by Neil Bauman, Ph.D.
A man wrote:
I have extreme sensitivity in my hearing and some distortion as well. My ears buzz slightly to my own voice and others that have a deep tone in their voice. I believe this was sound-induced from my iPod and loud video gaming with head phones. My hearing is good except most everything with a high frequency hurts my ears and causes me distress. I have had this for a month and a half. Do you think it is permanent?
I think your extreme sensitivity to high frequency sounds will slowly go away if you protect your ears from louder sounds from now on. It may never completely go away, but it should be a lot better given enough time.
Very often exposing your ears to loud sounds results in damage to your ears such that you now perceive some sounds as being much too loud—in your case, the high-frequency sounds. This is called hyperacusis.
The problem can result from just one loud sound, but the “fix” often takes several months. It is generally a slow process. Think of it like a sprain—you get it in one sudden wrench—but healing takes weeks or months—slowly getting better. However, if during this time, if you wrench it again, you have to start all over again.
Your ears are the same way. That is why you must be so careful not to expose your ears to those damaging levels of sound again. Wear ear protectors in such situations if you can’t turn the sound down.
At the same time, don’t overprotect your ears by wearing ear protectors all the time, or you can make the situation even worse. I can’t emphasize this enough. Your ears need adequate sounds reaching them all the time to keep your hyperacusis under control—just not too loud.
i am 5 months with hearing loss due to a concert. very down over it. any body get their hearing back after a 6 or 9 month wait? i am always hoping but not a lucky guy at all1
Hello. My ears have seemed to be severely sensitive to noise for the past month. I was wondering if I could try covering them up with earplugs for about a week, as even when I try to let them heal they become sore. They do not hurt from music, though my own voice will sometimes irritate them and many other day to day noises. During this week, I was planning on using music to equal out the protection so they do not become worse. Though I fear they will not heal. Can they heal? And what should I do to improve the process? Thank you for all your help.
Hi Avivt:
What caused your sound sensitivity in the first place? Loud noise? Medications? or?
If music doesn’t bother your hyperacusis, then you could try as you suggest. I’ve never seen anyone do this before, but it seems to be a reasonable way to cope and let your ears heal–as long as they get adequate sound stimulation, it should not make your hyperacusis worse.
At the same timme, I’d encourage you to only wear the earplugs in situations where you have a high likelihood of hearing sounds that are too loud. So in quiet environments, take them off.
Yes, your ears can heal from their hyperacusis. Just be aware that it can be a slow process and can take a good number of months–depending on how bad your sound sensitivity is and your emotional attitude towards your hyperacusis.
I wish you well.
Cordially,
Neil
I have some sound sensitivity at one frequency of my right ear but haven’t noticed it in my left ear but yet I get burning pain after hearing some sounds in my left ear will this get better. This was from a loud noise exposure.
Hi Duane:
Obviously you experienced some degree of acoustic shock to your auditory system from the loud noise exposure that has left you with some loudness hyperacusis (sound sensitivity) and ear pain. This is common when you have acoustic shock disorder.
It should get better over time–but noise damage can take months to “heal”. In the meantime, you need to protect your ears from louder sounds to give them a chance to heal.
Cordially,
Neil
Hi, I have noticed that the sound sensitivity in my right ear will stop if I plug my left ear. Have you heard of this before? Thanks
Hi Duane:
Can’t remember if I have or not, but it is not so surprising. Your two ears are “connected” in your brain so they can come to each other’s aid, so to speak.
Is your left ear somehow causing the sound sensitivity and imputing it on your right ear? Something to consider.
Cordially,
Neil
Hello Dr. Neil, about two weeks ago I went to get my earwax removed by an ENT. Ever since then, my ears have been so sensitive to loud music and certain loud sounds. Could it really be from the earwax removing machine he used or what?
Hi Louie:
If this happened in the few days after you had your ears cleaned, and you hadn’t exposed your ears to loud sounds around that time, then it is entirely possible if in the process of removing the wax your eardrum was pulled forward or pushed back with too much force. The result to your inner ear would be exactly the same as if you had exposed your ears to a sudden very loud that also could cause ear sensitivity. This sensitivity is called loudness hyperacusis.
Cordially,
Neil
Hi Dr Baumam,
5 weeks ago (early September 2021) I put some sodium bicarbonate down my ears and my right ear starting ringing (tinnitus), a few days later my left ear started ringing, there was no pain or discharge. A week before this my outer earache when I woke up from bed for a few seconds but it went away after a few days.
On sept the 20th I was watching football (soccer) in the background, when the commentator screamed, it wasn’t that loud (around 70ish decibels and I was quite far from the tv – 2metres)
However, from this incident my left ear made a popping sound, and I could suddenly hear the vibrations of sound in both ears. This also led to my ears aching and eventually burning, while I also could feel my ear drum contracting.
Couple days later I went to the doctors who said I have a middle ear infection and gave me clarithromycin. Through this my ear burning pain significantly decreased and my sensitivity to sound has decreased but it is still there (60ldl to 70ldl).
I feel my LDL level has improved again to around 75/80 but high frequency sounds still bother me (i.e cutlery). My ears ache constantly, and I have realised that it can build up to burning if I’m exposed to sound. Also, if I focus, I can feel my inner ear drum contracting and if I’m with a group of large people talking (i.e 10 people) it would make my head hurt.
The tinnitus is manageable as I notice it only when its quiet i.e., when I’m sleeping. It rings in 1 ear at a time. While I also feel a pressure/tightness/fulness feeling near my ear area (eustachian tube area?) at night between 2 to 4am, the ENT have checked this and given me flixonase. I have also arranged a CT scan and a referral to have my jaw checked (Its slightly tender when touched and for a few years has been clicking when I yawn)
I have no history of going to clubs, music festivals etc and don’t work in a loud environment (I graduated from uni recently). I used to listen to music on my wired apple headphones on average 2 hours a day but have never exceeded the 60% limit on my phone – this is around 70/75 decibels.
I have no previous history of ear disease/problems bar 5 years ago when I got a chest and middle ear infection. The middle ear infection gave me very mild tinnitus which went away after 3/4 weeks.
I had an ENT check my ears and they have said both my ear canals and tympanic membrane being healthy and my heating test came out as perfect bar slight inflammation in my right ear.
So my question is this Loudness/pain hyperacusis permanent? even if this recovers will I have to be careful for the rest of my life even though I have no history of abusing my ears? And is it possible for the mild middle ear infection and low level sound to have permanently damaged my ears?
Hi Naim:
What was the sodium bicarbonate for — to get rid of ear wax? or? I’ve never heard of people doing that, and thus obviously haven’t heard of it causing tinnitus either.
I take it the commentator’s scream really startled you, correct? If you you experienced acoustic shock even though the volume wasn’t excessive at all.
The symptoms you mention such as the ear pain (burning sensation), the vibrations of your eardrum (Tonic Tensor Tympani Syndrome), sound sensitivity (loudness hyperacusis), ear fullness, etc. are common in acoustic shock incidents.
From what you say, I think your doctor was way off base saying you had a middle ear infection. How did he justify that diagnosis from hearing a commentator scream? I don’t think your doctor had a clue what was wrong and just prescribed stuff to make you think he knew what was going on.
No, your acoustic shock disorder should not be permanent. As you’ve already seen, some of the symptoms are slowly going away. Acoustic shock symptoms can take some months to go away.
Because acoustic shock isn’t a “disease”, you basically treat each of the symptoms separately if they continue to bother you.
My book “Hypersensitive to Sound?” deals with all these various symptoms and will help you. You can get a copy at https://hearinglosshelp.com/shop/hypersensitive-to-sound/ if you so choose to do so. Since you live in the UK, get the eBook not the printed book as the postage is horrendous to any place outside the USA. ($60.00 US$ or more–that’s way more than the book costs).
I don’t think your ears will be more sensitive in the future. But everyone’s ears are different in respect to the startle reflex–and if your startle reflex threshold is lower than average, then you may find that startling sounds, even when not very loud will result in acoustic shock incidents. Only time will tell.
I don’t there is any permanent damage to your ears. So don’t worry about your ears now–anxiety and worry just make things worse. Remain calm and let them “heal”.
Cordially,
Neil
Hi Dr Bauman,
For some reason I had the urge to clean my ear wax, even though I didn’t have any excesses wax symptoms in my ear, I had a big interview coming up for my dream job and was stressed, so I wasn’t thinking logically. I think the bicarbonate was possibly expired as I don’t trust amazon to make sure things are not out of date.
The football commentator screaming was unexpected as I was on my phone while it was playing in the background.
The gp just quickly put a otoscope in both my ears and asked for my symptom’s. All I had before the popping incident was tinnitus ringing, no pain no discharge.
I also did have an incident 5 days later when I flushed my toilet both my ears made an explosion sound, for a couple of minutes my tinnitus went very loud, I felt extremely light headed and had to lie down. I went to A and E where the doctor said my ears were perfectly fine, at that time while I was waiting for the A&E doctor to see me my ears started burning as I was stuck in the waiting room with people for 4 hours, he said he expected me to recoil from pain when he put the otoscopy but I had no reaction.
Also I have realised that even sounds at a low LDL that I don’t expect can startle me, i.e. if someone slams the door or suddenly raises there voice even if it isn’t loud can startle me if I dont expect it. However if I expect it even at higher volumes it doesn’t effect me (bar sounds at 75/80LDL or high frequency noise)
And if this is Acoustic shock disorder does this mean the Hyperacusis can come back easily/relapse in the future., i.e. should I avoid going to the movies, listening to music, going out etc.
And I want to thank you for the help you have provided me, you are a lifesaver and I wont ever forget the help you have provided me and I will make sure to buy the book asap.
Kind regards,
Naim
Hi Naim:
I don’t think that sodium bicarbonate “expires”. It remains the same basically “forever” as far as I know.
Going to a GP for ear problems is almost a waste of time as they don’t know much about ear conditions, so assume too much because there are no external symptoms for many ear conditions.
The toilet flushing incident is a type of sound sensitivity that affects your balance. This, too, can be a symptom of acoustic shock disorder.
Your acoustic reflex (startle reflex) now seem to have a low tolerance to sound. As you have noted, it is not the volume of the sound, but whether it is unexpected that kicks in the acoustic reflex.
