. My HMO Is probably going to do a standard audio hearing tests which is scheduled in a week or so, but it might not uncover any hearing damage. Currently i hear everything fine, and some of the online hearing tests that you provided in your other links show my audiogram to be normal. However I do want to do this right in my recovery.. as i see it theres couple options.
1. Wait another 2 months see how my hyperacusis and tinnitis is through just at home self care.. During this time, i would continue to do CBT, and continue to push the envelop of my sensitivity, i think i read in another link i should have some spurts of sound during the day higher than 60DB, but lower than 80 DB., and if i’m in a quiet room, have some music playing or some pink noise.
2. Immediately, Find a specialist local to my area, or an approved one that dr jastreboff recommended off his website.. which is about 500 miles from home, local would be UCSF, or an ATA approved one. And start an evaluation or be on the TRT method. Your book had alot of things to consider when picking the “right” specialist,
Basically would delaying action and doing self treatment, be doing any harm,, or should i seek professional help now to help jumpstart the recovery process?
Hi Tony:
The time to seek professional help is when you realize that you need help because you can’t gain control on your own.
Plan 1 sounds good if it works for you. Delaying action isn’t necessarily harmful if you are following good procedures like not exposing your ears to loud sounds, having constant background sounds around you 24/7, not obsessing over your tinnitus/hyperacusis, etc.–all the things I’ve laid out in my books and articles.
If you anxiety level keeps rising, then you need professional help because you need to get/keep your anxiety under control in order to have success.
Cordially,
Neil
I’m curious if i’m dynamic range is collapsed in high frequencies, mainly the dishes, and kids squeeky voice and such. How do i subject myself to that level of frequency purely based on the decibels? I tried 65 Decibels of pink noise from a radio, measured it with a sound meter.. Its fairly loud, and felt normal to me since it was a much lower frequency, (no wincing, and beyond that not sure how i could sleep with that level of volume), but the plates clanging in kitchen has a much sharp, “louder”, perception to it. It makes wince a second, and too much of it makes me want to leave the room as my brain seems to get overloaded with too much of that high frequency sound.
Would my thresholds of high frequency increase naturally through time , if my household is generally on average in 45-55 DB range, and with kids and dinner time .. it can spike at 65 or 70 or maybe higher decibels due to the high frequency with plates.
Is habituation, or retraining focused on Decibel loudness, or in frequency to desensitize myself? or Both.. A bit too technical for me..
Any thoughts?
Hi Tony:
The pink noise is broadband noise so it has a high-frequency component. White noise has even more if you are trying to habituate to the higher frequencies. But using pink noise is a good starting place. You want to expose your ears to this pink noise all the time while you are in the kitchen–basically 24/7 so you get your hyperacusis under control and somewhere along the line, switch to white noise and see if that helps more with the higher frequency sounds.
You don’t have to keep the volume at 65 dB if it bothers your sleep. You don’t want to do anything that aggravates your hyperacusis/tinnitus because that makes you focus more on it. You only increase the volume as you can stand it without problems developing.
There’s nothing that says you can’t turn the volume up (or down) while in the kitchen and reset it to a comfortable level the rest of the time if that helps.
There are two different aspects of habituation. First, you habituate to your reaction to the sound, then you habituate to the level of the sound. Of course you can be doing both at the same time.
To begin with, it is more important to work towards habituating to your reaction to the sounds that both you so that they no longer bother you.
Cordially,
Neil
Hello Neil,
About 13 days ago I fired one 223 shot from an AR-15 with a muzzle brake after forgetting to put on hearing protection. Since then I have been having nonstop ringing in my ears that varies in tone and volume hour to hour. Sometimes it makes it hard to sleep. sometimes it only bothers me a little. While some days have been somewhat better than others, its really hard to tell if it has improved at all from day one.
Additionally I have noticed my ears had been mildly sensitive to certain frequencies, and It sometimes feels like there is mild pressure inside my ears. The sensitivity has gone away completely as of a few days ago, but I still feel pressure in my ears occasionally. While I haven’t noticed any hearing loss, even immediately after firing the gun, and have done some hearing tests online that seem fine, I still have a doctors appointment pending to find out for sure.
I was wondering what you thought my chances are of the tinnitus getting better are at this point considering I haven’t had any noticeable hearing loss, even immediately after firing the gun. I’ve been trying not to stress too much about this but some days it gets pretty hard not to.
Hi Nathan:
Although muzzle brakes reduce the sound from the forward direction, depending on how they are designed, they can still put out quite a shock wave laterally and that is what can wreck your ears.
This can result in tinnitus like you now have, as well as sound sensitivity (loudness hyperacusis) and a feeling of pressure in your ears.
Fortunately, your hyperacusis has faded and the feeling of pressure will too, in time.
It is good that your tinnitus varies. To me this means that it is also not going to be permanent.
So what you should be doing instead of stressing over it, is just going about your daily activities, but protect your ears for the next couple of months from loud sounds while your ears “heal”. Your ears are now more sensitive to louder sounds and exposing them to loud sounds will bring back the hyperacusis and make your tinnitus worse.
Cordially,
Neil
Hello Niel, just wanted to give an update for you and for those who also might be going through the same thing.
I got a hearing test about a week after the original post, and while my hearing is in the normal range across every frequency, there was a dip down to -20db on the graph that the doctor said was likely from the gunshot.
The hyperacusis did come back, then went away and came back again a few times over the course of weeks. I haven’t had any hyperacuses for well over a month now though.
the tinnitus volume has gone down significantly too, and is no longer causing any sleeping issues. I have a constant high-pitched ringing in both ears, as well as more annoyingly a multi-tone ring that is louder the more background noise there is, However that part of the tinnitus is sort of doing the same thing the hyperacusis did where it is going away and coming back.
Theres a clinic near me that my doctor referred me to that does notch therapy, that i also read a lot of good things about on the internet, but I think I’m gonna hold off on that until a year has passed to see where I am at because its $4k out of pocket.
Thank you for the response earlier, it did calm me down a bit while I was going through the worst of it. I ended up losing 15 pounds from anxiety, but I am over that part now.
From what I read online this can keep improving over the course of a year and sometimes two years, so I’m hoping to get further improvement on the ringing, although it wont be the end of the world if it doesn’t improve much .
Hi Nathan:
It’s great that your hyperacusis has gone away and your tinnitus has reduced to much lower levels.
The 20 dB loss was at 4,000 Hz, wasn’t it? That is called the noise notch.
The multi-tone tinnitus that gets louder as the background noise increases is called reactive tinnitus–which is actually a combination of tinnitus and hyperacusis–so your hyperacusis is not quite gone yet.
I wouldn’t do notch-noise therapy until you are sure your hyperacusis and reactive tinnitus are totally gone–so waiting a year is a good idea. And I’ll bet by the time a year has gone by, your tinnitus won’t bother you so there probably won’t be a need for the notch-noise therapy anyway (and you save yourself a wad of money).
Keep on protecting your ears from loud sounds and ignoring your tinnitus and things should go well with you in the future.
Cordially,
Neil
Hey man I was wondering has it gotten better since this post I am 5 weeks in now
Question: I had an incident a few months ago with a gunshot inside a small room that left my ears in a lot of pain. I’ve healed up as good as I imagine I will be able to. Now that my ears have healed for the past 4 months am I able to safely go back to the shooting range? Obviously I would wear double protection; but would this be enough? Are outdoor ranges better for the ears than indoor ranges? Aside from suppressors, is shooting a firearm going to hurt the ears regardless of how well you try to protection them? Thanks in advance.
Hi Nicholas:
I think you can safely go back to shooting if your ears are healed up so that even louder sounds do not bother you anymore. Double ear protection should be enough–but if you find your ears are acting up, then you’ll know otherwise and you want to take it easy on the shooting.
All things being equal, I’d say an outdoor range lets gunshot sounds dissipate more than in an indoor range. And hopefully, you can be further away from other shooters so you don’t get blasted by their gunshots as much as you would in an indoor range.
Gunshots are pretty loud, but if your protectors are enough, you should be able to continue shooting. Normally, ear protectors can give you around 30 dB of protection. But if the gunshots are loud and they can be 140 dB or more depending on the gun and the load, 30 dB of protection may not really be enough if your ears are a bit sensitive which they may well be.
That is why you want to proceed carefully and see what happens. And give your ears a rest after a volley of shots. Get right away from all the noise for 15 or more minutes.
I think you’ll discover what your ears can now stand and then act accordingly.
Cordially,
Neil
Can you explain what happened with the gunshot in a small room I have had similar fate smh 😓 did you ears ring long after?
Hey man how good have your ears healed are they still ringing or has it gotten better or softer?
Hi Neil,
About a month ago I had a range ex with the military and wore my earplugs. Although I wore ear plugs I noticed slight ringing in my ears when shooting and after the shoot my tinnitus and dysacusis is much worse. I had an acoustic trauma from a shotgun in 2007 and that left me with permanent tinnitus and dysacusis in my right ear but the tinnitus slowly lowered in volume. The tinnitus I have since the range ex is extremely loud and around 4kHz. Is it too late for me to try any vitamin therapies or anything like that?
The first week after the range ex I loaded up on vitamin c, magnesium, b12, vitamin a and vitamin e. We were shooting m4s and my ears would ring after some of the shots but I assumed it was bone conduction.
Is there anything I can do? This tinnitus is very loud. My life is terrible right now. It has lowered my quality of life significantly and I can’t hear right, my right ear is almost always distorted and if I put my finger in there it seems to make the ringing worse.
Hi Xavier:
You did well to load up on the various supplements you did. However, there are two things you should changes. First, you missed taking high doses (around 1,800 mg of N-acetyl cysteine (NAC) per day. That helps your body make large amounts of glutathione–it’s powerful antioxidant that is necessary to kill the free radicals that form in your ears from noise exposure. You also should have included zinc with your other supplements.
Second, and this is just as important, before you do any more range ex in the future or will be exposing your ears to other loud noise environments, load up on the NAC and other supplements for a week BEFORE, as well as for two weeks after.
Since it has been a month since all the racket, probably NAC and supplements aren’t going to get rid of the damage, or your tinnitus. I’d continue to take zinc and magnesium as a maintenance dose–for good health in general as well as for you ears. Note: if you are taking magnesium, make sure you are taking a chelated magnesium, and not the cheap magnesium oxide as your body cannot absorb much magnesium in that form. The most bioavailable form of magnesium (and the one I take) is magnesium threonate. And while I’m at it, zinc picolinate is a very bioavailable form of zinc (which I also take).
What can you do now to ease your tinnitus? First, protect your ears from all louder sounds to give you ears a change to heal. This can take a number of months. Wear ear protectors around louder sounds. If you listen to music, keep the volume down to 70 dB. Don’t overprotect your ears by wearing ear protectors when they are not necessary or you can end up with hyperacusis. Your ears WANT to hear sounds–just not too loud.
Second, you might want to engage in sound therapy such as listening to white/pink noise to help mask your tinnitus so you can better deal with it–especially at night. Even better, you might find that water sounds (waves lapping on the beach, babbling brook sounds, rainfall, waterfalls, etc) will both help mask your tinnitus AND relax you so you fall asleep easier.
Note: you are not trying to mask (hide) your tinnitus, but just mix the sound therapy sounds with your tinnitus. Then ignore the sounds since they are basically meaningless background sounds and while you do that ,you will also ignore you tinnitus.
Third, and this is very important. Since tinnitus is a psychosomatic condition, you need to treat the emotional aspects of your tinnitus. This means that you MUST NOT treat your tinnitus as a threat to your well-being in any way. By doing so, your limbic system will NOT let your brain ignore it. Instead, treat your tinnitus the same as you do any useless, meaningless background sound–which is, you basically ignore it. A good example is to treat your tinnitus like you do fridge noise. It is just there–neither good or bad–in the background. It is a sound you can safely ignore, so you do. Treat your tinnitus like that and it should fade into the background just like the fridge noise does.
This is not a fast process, but a necessary one if you want to gain control over your tinnitus.
Cordially,
Neil
Neil, you are such a kind person for taking the time to write such detailed responses. Since my last post my condition hasn’t improved a whole lot. I still have the tinnitus and hearing sensitivity.
I am scheduled to do a military course soon (3 days) and the last two days of the course will see us using m4s with 556 blank rounds which produce 100-140db, and artillery simulation rounds (120-150db). Do you think I can attend this exercise or is it not worth the risk? I would be wearing 30NRR earplugs and 24NRR over ear electronic muffs. The firing would be intermittent. I have loaded up on magnesium and turmeric. I don’t have NAC on hand but I will have it when I return after the exercise (2 days after shooting).
Again, my condition is not good now the tinnitus is piercing at around 2000hz or so…or 4000hz, I have difficulty narrowing it. It’s loud though and constant. I also ended up with some intermittent tinnitus in my left ear. Is there still hope for improvement like what happened to me in the past? It breaks my heart that despite trying to use earplugs and taking supplements following this happening I still ended up with bad tinnitus in both ears. I hope there are better treatments soon. The distorted hearing (faucets, kids voices, my wife voice) is very uncomfortable.