You’ll find a lot of pertinent information for your particular situation regarding acoustic shock, the startle reflex, etc. in Chapter 18 in my Hypersensitive book.
You don’t want to avoid sounds, but you need to avoid louder sounds while your ears “heal”. So it is a good idea to carry foam ear protectors with you, and if you notice the sounds are getting to loud for your ears at any given time, put them on for just as long as you need them. You don’t want to wear ear protectors unnecessarily as that will just make your hyperacusis worse. But so will exposing your ears to loud sounds while they are “healing”. So you walk a fine line between the two.
But in all this, it is important that you remain calm and keep your worry and anxiety under control, because that will just make things worse too.
Cordially,
Neil
Hi Dr Bauman,
Sorry to bother you again, I have a few questions I would like to ask you.
1) What can I do to improve my startle reflex from unexpected sounds? Iv been just living normally at Home (only going out to friends/families house here and there), exposing myself to cutlery here and there and only wearing my ear muffs if I expect sounds above 85 decibels to occur.
2) Should I use white noise/Pink noise at night and when I’m in quiet/silent situations at home. I tried this but I realised it eventually led to my ears burning later in the day.
3) If ears start burning/hurting from sound should I push through it or go back to silence for it to calm down
4) At night I sometimes wake up with my ears hurting, what should I do in this regard? Iv been having co codamol as I’ve heard that Ibuprofen is otoxic and paracetamol has not been strong enough.
However, in your book paracetamol is on the list of no goes. So, should I avoid this as well. If so, how should I deal with the pain? i.e are there any meds I can take.
Kind regards,
Naim
Hello Dr Neil Bauman, I just got hyperacusis and tinnitus from an mri procedure April 9 and it is very very distressing……will this go away in perhaps a few months? Thank you so very much……
Hi Sheri:
It can go away for sure–but so much depends on your psychological make-up. If you worry about your ears and think negatively about it, you reduce the chances that it will get better. However, if you learn to control your anxiety over this incident, and if necessary, implement appropriate sound therapy, you have an excellent chance of it going away completely or at least reducing by 80% – 90%.
Depending on how bad it is, you should protect your ears from louder sounds and slowly build up your tolerance to louder sounds. This can be a slow process and take several months to 3 years or so. So don’t be discouraged if you don’t see quick results.
If you need help implementing a good strategy to help you get back to normal, email me privately and I’ll work with you. My email is at the bottom of every page on this site.
Cordially,
Neil
Hello. So recently for the past 3 weeks I had a bit of hearing loss in my right ear, though it seems to have returned. My tinnitus however, it now sounds like a flickering lightbulb. It isn’t a constant hum, rather every second it turns off and on. It is very hard to concentrate with, and in the mornings, it is sometimes not there. It is usually later in the day that it sparks up. Since my hearing returned, could this new form of tinnitus calm down too? I don’t hear ur much when i wake up, so I was thinking that that could be a sign that it still can heal. i believe it has been around 3 weeks and only about 3 days ago did my hearing return to normal. Please let me know your thoughts. Thank you for your time.
Hi Margaret:
What caused your hearing loss 3 weeks ago? And how bad was it? This is an important piece of information I need to understand your situation. Also, did your hearing come back on its own, or were you taking drugs to help?
Is this “flickering” tinnitus a sound sensation only, or do you feel it as well (such as a fluttering sensation as it flicks on and off)?
Another question, do you have a stiff neck/shoulders?
Cordially,
Neil
it seems to be a sound sensation only. the hearing loss was caused by headphones. about 5% of my hearing was gone in accordance to Apple’s Balance scale. my hearing came back on its own after around 3 weeks and rest. and no, i do not have stiff shoulders. Thank you.
Hi Margaret:
Based on what you say, I’d think your tinnitus will fade away in time. I think it gets worse as the day wears on from the accumulated sound you hear during the day. It quietens down during the silence of the night. So if your day is noisy, cutting down on the noise should let your tinnitus remain quieter as the day wears on.
Cordially,
Neil
Hello. I had my first ever migraine in August this year (a very severe attack that lasted 3 weeks). While healing, I noticed tinnitus developed. 2 weeks later, I was very sensitive to all noises. I could initially meet people and socialize but gradually it became prominent enough that I don’t go out. Some days my LDLs are in 50s and some in 70s. Don’t know what’s happening as there was no acoustic damage. I had a migraine one day and developed tinnitus and hyperacusis weeks later. Is there any hope? Can life improve?
Hi Rhea:
Migraines and ear problems can be related so if you get migraines, you can also develop ear problems. It’s not that one causes the other so much as that they both arise from the same underlying condition. So finding what caused your migraine may give a clue as to how best treat both of these conditions.
Tinnitus and hyperacusis (especially hyperacusis) don’t develop right away, but commonly a couple of weeks later like you have experienced.
And yes, there is always hope. Never give up hope. I’ll explain more in my reply to your private email to me.
Cordially,
Neil
Hi. I am very worried as yesterday i was exposed to loud noises and today my right ear is now extremely hollow and my tinnitus is very loud and sensitive. Will this go away? I have been keeping it away from loud noises though the tinnitus is so loud it hurts sometimes when I move. I have already suffered from hearing loss, hyperacusis in my left ear, and tinnitus in both. Though this tinnitus in my right is unbearable. will it go away? Thank you for your time.
Hi Madeline:
The question is not “will it go away?” but “what do I need to do in order to gain control over my tinnitus and hyperacusis so it will no longer be an issue in my life?” Then, whether you still hear it (or not) doesn’t make any difference.
To make this happen requires time and effort on your part. It can take from a few days to a few weeks to a few months and even to a few years for this to happen depending on your situation, your emotional/psychological makeup and how faithfully you work through the healing process.
Cordially,
Neil
Hello. So the hollow part has gone away and the tinnitus has gone down a bit, though I can still notice it flare up when I talk and effects me a bit in quiet places.
though it improved much yesterday, today it has not done much. Is this a good sign of the healing process and if so, will it continue to heal? Thank you for all of your advice.
Hi Madeline:
Yes, all good signs. So you may recover quite rapidly. But you still have to be patient.
Cordially,
Neil
Hello. So I have had hyperacusis in my right ear for almost a year now. I tried to ignore it at first and keep my hopes up and continued living normally with sound. Though I realized that it hasn’t. I’ll admit i have not taken care of my ears correctly as i simply tried to ignore it. If i protect them now for a few months, do you think it can go away? Please let me know your thoughts. Thank you.
Hi Mark:
How did you come to acquire the hyperacusis?
I take it that for the past year you didn’t protect your ears from louder sounds while they “healed”, did you? Not protecting them form louder sounds while they heal (especially loud sounds) means that it can’t get better.
You need to protect your ears from sounds loud enough to cause your loudness hyperacusis to kick in. But just wear ear protectors when that happens. Wearing them too much can just make things worse.
If you don’t worry about your hyperacusis and give your ears a rest form louder sounds while the “heal”, but don’t overprotect them when the sounds do not cause your hyperacusis to kick in, it should go away in time.
Just remember that if you expose your ears to loud sounds in the future, the hyperacusis will likely come back, so you need to practice proper ear protection in the future.
Cordially,
Neil
I listened too much music when I was younger, and led them to be sensitive. I also have a cleft lip, which I believe also too k part as I went through a major jaw surgery. I asked the surgeons, and they said that the trauma can cause issues for my ear. Thank you for the advice. I will be sure to protect them well.
Hi David:
It is very unlikely, barring a miracle, that you will get your hearing back if it has now been 5 months and it hasn’t returned.
Typically loud sounds produce an abundance of free radicals in your inner ears which “zap” the hair cells. When these hair cells die, you lose some of your hearing. This hearing loss is permanent.
If perchance, the loud sounds dislocated the tiny bones in your middle ears, then an ear specialist could likely repair the damage.
The easy way to tell is this. If your hearing results on your audiogram show only a sensorineural hearing loss, you hearing loss is almost certainly permanent. However, if it shows a conductive loss, an ear specialist could likely fix it.
Hi know this is really old but I went to a music festival one month ago. I got a hearing test and everything is good but I feel a sharp pain in my ear. I find it really hard to concentrate sometimes in school and I’m super sensitive to loud noises. Is this serious ?
Hi Kyle:
If you expose your ears to loud sounds such as a music festival, you end up with acoustic trauma. One common result is supersensitivity to sound (hyperacusis) and louder sounds can really hurt.
It can take a long time (a number of months) for your ears to heal. During this time, you need to avoid louder sounds or you will just prolong the situation. And in the future, whenever you are going to be around loud sounds, wear ear protectors.
Even so, you have likely caused permanent damage to your ears–you’ll probably find that you do not understand speech in noise like you once did. This will only get worse with time. That is why it is so important to protect your ears from loud sounds.
Hearing testing doesn’t pick up the kind of damage you did to your ears. That is why it is called hidden hearing loss, but it is very real nevertheless.
Cordially,
Neil
Hi so I went too a loud rock concert and this is only the same night but ears are ringing whenever I move and doing stop unless I put my finger in my ears. Then if I take my finger out it’s fine until I move again is this normal? however I’m not sensitive to loud noises as far as I know
Hi Lilly:
I’ve never heard of exactly your experience before. How are you ears doing now?
Cordially,
Neil
Hi Dr. Bauman,
I had similar situation. I have a lasting ear pain after I went to a concert 1 month ago. It’s been lasting for 1 month. I have no dizzying or ringing in my ear. I was hypersensitive of sound, and the pain is always there. It gets better sometimes, but sometimes it gets worse. I went to see doctors for several times, but they all said my ear looked fine. My hearing test and acoustic impedance test looks good. But as you said, the hearing test cannot pick up the damage, so what kind of test can I have to diagnose my problem?
Thank you very much!
Hi Jackie:
Ear pain and hypersensitivity to sound (hyperacusis) are two of the symptoms of Acoustic Shock Syndrome, which is almost certainly what you have experienced. You don’t need a specific test for this. Your recent history shows it.
Cordially,
Neil
Hi doctor it’s James again from a while back.Ive done what you told me and just kept calm about my hyperacusis and tinnitus and im happy to say that both stuff is alot better.