Thank you again so much for being so responsive and offering your knowledge free of charge. The world needs more people like you, Dr. Bauman.
Hi Xavier:
Personally, I wouldn’t take the course at this time. You need your ears to get back to normal or near normal first.
Wearing ear protectors of 30 dB and then ear muffs of 24 dB on top of that would appear to reduce the volume by 54 dB, but that would not be true at all. In actual fact, due to its logarithmic scale, adding 30 plus 24 dB = 31 dB. You only get 1 extra dB of protection. This means that if a gun report is 150 dB, you are still exposing your ears to 119 dB of sound which is more than your ears should stand at this point.
Ideally, to protect your ears, you should load up on NAC ahead of time–taking it for 3 or 4 days before the shooting starts and continuing for a week or two after it ends.
Cordially,
Neil
My right ear also got subjected to high traumatic noise not from the rifle range but from reloading the shells of a 50 bmg shell. I was seating a primer in and there it goes “BOOM” after trying to force it in a bit. It’s been 2 weeks, i noticed that my hearing is better on the right ear but it still cannot pick up vibrations. For example if someone is walking up stairs, my left ear can pick up the vibrations, but my right ear can’t. Also very loud or high pitched sounds are muffled or out of place. And i can still hear the ringing in very quiet environments but it doesn’t bother me much and i can still sleep thru it. Is this going to be permanent?
Hi Tony:
That “boom” must have scared you a bit, huh? Assuming it was as loud as a gunshot at that close range I think you’ll find that you have some permanent damage to your hearing–perhaps not showing up on a standard audiogram–but rather hidden hearing loss. However, I’m sure you do have hearing loss, and some distorted hearing.
I don’t understand the business about vibrations. You feel vibrations, you hear sounds. Vibrations produce sound waves that you can hear. I think this is what you are meaning.
I’d give it a couple of months and see how your ears “heal”. You may always have a bit of tinnitus now due to the hearing loss–but if you just ignore it and go about your life, I think it won’t bother you–even when you do hear it.
Cordially,
Neil
T.Y. Dr. Bauman for your reply. I called my primary doctor and gave him more information. I told him days after the injury, when I blow my nose, i could hear air going thru my ear so he thinks my ear drum got busted or has a hole. I have had my ear drum busted like this before but not thru a loud gunshot type sound and would heal up within 2 weeks and my hearing back to normal. But now I am past 2 weeks, and sound still somewhat muffled, especially when its high volume sound, it sounds like there’s some ringing attached to it when there’s loud noise. The vibration issue I am talking about is for example, let’s say there’s a car in a major street next to your house that is bumping loud music with bass, my left ear will pick up the bass but my right ear wont. That is what I meant.
Also Dr. Bauman, since its been more than 2 weeks, I am barely finding out about the NAC supplement but I do take magnesium and zinc thru daily multi vitamins even before, during and after the event. Is it too late for me to start taking NAC?
Hi Tony:
When you say you hear air going through your ear are you meaning your eardrum is ruptured and you feel air going from the back of your throat up your Eustachian tube and out your ear canal, or are you talking about hearing crackling sounds in your Eustachian tube.
If you have a ruptured eardrum, it doesn’t necessarily heal up in two weeks. Some take longer and for others, the rupture never heals and needs surgery to close it. However, from what you describe, I don’t think your ear drum is ruptured.
When you hear tinnitus (ringing) attached to louder sounds, that sounds like you have some degree of reactive tinnitus–which i a combination of tinnitus and loudness hyperacusis.
I understand what you are saying about vibrations now. Obviously you have some degree of low-frequency hearing loss in that ear.
It will take more time than just two weeks for your ears to “heal”. I’d give it at least two months before you begin to worry. In the meantime, don’t expose you ears to louder sounds. They won’t heal if you keep exposing them to louder sounds. What they need right now is rest from louder sounds.
NAC taken now probably won’t do much good. You can take it and see, but I don’t hold out much hope that it will do much if anything since so much time has passed. It won’t hurt your ears to try it if you feel so inclined.
Cordially,
Neil
What I meant was I could hear the air going thru my ears like there is a leak or a hole. This is the 3rd time i injured my ear. The first 2 times was from boxing, when air gets pushed in your ear (my friend cought me with a left hook with his glove) and blew out my ear drum and this is how i know its ruptured. I would close my nose and mouth and blow ear thru my ears (kinda like when you’re releasing pressure at a higher altitude) and i can hear air running thru my ear but not in the normal ear (since ear drum has no hole). I dont hear any crackling sounds when i blow thru my bad ear. I never tried blowing since because what if there’s really a hole and it doesn’t heal. The first 2 times i had it ruptured, it would heal up within 2 weeks and everything back to normal, but with this one, its been 2+ weeks so i’m just concerned.
Would you recommend i put an ear plug on this ear during outings ? Sometimes you can’t control the environment if there’s construction or in a loud place like a restaurant.
Hi Tony:
Only wear earplugs when you need to–like coming into a construction zone or going into a loud restaurant. It’s very easy to get into the habit of wearing earplugs when you don’t need them–and this just causes loudness hyperacusis to get worse and worse. So be careful to take them out as soon as you no longer need them.
Cordially,
Neil
Hi, Neil
I went shooting with a friend at an outdoor range 5 days ago. Using in-ear plugs, I was pretty on top of keeping my ears protected. During ceasefire, I would pull my right plug halfway-out to have conversation, but for one shot, I fired a 5.56 AR15 shot before realizing I accidentally hadn’t plugged myself back up again. Ouch. I immediately sustained a plugged ear and a minor headache.
For the next few days, I had a muffled right ear. However, I had no noticeable tinnitus. I don’t know if I wasn’t noticing it or if it just wasn’t there the first two days, but about 48 hours after the shooting, my head was ringing loud as ever. I had trouble sleeping that night, but woke up with no obnoxious T (there may have been light ringing, but not really distracting).
Now at day 5, my right ear doesn’t really feel all that stuffed up, though through snapping my fingers I can notice that my right ear doesn’t hear as sharp as my left. The tinnitus wasn’t noticeable when I woke up again yesterday, but this morning made a roaring comeback. I’d like to think it’s not as loud, but it’s hard to tell. I also feel like it may have shifted to my left ear now? I’m not sure if this is normal during the recovery.
With that background, I have a few questions for you:
1. You mentioned zinc, magnesium, and NAC as supplements that can help with the recovery. I’ve always taken zinc and magnesium daily, but just discovering this blog today, I’ve seen you mention NAC as something that can help if taken quickly. I plan on buying some in the next hour, but is it too late for it to have any kind of effect? I’ll be taking it regardless until you answer.
2. When I wake up in the morning, if I’ve fallen asleep on my right ear, I wake up with it “deaf”. Like it sounds even worse than it did day 1 and actually scared me into thinking I was losing my hearing the first morning it happened. It seems to clear up within 15-20 minutes, but even with my right ear more or less feeling unclogged, I’m still experiencing this “deaf-ear” issue if I sleep on it long enough. Is this normal with acoustic trauma or something more serious? Is it a permanent issue?
3. Lastly, as I mentioned earlier, my T seems really random right now. Sometimes it blares for hours, then it’ll randomly “stop” for a short while (I’m not noticing it or it’s just not there, I can’t tell). I can wake up from a nap and it’s gone, and in the case of this morning, I woke up with it buzzing and seemingly coming from my left ear now. Is this a bad sign?
I understand from reading through your responses that it can take weeks/months for ear injuries and tinnitus to recover and I think I’ve been good at avoiding loud noises, in-ear music, etc. so far, so I’m keeping hope as I’m early in the recovery.
Thanks for your help, Dr. Bauman!
Hi Travis:
Oops! It’s so easy to make an honest mistake. Unfortunately, our ears don’t know the difference between an honest mistake and deliberately exposing our ears to dangerously loud sounds.
Because the resulting loud sound was so unexpected (you thought your earplugs were working) and so sudden, you experienced acoustic shock and that can be worse because you didn’t “flinch” in anticipation of the shot going off.
Although tinnitus can be almost immediate, with acoustic shock, you can experience delayed symptoms too. And tinnitus can shift from side to side. So don’t read too much into that. I think your ears are just getting started on the healing process.
1. Normally, NAC will be more effective if taken a few days before the loud noise episodes and continuing for a couple of weeks afterwards. That way your body has increased its supply of glutathione to zap free radicals as they form (as a result of loud noise) before they have a chance to kill the hair cells in your ears.
No doubt, you still have some free radicals left now, but certainly not as many as before. Taking NAC to “zap the zappers” is all to the good. Personally, I’d take around 1.800 to 2,000 mg a day for the next week. After that it is probably too late to make much/any difference.
2. I don’t think I’ve heard of sleeping on your damaged ear making it go temporarily deaf. I can think of two scenarios though that could cause it. Not sure if either applies to you. One is that your ear clogs up and drains down to the lower ear so when you wake up (like if you have a cold) your ear is clogged up and muffled. When you get up and move around, the gunk drains out of your Eustachian tube, and your hearing returns.
The second scenario is if you kink your neck as you sleep on that side, and the auditory nerve is pinched so it doesn’t work properly until you get up and more around. This takes the pressure off the nerve and it begins working properly again.
3. I always say that intermittent tinnitus is a good sign–at least it shows that it does not have to be permanent. Just accept that it does this and basically ignore it, and in time I think you’ll find it ultimately disappears or is just a faint sound in the background where it won’t bother you.
You want to give your right ear a rest from louder sounds as it heals. This does not mean total quiet, just not exposing it to louder sounds until it can safely stand them again. And as you noted, this can take a few months.
As long as you don’t worry about and obsess over your ears/tinnitus, I think you will do well in the future. Just give it time.
Cordially,
Neil
Dr. Bauman, thank you for replying to my messages. All i can hope now is just pray to God i get my full hearing back on my right ear and give it 2-3 months. If not, i guess i would say its better that I lost my hearing vs. my eyeballs because i also didnt have eye protection
Dr. Bauman,
Your forum has been very helpful. Eight days ago, on a Saturday, I shot a .223 AR-15, for a total of 60 shots, over the course of roughly 20 minutes.
Since that time, my left ear has been muffled (auditory fullness), and I’ve had tinnitus in the left ear. Three days after the shooting, I started taking oral prednisone, and five days after (on Thursday) I received an intratympanic injection with increased dosage of oral steroids. I’m also taking magnesium and 1200 mg n-acetyl cysteine, which I started today.
I am now 8 days post-acoustic trauma. I haven’t noticed any improvement, but I continue to to take 60 mg prednisone, magnesium, and NAT. I am trying to schedule a repeat injection this week.
My question is this: what is the likelihood the sensation of aural fullness subsides? I understand I’ll likely have some degree of permanent hearing loss, but right now it feels as though I have maybe 10% hearing in my left ear.
I have a repeat audiogram schedule for roughly one month out. Can this type of injury take a few weeks to heal or stabilize? Should I expect to live with this sensation permanently?
Hi Adam:
I take it that you weren’t wearing any ear protection, and that you shoot right-handed, correct?
That is why your left ear got the brunt of the noise and thus is “acting up”.
The muffled feeling should go away in time as the inflamed nerves calm down. Noise damage takes time to heal. You want things to heal in a few days, but with noise, you should expect it to take several months. This feeling is independent of whether you have hearing loss or tinnitus.
Cordially,
Neil
Hello Dr. Bauman,
I appreciate you taking the time to respond to everyone here and was hoping you could answer a question specific to my issue:
5 days ago my friend who I was visiting took me to a shooting range. Clearly the foam ear plugs I was wearing were not in properly, as one of them fell out at one point. The noise in general was very load and almost painful in a few instances.
It’s now been 5 days now and my ears still feel clogged (as though they need to be popped). It’s not painful, just that feeling of pressure. I flew back home 3 days ago, which I’m guessing didn’t help the issue being in an airplane and all.
I can hear well and do not have any ringing, just the clogged/pressure feeling along with what sounds like a whisper/howling type sound (for lack of better word) in my left ear whenever I yawn.
I visited my doctor yesterday and she did not see any damage to the eardrums, and mentioned something about Eustachian tube disfunction causing the clogged feeling, but she made it sound like that wasn’t related to the load noise, which was confusing. Or maybe I misunderstood what she was saying.
At any rate, my question is: Even if I end up having a little hearing loss from this occurrence, how likely is it that the clogged/pressure feeling will go away, either on its own or through some procedure if needed (and if any exist)? It has been quite bothersome and a little concerning.
I’ll add that when I talk there is a slight muffled sound that feels like it’s coming from my left ear, and if I talk in a very high pitched voice (i.e. hum a high note) there’s a slight ringing/echo in the left ear as well.
Thanks in advance for your time,
Alan
Hi Alan:
Normally, when your ear feels blocked, it is due to your Eustachian tubes being clogged. That is what your doctor was referring to. However, there are other things that can give you that blocked feeling and exposing your ears to loud sounds is one of them. This is because your trigeminal nerve enervates (controls) both the tensor tympani muscle in your middle ear and your Eustachian tube. All the sudden shots hyperactivated/irritated/inflamed one branch of your trigeminal nerve and this irritation can “flow” to other branches of the same nerve–such as your Eustachian tube–causing problems there too since your trigeminal nerve also enervates your Eustachian tube.
The result is that your Eustachian can be closed when it should be open and vice versa, causing that blocked feeling (even though it is not clogged). This is what threw your doctor.
You need to give it time for your ear to get back to normal. Protect your ears from sudden loud sounds in the future as it “heals”. In time your symptoms should go away–but you may always have a bit of tinnitus–although it shouldn’t bother you.
Best not to worry or be anxious about it, and let things slowly get back to normal.
Cordially,
Neil
Thanks Dr. Bauman for taking the time to reply,
Just to give an update, it’s now been 10 days. The muffled sound in my left ear seems (which I’m not sure I mentioned initially) seems to be getting a little better, but the pressure feeling has been nonstop in both ears and has even brought on some mild dizziness at times (uggh, hope it’s not Meniere’s disease).
I had a hearing test today. Have some “mild” hearing loss in the left ear between 500-1,000 Hz, otherwise everything good including the Tympanometry and OEAs tests. The person doing the test thought my issues might be related to my inner ears, but she wasn’t able to say much.
Seeing an ENT tomorrow so will see what he says. Honestly, I can live with some mild hearing loss but this nonstop feeling of pressure in my ears is exhausting. I’ve also had a dry throat and bit of a cough the last few days so wondering if perhaps there’s some infection or something that’s adding to this feeling of ear pressure/congestion.
Question – are doctors able to see the inner ear well enough to know what’s going on (i.e infection, etc), or is an MRI scan usually needed?
Thanks,
Alan
Hi Alan:
Doctors cannot see the inner ear at all. It is buried in the thickest part of your skull. So they only way they “see” anything is via MRIs or CAT scans.
Let me know what you ENT thinks you have.
Cordially,
Neil
Hi Dr. Bauman,
My ENT prescribed a 14 day course of Prednisone followed up by another hearing test to see if that might help with the hearing loss in the left ear, Started it today, 12 days since the incident.
Regarding the pressure in both ears, I really didn’t get a clear answer. He seemed to think it was a little odd that it would be related to the shooting range since my right ear is in good shape according to my hearing test, so he thought it might be more related to a viral infection/inflammation. But I’ve come across several references to how exposure to loud noise can cause this clogged feeling as well, just as you have mentioned.
He didn’t think it was bacterial but is it possible there is would be no way to know this since there’s no way to visually see in the inner ear without a scan?
Alan
Hi Dr. Bauman,
Hope you’re doing well. I wanted to follow up on your comments as it seems you hit the nail on the head in my case regarding how the loud shots irritated/inflamed the trigeminal nerve and seems to have caused the tensor tympani muscle to spasm (fluttering sound) as well as the blocked ear feeling.
In fact, I came across an article “A Case of Acoustic Shock with Post-trauma Trigeminal-Autonomic Activation” which even states how this can account for nasal congestion, which is something I’ve coincidentally been having since the shooting range incident.
Unfortunately it’s been hard to find much info on treatment options, and my ENT told me that if my issue is in fact related to the trigeminal nerve causing everything, that this would be a more advanced case that’s not his expertise (sigh).
My question is: In your experience does this pressure/blocked feeling in the ears typically go away over time? If I understand correctly, tensor tympani muscle spams do not always go away on their own, so if this is what is causing the clogged feeling then this has me a little concerned. Or is it the trigeminal nerve itself causing the blocked feeling and does this usually calm down over time?
It’s now been 3 weeks with little (if any) improvement. I can live with a little hearing loss and tinnitus if need be, but this pressure feeling in the ears has been driving me a bit crazy.
Thanks again for your time.
Alan
Hi Alan:
Not too many people think of trigeminal nerve involvement when they have “funny” things happening to their ears, but as that article pointed out, this is what can happen.
I had read that article you mentioned. Unfortunately, it came out after I had published by book, “Hypersensitive to Sound?” but, even so, I included most of the information in that article gleaned from other sources.
That article didn’t give any treatments for Acoustic Shock Disorder (ASD). There is no one treatment (or any overall effective treatment) for ASD. Current thinking is that you treat each symptom (loudness hyperacusis, ear pain, TTTS, etc) separately. So if your trigeminal nerve is causing you pain you’d go to a pain expert who knows how to successfully treat trigeminal nerve pain, etc.
These things take time and you are only 3 weeks out since this incident. You need to give it time. But you also need to keep your anxiety under control as all of the components of ASD are exacerbated by anxiety.
If you haven’t already read my book, “Hypersensitive to Sound” you will find many helpful sections for each of the components that go to make up Acoustic Shock Disorder, as well as a whole section on ASD itself. You can get it at
https://hearinglosshelp.com/shop/hypersensitive-to-sound/
Cordially,
Neil
Thanks Dr. Bauman,
I will definitely pick up your book.
Fortunately I have not experienced any pain. I can see how treating symptoms of ear pressure and sinus congestion related to trigeminal nerve irritation/inflamation can get a little tricky since they probably don’t fall under any one doctor’s specialty. But from what it sounds like, hopefully these issues will calm down as the nerve itself calms down over time.
Alan
Hi Alan:
You can always be hopeful. Keep the anxiety down and eating a anti-inflammatory diet won’t hurt either. In other words stay away from the inflammatory foods that are high in omega 6 fats and low in omega 3 fats–basically staying away from vegetable oils.
Cordially,
Neil
Hi Dr Bauman,
Just yesterday I had a situation where I was sighting in my rifle with hearing protection. I regrettably forgot to replace the ear muffs for one shot and now have a bit of ringing mainly in my left ear. The ringing was fairly loud last night and through the night but has since subsided to a low hum. My right ear does not seem affected anymore other than the pitch of the hum which I believe is coming from the left side. My left ear feels slightly muffled and conjested but there is no apparent hearing loss that I can detect. I have read through some comments and have taken zinc and magnesium thus far. I am going to the store to get some NAC as you have stated. What do you believe is the likely outcome here?
There has been a significant improvement since even last night which gives me hope of a full recovery. I just would like to hear your input.
Hi Cole:
I assume you are right-handed so your left ear got the brunt of the blast so it is worse than your right ear.
Since things are improving so rapidly, I’m hopeful that you will make a full recovery, especially if you start taking the NAC today. Time is of the essence where NAC in concerned.
Cordially,
Neil
I started just now with 2000 mg of NAC. Roughly 18 hours after the incident. I will keep you updated on progress. Thank you
Dr Bauman,
Update, it’s been 36 hours and the fullness/congestion has noticeably decreased. I have no noticeable hearing loss, although I am sure there is to a degree. I still have some ringing in my left ear but oddly when I lay down on my pillow the right side is more disrupting to sleep. I started NAC, zinc, and magnesium yesterday, roughly 18 hours after the incident. I also have set up an appointment for tomorrow to see if I can get prescribed an oral steroid for a couple weeks. Overall, progress has been made towards the better, even in just 36 hours, and I know acoustic shock takes time to heal. My main concern is the tinnitus, is this something that should wain away through time?
The tinnitus is not noticeable in most situations. Only in enclosed, quiet places like when I am alone in my office or trying to go to sleep. Outside, driving in the car, and other things seem to effectively drown it out unless I concentrate on the noise. This also seems like a good sign.
Hi Cole:
Personally, I wouldn’t go for steroids. They aren’t the solution for tinnitus in my experience and can cause other problems.
Your tinnitus is fading away, so just give it time. And DON’T try to listen for it. That just tells your brain that it must be important and so it won’t fade away. Much better to just forget about your tinnitus and focus on the loves of your life–and let it fade away.
Cordially,
Neil
Dr Baumann,
Update: Going on 6 days from the injury. Fullness has subsided greatly, I would say 90% gone. I have been experiencing some sinus issues and congestion even before the injury which I do not believe is helping my situation either. The tinnitus improvements have not changed very much since around 3 days after the injury but in the last 24 hours has greatly subsided. It seems that the sound has moved from a ring to more of a hum/buzz unless I close my ears up, to which I can still hear the ring. My sleep has been fine using masking techniques and the improvements in tinnitus have been recognized through my growing lack of dependence on the noise to sleep. During the day it seems to ratchet up a bit but it does seem to be getting better day by day. I am continuing the high dosage zinc/magnesium/NAC intake as well as a tapered oral steroid. Is my situation looking favorable?
Hi Cole:
I’d say you are progressing just fine.
Cordially,
Neil
I also noticed this morning when I woke up that I could not hear the tinnitus in either ear against my pillow. Maybe just slightly but if it was there I could barely notice it. As the day has gone on it has increased again but this also gives me hope as to the fact that the tinnitus should fade away with a more time. Again, it has not even been a week and I have seen significant improvements.
Dr Bauman,
Today I have noticed no tinnitus in my left ear at all. It is either so faint that I do not notice it or it has disappeared. The problem still lies with my right ear. In the days leading up to the acoustic trauma event, I was decently congested and was experiencing some allergies/sinus flare ups. Post gun shot my left ear was the most concerning due to the muffledness and immediate congestion I experienced, along with ringing. Do you think the lingering effects on my right ear could be caused by my still lingering sinus/allergy issues? It just seems odd that the ear that was most affected seems to be almost normal while the other has not quite recovered yet.
HI Neil,
I wanted to post again regarding the menieres issues/noise exposure. Roughly 90 days ago I had a painful pop in my right ear and my hearing thresholds all improved by 25 to 40 decibels. Specifically in the low frequencies. I am back to minimal loss/normal hearing in all the lows/mids/highs. Seems the chiropractor did the trick. One issue I am having now is with the high pitched tinnitus. The roaring I had before was so intense it blocked out everything. Now that I can hear okay I’ve found that all my hearing above 9.5k is gone. I cant hear a 10k pure tone at any volume. I have an extremely loud ring at 10k to12k. How does one approach an issue like this? I cannot hear anything where the tinnitus resides and it pierces right through white noise, masking sounds. My minimum masking level was measured at 75 decibels by an audiologist. She said she is not sure how to help being the pitch is so high. Have you heard of any technique to mask an impossible sound. I dont think I’ll survive.
Best,
Josh
Hi Joshua:
Great that your hearing came back after the chiropractic treatment.
Since your ultra-high frequency hearing is gone, I’m not at all surprised that your tinnitus is a high-pitched sound since tinnitus often occurs close to the frequencies of your maximum hearing loss.
Now, as regards masking. If your minimum masking level is 75 dB and you need a louder sound to mask it, you’ll be damaging your hearing trying to do that.
However, you shouldn’t be masking your tinnitus anyways. All masking does is hide your tinnitus under louder sounds. When you stop the sounds, there your tinnitus is.
It is much better to habituate to your tinnitus by MIXING your tinnitus with a broadband sound, not MASKING it. With mixing, the mixing sound is less than your tinnitus volume. As you increase the volume of your broadband sound, you reach a point where the sound mixes/blends into your tinnitus. That’s the mixing point. Now over time, you learn to ignore this mixed signal and you begin to perceive it as softer. When this happens, you remix it at a lower level and again ignore it. Again, in time you perceive it as lower in volume. You keep doing this until it is down to a volume that doesn’t bother you.
Note: habituation can only happen if you do NOT think of your tinnitus as a threat to your well-being. As long as you consider it a threat your limbic system cannot ignore it as one of its jobs to to warn your brain of any threat to you. Therefore, you need to treat it as a totally unimportant background sound that is not even worthy of your attention.
For a mixing sound you can choose white noise, pink noise, fractal music, or the best of all–various water sounds–waves on the beach, waterfalls, rainfall sounds, babbling brook sounds, etc. Whatever works for you. Just choose a sound that is random (as these are and does not annoy you. If it annoys you, again, you won’t habituate to it.
Cordially,
Neil
Dear Dr.
I thank you for replying to all of my earlier post regarding my right ear. It’s been over two years since the faulty earplug failed to protect my right ear. I have been doing many things to try and get on with my life. The fullness in my ear seems to have mostly subsided, but I still am having bad, dull burning pain. This pain feels like it’s right at the front of my tragus but deep in the face. Noise doesnt cause it and I don’t find sound uncomfortable. It feels like a slotted screwdriver that has been ground off being stuck in there. Very unnerving and so debilitating I typically have to take tylenol and go put a hot pad over my ear.My question is do you know what type of doctor I would see for pain like this? I’ve seen a neuromuscular dentist and it’s not tmj. Neurorolgist said it’s not trigeminal neuralgia. And my eustachian tubes which used to give me trouble seem to finally work correctly and I can pop my ears. My upper range hearing is shot to hell but I can hear up to 11k now. Before was 9.5k and it was dead.Have you ever seen or heard of any cases like this? I have never had vertigo but I have had all symptoms of cochlear hydrops. Any input is appreciated. Thanks in advance for your time.