Cuttlery and spanners fron my garage doesn’t seam to annoy my ears anymore,keys rattling and high pitch voices still bother my ears a bit.My tinnitus also healed alot,even to the point that i can bearly hear it even though i know its still there ive grown used to it.One thing thats bothering me is that sometimes my ears will just randomly flutter or click for no reason at all.My ears isnt clogged as much as it used to be before.Do you think its good progress for 4 and a half months and should i worrt about the clicking sound in my ears?
Thanks anyway for reading my comments and i definitely would have recoverd this much without this page.
Hi James:
I think you are making excellent progress. The random fluttering or clicking is probably tonic tensor tympani syndrome (TTTS) kicking in. Usually it occurs when you are particularly anxious or stressed. I’d just ignore it and let it go away.
Cordially,
Neil
Hello so I’ve had ringing in my ears for 2 weeks I know it’s possible it will go away a rare case since I’ve had it this long, it happened when I listened to my music too loud so I understand I did some damage I went to an audiologist already she said I had not lost any hearing of course I understand there’s something call hidden damage what is that exactly, she also referred me to an ENT for the sensitivity in my ears, and the ear pain in my right ear especially hurts with very loud sounds yelling brakes sweaking etc.
Hi Alicia:
If you’ve only had tinnitus for two weeks now, you can still hope it will fade away in time.
You now also have hyperacusis–that’s why some sounds are so loud they hurt. This too, can normalize in time–but you have to protect your ears from further loud sounds in order for that to happen.
Hidden hearing loss is hearing loss that does not show up on a standard audiogram. It really manifests itself when you try to hear someone talking in a noisy area. You’ll notice you can’t understand them like you used to.
Cordially,
Neil
Thank you so much,and your correct on not being able to hear people in loud areas. Also how Long will it be before I know it’s permanent? And can hidden damage progress into total hearing loss or no?
Hi Alicia:
I’d give it two months or so.
I’ve not heard of hidden hearing loss progressing to total deafness. But it can progress (or recover a bit) in the months following noise damage. That is why you want to give it time. But realize that damage to your ears is cumulative. So each time you damage your ears, you lose more hearing. Eventually, you won’t have much hearing left, but almost always, you will still be able to hear loud sounds.
Cordially,
Neil
Thank you so much,and your correct on not being able to hear people in loud areas. Also how Long will it be before I know it’s permanent? And can hidden damage progress into total hearing loss or no?
Hello, Doctor Neil, hope you and your family are doing fine during these troubling times.
About 5 weeks ago I came down with the flu lasting about 5 days. My symptoms during this illness were fever and excessive mucus and as a result heavy congestion. After I got better I noticed a continuous buzzing sound in my left ear. What’s worse is I noticed when I opened my faucet, I could hear a sharp noise from my left ear. A couple of days later my condition worsened, the buzzing in my ear became louder and the my intolerance to louder noises (more so sharp noises) grew.
It was then that I decided to see an ENT. He took a look at my ears, cleaned out the ear wax but didn’t find anything and said my ears may still be under inflammation. He prescribed me Prednisone for the inflammation. After finishing the prescription, I noticed my problem did not get better at all. So the following week I went back in and he simply said there was nothing else to do and gave me Lipo-Flavonoid and let me go on my way. After about 3 days use of Lipo-Flavonoid, my condition improved a whole lot. I was now able to tolerate the faucet being open for more than 30 seconds, though still irritable to my ear after repeated tries. The constant buzzing decreased in overall loudness and while taking Lipo-Flavonoid became almost intermittent, to the point were I sometimes would not hear it or perceive it entirely.
I was very much relieved, and thought I could stop my condition entirely. I decided to go to another ENT since the first one sort of ignored me. I went to this new ENT and had a hearing test, he said my hearing was excellent and saw no evidence of swelling, infection or fluid build up. He sent me to get an MRI to rule out any other causes of the tinnitus/hyperacusis. He then reviewed my MRI and found nothing at all, nothing that would cause my problems. He also said that it’s possible that due to the viral infection some pressure could have built up and this might be causing my tinnitus. He said it could take up to months for this pressure resulting from viral infection to go away and thus relieve me from my symptoms.
A few weeks later I decided to go to another ENT because I heard a new ringing sound on my left ear. This made me panic and thus schedule an appointment. Once again, I had a hearing test, which proved once again I have excellent hearing. The doctor was much less concerned than my previous ENT, he basically said I just have to deal with it. When I asked about some of the treatment options I saw on their website, he said those were only given to patients with hearing loss. As in, he couldn’t really put me on any treatment because my hearing has not deteriorated. Too bad for me, should have cheated on that test I guess. I asked if there was any way they could test if the sounds I am hearing are objective or subjective and he said this was not possible. He also said my symptoms could be permanent or they could very well continue to decline until they are at less perceivable levels or go away completely.
I am now in the process of scheduling another appointment with a doctor at the University of Miami. I researched and they have one of the best otolaryngologist depts. in the nation. They are close to me and that’s why I decided to give them a try. They also administer the Desyncra therapy to tinnitus patients. If my tinnitus/hyperacusis does not get better I definitely would like to give something like this a try.
I would be able to better cope with the tinnitus but I seem to hear it everywhere, no matter the sounds around me. It seems to go up or down in level and adjust to ambient sounds. In this way, it appears I am always hearing it unless I’m around very loud noises. I do notice at nights if I wake up, the tinnitus is barely noticeable and just think that if it were like this all day I wouldn’t have a problem. I am still hoping to get a whole lot better or recover completely.
I have a few questions for you if you could please answer them.
Is it possible to get tinnitus/hyperacusis after a cold/flu?
If yes to question 1, how long is recovery time from these symptoms? Could this cold/flu cause a more permanent tinnitus/hyperacusis?
Is it true, as mentioned by the last ENT I saw, that I cannot be treated for tinnitus/hyperacusis since I have not had hearing loss?
Could deficiency in vitamin b-12 cause T/H?
How much longer should I wait to try therapies such as Desyncra?
If my symptoms do not go away, can I expect them to at least decrease in intensity?
What can I do to decrease the T/H?
Thank you for taking the time to read this and answer. I very much appreciate it. Hope you and your family are well.
Hi Frank:
Yes, it is possible and fairly common to get tinnitus after a cold since your middle ears clog up and cause some degree of conductive hearing loss. Often this results in tinnitus until the congesting clears and your hearing returns to normal, then the tinnitus goes away.
If the virus gets into your inner ear, it can cause tinnitus and distorted hearing (which would include milder hyperacusis) and sometimes hearing loss.
Depending on which scenario you have–the first one–this lasts until your middle ear and Eustachian tube clear which can take a week or up to 3 months.
If the virus gets into your inner ear, the results can be temporary or permanent–no way to tell in advance. However, you could expect the hyperacusis to fade away in time as your ear heals. And the tinnitus too–if you learn to ignore it and not treat it like a threat to your well-being. If you focus on and worry about your tinnitus and hyperacusis, you just set yourself for it to get worse and become permanent.
While you have hyperacusis, you want to give your ears a rest from louder sounds so they can recover. I’d keep sounds to 70 dB and lower while they recover.
That is garbage. You can be treated for both tinnitus and hyperacusis whether you have hearing loss or not. In fact, a third of the people that come to hearing professionals for help with their hyperacusis don’t have any hearing loss. And a high proportion of them also have tinnitus. Maybe your doctor was really saying that he doesn’t have a clue how to treat people without hearing loss.
I’m sure vitamin and mineral deficiencies can cause tinnitus, but I doubt it is so in your case or you should have had the tinnitus before you had the virus, not just after. Two good minerals that you may be low on are zinc and magnesium, so it sure wouldn’t hurt to take supplements. I take both daily for good ear (and body) health.
If you are able to successfully deal with your tinnitus/hyperacusis on your own and don’t worry/focus on your tinnitus/hyperacusis, they should fade away in time. Personally, I’d give it 3 months and then see where you are at. You may find they are gone or reduced in severity.
Desyncra is a pretty new development–not to mention expensive. I’ve read it is $4,000.00 which seems awfully high to me. It might be necessary for someone with intractible tinnitus, but you are not there.
Incidentally, your tinnitus seems to get louder with increasing sound levels and then drops as the sound drops. This is called reactive tinnitus–which is a combination of tinnitus and hyperacusis.
Normally, when you have both hyperacusis and tinnitus, you treat the hyperacusis first or at the same time as your tinnitus. You don’t get good results if you just treat your tinnitus.
Probably the two best things to do is 1. avoid louder environments to give your ears time to heal, and 2. don’t worry about your ears but focus on the loves of your life instead.
Cordially,
Neil
Hi Dr
About 3 weeks ago I shot a .308 cal gun 2 times in a row.
When i was done shooting,i released that about a halfhour later my one ear fully recovered while the other ear where still feeling full and i didn’t hear much out of it.
Two days later the ear fully recovered but then i released that all the sudden i was sensitive to some sounds and every now and then my ears felt clogged and I have tinnitus.
Wil this ever go away?
Hi James:
When you shoot a rifle–I assume your .308 was a rifle–you tuck one ear back and one ear is forward. The forward-facing ear adsorbs more of the muzzle-blast than the other ear so that is the one that mostly feels muffled/blocked, etc. and is more susceptible to tinnitus and hearing loss.
If you shot without ear protectors, your ears suffered acoustic shock. One of the things about acoustic shock is that not all the symptoms appear right away. Supersensitivity to sounds can be one of those delayed symptoms.
Typically, this supersensitivity to sound will fade away in time as your ears “heal”, and if you do not expose your ears to loud sounds without protection in the meantime. It may take a few months so don’t be impatient.
Cordially,
Neil
Hi Dr
Hi would like to ask you something outside of the forum . Can I have your email adress?
Hi Alex:
I sent it to you, but maybe it’s in your junk box. In any case, my email and other contact information are at the bottom of every page on the website.
Cordially,
Neil
Hallo Doctor
I had tinnitus ever since i got hyperacusis because of going me not wearing ear protection,will the tinnitus go away when the hyperacusis does or is it permanent?
Hi George:
When you successfully treat loudness hyperacusis, typically you will get your tinnitus under control at the same time. It may or may not go completely away, but as you habituate to your tinnitus, it won’t matter to you whether you hear it or not because it won’t bother you.
Cordially,
Neil
hi doctor
Its James again,i just want to say thanks for your feedback,you helped me more than my ENT doctor.
I just want to ask,is it only when hyperacisis is a symptom of acoustic trauma that it will go away?I know some people say it doensnt go away and that you need special therapy.
Hi James:
Hyperacusis can be treated no matter how you get it and no matter what it may have been associated with. You may need special help if you can’t deal with it yourself. Typically, if it is mild and you don’t worry about it, it will go away on its own. However, if you worry about it, or have a severe case, you’ll need a professional to help get you on track and keep you there as you progress through hyperacusis therapy.
Cordially,
Neil
Hallo doctor,
Ive had hyperacusis now for 4 months.I originally got it from exposure to a loud noise.Im relatively relaxed about it but eversince about a week ago i started to worry about it because there has been no improvement with the sensitivity and my ears still feels clogged alot of the time.Do you think it will still go away and how much longer should i probably wait?
Hi Peter:
Hyperacusis can take months to go away. I sure wouldn’t give up hope. But anxiety is an enemy of hyperacusis. So you need to get your anxiety under control so it doesn’t affect your hyperacusis fading away. It is a good sign that your Eustachian tubes are working at least some of the time eliminating that clogged feeling. This is all part and parcel of the same condition.
What is your strategy for helping your hyperacusis? Are you doing anything, or just hoping it will go away?
Two things you should be doing, besides controlling your anxiety is to protect your ears from louder sounds so they can “heal”, but not overprotect them, and second, surround yourself with quiet background sounds 24/7 so your brain always has real sounds to listen to.
Cordially,
Neil
Hallo again doctor,
thanks for the feedback.I haven’t exposed my ears to any load sounds since i damaged it but i do listen to soft music every now and then,or watch television.I dont know if those things are slowing down the healing process. my hyperacusis isn’t that severe,only some sounds bother me and some days my ears feel better then others.
I’ve started using essential oils for my ear about a week ago and my tinnitus is almost gone and getting better by the day.I think the oils have helped the hyperacusis a bit too.
Hello doctor, so back in Late April of 2020, I had a head phone enjoy to my right ear. Made my ears extremely sensitive to sounds and gave me vertigo. Went to see my primary 2 different ones and they said nothing was wrong with ears no infection. With me still not satisfied I was went to see a ent and did a hearing test in September after a really tough summer. The ent said nothing was wrong with my hearing which was never my concern my problem is turning the volume down and to stop the pain. I think slowed down the healing process of my hyperacusis by listening to headphones again during the following months because the doctor said it wouldn’t damage them. But since I stoped it’s slowing getting better. I started listen to PINK NOISE (do you recommend it?) and it did seem to help but I think sent body into a anxiety panic attack. And they hyperacusis did come back but not as bad as it use be. I can tolerate sounds that I couldn’t when the damage first took place. But it’s still has a burning sensation in environment around a lot of people that I can’t avoid do to my job. Any advice on the healing process. And how to get the anxiety down oils, certain music, etc… PLEASE help. Some days are better than others. Do you see a full recovery possible? Will I be able to listen to music again and be around crowds without getting upset or aggravated. Please give me some advice I’ve been to to 2 different primary doctors and one specialist. I feel like I help myself more than the professionals but just wanna know what right and not to do the best healing options.
Hi Jaime:
I agree with you that very few doctors know anything about hyperacusis on therefore can’t really help you. Your first sentence isn’t clear– some words are missing or wrong so I’m going to assume that you were enjoying loud music through your headphones.
The result seems to be that you became sensitive to sounds (loudness hyperacusis) and you got vertigo from these loud sounds (vestibular hyperacusis). You don’t mention the vertical anymore so I assume that the vertigo went away and you no longer have any balance issues, correct?
Loudness hyperacusis is often accompanied by pain hyperacusis. When you get loudness hyperacusis you need to get the sound down. There’s nothing wrong with listening to music through headphones, but you need to keep the volume at a low level. You should never listen to music any louder than you listen to people talking. That’s a safe level, especially now that you have hyperacusis.
Louder sounds can cause you pain as you have found out. That is why you’ve got to stay out of noisy situations that can cause the pain, and if you can’t avoid those specific situations, you need to wear ear protectors.
The problem with wearing ear protectors is that it is so easy to over use them when they are not absolutely needed and this just sets you back in trying to get your hyperacusis under control. So yes, wear them when you need to, but as soon as you don’t need them, take them off.
Listening to pink noise is a good idea. You want to set the level of listing to the pink noise to a level just below where sounds striped to annoy you as your hyperacusis kicks in. You don’t want your hyperacusis to react in any way to the pink noise. Then, over a period of weeks you can slowly turn the volume of the pink noise up to a level that your ears can stand at that point. Remember, the volume is always just a little bit less than where the sound causes your hyperacusis to react.
Yes, you can expect a full recovery, or close to a full recovery, but your ears may always be somewhat sensitive to louder sounds so you can’t just go into a really noisy venue like a nightclub or concert where the volume is wide open without wearing properly fitted ear protectors because if you do your just asking for even worse hyperacusis.
Since hyperacusis is a psychosomatic condition, you not only have to treat the “physical” component with sound therapy such as pink noise, but you also have to treat the emotional/psychological component. A good program for this is a cognitive behavioral therapy program modified to deal with loudness hyperacusis.
You can learn a lot more about various kinds of hyperacusis that you are experiencing and how to effectively deal with them by reading my comprehensive new book “hypersensitive to sound” at https://hearinglosshelp.com/shop/hypersensitive-to-sound/ .
Cordially,
Neil
hi I know this is old but I believe to have Hyperacusis in my left ear more than my right. it started about 2 weeks ago and I am trying to rest it starting about 2 days ago. I understand that it was from noise as I have tinnitus too, but I am scared it will never go away. About a year ago my ears were extremely sore towards many things, and it took about 2 weeks for them to heal. Will it be able to heal ever? Thank you for your time.
Hi Maddie:
Did you expose your ears to loud sounds 2 or 3 weeks ago? Is that what brought this on?
Why are you scared it won’t go away. It went away a year ago, so by giving your ears a rest from louder sounds for a couple of months should let it happen again.
Just be aware that the more you expose your ears to louder sounds, the less likely your ears will completely recover the next time.
Cordially,
Neil
I believe I am scared because this time instead of a soreness in both, it is rather a sharp pain in my right ear due to sensitivity. I did expose my ears to loud sounds, and I have improved at protecting them from them.
eft ear* Also, I am now used to the tinnitus, but is is the sensitivity and the sharp pains that I fear may not go away. Thank you for all your help.
Hi Maddie:
Ear pain is one of the symptoms of acoustic shock due to exposing your ears to sudden loud sounds.
Tell me more about this pain. Is it there all the time, or only when you hear sounds above a certain level.
The sensitivity to sound is loudness hyperacusis and the pain is probably pain hyperacusis.
Cordially,
Neil
no, it is only there when there is a loud noise or sudden loud noise I would say. when I am typing it hurts a bit, though listening to music does not hurt at all.
Hi Maddie:
You want to protect your ears from louder sounds that cause problems. If you know you are going to be around louder sounds, wear ear protectors, and maybe when you are typing too. But only wear them when you need to, and take them off as soon as you don’t need them or you can make hyperacusis worse. Do this for as long as you need to so your ears have a chance to heal. This could be two months or more.
Cordially,
Neil
It is possible to get much better or even cured from hyperacusis ! TRT (Tinnitus Retraining Therapy) is probably the best treatment. In TRT you wear a sound-generator for many hours a day. It looks like a hearing-aid.
A cheaper method is to listen to pink noise at a soft level many hours a day.
A third alternative is to listen to a CD, (music of your own choise), every day, a bit louder than comfortable, but not so loud that you suffer.
I have had an extreem level of hyperacusis twice and have got much better from all three methods.
The Hyperacusis Network has a list of where to get TRT worldwide, and they sell pink noise-CD`s.
HI i am experincing the same can i improve this by hearing pink noise from app that is avilable.
Hi Gururaj:
Pink noise is fine to listen to.
Cordially,
Neil
I suffered through fire alarm testing in our plant for an hour. It has left me with tinnitus constantly like a million crickets chirping, highly sensitive to high frequnecies and loud noises (have to take earplugs with me all day and night). These sounds can and have caused great pain and migraines. I have had tinnitus, shaking of arms and legs, severe earaches, vetigo / dizzyness and loss of balance (like walking like one is drunk). I can no longer multitask and at times start to stutter. I have never had any of this prior to this fire alarm testing which has been 5 months ago. I have gone through all sorts of testing and no tumors or anything can be physically found. I read about “recruitment” and all the symtoms are the same. I have tried Cds of music at night of low sounds to try defusing the tinnitus at night to be able to sleep. I carry earplugs with me going to resturants and to stores. The noises there can just about cause me to come out of my skin and cause migraines to start.
What really bugs me is I have only hearing in one ear all of my life. Now that is screwed up now and I feel that this has caused 180o change in my life. I don’t dare run or move fast for fear of losing balance. I have been using a cane (prior to that was a walker because the shaking in my legs was so bad) to try to balance when walking.
I was very active and now I can not work because of the above problems.
What now can I expect with this “recruitment”?
Hi Pat:
Your story illustrates the fact that you have to protect your ears when around loud sounds. You don’t have to put up with loud fire alarms for one hour. That’s dangerous to your ears as you have unfortunately found out.
When a sound is too loud, you either need to wear ear protectors–the foam ones you can get at almost any drugstore are fine, or get out.
Once the extreme sensitivity to sound happens, it takes a lot of time and patience to get past it. This can take several months or longer–so don’t expect a quick fix.
I think it is rather unusual to have your balance so (permanently) affected by the noise. I’m not sure whether your balance system was permanently affected by the trauma of the sound (free radicals generated that destroyed balance hair cells for example) or whether you have a condition such as Tulio’s Phenomenon that causes loud sounds to affect balance, or whether something else is going on.