Hi Joshua:
It seems as if you ears are back to normal as much as they can be, apart from the pain.
As I understand it, the pain you are now experiencing has become a permanent pain loop and is not dependent on the original cause. Therefore, the doctor to see is a “pain” doctor–one who treats people for permanent pain. You need to learn how to break the pain loop now. (It’s sort of analogous to breaking a tinnitus loop to get rid of permanent tinnitus.) I would have thought your neurologist could have told you that, or helped you.
Cordially,
Neil
Hi Neil,
I am not a native english speaker, so I want to say sorry about my english.
I was at music festival 2,5 weeks ago. I usually wear earplugs but forgot them this time. In the past when I was in my 20s I didn’t always use earplug at concerts, now I am 34. I don’t go to loud places: conserts,movies etc often, maybe once or couple of times a year or less. I mostly listen to music in a car, not headphones.
I was almost at the front row of one consert for almost two songs, it was such a stupid idea. The music felt really loud even though I have read that this particular festival usually keeps desibels less than 95 but I dont were the desibels more than that near the stage. I felt like I couldn’t deal with the loud sound and walked further from the stage and stayed there like 10 minutes but even that felt too much after the loud noise at the front. I walked far away from the stage to give rest for my ears. The loud music in the front felt awful in my ears, such an ear-piercing sound, I felt like my eardrums were vibrating. It definitely was too much for my ears, uncomfortable I felt like I had difficulties to hear after that normally, everything sounded muffled. My hearing returned soon after the loud sound exposure to normal but I was a bit worried. I stayed at the festival for few hours but didnt go near the stage anymore and listened to music far away. Everything felt fine until…
Next night I woke up to tinnitus in the middle of the night. And my tinnitus has lasted for 2,5 weeks. I haven’t had tinnitus before, maybe like few seconds “beep” in my ears really rarely but not like this – 24/7 tinnitus. I hear whooshing and chinking sound, especially in my left ear. Two different sounds. Sometimes T sounds like a morse code in my left ear, sometimes high pitch ” beeep”. There is no silence anymore. I cant get tinnitus out of my thoughts and have difficulties to consentrate. I am really stressed and my mood is really low. T bothers me when especially during the
silence and during the night. I have kept 60 db air conditioner on to help me sleep and luckily it has worked even though I wake up because of T. I sleep with my earplugs on like I have done for many years during night. I have had issues with insomnia in the past. I have slowly tried to taper my sleeping pill (benzo) I have been prescribed for years and I dont know has the drug or taper made me sensitive to sound. I have managed to taper it to a really tiny dose and my plan is to stop it.
After a week of tinnitus I saw ENT doctor. He said that I should have come earlier so something could have been done (meds). He said my tinnitus will more likely pass and he thought it would stop in two to three weeks. He said my ears look normal and cleaned my ears. He made Weber test. It showed normal even though I am not sure did I hear the sound more in my left ear than both ears but I said both ears. I went to audiogram(made by audiologist) and it was normal otherwise but there was a small drop at 3000 but doctor thought it was irrelevant finding. He said that if it was other day the audiogram could show normal and probably hadnt got anything to do with the festival. He said the drop would be in other frequencies if that festival had caused hearing loss so there was nothing to worry about. He also said I probably have hyperacusis too because some noises seem to make my tinnitus worse. I feel like many sounds feel distorted and trigger high pitch tinnitus on top of the sound that stops after the sound stops. Music and sometimes even hearing people speak sounds weird, somehow a bit. muffled. Especially in left ear. I cant enjoy music. Especially my left ear feels congested even though its not.
I have made online hearing tests that usually show I have normal hearing. I have listened to high pitch sound hearing tests (+8000 khz) and it seems like I can hear 12000khz left ear but 15000 khz right ear. I dont know how reliable they are though
Here are my questions.
I feel like I am even more confused after seeing the doctor. Can there still be hidden damage/hearing loss in my ear/ears? Can it be possible that small drop in 3000 khz was caused by that festival and is a sign of hearing loss? Doctor I saw didnt think so. Can this tinnitus still pass even though its 2,5 weeks since festival that triggered this? When is tinnitus most likely permanent… I am just thinking and worrying this will be permanent and I dont know how to handle this. What I could do to help myself to heal?
Reading this thread has helped me and thank you for helping people
Best,
Heidi
Hi Heidi:
Your English is perfectly fine. You don’t need to apologize for it.
Whenever you go to loud concerts, etc. without wearing ear protectors, you risk damaging your ears. Some of this damage is “hidden” so doesn’t show up on a standard audiogram. The more you do this, the more damage occurs. Eventually, the damage will show up on an audiogram, typically as a “noise notch” around 4,000 Hz. However, the hidden damage is still there and often manifests itself as trouble hearing/understanding speech in noisier places.
You may get tinnitus from the very first loud exposure to sound, but often it is temporary and goes away in a few hours. However, the more you expose your ears to loud sounds, the longer the tinnitus lasts, and may become permanent. So besides hearing loss, you may also have tinnitus. Another good reason to protect your ears from loud sounds.
Typically, tinnitus seems worse at night (or other times when it is quiet), so having a background sound on like you are doing with your air conditioner is a good strategy for helping you deal with your tinnitus.
However, you mention that you normally sleep with ear plugs in. This is a bad thing because it starves your ears/brain for sound, and thus your brain turns up its internal volume. The result is that you begin to hear all sounds as louder than normal. You become sensitive to sound. This is called loudness hyperacusis. You can also get hyperacusis from exposing your ears to loud sounds like at the last concert you went to.
In addition, if you taper off a benzo too fast, that can cause tinnitus and hyperacusis too. If you have been on a benzo for “years”, you need to do a slow taper that will take from 9 months to a year or more. Anything faster can cause tinnitus and hyperacusis.
I’m glad you are working to get off the benzo, but it is not easy if you have built up much of a dependence on it, but you can do it–just very slowly–especially at the end like you are now approaching.
Tinnitus can have several sounds that can change from time to time. For example, yesterday, my prime tinnitus sound was a low rumbling sound. Today it is a high hissy-whine sound (my most common tinnitus sound). Don’t worry about these changes in your tinnitus sounds. That’s just the way it is.
When you have both tinnitus and hyperacusis, they can combine to give you reactive tinnitus. This is what you are now experiencing when louder sounds make your tinnitus louder and when they stop your tinnitus drops back to baseline.
Muffled sounds and distorted sounds are two more side effects of exposing your ears to loud sounds. Hopefully, these two symptoms will fade away as your ears “heal”. This can take several months. Ear damage can occur in almost an instant, but take months and months to recover–so don’t lose hope. Just protect your ears from loud sounds for the next several months to give them time to recover.
Now to answer your questions.
Yes, you no doubt have some degree of hidden hearing loss from all the loud venues you have attended in the past.
The notch at 3,000 Hz could have been caused by the last concert, or it could have been caused by one or more of the previous ones you attended. There is no way of knowing unless you had an audiogram from previously to compare to.
Yes, the tinnitus can still go away, but the longer it lasts, the more likely it will be permanent. If it is getting fainter week by week or you have periods of no tinnitus, that is a good sign it is going away. If it stays the same volume week after week, and no periods of no tinnitus, that indicates it is probably going to be permanent.
Now here’s some good news. Whether your tinnitus is temporary or permanent ultimately makes no difference if you habituate to your tinnitus so that it no longer bothers you. Then, whether you hear it or not doesn’t make any difference. I have had constant tinnitus for more than 70 years (that’s a LONG time), and my tinnitus is ringing away as I write this, but it does not bother me. It doesn’t affect my concentration. It doesn’t affect my sleep. It doesn’t affect my love of living. It is just “there”. And hours go by when I’m not even aware I have tinnitus–but it is still there nonetheless.
What makes all the difference? It’s your attitude towards your tinnitus. If you focus on your tinnitus and how it is disrupting your life, it remains the same or gets worse. However, if you treat it as a totally unimportant, useless, background sound that it is safe to ignore, in time you will habituate to it and it will no longer bother you, so whether you hear it or not makes no difference. That’s what you want to aim for.
Cordially,
Neil
This helps me so much! I had a firework mortar explode 3.2 meters from me and I got on Prednisone 9 days (within two weeks) after. The followed up by Dexamethasone within that same heal month. All my test came back normal from the ENT and Ear specialist. I still have Tinnitus and distorted hearing 5 months into recovery that’s been fluctuating (The Tinnitus and distorted hearing has noticably improved, but takes a step back and then forth it seems from time to time. The nurse told me that I shouldn’t have these symptoms and maybe it’s my brain relearning to process sound again. She told me to live life like normal, but be smart with the volume not loud and wear protection. Do you think it’s just taking me months (possibly 6 – 12) to heal or longer? I also don’t have a spleen and I know I take longer to recover from things.
Hi Yanike:
I’d suggest you have Acoustic Shock Disorder and that takes much longer to “heal” than if you just got some tinnitus from the mortar exploding. The nurse was right on–protect your ears from louder sounds while they heal. It may take you a year or so. The good news is that you are getting better. But exposing your ears to louder sounds than they are ready for is setting you back a step or two at each occurrence. So give your ears a bit more rest in relative quiet so these setbacks don’t occur. Just don’t overdo the ear protection–only wear them when you really need to.
Cordially,
Neil
Hi Neal, thank you a lot for your response. I got answers to many of my questions that I have been thinking a lot and a lot of important information that helps me understand this symptom more.
The term “reactive tinnitus” describes pretty well how my tinnitus is like at the moment.
For a couple of nights I have been trying to sleep without earplugs. It is not easy after getting used to them but there is a good reason why they are probably not the best idea, you mentioned. It was a surprise I was able to sleep without them too without my sleep being as disrupted as I would have thought.
I think my tinnitus have got a little fainter overall during the weeks but it is fluctuating a lot and there are days when it bothers me a lot and days when it bothers me less. Yesterday morning I woke up and didn’t hear it at all in silence. I have had a couple of moments like that during weeks but usually I hear it. Unfortunately tinnitus came back and this morning its been worse. I feel like I mostly hear T in my left ear at the moment and it was the ear that was on the side of stage speaker at the concert.
Thanks for sharing your story and it feels comforting to hear it is possible to habituate and it is possible tinnitus doesn’t bother as much in the future even if it wouldn’t go away completely. I believe it can take a bit time to habituate. I am still in a phase I learn to deal with this
When you advice to protect my ears from loud sounds for next several months to give my ears time to recover it is a great advice but I am just a bit confused what loud sounds mean? Sometimes when I have gone out to a park and there are for example dogs barking in I feel uncomfortable in my ears (probably hyperacusis). Should I put earplugs to my ears when I am in situations like that and carry them with me? I have understood keeping earplugs constantly in ears in everyday situations is a no no and can make hyperacusis even worse. Problem is I am studying to be a teacher. Sometimes noise levels can go up when I practise in school (for example exercise or music classes). I have been able to avoid those classes now after my T started but next few months I am not if I don’t take a break in those studies. I am basically a bit afraid of loud sounds because of my T and reactive tinnitus and other noise induces symptoms. The ENT doctor said I shouldn’t avoid those situations and continue living normally. Maybe to try those situation with earplugs at first and slowly get used to those sounds
What is your opinion could the sound in those classes in school disrupt my healing process? My health is my priority. I am interested in your opinion.
I have decided to take a break going to all sorts of loud places such as concerts or movies or loud restaurants etc for a many months minimum and avoid loud sounds. I have read that some people with chronic T don’t go to those places at all and I really well understand why. I feel that thought a bit depressing. Idea I couldn’t go to those places in the future at all even with earplugs without risking my tinnitus getting worse.
I am also afraid am I able to work as a teacher in future if the hyperacusis/reactive tinnitus doesn’t heal at all.
But I try not to think too far.
Best,
Heidi
Hi Heidi:
I purposely was vague about avoiding “louder sounds” because it depends on how you perceive them. If they make your tinnitus worse, or cause reactive tinnitus, then they are “louder sounds” for you AT THAT TIME. As your ear improve, then you’ll be able to stand sounds louder than you can now. But this is a process that takes time, so be patient and don’t rush it.
So, if in the park you are close to barking dogs, its not wrong to put in your ear protectors while you need them, and take them out when you are further away from the barking dogs. It is a good idea to carry ear protectors with you for when you need them until your ears return to normal or near normal.
You ENT is basically right–but he doesn’t understand hyperacusis. What I’d do is do is go ahead with your practice teaching in music and exercise classes, but if needed wear your ear protectors to get the racket down to where you can handle it. You don’t ever want to cut out sounds completely–just reduce the peak volumes while your ears heal.
Don’t be afraid of sounds as that will just lead to fear hyperacusis (also called phonophobia). Knowing you have your ear protectors with you and can use them at any time will help take the fear away.