Regards
Neil
Hi, Neil
My name is Alex and I’m a little concern about my issue, I work in a trailershop we’re sounds are normally loud, I have developed Tinnitus in my left ear, I went to an ent and they did an hearing test and found that I cant hear 4k hz and 35db everything else was ok, I’m also terrified to other sounds because I perceive them as dangerous, my T started slowly only hear at nights, and I started reading and I got anxious and ever since my Tinnitus has been bothering me, is being about 25 days since I started hearing them during day time routine, I also feel some kind of fullness in my ear, I talked to my ENT and explained that my Tinnitus started with my neck, because I use to feel tension in my neck and I pull my head to the side excessively to crack it and feel relief, I also have 2 wisdom teeth on the bottom of my jaw, this is affecting my life style in such a dramatic way that i couldn’t stop crying because i keep concentrating on my hearing loss, any help or advice will be really appreciated! I started to hear T in Jan, 10, 2019 but I used to hear “electricity sound” T only at bed at times. Thank you again for any advice!
Hi Alex:
Your 35 dB hearing loss at 4000 Hz is called a noise notch and is indicative of noise damage to your ears. When you are working in a noisy shop, you need to wear ear protectors while the racket is going on or you’ll just wreck your ears worse.
You only need to worry about loud sounds damaging your ears if they are louder than 75 dB or so.
There is no point in worrying about the hearing loss you already have it’s happened. It is nothing you can do about it now. But by wearing ear protectors when you were in noisy situations you can help prevent further hearing loss in the future.
Tinnitus very often accompanies hearing loss, so I’m not surprised that you have tinnitus along with your hearing loss. don’t obsess over your tinnitus or you’ll just make it worse. A good way to deal with your tinnitus is to totally and completely ignore it by focusing on other things and just let it be there in the background. If you totally ignore it, often it will fade away and hours will go by without your being able to even hear you tinnitus, although it will always be there.
In the grand scheme of things, it’s no big deal. I’ve had tinnitus for close to 70 years now and as I say it’s no big deal. I choose not to let my tinnitus bother me even though my ears are screaming away right now because were talking about tinnitus. The good news is that it in a few minutes as long as I don’t answer more questions on tinnitus my tinnitus will fade into the background and I won’t be aware that I even have tinnitus. You can learn to do this to.
Cordially,
Neil
In May I was diagnosed with Recruitment. Some days are worse than others such as the sound of my own voice bothers me. I no longer want to talk on the phone because it hurts. Thank God for texting.
I had a hearing test and the doctor said I also had hearing loss. I assume if it were fixable like stated above he would have said so.
Has anyone ever fully recovered from recruitment?
Will the pain in my ears ever stop?
I am also seeing a neurologist for daily headaches. I have an MRI scheduled next week.
However, just in the past 3 weeks I started getting dizzy.
Could the dizziness be from the recruitment?
I appreciate any answers or advice.
Thank you.
hey, i was just wondering this is my 5th day of ringing in my left ear and i dont feel like things are changing or getting any better, i went and got my ears tested though and i wasnt diagnosed with any problems or loss of hearing, can anyone tell me if the ringing will stay ? is it permanent ? and for how long approximately ?
Hi Charly:
You don’t say what caused your ears to ring, or anything else that might help me help you. If you want help, you’ve got to tell the whole story.
Regards
Neil
So I am 15 and I have been listening to loud music and I have had ringing in my ears for 2 months will it go away I’m really scared.plz tell me it will go away
Hi Caitlynn:
When you listen to loud music, you slowly (or not so slowly) damage your ears. This results in hearing loss, sound sensitivity and tinnitus (ringing in your ears). Since you’ve now had the ringing for two months, the chances are that you have caused permanent damage and thus the tinnitus may be permanent too.
At this point you need to change your lifestyle to control the damage. From this point on, whenever you listen to loud sounds/music, you will just make things worse. So–you need to turn the music down to a level approximately as loud as normal speech–not much louder. If you are at a live event, you need to wear ear protectors. And most importantly, you need to learn to ignore your tinnitus, by focusing on the loves of your life. You need to have a neutral emotional response to your tinnitus. If you dwell on it and how it is driving you “buggy”, it will just get worse.
If you focus on other things and remain totally neutral emotionally towards your tinnitus, then, over time, it will almost certainly begin to fade into the background and not bother you–even though it may still be there. That’s the secret to successfully dealing with your tinnitus.
I’ve lived with my tinnitus for more than 60 years now (the result of a severe hereditary hearing loss) and I can say that it doesn’t bother me, even though it is there all the time. For example, just answering your question has spiked my tinnitus so that it is LOUD, but in a few minutes as I do something else, it will fade back down to its normal level.
Cordially,
Neil
I don’t agree with you saying it’s permanent after 2 months? If I may ask where are you getting your statistics from?
Hi B:
You don’t have to agree with me. It’s your prerogative not to if you feel that I’m wrong.
What are you referring to as “it’s permanent after 2 months”–hearing loss, hidden hearing loss, tinnitus, hyperacusis or what? I can’t accurately answer such a nebulous question.
Cordially,
Neil
Dear Doctor,
I’m sorry to bother you but I wondered if you could give me a piece of advice on hyperacusis because I wasn’t very satisfied with my visit to an audiologist. I would be grateful for your answer.
I have had hyperacusis in my left ear for 2,5 months. It is the second time I have this problem (3 years ago I had an acoustic injury and I got hyperacusis in my left ear for about 6-7 months, it went away by itself, some sensitivities remained but I was doing fine). Now I had another injury and I think that my symptoms are a bit worse. I would say that some of them are rather uncommon/unmentioned here:
1. There isn’t any problem with my right ear.
2. I have no tinnitus.
3. I feel like I had some kind of an “ear filter” removed, like the ear was “open and fragile”.
4. It’s not about the volume. I can tolerate some louder sounds which are steady, unchanging. I have a great problem with sudden, short, percussive sounds – even if they are quiet or moderate. I can almost “feel” the sound wave in my eardrum and it’s not pleasant, sometimes I can feel a slight electric charge for a split second. Awful.
5. The same is with frequencies – some of them resonate strangily in this ear, some don’t.
6. If there are a lot of sounds around me, these symptoms are not so noticeable (besides increased sensitivity of course).
7. I have no pain. Sometimes I feel fullness and the ear often clogs but that is a small problem.
I have been wearing WSG for about 3 weeks. My audiologist said that my LDL isn’t very bad and I couldn’t explain her that the volume is not my greatest concern but the things I mentioned above.
Are these unusual symptoms? I’m a little quaker and although I’m doing everything I can (TRT, listening to music at low levels as Dr. Nagler advised, not protecting my ears, avoiding enormous noise) and I have recovered before – sometimes I’m so worried and think “maybe this time it’s irreversible? maybe it’s something worse?” Please, help me not to lose my hope and be optimistic. I’m a musician and my life is at deadlock now. Temporarily, I hope.
Best wishes!
Hi Piotr:
Each time you have acoustic trauma such that your hyperacusis gets worse, you are risking it becoming more and more permanent. Thus you have to try very hard to avoid such incidents by thinking ahead of time what you can do to avoid or quickly counteract them.
Point 3 is a good description–your ear feels “open and fragile”. Another way of saying is is that the volume seems to be turned up too loud on certain sounds (because the “filter” is “removed”.
Hyperacusis is not just one kind of thing. There are many different personal variations of it. What you are experiencing is “normal” for your kind of hyperacusis. For example, not ALL sounds seem too loud. It is certain frequencies of sounds that bother you–and as you say–short percussive sounds. This is common to many people with hyperacusis. That is why clinking cutlery bothers many. So do setting dishes or glassware on the table. These are not loud sounds, but boy can they hurt because we PERCEIVE them as so loud.
I suspect your audiologist just tested your LDL by telling you to tell her when her voice became uncomfortably loud while she was speaking to you and turning up the volume. This is not the correct way to determine LDL in a person with hyperacusis (or recruitment either for that matter). What your audiologist needs to do is check for LDL at EACH TEST FREQUENCY. It may be that only one or two test frequencies have a real problem and the rest test normally–just like regular speech did with you.
As a musician, you need to wear special musician’s ear plugs that cut the volume, but do not distort the music. But in addition, in your case, you may find certain frequencies need to be reduced relative to surrounding frequencies.
When you have hyperacusis, one of the secrets is ALWAYS to protect your ears from loud sounds, but not overprotect your ears from “normal” sounds. If you do, you can make your hyperacusis worse. There can be a fine line exactly where the “normal” and “loud” sound lines meet. You need to find that line and protect from sounds above that line and not from sounds below that line.
Cordially,
Neil
Hello, I have very sensitive hearing meaning I hear things I dont want to all the time, like the neighbors TV or music or cupboards or them walking through the walls & other sounds like the birds chirping outside with all the heavy duty windows & doors closed. I seem to cherish silence which is rare to get These sounds dont seem to bother others like they do me. Its not painful i just wish my hearing wasn’t so good. Is there anything i can do to make it less good if u will? It annoys the daylights out of me. Most people have the opposite going on where they have hearing loss mine is too sensitive & I don’t like it. I pick up all kinds of noise other people say they don’t even hear. HELP!!! I almost want to have a procedure done to make it less sensitive… Is that even possible? Thank you.
Hi Denyel:
I think I know what you have–and it is NOT very sensitive ears. I think you have a condition known as Musical Ear Syndrome (MES) where you hear various phantom sounds–like your neighbor’s TV on or music, the birds, etc., etc. One easy way to tell whether you have MES is when you hear these sounds, put your hands or pillow over your ears. If you still hear them, then you know they are not real. If they get softer or go away, then they likely are real sounds.
MES affects many people with hearing loss. Your brain makes up for your lack of hearing by somehow messing up memory circuits with your auditory circuits and thus you hear what appears to be real sounds–and they do seem to be coming from your ears–but they are totally phantom.
If you want to learn more about this condition see my article on MES at http://hearinglosshelp.com/blog/musical-ear-syndrome-the-phantom-voices-ethereal-music-other-spooky-sounds-many-hard-of-hearing-people-secretly-experience/
This is nothing to be worried about. You are not going nuts. I’ve heard from thousands of hard of hearing people that hear such things. It’s quite common.
Cordially,
Neil
Hi Neil,
I came across your blog and proved to be most invaluable for reading on my current condition, I was wondering if you could help clarify what I might have.
I used to play in a few bands which caused me intermittent Tinnitus that tends to come and go, however last week a siren went past and , for split second turned on its siren right next to me.
My hearing seeme fine, no deafness to my knowledge but Since then, I’ve noticed certain high frequencies startle me, for example car brakes specifically and certain high pitches from games.
In the games the same noises still startle me But less as I turn the volume down on my television.
What could this be and Would this tone down over time , I’m quite concerned .
Best,
Tom
Hi Tom:
What you have experienced is called acoustic shock (or acoustic trauma). The sudden loud sound (the siren) damages your inner ear. The result can be hyperacusis (which you now have), tinnitus, otalgia (ear pain), and sometimes dizziness and tonic tensor tympani syndrome (where your eardrum flutters or clicks). Some people also experience trigeminal nerve irritability.
As you have found out, certain sounds are now much too loud (and may be distorted). In your case, it is the high-frequency sounds.
Typically, over time the hyperacusis will get less and less until your ears are back to normal. However, every time you expose them to a loud sound, you can make it worse and have to start all over again.
Think of a bruise. It takes time to heal, and if you whack it while it is healing it just takes longer and longer to heal. That is a good analogy to your ears healing from hyperacusis.
Cordially,
Neil
Hi. I started having a problem with right ear back in February of this year. What felt like fluid in the ear and ear pressure and fullness. I waited awhile to go to the dr and when I did it turned out I had the flu and a severe sinus infection. After a round of antibiotics my ears got better and two weeks later they got worse again. I was told by one dr that I dad etd. So then I saw an ent just last week and said that my problem is nothing serious but he showed I had some hearing loss which was rare for a person my age (39). He put me on some steroids because now my ears feel like they are swollen inside. A lot of this I can deal with but the past 2 weeks my ears have become extremely sensitive to certain pitches/sounds and I’m finding this unbearable especially at work. I work in customer service at a casino. I just don’t understand why now I’m having issues with sound sensitivity. Please help. Depressed and anxious!!
Hi Joe:
There are several common causes of sound sensitivity. One is exposing your ears to loud sounds (and you work in a fairly noisy environment it appears). Second is viruses attacking your inner ears (maybe the flu virus). Third is taking various drugs (and you have taken some recently). Fourth is hearing loss (which you have discovered you have). Also, sound sensitivity is often associated with tinnitus (which you don’t mention).
I don’t have near enough information on your situation to really help you. You can email me privately if you want to and we’ll take it from there.
Cordially,
Neil
Hi, I was wondering if you could please help me. After djing and listening to relatively loud music for about half a year, my ears became sensitive and it’s hard to listen to music at normal volumes especially for long periods of time. I can tolerate other sounds it just seems to be loud audio that causes a dull pain in my ears. Do you know what I have and if there’s any way that I could fix it? I saw my GP and he said I might have hyperacusis, but I have to wait a month before I can see an ENT doctor because he was booked out. Thanks
Hi Drew:
All the loud racket you have exposed your ears to over the months has damaged your ears and no doubt resulted in hyperacusis where some/all sounds now sound too loud and can hurt. You can’t abuse your ears like you have and not expect to get off scott free.
Think of it this way. You have severely bruised your ears and thus it is going to take some months for the bruising to go away. Every time you expose your ears to loud sounds, it’s like whacking the bruise again–making the damage even worse and prolonging the time it takes for healing.
The obvious treatment is to stop whacking the bruise–which means you have to stop exposing your ears to louder sounds for some months and allow the “bruise” to heal up. You should not be exposing your ears to sounds much louder than normal human speech. That means you should listen to music at the same volume you hear speech–not way up there like you have been doing.
In time, your ears will typically lose their supersensitivity to loud sounds. However, the underlying damage you have already caused is permanent. Thus, in the future you have to protect your ears from loud sounds or the same thing will happen all over again–and each time it will tend to get worse–not something you want to live with.
Thus, you have to protect your ears from loud sounds–but at the same time, you must NOT overprotect your ears from normal sounds or your brain will turn up its internal volume and make things worse.
You may not like what I have told you, but that is the reality of the situation.
A word to the wise…
Cordially,
Neil
Hi Neil,
2 Months ago I was fitting an alarm system and the external sounder went off as I was stuck up a ladder, immediately after my ears were ringing and my hearing was dull but worse in the left ear.
I waited about a week to see if things would improve but they didn’t, I have suffered problems with ear wax in the past so I syringed my ears and got a few good lumps of wax out of both ears, My hearing did improve after that and it felt like the balance was restored.
Things still sound odd though, As if everything is of a higher pitch like the treble has been turned up, I also seem to have tinnitus although this seems to get worse when I listen to sounds or even the wind when I am outside and then almost completely goes away when I am in silence. My left ear feels full at times too and when I try to pop my ears the left ear makes crackle sounds like its full of fluid but this comes and goes. For the last 6 weeks it seems to be particularly worse in the mornings but would clear as the morning went on.
I did see a hearing specialist who gave me a hearing test, he said it did show high frequency noise damage but that my ears and hearing are very good and therefore it didn’t really matter!
I am not hard of hearing infact talking to people their voice seems louder and full of treble, and I can even hear the ticking of my watch on the other side of my desk. After reading your blog here I now understand that to be a form of hyperacusis. A lot of your comments here have helped me to understand the issues I am facing, 2 months in and things still sound odd, the stress isn’t helping, I just hope that in time these symptoms will get better. Everyone seems to talk about dull hearing but will the enhanced treble and ringing when listening to sound I am experiencing improve with time??
Thankyou.
Hi Jason:
It is obvious to me that you do indeed have hyperacusis, particularly in the higher frequencies. That is why the treble sounds so loud to you now–which seems “stupid” since that is where you have the hearing loss–but that is how hyperacusis can work.
Remember my analogy to “bruised ears”. It will take time–and it could be 6 months or a year for the “bruising” to go away and your ears get back to normal. Just remember, during this time, you have to protect your ears from loud sounds or you are just “whacking the bruise” and making things worse.
At the same time, as much as is possible, forget about your hyperacusis and tinnitus, and how sounds sound–and focus on the loves of your life instead. This is important so your brain doesn’t grow now connections that will enhance these conditions.
I wish you well.
Cordially,
Neil
Hi Neil,
Reading your comments here have calmed me down alot, so thank you for those.
I am 25 and i have tinnitus, ive had it since i was about 23, i spent alot of my youth out clubbing and working out in clubbing islands thinking that nothing could affect me, until one final club experience left my ears with constant ringing. I went to the doctors, she looked at me and asked ifi had been any loud explosions recently to which i was truley surprised, she said half of my right eardrum had perforated and 1 3rd of my left. I rested for 6 weeks and it grew back, much to my disappointment the tinnitus stayed.
Ever since then, i have worn ear protection when entering nightclubs, and despite a number of ear infections from using the plugs, things have been gradually okay. The other day me and my colleagues went to the cinema to see an action film( lots of guns and cars crashing) and my ears were in agony after ( i havent worn ear plugs to the cinema before) after a couple of weeks they got gradually better again. Then on Friday, i was playing in a soccer tournament (ive tried to indluge in my passions again, to keep my mind off the noise and be positive) and i was stood behind the goal when our team wasn’t playing, the thud of the ball against the rattly gates hurt my ears and even though i was stood further away this one shot hit the gate very loudly and my right ear popped and what felt like a vacuum i could hardly hear for a few seconds before sound came back again. Ever since then, i have had sharp pains in my inner ear, actual painful pricks and also slightly on my left ear. At this moment in time speech is about the loudest i can deal with without noticeably straining my ears. I went to the doctors because naturally i thougth i had burst my eardrum again but she said neither eardrum was perforated and there was no sign of infection. This has me worried, since the soccer incident my tinnitus has also got louder and im hoping and praying the ringing and inner ear pain will subside. Clinking cutlery is a particualr pain point at the moment. I was suppose to be going with my friends on a clubbing holiday(with protection of course) end of sept but im going to cancel that because im really worried that one more loud event could really damage my hearing further. I can (just about) deal with tinnitus but i cant deal with the inner ear pain and not being able to deal with normal soudns, now its only been 5 days since the even occured. I have booked a doctos appointment in the hope to be referred to an audiologist but deep down i know there isnt much they can do. I just hope by the time im an older man there will some effective treatment for this kind of injury. I will continue to rest it and now always wear protection to an event no matter where im going not just in the clubs ie (cinema, soccer game etc) However in the meantime im going to stay in as much quiet as possible in order to give my ears time to recover, i just hope to god they will. Thanks for any advice and reassurance you may give me on the above.
Hi Marcus:
You have terribly abused your ears in the past, so it is no wonder that you have tinnitus now. You have also no doubt damaged the underlying structures such as the spiral ganglion and this will lead to hearing loss and trouble understanding speech in less than ideal conditions. That’s the reality of your situation.
Why are you getting ear infections from wearing ear protectors? That should not be happening. Are you wearing new ones each time or reusing old ones. I think you should use new ones each time and see if that ends the problem.
Not only do you have tinnitus now, but also hyperacusis. That is why many sounds especially the clinking cutlery and kindred sounds seem so loud to you. Very often this is one of the results of noise trauma–exposing your ears to excessively loud sounds.
You are finally wising up. You need to give your ears a rest from loud sounds for several months and hope that most of the hyperacusis goes away. Then, in the future, you ALWAYS have to protect your ears from loud sounds. At the same time, you must not wear ear protectors where you don’t need them, or you will actually make your hyperacusis worse.
Realize that your ears have sustained permanent damage so they will always be more “fragile” than they were before, so take extra care of them, and hopefully in the future, you will be able to function reasonably normally.
Cordially,
Neil
Hi Dr. Bauman,
For the past three months I have been sick with a “mystery” illness that my doctor had written off as nothing for so long, that somehow now it has affected my ears. I had inflammation of my nose (never had allergies) a swollen throat (like someone was choking me) and my Dr thought it was acid reflux mixed with anxiety and allergies, again even after I had told her that I’ve never had an allergy in my life. Three months of this and then I noticed my ears felt blocked so I went to see her again and she said oh they just need to be cleaned. She cleaned them and it was excruciatingly painful. Immediately I felt ike I had hearing loss, but thought maybe my ears just hadn’t been cleaned in a while and were adjusting. Nope. Two weeks later and I had ringing in my ears periodically, now its a low noise in my right ear, and I have super sensitivity to loud alarming noises, such as the sound of brakes, horns, or bells, and I have lost hearing as well. I have an appointment with an ENT on Monday, since my Dr says she can’t see anything wrong with the middle ear. Please help me.