You can go to noisy venues if you really want to–but be sure your ear protectors can keep the volume down to a level the works for your ears at whatever stage of recovery they are in at the time.
The fact that your tinnitus is fluctuating is a good sign as your brain is trying to get things back on track, but resetting your sound filters to the right level. Just work with your brain by doing the above things.
I believe you will ultimately succeed!
Cordially,
Neil
I shot 24 rounds from my handgun yesterday in an outdoor range with no hearing protection. My left ear is still muffled and I have a constant ringing in my ear. I’m only 20 years old, will this go away?
Hi Josh:
You should never shoot guns without adequate ear protection so you avoid problems like you now have.
Probably the muffled feeling will go away in a few days, if it hasn’t already gone away. The same may apply to your tinnitus, or may not. You want to protect your ears from loud noises for the next month so your ears have a chance to “heal”. By then you should know how your tinnitus is progressing. In the meantime, don’t worry about your tinnitus as by focusing on it, you will just make things worse. Rather, ignore it by focusing on the loves of your life.
Cordially,
Neil
Dear Dr. Bauman,
First I would like to thank you very much about maintaining this blog, and writing some of hearing loss books. I have re-read this blog a couple times of week now.
I bought both of your Hypersensitive to Sound and Take Control of Your Tinnitus, and in the process of reading them.
So for my story,
I went to a semi outdoor gun range on October 2, and was shooting some small caliber pistol (22lr and 9mm). I wore a 25db earmuff.
I got sensitive ear, and know that hearing damage is cumulative. As such I don’t go to the range that often. Maybe once a month or every 2 months, and if any only spent about 30 – 40 mins there.
Usually when I go to the range, I wear both a foam ear plug, and earmuff. But in this case, I only wore a 25db earmuff, and for pistol, usually it has been fine for me.
I always double up, when I go to the rifle section, but not always for the pistol section.
After about 30 mins, someone occupied a booth next to me on my right, and shot an AR pistol. I don’t think that he should have been in that area, but I guess it was my bad luck day.
As soon as he shot a round, I felt the sound was a bit too loud for my earmuff, and I also felt a short dull pain on my right ear, but after that it was fine.
My mistake was, I should have leave right away. But because my hearing recovered right away, I decided to stay, and he shot about 5 – 6 more rounds.
After he shot 5 – 6 more rounds, I decided to tap off, and leave.
That night, I felt some fullness on my right ear. I thought everything was going to be ok, because about 6 months before that, I had similar fullness issue, when someone shot a super loud round, at 2 booths over (unlike this time where it was next to me)
Also if I’m not mistaken, I did wear both earplug and earmuff at that time.
I tested my right hearing by plugging my left ear and listening to soft music using my right ear only, and I could hear without issue.
I didn’t know about NAC, then. But on that week, I drank some Centrum multivitamin.
The fullness on the right ear remains throughout the week.
The following Saturday (October 9), when I woke up, I started to have some Tinnitus. It sounded like faint cracking sound, and sometimes like the pitch from an old fluoerescent light.
As soon as that happened, I realized that now it is getting serious, and started researching about this, where I found your blog.
I tried to find some NAC at that weekend, but could not find anywhere. But I started to drink Zinc and Magnesium supplement at the dose that you recommend.
I managed to get some NAC on Tuesday (11 days after I went to the range, or 4 days after the Tinnitus started to happen) and used 1500mg dose (two tablets)
I also booked an ENT appointment on the same Tuesday, and did hearing test.
The hearing test was normal, from the -10 to 20 db, although the right ear scored a tiny bit lower than the left ear as expected. The speech testing was 100% for both ear, with speech recognitiion threshold of 10 at left ear and 15 at right ear.
For the tinnitus, it was at around 6000 Hz, at 20 db.
I did not have any notch at 6000 Hz, in the hearing test though.
The ENT prescribed me 4mg Methyl Prednisolone in tapered dose (6X4mg on Tuesday, then 5x4mg on Wednesday and so on)
About 2 days after I got the Prednisolone, the fullness on the right ear started to disappear.
Starting the weekend the Tinnitus happened, I took about:
– 483 mg magnesium supplement (magnesium oxide for the first a couple days, then I switched to Chelated Magnesium)
– 30 mg zinc Glycinate
– 1 tablet of Vitamin C, E, and B complex as recommended at the label
– Started Tuesday, NAC at 750 mg (local store brand) and 600 mg (NOW brand)
– Increase fresh fruit intake such as Banana, Apple, Oranges
Fast forward 3 weeks later, currently, the Tinnitus is still there, faint for the most part, although it is fluctuating a lot.
Sometimes when I woke up at 3 or 4 AM, the tinnitus disappeared, sometimes it came back faint, within a min or so if I start to think about it.
Sometimes it wont come back, after many minutes.
Sometimes when I woke up, the sound change, to just some minor cracking sound. Occasionally it sounds like the high pitch from old neon light, also faint.
Sometimes it can be very very faint tone
One thing for sure is, the Tinnitus tone somtimes does get a tiny bit louder, when there are other noises, such as fan, washing machine.
And when this happened, if I wear my 31db noise reduction earmuff, I can sort of reset the Tinnitus sound to make it very very faint.
Although if the external noise remains, then it will get slowly louder, after I remove the earmuff. I tried to not wear earmuff all the time per your suggestion though.
Also quite sometimes I can feel my right ear feels tired much easier than the left ear, especially when I’m driving in my car, or listening to sounds.
After 2.5 weeks I also start to taper down the supplement that I was taking.
Now I take 600 mg NAC every other day, Magnesium at 280 mg, Zinc at 10 mg, and so on.
My questions now are:
Am I ok to start tapering down on the supplements after about 3 weeks?
How come the faint high pitch sometimes only happen, when there are other noises around me? When this happpened, I can reduce the faint high pitch very quickly by wearing earmuff.
Is there anything else I can still do to hopefully help with the healing process?
I’m not planning to go to any loud place for several months, and if any I’ll make sure to bring some foam ear plug.
I learned my lesson, and most likely giving up sport shooting completely.
Assuming I can recover, I will take a couple years hiatus, and probably will only shoot with suppressor, and when there is nobody at the range, along with earplug and earmuff.
Hi IB:
To answer your questions. Probably the best thing you can do, since your tinnitus is not loud at all is learn to ignore it. Every time you listen for it, you are just telling your brain that it is an important sound and to make it louder–just the opposite of what you want. So focus on anything/everything else but your tinnitus and it will fade into the background like it has been doing. You don’t want to keep undoing the good things that are happening.
You also likely have some loudness hyperacusis that is reacting with your tinnitus–called reactive tinnitus. That is why your tinnitus gets louder when background sounds get louder. As long as it is not loud and bothersome, I’d ignore it too. You don’t want to give it attention either.
You can stop the supplements now if you want to. They have done their jobs. However, you can continue to take them at lower doses. I take zinc, magnesium and NAC every day for good health–just not at high doses.
Remain calm and don’t worry about your ears now. As I said, focus on other things and thereby ignore your tinnitus and you’ll find hours go by without your being aware of hearing it. That is good.
Cordially,
Neil
Hi Neil
I shoot a single round of an ar15 without ear protection on New Years eve and I immediately felt discomforting my left ear, I heard muffled sound for about 2 minutes and ringing also, its been 4 days since then and I just had my ears cleanse with water and a syringe and I dont know if it was a good idea, also took only 1 pill of cinnarizine and ibuprofen for inflammation according to the Dr.
I have less ringing since day 1 but also when going to sleep I have trouble because cant stop hearing the ringing and its costing me a lot of energy im having trouble going on with my normal life.
What do you think, should I go to a ENT or wait more days if it stops by its own?
Hi Adrian:
If you go to an ENT, he won’t be able to get rid of your tinnitus. Probably all he’ll do is prescribe you a sedative and tell you to go home and learn to live with it.
What I’d do is put on some sound at night when you are going to sleep to reduce the contrast between silence and your tinnitus. You don’t want to drown it out, just take the edge off it. Many people find all they need is a fan running in their bedroom. Or you can download and listen to water sounds–waterfall, waves on the beach, babbling brook, fountain sounds, rainfall, etc. These are naturally soothing sounds and will help you get to sleep.
Learn to ignore your tinnitus and let it fade into the background. If you focus on it, worry about it, and think of it as a threat to your well-being, you’ll just make things worse and worse.
Cordially,
Neil
Hi Neil
I went to the ENT because I didnt slept for 2 straight days and my ears were in good condition, only the left one is bruised because of the gun explosion. ENT prescribed prednisone and cinnarizine, also some rivotril when im unable to sleep at night.
Prednisone has helped a lot I dont feel the fullness in the ears anymore, and tinnitus is getting quitter but still there, do you think is good progress? Is it possible to get an outcome like this with no hearing damage at all?
Hi Adrian:
You are making good progress. It can take several weeks for tinnitus from a gunshot to fade away. Just continue to ignore your tinnitus and focus on the loves of your life.
You may have some hidden hearing loss from this episode, but then egain, you may not have suffered any hearing loss. Only time will tell. If any, it should be minor since you have not noticed any so far.
Cordially,
Neil
Hi Dr. Bauman,
I shot a round from an AR15 today outdoors having forgotten to put ear protection on. I have the same symptoms as most describe above. Ringing, hearing loss, muffled sounds, tinnitus, etc. I’m a helicopter pilot as well so I will be exposed to turbine noise at work which it sounds like is not good. I will wear ear protection at work to keep the noise to a minimum to let the ears heal as you say in the above threads. Is there anything else I can do to minimize this loss and discomfort? Also, I’ve read above you sometimes recommend medications as well?
Thank you kindly for your time.
Hi Jake:
As you now know, you want to wear ear protectors around louder sounds, but you do NOT want to overprotect your ears or you can develop loudness hyperacusis or make it worse if you already have it.
I’d take N-acetyl-cysteine (NAC) if this happened in the past week or so, but if longer ago, it probably won’t be very effective. And of course, I recommend taking the minerals zinc and magnesium. (The most bioavailable forms are magnesium threonate and zinc picolinate.)
Cordially,
Neil
Hi Neil,
in 2007 I experienced an acoustic trauma from using a 12ga shotgun with no ear pro while hunting. I became depressed and experienced tinnitus and distorted hearing. I did not lose any hearing on the audiogram but I was left with tinnitus and permanent distorted hearing at higher frequencies (plates clanging, women’s voices, children’s voices, coughs, etc). Although this was irritating I did eventually adjust and the tinnitus which was at around 2400hz eventually faded to the point that it was extremely quiet.This event did challenge me and it changed my state of existence.
I am a hunter shooter as a personal hobby and I also have to shoot as a requirement of my job. During April of 2021 I did a range day with an organized shooting group and despite wearing the 31db yellow 3m soft foam ear plugs I experienced a worsening of my conditions. We were shooting ar15, upon the shots my ears would SLIGHTLY ring but they did not hurt and I did not lose hearing after each shot as before in 2007 without plugs. I assumed the ringing was just from recoil from the rifle because sometimes I would get that from shooting high powered rifles in the past. Following this range shoot, my symptoms worsened, I have worse distortion and the tinnitus is unbearable, at around 3400hz and piercing. We also did some physical exercises and I noticed my neck was bad. On the way back from the exercise the AC unit on the bus malfunctioned and I found it extremely loud. I plugged my ears but it bothered me. My symptoms worsened following this weekend and I developed a high pitched constant “hiss” that seems to sync with my heart beat and the flexing of my right masseter.
Flash forward to present, early January 2022 and my subjective tinnitus is horrific. It is extremely loud (only in right ear at 3400hz) and it has many aspects – a metallic ringing sound, a sea shell like sound, a piercing tea kettle like sound…the only thing that helps is a hot shower or playing residual inhibition neuromodulation videos. I still have the distorted hearing and it seems to be a little worse, the sound of fans oscillating and toilets flushing is extremely tinny and distorted.
The second sound of concern, is the ultra high pitched frequency tinnitus that “hisses” and is variable. Some days it is absolutely unbearable. I can hear my “heartbeat” through it on times and if i flex my right masseter muscle it “chirps” with each flex. It is incredibly annoying and although I experienced this prior to the 2nd acoustic trauma incident, it has become omnipresent since the 2nd event and worsened. I also noticed if I heard a loud sound after the 2nd acoustic trauma incident I would hear this high pitched sound flare up and hear my heartbeat and stuff. If I place my finger into my right ear sometimes when I move my finger around my ear sort of “rings” in a similar way but not quite as high pitched. This constant hissing is very bothersome and it bothers me that when I flex my right jaw it chirps in sync. This sound is unmaskable.
I wear a bite plate for bruxism since 2016. After a night of the plate when I flex my left masseter I can get the same chirping sound on the left side but not like the right and when I remove the bite plate the left side chirp goes away. I do think my jaw might be slightly out of line but not severely. I exercise frequently and weight lift and eat healthy.