Hi Desiree:
The first thought that came to mind was that you have been exposed to molds or mildews in your house that are causing your “mystery illness”. Check it out and see if that is a possibility.
How did your doctor clean your ears? If it was so painful, I wonder if she didn’t do some damage that has resulted in your sensitivity to sound. This happens when doctors are “rough”. Cleaning your ears out should be painless.
Cordially,
Neil
I have thought of that as a factor, and am staying with family for a few weeks to see if it helps. So far I haven’t noticed a difference, but I have heard that it can take a couple months to notice the difference. I am beginning to think it’s viral? Potentially Epstein Barr Virus? The doctor used a syringe with hydrogen peroxide I believe. If this is the case, and its a result of the doctor being too rough with my ears, should they heal within time?
Hi Neil! So I have recently been dealing with Hyperacusis, no tinnitus thankfully. My hyperacusis begin while I was sitting in a lecture hall and a boy behind me sneezed very loudly in my ear which absolutely scared me since it was so unexpected! I don’t have any hearing loss as I’ve gotten it checked. My hyperacusis is getting better slowly but the sensitivity is on off. Sometimes I’ll experience it and sometimes I won’t. How do you feel about sneezes triggering hyperacusis. I know people deal with hyperacusis much longer because of medical illnesses, do you think I will continue to deal with hyperacusis for a while because of a loud unexpected noise? Please let me know how you feel about my case. I could not afford to see a specialist on Hyperacusis because it is super expensive. I avoid wearing ear plugs so that way my ears can try and become used to sounds and frequencies. Do you think I need to protect my ears still? Even though My case is mild?
Hi Aarti;
I’ve never heard of sneezing causing hyperacusis before–but I don’t doubt that was the cause in your case. It was loud and unexpected (so your acoustic reflex didn’t kick in and help protect your ears).
It takes time for your ears to recover–not just a few days, but rather two or three months or so. I think you just need to give it time.
In the meantime, you still need to protect your ears from loud sounds, but not from normal everyday sounds. As you understand, if you overprotect your ears you just make matters worse. But if you fail to protect your ears from truly loud sounds, you’ll also make matter worse and set your recovery back to square one–where you’ll have to start all over again.
Cordially,
Neil
Hello, I am a drummer and for the last few years have not used protection. About a year ago I had an extra loud show and woke up with a dull tone in my ear around 2.5k and some fullness. It has never got any worse and I have never let it bother me. I can only hear it in dead silence, my right ear has a slight ring as well.. but very low, very quiet.. I have never let this bother me in the past.
About 6 weeks ago, I started to worry about my hearing, started wearing protection too.. but really started to stress out about my ears.. for whatever reason, I don’t know. I went thru this for about 2 or 3 weeks, worrying about my hearing in general, thinking specifically about the slight ringing and worrying about what it might become in the future.. Then one day I went to lunch at a restaurant that I frequent, a fairly open, lively noisy place.. out of nowhere, I started to hearing this ringing in my ears that felt like it was in the middle of my head around 11khz.. it really scared me and i thought to myself i have put so much stress on myself that I actually created something real..
And now for the last 4 weeks my ears have done this sort of reactive ring when I am around certain settings, TV’s, open places with background noise… I can get it to go away sometimes and in other settings I have no ringing at all. And as soon as I get away from the setting that is causing it it goes away… If i sit in a silent room, it’s not there.
I’m not sure what to do, the ringing isn’t painful, but it stays above the external sound and at the front of my hearing and seems to push the external sound in the background.
At this point I’m not sure whether to avoid this happening or if I need to keep myself there as if to let my ears adjust.
I was just trying to add that the ringing also seems to be originating in the other ear that doesn’t have the low tone that I described above.
Any advice is extremely appreciated.
Thank you
Hi Rob:
Knowing that you have exposed your ears to loud sounds in the past tells me that you have damaged your ears to some degree. A lot of this damage is hidden so you don’t realize you have done this damage to the underlying support structures in your inner ears.
The result is that now you are hearing tinnitus. Tinnitus is often the result of noise damage to your ears. It can take all sorts of forms. You seem to have constant background tinnitus (I have too) and now some reactive tinnitus where you tinnitus gets louder with certain sounds and certain levels of sound.
Things are only going to get worse if you don’t start protecting your ears NOW. You need to keep the volume to below 80 dB. This means you’ll need to wear ear protectors when you are drumming or are in loud venues.
You should also try to keep the level of noise down to just below where your tinnitus starts to react to it. Give your ears a rest from all the racket for a month or two so they can “heal”. This is not a quick process, but takes time.
You don’t want to keep exposing your ears to louder sounds, and hoping they will “adjust”. That won’t happen. In fact, likely just the opposite will happen. So use ear protectors when the sound level goes above 80 dB. However, there is a fine line you tread. If you overprotect your ears, you will make things worse too. So only wear the ear protectors when the level is over 80 dB or so, and take them off as soon as the level drops below that.
Cordially,
Neil
Hi please can you help me? I had a bad incident 5 days ago and i think my hearing is done forever. Well basically I had two sound alarms in my window because someone broke into my bathroom before and i was afraid that it could happen again and that i wouldnt wake up. So I bought 2 personal security alarms that were 100db each and put them right next to each other, this made me feel secure that if someone broke into my bathroom i would wake up since i had two 100db alarms next to each other. Well 5 days ago the alarms went off for no reason and they wouldnt turn off so i had to get a screw and unscrew them both and take the batteries out. It took me at least 2-3 minutes to do that and they were both ringing on alarm mode for 2-3 minutes both together 200db. (Each alarm was 100db sound power.)
Ever since this incident happened (5 days ago) I’ve been hearing buzzing and ringing sounds which i read online i think is tinnitus and it can be permanent.
I have learned to get use to it even though its kind of annoying.
I have a bigger problem though that i need help on. Ever since this incident from the two alarms (5 days ago) almost everything hurts my ears, turning the water on to the sink faucet, typing on the computer keyboard, hearing myself speak very lowly, or hearing others speak very lowly hurts my ears.
My ears hurt really bad to everything. I’m worried I’m going to be this way forever. Did i permanently damage my ears forever? (Also I have to leave my windows open because i suffer from severe claustrophobia and its killing my ears the outside hearing traffic, cars, dogs barking, etc.)
Please will i get better? What should i do? And also what to do when have hyperacusis and claustrophobia i cant close windows?
Forgot to ask:
2) Will normal sounds damage my ear? (I read that you said to not completly stop sound or it will make everything worst and worsen your condition. —————– I really thought that loud sounds (as long it isnt a concert loud) I would be fine, that it hurts my ears, and gives me headaches but it would go away and not damage your ears. (As long as its not a concert loud, etc.) That you have to learn to deal wtih everyday sounds that are kind of loud like laundry, cars driving by, and so on.
I’m confused. I didnt go to a concert or anything i just been around cars driving by that hurt my ear kinda and laundrying my clothes loud but normal day sound i think that you shouldnt avoid? (And now my hyperacusis i think is getting worst, like when the problem first started 5 days ago my ears hurt to mostly any sound, BUT im 100% when i heard people speak in normal tone or myself speak in a normal tone my ears didnt hurt. And now suddenly 5 days later my ears really hurt just hearing myself speak or hearing others speak, so i have gotten worst. im confused why i didnt go to a concert or anything i have heard everyday sound that you shouldnt avoid like cars (not speeding or driving fast) just cars in general, laundry once in awhile just everyday sounds. I don’t understand why my hyperacusis has gotten worst?
2A) Please now i am in complete fear that anything can make my hyperacusis worst. I fear that my hyperacusis will get so bad that i’ll be in ear pain 24/7 and be suicidal and want to die because the ear pain 24/7. I’m confused now on what to do and how i should live my life. My hyperacusis got worst when it first started i didnt get pain in my ear when hearing people talk or hearing myself speak now i do. (Didnt go to a concert or anything, just dealing with daily sounds like driving a car, laundry once in a while, —— I’m so confused now on what to do to not make hyperacusis worst im thinkign i have to plug my ears 24/7. This happening where hearing myself speak hurts my ears and others speak hurts my ears has made me really suicidal and afraid. Because i wasnt like this when the problem first occured 4-5 days later i started feeling ear pain hearing myself speak and others speak so i got worst and i don’t know what i done wrong and im so scared now to get worst bad to the point that i have ear pain 24/7 in both ears i read on forums of people having this with their hyperacusis.
I’m so scared i can’t watch tv on very low volume ears hurt too much even when its on low low volume.
I’m just so unhappy. I fear so badly that my hyperacusis is going to get bad where i feel ear pain in both ears 24/7 all day everyday. I feel like i have to ear plug both my ears 24/7 but one day a bad event will happen and my ears will be destroyed (Some alarm goes off, something explodes, a car crashes, i dont know.. )
3) Am i going to get better? What should i do? (I’m upset too because im claustrophobic and live with my parents and cant avoid sound for the most part like other people i have to leave my windows open because severe claustrophobia and hear traffic, cars, dog barking, and other loud sounds. 🙁 )
Thank you so much for your time. Hope you can respond asap feeling extremely sad and suicidal.
Hi Aaron:
You have to realize that there are two different things here. One is whether real loud sounds will damage your ears, and two whether sounds you PERCEIVE as loud will damage your ears.
Yes, true loud sounds will damage your ears–and you have experienced ear damage. Probably a lot of the spiral ganglion neurons that connect your hair cells to your auditory nerve have been killed and the synapses broken.
However, normal sounds up to 75 or 80 dB will not damage your ears physically. However, when you have hyperacusis, it will FEEL like these sounds are too loud and thus will damage your ears–but they won’t cause physical damage.
Often it takes a few days for the damage to become apparent–thus your hyperacusis seems worse now that it did right after the incident.