Any Dr. Bauman, thank you for reading my short story. I am finding the sounds horrible and have had thoughts about how I can live my life like this. I am constantly on edge from it and I cannot ignore the sound(s). Outside of this I have a near perfect life outside of this; I work in healthcare and have a good side job and a supportive family structure. Do you have any advice as to how to proceed. I am desperate, I am trying my best to ignore these sounds but my quality of life is horrible right now.
Thank you for your time
Hi Barry:
The distorted hearing you describe was loudness hyperacusis. It often accompanies tinnitus after you expose your ears to loud, sudden sounds like gunshots.
Your April episodes just made matters worse. I take it you are left-handed and shoot left-handed, and that is why your right ear is your worse ear.
Your loudness hyperacusis has acted up again. It is common for it not to appear right away like tinnitus often does, but develops a week or two later which seems to have been your experience too.
You also have some degree of somatosensory tinnitus (the pulsatile tinnitus and flexing your masseter muscles.
Normally, you want to treat your loudness hyperacusis before you treat your tinnitus. If you try treating your tinnitus first, the tinnitus treatment may exacerbate your loudness hyperacusis.
I’d suggest you get and read my book called “Hypersensitive to Sound?” and begin practicing the principles laid down for loudness hyperacusis. You can get this book at https://hearinglosshelp.com/shop/hypersensitive-to-sound/.
In addition, I suggest you get the new 8th edition of my book on Tinnitus when it comes out in the next two weeks. It has a lot more information than the current 7th edition, so I suggest you wait until it comes out. You’ll be able to get it at the same link as the current edition, namely, https://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/ .
Also, you need to avoid shooting for some months and let your ears “heal”. This is a slow process and if you rush it, you just set yourself back again.
Cordially,
Neil
thank you Neil. Do you think it is possible to make the tinnitus dissipate? Either the steady tinnitus or the somatosensory which pulses with my heart beat and when I flex my masseter. Also, when do you think I’ll be okay to shoot again? I still have training to do that will see me sleep deprived and under stress and loud fire/bangs (albeit with ear plus and ear muffs). But it’s not in the immediate future but months away. I will buy both of your books. I also have bruxism and I wear a bite plate and I have been referred to an orthodontist to have my bite corrected as my jaw is out of line. Is there anything that can be done for the somatosensory tinnitus or the occasional rumbling that happens too? Sorry for all these questions; but doctors have nothing to offer for treating these issues! If I could get rid of the somatosensory tinnitus and lower the constant subjective tinnitus my quality of life would be a lot better. I’ve tried magnesium, it doesn’t really do much for me.
Thank you god bless you for sharing your knowledge with those suffering.
Hi Barry:
I think you have a good chance of getting your somatosensory tinnitus under control when you get your bite and jaw properly aligned. You may find that having massage therapy on your head, neck and shoulders will also help. One session should tell your massage therapist whether (and how bad) your muscles are way to tight.
For your neurophysiologic tinnitus (from noise exposure), the standard tinnitus treatment of psychological counseling and sound therapy should really help you get your tinnitus under control.
The latest edition of my tinnitus book is now available and it teaches you all you need to know about such things. You can get it at https://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/ .
As for shooting again, I’d wait until you have your loudness hyperacusis under control and your ears are back to normal in this respect. The big thing is that you don’t want to expose your ears to sounds so loud that they make your hyperacusis worse. So if wearing ear plugs and earmuffs over them works for you now, then you could resume shooting. Just take it easy and not do too much at one time. I’d just shoot off 2 or 3 rounds and then wait 2 weeks and see if in that intervening time your hyperacusis is worse or not. If worse, you are not ready yet. If it doesn’t affect your hyperacusis, then you might want to take up shooting again–but slowly build up–not doing a lot of shooting all at once. Wait the two weeks between sessions to be sure it is not affecting your hyperacusis.
Cordially,
Neil
Do you think the somatosensory tinnnitus that pluses with my heartbeat and can be modulated by the jaw is from maladaptive plasticity in the auditory pathway following noise damage or is it related to the jaw alignment and bruxism? It started before the second acoustic trauma but when the second acoustic trauma happened it got super bad and now it’s horrible.
Thanks Neil,
Hi Barry:
If your “tinnitus” pulses in unison with your heartbeat, then it is not somatosensory tinnitus. In fact, it is not tinnitus at all, but rather a somatosound, although it has been called tinnitus for “forever”. Since it is not really tinnitus, it doesn’t do things like real tinnitus does–such as maladaptive plasticity.
Having said that, if you can change your tinnitus by moving your head, neck or jaw, then you have somatosensory tinnitus. You can have somatosounds and somatosensory tinnitus at the same time. You can also have the common neurophysiologic tinnitus too. They are not mutually exclusive of each other.
You should deal with each condition separately as the treatments for one of these conditions is different from treatments for the other two.
You may not be able to get rid of them entirely, but getting them down to a low level, or any lower level, will be a blessing.
Cordially,
Neil
I went to the shooting range for the first time ever today. I put the ear plugs in but I have small ears and I had to keep stuffing them down in my ears. Afterwards, my left ear was terribly muffled, and accompanied by ringing. I have started on NAC, after I read a few posts, and I’m hoping and praying my ear stops being muffled. I wish I would’ve never went to the shooting range 🙁
Hi Rachel:
It is so important to have ear protectors that work for you ears. If the small foam ones won’t stay in your ears, better to wear the ear muff style ear protectors.
Taking the NAC right away and continuing for a couple of weeks is an excellent place to start. It may take some weeks, but the muffled feeling should eventually fade away. It all depends on how sensitive you ears are, and how many rounds were fired by you and anyone close by.
Cordially,
Neil
UPDATE: After 48 hrs: taking 1800 MG of NAC, 30 MG of Zinc, and Magnesium my muffled ear is 60 percent gone. Now I’m left with tinnitus which does not bother me because it is not harmful to me. I have hyperacusis as well but it does not bother me I’m just thankful muffled is gone. Going forward I will do the work to protect my hearing. You never know what a precious gift from GOD it is until you almost lose it. Also, Neil God bless you and thank you for giving hope to situations that may seem hopeless. It wasn’t by coincidence that I stumbled upon this page, and I’m so blessed I did in these crucial hrs. ALL GLORY TO GOD WHO IS A HEALER! In Jesus name!
Hi Rachel:
Great that the muffled feeling is mostly gone. That regimen you are taking should help your ears heal. Hopefully it will also help with your tinnitus and hyperacusis.
You always need to be cognizant of your hearing and the sounds around you that can damage it.
And no, it wasn’t a coincidence. God regularly sends people to me so I can help them. As the Scriptures say, “As we have therefore opportunity, let us do good unto all men, especially unto them who are of the household of faith. (Galatians 6:10).
Cordially,
Neil
Hello,
I am a 20-year-old that went target shooting last week with these headphones that were not made for firearms. I fired bout 30-45 rounds out of a 9mm handgun outdoors. Each round that went off, I noticed a slight ring in my ears after each shot but mistakenly decided to ignore it. It was the day after that I noticed that my ears were ringing, and it gets significantly louder when I focus on it, as well as when I open my mouth. There is a slight fullness feeling in both ears, as well as a slight sensitivity to noise. Two days ago I was in a crowd of people clapping and my ears were ringing from it as well as slight pain. When will this begin to gradually fade away? I have become very worried about this and I’d like to know what measures I can take as soon as possible to put an end to the ringing. I initially didn’t thin k that it would be such a big deal while shooting because I thought that police and soldiers are used to it. The more research I’ve done the more I regret that I did that and it has amplified how worried I am. There are those that say it is permanent ringing, what can I do.
I have now just taken Magnesium, Vitamin E, and Vitamin D as they supposedly help with healing. I will try to take those every day!
Respectfully,
Jonathan
Hi Jonathan:
You have learned your lesson–proper ear protection when shooting. Now, the most important things you can do (apart from your vitamins) is 1) protect your ears from louder sounds while your ears heal. This means staying away from all loud venues and not listening to loud music. And 2) quit listening for your tinnitus to see how loud it is. This just tells your brain it is an important sound and thus it turns up your internal volume so you can hear it better–just the opposite of what you want to happen.
The solution is to focus on things other than your tinnitus and thereby basically ignore your tinnitus. This gives your brain permission to turn down the internal volume so you seldom hear your tinnitus and even when you do, it doesn’t bother you.
The way you do this is NOT to think of your tinnitus as a threat to your well-being. Anything that is a real or perceived threat can never be habituated to. So think of your tinnitus as a totally unimportant, useless, background sound that it IS safe to ignore, then ignore it.
In time, you’ll realize that hours go by without your being aware you even have tinnitus, and if you do hear it, it’s no big deal–so you just focus on the loves of your life and it will disappear again. That’s the secret. It’s worked for me for close to 70 years now.
Cordially,
Neil
I went to a indoor range on 6/3/2022 I wore ear protection but obviously not properly I shot close to 100 rounds and I couldn’t tell anything was wrong until I took my ear protection off my right ear was muffled accompanied by a low hum/buzz which is tinnitus I’m on day 2 and the muffle does seem a little better it’s not as extreme but low noises such as conversation raises the noise of my tinnitus I’d say for about 15-30 mins but I also think that’s just a side affect of my right ear being muffled and not receiving noises properly what’s your opining on that? I’m I’ve been taking the supplements you suggested such as nac, magnesium… etc how long do you think it’ll take for things to go back to normal?
Hi Derrick:
You can’t tell much immediately after a trauma incident. I’d give it a week, then see if you have any lingering symptoms. Noise damage varies from person to person and by how loud the sounds were through you ear protectors, etc. In your case, I think the protectors did a lot of good, so you may find your ears are back to normal or near normal in a couple of weeks if hyperacusis doesn’t develop in the meantime. But you are taking the supplements and that should help.
Cordially,
Neil
Hi thanks for the fast response it’s been about a week and things have got a whole lot better my ear still feels full from time to time but not as severe as it was when it first started my tinnitus still gets higher from my voice for as long as I’m speaking then it fades away I’ve noticed it doesn’t go over sounds like my tv or tik tok if I’m watching videos like it used to. So it’s getting better? Is this considered hyperacusis and how do I treat it, or do my ears just need more time to get back to normal and cause I’m still sensitive to low bass like vibration such as my voice.
Hi Derrick:
Your ears are definitely getting better. You are making good progress. I’d just give it more time–see what another week or two brings. The main thing is to not expose your ears to loud sounds while they “heal”. If you have to be around loud sounds, wear ear protectors.
If you still have problems after a couple of weeks, let me know what’s going on at that time.
Cordially,
Neil
Hi doc another update my ears still feel like they’re getting a little better it’s mainly just this buzz in my right ear now, I think I messed up tho I stopped taking the supplements I only took them for 2-3 days because the muffledness dropped was I wrong for doing so? And if so should I start taking them again, I have noticed when I first wake up sometimes the tinnitus try’s to change in noise but then goes away, as the day progresses is this a good thing?
Hi Derrick:
It’s always a good thing when your tinnitus goes away for any reason. Hopefully, as time goes on, it will go away, and stay away longer and longer.
It’s a good idea to continue to take the supplements until your ears are back to normal. I take NAC, zinc and magnesium daily just for good health. So don’t worry abut taking them for too long. Just don’t take them in very high doses for a long time.
Cordially,
Neil
Hi doc it’s me again with another update so it’s been about 4 weeks now and it does feel better my ears are still ringing although it is quieter and I even feel a uneven pressure in my ear still from time to time do I still just need time for them to heal or should I go see a ENT, side note still when I touch my ear, scratch my head or hear certain bass like noises it raise my t for as long as the noise is going on I also forgot to mention I’ve had t my whole life I am 20 and never heard a quiet room lol but I’m just not used to it being this loud, so my final question is am I stuck like this? Or do I need more time I’ve seen you tell other people 2-3 months but I just don’t know any info will help thanks.
Hi Derrick:
It’s only 4 weeks so far. Healing takes time–and it is different for everyone depending on the severity of the “damage” and how the person deals with it. It could take 2 or 3 months, or it could take 2 or 3 years.
The main point is that you are getting better–so that is good. Just give it more time. I don’t see any point in going to an ENT because he will probably just tell you to go home and learn to live with it since it is not a medical problem that he can “fix”.
Let me know in another month or two how things are going. Hopefully, you’ll be able to tell me things are still improving and it’s not much of an issue anymore.
Cordially,
Neil
Hi Dr Neil,
I’ve read your blog extensively; it’s been so helpful to me during this difficult period. Thank you so much.
About 8 weeks ago I was at a rifle range without sufficient ear protection (I was only wearing the foam ear plugs). In any case, I suffered severe acoustic shock in my left ear. The first 4 to 5 weeks were very difficult with fullness, tinnitus and hyperacusis.
The fullness and hyperacusis have subsided but I still have severe persistent tinnitus. In addition to the tinnitus, I also experience weird metallic sounds when, for example, I touch my ear, yawn, cough, sneeze, etc…
My audiologist noted moderate hearing loss from 750 to 1500 htz in my left ear (the injured ear). This also is surprising because most hearing loss from loud sounds appears to occur at higher frequencies from what I have noted (i.e. > ~4000 htz). I’m hopeful this is a misdiagnosis as it was difficult to take the test with the tinnitus distracting me. I will likely retest in a few months.
My question for you is: when you say that after acoustic shock it can take 6 months or longer to “heal” do you mean that is the period of habituation or do nerves inside the ear actually repair themselves over that time? It feels like the weird temporary metallic sounds that I experience when I yawn are perhaps from nerve damage and I’m curious if those will heal/repair over time? Also, curious if that “healing” will also help my tinnitus moderate, in addition to the benefit of habituation?
thanks so much,
Kevin
Hi Kevin:
It is normal for the noise notch to be around 4,000 Hz, but it doesn’t have to be that way. I can be somewhat dependent on the frequency of the loud sound.
If you have trouble hearing the tones because of your tinnitus, ask your audiologist to use warble tones or double beeps. That makes it much easier to tell when the tones are on in spite of your tinnitus. I like the warble tones the best.
It’s good that the feeling of fullness and hyperacusis have gone away.
When I say “heal” there are several aspects to that. One is the synapses that are broken due to the loud sound. They can repair themselves to some degree, but if they can’t, then the underlying support cell to a hair cell dies and when that happens, the hair cell also dies. This can take up to 3 months or so.
Two is that certain somatosensory nerves are hyperactivated due to the loud sudden sound, and it takes time for this hyperactivity or hypervigilance to calm down. This can take a good number of months. I think this is what your problem is now.
That is why touching your ear, yawning, coughing or sneezing can cause the weird metallic sound when you activate your facial nerve or trigeminal nerve.
In this case, there is no physical damage as such. Rather, the nerves are on “full alert” and thus are supersensitive to stimulation and thus over-react–and your brain interprets this as sound.
I would expect by now that your tinnitus would be starting to habituate, but in order to habituate, you need to treat your tinnitus as not being a threat to your well-being in any way, and thus are sounds that are safe to ignore. Then you need to ignore them. If you focus on them, your limbic system is forced to bring them to your attention and thus your tinnitus remains or gets worse.
I’d suggest you practice calming exercises and calming breathing. You might also want stay away from excitatory neurotransmitters such as glutamate and take extra calming neurotransmitters such as GABA (gamma amino-butyric acid) and kindred calming supplements.
Cordially,
Neil
Hi Dr Neil.
Thanks for your response above. I followed your advice on warble tones and had an updated audiogram which confirmed the results of my first one, which is that I have low frequency noise notch hearing loss. Thanks for your advice on this.
Also, if you don’t mind I have a follow up question on the second part of my initial post, which was in regards to the somatosensory tinnitus that I’m experiencing after the acoustic trauma. This is on top of my baseline tinnitus, I also experience a second tinnitus that is instigated when I chew, yawn, sneeze, scratch my head, face, etc.. Initially you suggested that this is from hyper-sensitive nerves from the loud noise and that it will take time to calm down.
Unfortunately, it’s now been about 5 months since my acoustic trauma injury, and I’ve seen no improvement. This is really hard to habituate to since it completely modulates from touch and physical sensations. I’m quite worried about this and I’ve been to two ENTs & Audiologists that seem perplexed by this? What do you recommend I do? Will this take many months or years to heal, or do I need some serious nerve calming medication to address this (i take Gaba, do breathing, meditation, etc. and nothing works). it’s quite scary.
Many thanks for your advice,
Kevin
Hi Kevin:
You have been doing some good things, but unfortunately, your somatosensory tinnitus isn’t getting better, I think you need to be even more proactive since your doctors don’t have a clue how to help you. There are a number of things you can try. At this point, you’d do well to get my book on tinnitus and specifically read Chapter 9 on somatosensory tinnitus and then Chapter 26 on treating somatosensory tinnitus. See if anything pops out at you.
You might want to try some of the therapies explained in other chapters. For example, Chapter 32 on neuromodulation such as Transcutaneous Electrical Nerve Stimulation and Vagus-Nerve Stimulation.
There is a LOT of information on tinnitus in this book, and as you read it, something may trigger an idea of what might work in your case. All of the therapies work for some people, but none of the work for all people. Thus, the trick is to find what therapy or therapies help you. This is largely a trial and error process.
I’ll help you, but in this book I have distilled pretty much everything I know about tinnitus so it’s well worth reading it.
You can order this book from https://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/ .
Cordially,
Neil
Thanks Dr Neil,
I appreciate your advice and I just ordered your book via Amazon. I will read the chapters suggested.
Interestingly, my left ear (injured ear) actually physically vibrates/pulsates, and I can feel it with my finger when I touch the ear. I do not feel the same sensations when touching my good ear. I really wonder if those are somatic nerves (spasming) or something else? I was curious if you’ve ever heard of somatic injury accompanying an acoustic trauma?
In any case, I will read your book and seek out some of the therapies you advocate for. I’ll reach out privately if I need some advice on doctors or facilities that perform these treatments.
many thanks,
Kevin
Hi Kevin:
Is it your eardrum pulsing. If so, that is common with acoustic trauma. This is called Tonic Tensor Tympani Syndrome (TTTS). Your trigeminal nerve innervates the tensor veli palatini and tensor tympani muscles that can rhythmically tug on your ear drum causing it to spasm/vibrate. You normally hear this as a thumping or other sound.
If you want to learn more about TTTS and related stuff, you can find out a lot more in Chapter 18 of the companion book to the tinnitus book, called “Hypersensitive to Sound?”. This book also tells you all about loudness hyperacusis.
Cordially,
Neil
Hey Dr, I appreciate you having this thread to relate to.
I hope you can provide some insight to my current situation.
On January 18th one of my friends shot a rifle on his private property in upstate and didn’t give me a heads up that he was going to shoot. When he took the shot, I instantly heard a ringing noise in my left ear.
1 week after the incident (1/25) I visited an E&T dr. The Dr prescribed me perdnisone for one week & provided an audiometry test. The test discovered that I had a 50db loss in me left ear at 1k hz and a 50db loss in my left ear at 4k hz (my right ear is fine).
A week later (02/1) I went back to the E&T and had another audiometry test. The test results shown that the prednisone worked to some effect and my left ear went from 50db to 40db at 1k hz and 50db to 40db at 4k hz. The ringing in that week span seemed to go down as well in my left ear. The dr went on to recommend intratympanic steroid injections. I went on to get (2) shots of the steroids over the span of 1 week.
After the (2) shots, I went back for a hearing test on 2/12. The results of the hearing test went from 40db to 35db at 1k hz and the 40db at 4k hz stood about the same.
The E&T told me to let time play its course and to come back in one month for another hearing test.
Do you think I have a chance for my hearing at my left ear to recover over time or is this something that will stay as is?
Also I’ve never had tinnitus untill this situation, do you think it will ever fade out?
Also adding additional information, I’m 26 years old & have never had an ear issue till this incident.
I appreciate your time.
Thanks
JC
Hi JC:
I assume your left ear was facing the gun so it got the brunt of the blast and that is why it has the problem, and your right ear was somewhat sheltered, so it didn’t sustain much, if any, damage.
There’s always a chance of your hearing returning, but I don’t think it’s very likely to happen. Your hearing may improve a bit more, but I wouldn’t expect more than maybe a 5 dB improvement since it is a month since this happened. You had timely and appropriate treatment.
Like your ENT said, give it some time now. Your tinnitus may continue to fade away–especially if you don’t focus on it. Just ignore it and focus on the loves of your life. Treat it as an unimportant background sound that is safe to ignore.
If you’d like to email me (my email is at the bottom of each page on the website), I’ve love to see a copy of your audiograms.
One more thing. Don’t expose your ears to loud sounds at this point. Give it a chance to heal. This could take several months. If you’re going to be around loud sounds, wear ear protectors.
Cordially,
Neil
Hi Dr. Bauman,
This may be your only question from a shooter who *doesn’t* have hearing loss, as I always wear both high-end plugs and earmuffs. I’m wondering whether holding a cheek weld (cheek pressed against the rifle stock for stability) increases noise exposure via bone conduction vs bone conduction through the air alone. I would think it would, but I haven’t managed to find any concrete information on this. Thank you.
Hi Tom:
Glad you are protecting your hearing from the get go.
You are asking a great question. I’ve never seen a concrete answer either. But let’s think this through logically. Most of the sound comes from the muzzle blast–so that is air conduction and you are already protecting as much as you can against air conduction sounds.
Bone conduction sounds are not as strong as air conduction sounds as they only indirectly connect to your inner ear.
A cheek weld would conduct bone conduction sounds better than a shoulder weld, but I doubt it adds significantly to what your inner ears “hear”. Dealing with decibels requires “funny” arithmetic. For example, if the air conduction sound is 150 dB and the bone conduction sound is 30 dB less (which I think would be about right), the bone conduction sound reaching your inner ears would be only about 120 dB. When adding decibels together 150 dB and 150 dB does not add up to 300 dB like you might expect, but only to 153 dB. Thus, when adding 150 and 120 dB would make such a small difference, it wouldn’t really be noticeable.
You should be able to prove it for yourself by holding the rifle tight against your cheek and see how loud it sounds. Then fire the rifle again, but just using a shoulder weld and see it you really notice a difference in the sound reaching your inner ear. I’ll bet you don’t.
Cordially,
Neil
Hi again Dr. Niel
I’d like to thank you for responding and are coming in with a report of how it’s going with the snowblower incident.
It has varied quite alot and I’m on day 8 since it happened. I managed to get a hold on nac starting today (even if it might be a little late) and have been taking magnesium and zinc since day one.
My left ear now feels super sensitive to sounds. When I speak it kind of vibrates and hums differently than my right which was the most affected last week. Everything sounds pretty normal except my own voice which is kind of distorted and leans on the left side of my head if I could describe it. My tinnitus has not gone back to previous levels even if the intensity varies day by day. Today is a bad day, and I’m praying for it to be a temporary spike. It’s really hard to deal with it since the peeping is louder than anything else. I can’t drown it out anymore.
I’ve booked an appointment at an audiologist at the end of the month for evaluation. I can only hope for some improvement in the mean time.
Regards,
Christoffer
Hi Christoffer:
I’m hoping that your varying tinnitus indicates that you’ll have better days in the future. You’ll have “good” days and “bad” days, but hopefully, you’ll get more and more good days and fewer bad days, and that the bad days will not be so bad as time progresses.
Hopefully, the distortion will fade away too. You are still “early days”. You need to give it time–weeks or months to hopefully get back to normal or near normal, so be patient.
Cordially,
Neil
Hi Neil!
Thanks again for being so active and there for us.
I’ve since Iast wrote been to an audiologist after not being able to sleep for two days. My hearing turned out to be perfect and within the norm. This threw me off completely and I now realize what this is.
It didn’t have anything to do with the snowblower. It’s the result of being stressed and having panic attacks for the last year that has been filled with loads of emotional stress. It has never affected my normal tinnitus before though. Since I’ve reached a point where I understand what this is, I’ve mostly been able to control my tinnitus during the days. Yesterday was a good day where I could go hours without paying attention to it. Nighttime is rough though when everything feels like it goes up to a 10 on the volume control. The pitch of it changes in tone a lot during the days and I can feel a lot of strain in my jaw and neck. I’m trying to stretching out the jaw as much as I can and exercise more to try and keep my anxiety in check. I was prescribed some sleeping pills just to get a relief and will soon see a doctor to ask for help to manage my stress and anxiety issues.
Do you have any tips on what I can do more to try and alleviate this stress response so I can go back to my normal baseline? I know it’s only been about 14 days since the on set of louder tinnitus, but it doesn’t really help my anxiety.
Hi Christoffer:
Severe anxiety and stress can certainly make existing tinnitus worse in some people.
When you have trouble with your tinnitus at night, using a fan or listening to white noise or music of some sort helps to reduce the contrast between your tinnitus and total silence. Many people find this helps them to sleep.
Be careful with sleeping pills. So often they have unwanted side effects that will trap you if you rely on them. Taking them for a day or two is one thing, but taking them regularly for weeks or months is another and can make your tinnitus much worse.
One simple trick you can employ anywhere and at any time is to use relaxing breathing exercises. Controlled breathing exercises really work to help you relax. In there simplest form, you could breathe in to the count of 3 or 4, hold your breath for the same count, then breathe out for the same count.
There are many variations of this in the count you use and the cycle you use. The above 3-step cycle is one. The four step cycle is another where in addition to the above, you hold your breath for the same count after you have breathed out.
When you do this for 10 minutes and focus on your breathing and counting, you’ll find yourself more relaxed than when you started. You can do this as often as you need to during the day (and night).
Cordially,
Neil
Hi Neil,
Wow! I really appreciate your website because as many have said there is so much bad and negative information out there on the Internet. Your advice is a God send. God bless you! My ear issues started in the fall of 2023 when my right ear felt stopped up. After a while it popped, and I was able to hear clearly again and that was followed by major vertigo. This happened a couple of other times, but I haven’t had that exact issue in 2024. I did have a sensation that my ear was blocked and made an appointment with an ENT. The appointment was almost two months away and then the Dr. cancelled. By then the problem went away again so I let it go. On Saturday, Mar 16th, I went to an outdoor range for the first time, and we shot a variety of guns. (hand guns, shot guns, even AR 15). I had the foam ear plugs rated at 32DB. I didn’t notice anything major until late the next day. My right ear felt stopped up and my ears were ringing. I found that my ears were sensative to noise in the days to follow. I actually do sound for my church and the noise really bothered me. It all seemed too loud. Anyway, it’s now March 27, 2024, and I have improved slightly but my right ear is ringing, and my ears pop a lot. I felt like my right ear didn’t hear as well before shooting range and I keep trying to compare right to left. I have made an appointment with another ENT and they see me on April 4th. That was the earliest they’d see me. Since coming across your site, I now know to guard my ears from the loud noise. I have ordered some ear plugs to use in loud environments. Anyway, sorry for all the detail but sometimes at home my hearing feels normal except for the ringing and at work I get a lot of popping and sensation that I need for my ears to pop. Work has air handlers and white noise masking which seems loud since the range. Any advice? I feel like this has went on forever, but I see from many posts it may take a bit of time.
Hi Jack:
What happened in the fall of 2023 just before you noticed your right ear felt stopped up? Were you around a sudden loud noise of some kind? I need to know more about the background to whatever happened that first caused this ear-blocking sensation because it didn’t just come out of the blue without any cause.
Second, on the rifle range earlier this month, did you shoot left or right handed? In other words, on Which shoulder does the stock of the gun press?
Third, if you were wearing ear plugs with a protection factor of 32 dB, that is about as high a protection factor as you can get, so what protection factor do these new ear plug you have ordered have?
I know what your problem is–your ears have suffered from acoustic shock and it seems to be turning into acoustic shock disorder (ASD).
So answer my questions so I better understand your situation and I’ll explain what you need to do to get this all under control.
Cordially,
Neil
My suspicion is that in the fall I was dealing with fluid in my eustachian tubes (maybe allergies). I went to my GP and that’s what they suspected. They had me take OTC allergy medicine and it did get better after the vertigo was over. I brought it up because I thought it was ironic that I was thinking about contacting an ENT because of on/off stopped up feeling during the weeks before. There is very heavy pollen it this area of NC where I live. This may not have anything to do with my recent issues after going to the shooting range. For the 2nd question, I am right-handed, so I shoot with my right hand / side. For the 3rd question the new ear plugs are 24db but they are for when I’m in noisy areas like when I am at church. I ordered some that are fairly invisible. I probably won’t shoot again without the 32db in ear and headphone ear protection. My sons and friend had those and didn’t have problems. I was careful to have my ear plugs in the entire time I was shooting. I took one out to talk to the instructor and put it back in and may have not put it back in correctly. I did feel good (not completely normal) this morning but as I work in the office with the air handlers above going and sound masking, I feel like my ears need to pop to clear up. My work area sounds like a wind tunnel. It has an open ceiling and hanging cloud ceiling tiles in different places. It just happens the handler near me is one of the loudest. I have a noise cancelling headset if you think that would help temporarily. Thanks for your help
Hi Jack:
Back in the fall of ’23 you said your right ear felt stopped up and you had vertigo. Have you had any episodes of vertigo since then?
If so, do you have the stopped up sensation at the same time as you get the vertigo?
If so, I think I know what might be happening–and it has nothing to do with shooting episodes, although both can result in a stopped up feeling. When shooting, the stopped up feeling should be more prominent in your left ear since you shoot right-handed and that puts your left ear forward and your right ear back and thus more protected.
Are you saying that at work, the air handlers sound louder or different than normal now? If so, how do they sound different? And is this sound bothering you now or not? If so, you may want to try ear protectors–but you don’t want to cut out all sound. Your ears need to hear sounds in order to keep happy (and not develop loudness hyperacusis).
Cordially,
Neil
I went to hang out with my friend last night. We went to a shopping mall and a restaurant and that’s the first time I’ve done that since the range. I am definitely more sensitive to noise. I kept asking him if the music seemed way too loud and crowd noise bothered me also. I came home and the ringing was more prominent that before. I got some Zinc and Magnesium and have started taking that. Tomorrow will be two weeks and I thought most of this would be gone by then. I definitely understand what your posters are going through. It’s a very scary thing to think you’d be dealing with this long term or permanently. Some days you feel like you’re making progress and then you have a night like I just did. I see my ENT this coming Thursday so that would have been 2.5 weeks since the range. I hope they can be of benefit after that long. I made sure they knew I felt this was urgent.
Hi Jack:
Hearing sounds as louder than normal is one sign of ear damage following acoustic shock such as firing guns. People have different degrees of ear robustness–so one person may be bothered by gunshots and another standing beside him isn’t. It’s not fair, but that is the way it is.
Tinnitus from acoustic shocks can take a lot longer than just 2 weeks to fade away–again depending on the volume of the sounds and how sensitive your ears are. For most louder sounds, you’d expect the tinnitus to fade away in just a day or two, but it can persist for months depending on how bad you acoustic shock disorder is.
You will have good days and bad days. As time goes by, hopefully you’ll get more and more good days and fewer bad days.
I doubt that your ENT will be much help to you. Taking drugs, which is what they usually push, often just ultimately make matters worse in my opinion based on my experiences with others.
Cordially,
Neil
Hi Dr. Bauman,
I just wanted to update you on my ENT appointment. They tested my hearing it was no surprise my left ear was normal and the right ear had some hearing loss. They didn’t elaborate on how extensive but I know from the testing I was supposed to said yes when I heard a tone and I heard twice as many tones on my left ear. The PA thinks I could be dealing with two issues. The main issue she was concerned with was the shooting range trauma. She put me on a course of Prednisone. I’m on day two of that.
The thing I did not expect was she said my right ear drum had a flatten appearance as opposed to a rounded shape if that makes sense. She said they may have me do an MRI if thing didn’t see any improvement to see what might be going on in there. She speculated there could be some Eustachian tube issue. She said they would have me back after completing the Prednisone treatment, but the next open appointment was at the end of the month. They would retest my hearing then. Right now I feel like my hearing has improved in my right ear a little but if I’m around loud noise, put hear phones on for Zoom calls, or have my ear plugs in for a while my right ear gets that muffled feeling. There are times I don’t notice it. The ringing is still noticeable at times and sometimes no.
God bless,
Jack
Hi Jack:
Your eardrum is normally slightly concave. If it is either sucked in or bulging out (convex), you typically have problems with your Eustachian tube not equalizing the internal air pressure in your middle ear to the external surrounding air pressure. Yours is slightly bulging out (hence flat). An MRI may show something, but as far as I’m concerned your Acoustic Shock Disorder can cause the nerve controlling your Eustachian tube (trigeminal nerve) to be hyperstimulated and thus not send the proper signals to open and shut your Eustachian tube. So the trick is to get your trigeminal nerve to calm down. Taking drugs is not the best way to do this.
Personally, I’d take a GABA supplement as that is your brain’s main calming neurotransmitter.
Cordially,
Neil
Thanks so much! I’ll get a GABA supplement and start taking that today. I appreciate your advice!
Hi Dr. Bauman,
Hope you are well! Sorry for all the questions. I have been taking the GABA supplement and I’m not sure if it has helped the hearing situation, but it does make my sleep much better. The first night I took it I slept through the night without waking. I haven’t done that in years. I really do think my situation is Acoustic Shock. I ran the sound board at church Sunday and felt fine but after the service my ear was ringing /muffled again and I’m watching my environment with a db meter. At church the high was around the low 80s and averaged in the 70s. This afternoon on my commute home from work I was listening to a podcast at my normal levels and my ear was ringing pretty bad when I got out of the car. I’m not even sure about why the podcast in the car would have bothered my ear but do you think I should wear my ear plugs in more situations like these? The ear plugs reduce sound by around 21 – 25 db. I’m just concern like you have mentioned before about the sound sensitivity that can become worse by wearing ear plugs too much. Where is the balance with this? It does seem like things are so much better over the weekend when I’m at home. My ears were almost “normal” at times Saturday but then I have setbacks like yesterday and today. I pray for all of those with these type of hearing issues. Lord, please bring healing to all of these that have posted on this board!
Hi Jack:
Glad the GABA is working for some things. Getting good sleep makes coping with ear problems a LOT easier so that is a step in the right direction. You need to be patient. When you have acoustic shock disorder, it can take months to 3 years or so to get back to normal–depending on a lot of factors. There is no quick cure in my experience. It takes time for hyperactive and hyperstimulated nerves to calm down.
You don’t want to push your ears too loud too fast or you can set yourself back. You can tell when you are doing this as afterwards your ears get worse. So the levels you had at church were a bit too loud for your ears at this stage–even though they seemed fine at the time, they felt worse later. This does happen to others too.
If the podcast in the car was too loud, better to turn the volume down and see if that works for you rather than wearing ear protectors–but that is another possible solution. You want to wear ear protectors as little as possible, so turning down any audio equipment (radio) is a better choice than leaving the volume up and wearing ear protectors WHEN you have control of the volume. If you don’t have control of the volume and the sound is too loud for your ears at that point it time, then, by all means, wear your ear protectors.
Don’t try to go too fast. Even though you have better and worse days, don’t expose your ears to louder sounds on the good days–keep things slow and steady as your ears “heal”.
Cordially,
Neil
Hi Dr. Bauman,
Hope you have been well!
I had a few questions and wanted to update you on my progress.
I followed up with my ENT appointments and they had me do an MRI on my brain/inner ear. It really didn’t show anything that would help in my situation. After that they basically said there wasn’t anything we could do unless I wanted to do some type of therapy for the noise sensitivity. I didn’t want to go there as I felt it would be a lot more money and the MRI was very expensive.
I’ve had some good weeks and maybe even a several days of feeling “normal” where I didn’t need or think about ear plugs. I’m still more sensitive to certain noise but not as much as before. Kitchen noises are still tough, e.g., plates, pots, pans clanging together, people sneezing really loud near me unexpected, etc. I wear earplugs every time I’m at church now and other loud environments. I find that my right ear doesn’t like certain types of ear plugs that make pressure inside my ear. I get a slight dizzy sensation where I used those in my injured ear or if I cup the ear with my hand where it seals the ear airtight.
We went to a wedding over the weekend and the music was very loud. I wore an ear plug in the injured ear as was pleased with how well I felt after. No ringing or issues after. I went to work Monday, and I listened to a podcast at normal levels with the normal traffic noise. When I got home, I had a louder ringing in my injured ear than normal. I was trying to think if I had exposed myself to any abnormally loud noise but really don’t think so.
I did want to bring up something I read about. I read about a correlation between TMJ and the ears. The reason I bring it up is that for maybe a year I’ve noticed my jaw pops when I yawn at night. It is a painful pop. I try to avoid yawning too wide because I know my jaw will pop. I had my jaw pop like three times on the way back from the trip over the weekend. I guess since I can’t explain the loud ringing in my ear, I’m looking at that as a possibility or perhaps it’s complicating matters with the acoustic shock issue. I’m not sure but wanted your opinion. I’m not even 100% sure that I have TMJ just because my jaw pops. I know there are many other symptoms of the condition, and I don’t have most of those. My dentist did give me a night guard for when I sleep at night and consequently, I may have an impacted mower or sore tooth on my right side. I need to set up a dental appointment. Anyway, should I expect the ringing in my ear to get better? I’m at about 3 months since the shooting range. Every so often I feel I’m turning the corner then something else happens.
Thanks for your advice as always!
Jack
Hi Jack:
You are definitely getting better. So often we expect to slowly get better in a linear fashion–a bit better each day. However, in reality, it is more like waves on the beach. Sometimes the waves are almost non-existent and other times rather tempestuous. Thus you have good days and bad days and everything in between.
Over time, you begin to experience more and more good days and fewer and fewer bad days, and even the bad days aren’t as bad as they were at the beginning.
However, if you expose your ears to sudden or loud sounds, or even continuous louder sounds, you can experience setbacks. This just makes it take longer to ultimately “heal”. You are experiencing this as well–which sort of complicates the process. But just keep on doing what you are doing–expose your ears to sounds that they can stand without problems and protect them from sounds that make your tinnitus worse. Slowly you will get better–just don’t try to go too fast and push the envelope too much as that can result in setbacks like you have experienced.
Furthermore, you likely do have TMJ problems. In any case, when your jaw pops–that can create a loud sound that is conducted to your inner ears via bone conduction–and that could exacerbate your tinnitus, etc. Thus, it would be good to have this fixed if possible.
Cordially,
Neil