As I’ve said before, you need to protect your ears, but not to overprotect them. So you may have to wear ear plugs much of the time to start with.
This life is not without risks. True, you never know when a sudden loud sound will occur and you can’t protect against such things. But if/when they do, you need to immediately clap your hands to your ears to block out as much of the sound as you can to minimize your exposure to such sounds. Even so, your hyperacusis may get worse temporarily because of this–but you just continue on with the program and your ears will continue on their slow road to recovery.
I’m not sure what you can do about your claustrophobia when it interferes with the obvious treatment for your hyperacusis. Obviously, you want to close windows to keep louder sounds out and if you can’t do that, then ear plugs are probably the only answer. But just wear them as little as you need to–probably more now and then less and less as time goes by.
If, after a month or so, your hyperacusis isn’t something you can deal with, you need to seek out professional help at a tinnitus and hyperacusis center. Probably the best one is the Tinnitus and Hyperacusis center in Atlanta, GA run by Dr. Pawel Jastreboff.
Don’t let your hyperacusis overwhelm you. Take one day at a time–one step at a time, and you can always contact me for further help.
Cordially,
Neil
Hi Aaron:
Exposing your ears to that racket for several minutes can certainly result in tinnitus.
Just a point of correction. If you had two 100 dB alarms going off together, the total sound level would not be 200 dB–that would have instantly blown out your eardrums. (There are few things in this world that are that loud–even a rocket taking off is only about 180 dB.) Since decibels are a log scale, adding 100 dB and 100 dB would only equal 103 dB.
Yes, tinnitus can be permanent, or it can fade away in a few days to a few months. The big thing is to not obsess over it and treat your tinnitus sounds as environmental sounds that your typically ignore. The way you can do that is first you need to realize that tinnitus is NOT a threat to your well-being. When you understand that and thus treat your tinnitus as a meaningless background sound which you can safely ignore, it will begin to fade into the background and not bother you–so whether it is temporary or permanent doesn’t matter.
Noise trauma, such as you have experienced, often brings another unwelcome guest in addition to tinnitus. That guest is hyperacusis–where normal sounds now sound extremely loud–loud enough to hurt. These sounds seem to blow the top of your head off.
Typically, this condition is temporary while your ears recover. This may take several months–it won’t go away overnight. What you need to do during this time is protect your ears from loud sounds so you don’t continue to make it worse.
To that end, you might need to wear ear plugs or ear protectors (the cheap foam ones will work) when you are around louder sounds. However, you must not overprotect your ears or you will just make the hyperacusis even worse. Therefore, do NOT wear ear protectors when you don’t need to. Your ears NEED to hear sound so your brain doesn’t turn up its internal volume control to try to hear.
So, for the next number of months, you need to protect your ears from louder sounds while letting them hear sounds you can stand. SLOWLY over time you can let your ears hear louder and louder sounds as you slowly recover. Do not rush this as it can set you back to square one and you’ll have to start all over again. But you will succeed if you persevere at it.
Cordially,
Neil
Thank you Neil.
I have a quick question:
I really need to get dental work done. I need to get one cavity filled and my teeth cleaned. Can you tell me whats the best thing a person with tinnitus and hyperacusis should do? What would be the best options if you know please? Thanks Neil.
Hi Aaron:
First, I’d wear ear plugs to keep the noise down as much as possible.
Second, as the dentist to drill for 5 seconds, then wait for 5-10 seconds, then drill for 5 more seconds, etc. This really helps some people.
Third, do not let the dental hygienist use ultrasound cleaning tools. Manual (traditional) cleaning is much easier on the ears. You could also ask her to alternate 5 seconds on 5 seconds off if the sound of the polisher starts to bother you.
Cordially,
Neil
Thank you Neil I will tell the dentist about the 5 seconds drill then wait 10 seconds.
Sorry can i ask something shortly.
“Noise trauma, such as you have experienced, often brings another unwelcome guest in addition to tinnitus. That guest is hyperacusis–where normal sounds now sound extremely loud–loud enough to hurt. These sounds seem to blow the top of your head off.
Typically, this condition is temporary while your ears recover. This may take several months–it won’t go away overnight. What you need to do during this time is protect your ears from loud sounds so you don’t continue to make it worse.”
I forgot to mention that I had two 100db alarms go off right next to each other and also a 120db alarm too. In total 3 alarms right next to each other and i had to take out the screw and batteries for all of them which took 3-5 minutes which caused this hyperacusis and tinnitus.
Do you really think I can get 100% better and like a normal person in hearing again? Or at most just more better like 50% better but still have ear pain and problems to sounds?
I just dont see myself getting better from hyperacusis. I think its getting worst I showered yesterday and my ears were hurting badly to the shower faucet and i showered two days before that and didnt have ear pain.
Hi Aaron:
In the future you know that you need to FIRST protect your ears BEFORE trying to turn the alarms off when you are that close to them. You could have saved yourself all this trouble if you had.
I cannot predict the future. So much depends on how you psychologically treat your tinnitus and hyperacusis. If you worry about it and treat it as a threat to your wellbeing, then it is going to get worse, or at least not get better.
However, if you treat your tinnitus as something that is NOT a threat to your wellbeing, then it will tend to fade into the background and not bother you.
I sense you are in the first category. Thus, it is going to be harder for you to do this, but it WILL yield positive results. I had another man that took about 3 years before he got his ear pain under control and began to go out of his house without problems. It took a lot of work on his (and my) part to achieve this. So don’t expect overnight results.
Learn to focus on the loves of your life and not dwell on your tinnitus/hyperacusis.
Cordially,
Neil
Dear Neil,
Hello, I’m sorry i really needed to ask you this and wanted to know if you maybe knew.
1) I keep getting ear pain when i stand up or sit up, when i lay down i feel way less ear pain or no ear pain. Do you know what could be wrong?
2) I didnt notice until today but i grabbed something on the floor by ducking/squating/bending my knees then moved/stood back up and i felt pain in my ears. Its like both ears couldnt handle the force of standing back up and felt pain.
Please I need your advice badly. I’m afraid i’m going to be bed bound my whole life because i feel too much ear pain standing up or sitting up and feel so much better laying on my back less ear pain or no ear pain. What could be wrong?
Hi Aaron:
You need to give your ears time to heal. This is going to take some months. The more you focus on your ears and worry about being bedridden for the rest of your life is just making things worse and can become a self-fulfilling prophecy. That is why I keep telling you to calm down, focus on the loves of your life and give your ears time to heal.
Cordially,
Neil
thanks neil i will do that calm down and let ears heal and try my best to focus on other things.
i kind of had a few questions i really needed to know.
1) I believe things that are 85db to 80db or lower wont damage your hears even if they sound loud though to a person with hyperacusis.
Neil do you know where i can find a chart that tells the db level of things? I really have no clue what the db level is of anything i do so i get afraid of hearing damage.
2) Where I currently live there is only one gas station in the 20 mile area. I always have to go there because thats the only gas station to fill up gas. There is always loud music playing in gas station and at least a 10-15 minute wait in line because there is always tons of people there. What do i do if i need to go there at least once a week for a refill? (They even play music outside the lot where you pump gas and there is just alot of people there.) I’m afraid im hurting my recovery process but have no choice but to go there for gas and sometimes food.
Hi Aaron:
Probably a safer level is 70 to 75 dB. Higher level such as 80 to 85 dB can cause hearing loss if exposed to them for a long time.
1. There are lots of charts available on various websites. Here is the link to one such chart. http://www.noisehelp.com/noise-level-chart.html
You can also get APPs for your smart phone (assuming you have one) that turn your phone into a sound meter so you can see at any time what the sound level is around you. If you have an iPhone, you could download the APPs–SPL Meter, Decibels or SoundMeter.
2. When you are in noisy areas, just put on earplugs (ear protectors) for the duration. That should protect your ears and not aggravate your hyperacusis.
Cordially,
Neil
Sorry, last question.
3) Neil, I think my hearing goes off and on. Sometimes I hear normal and sometimes I hear alot less. It seems to go off and on my hearing. Can this get better and recover or this is permanent? Thank you~
Hi Aaron:
Any time your hearing returns to normal, I think this is a good sign that the problem is not permanent–because you hearing CAN return to normal at times. Hopefully, it will be normal more than abnormal as time goes on.
Cordially,
Neil
Hi Neil its been awhile I was wondering if you could give me some advice.
I have some very important things that i would like you to read if you have the time its of someone had had hypercausis and recovered from it. His name is Adam he wrote what he said on video and has two videos of what he said if you dont want to read it.
“https://docs.google.com/document/d/1Xr5SJDL1RYtKDEiTQrlmVd5RdUr4J73LiAADxHtfBt8/edit
Video 1:
https://www.youtube.com/watch?v=9vcApqcbrtc
Video 2:
https://www.youtube.com/watch?v=9GpyBFh-jSs”
1) What should i do if i went to a hearing aid specialist all my insurance can afford and the doctor there told me to put in ear plugs 24/7 and that my ear cant handle more than 65db. He lost crediblity with me this hearing aid specialist when he told me to put ear plugs in 24/7 because i know you and many sources say to NOT overprotect ears.
Its all my insurance can afford this hearing aid specialist. I really want to do white noise and pink noise therapy like this Adam person but i cant afford and rehab psychologist and even neuro-odologist. What should i do if i cant afford these doctors but need the help?
2) Can I ask how bad it is to over protect your ears with ear plugs because i have to leave my window open because my claustrophobic but the sound is so loud sometimes that i leave in ear plugs for at least 6-9 hours a day when i sleep. Can you tell me more about overprotection neil?
3) Can you tell me what you think overall of this Adam individual and his treatment plan and so on. And if you did similar with your patents? And what you would do differently from him if you would? Thank you Neil.
Hi Aaron:
What Adam did was basically what I tell people to do. I think he is right on the money for hyperacusis caused by excessive noise like he had and then coupled with all the anxiety.
You don’t necessarily need all the high priced professionals that Adam used. You can do it all yourself–maby not as well and not as easily, but you can do it. Follow the 6 principles he followed–3 each by the two different professionals. You can make your own white noise or pink noise generator. You can find examples on the internet and download them and listen to them on an iPod, smart phone, MP3 player, etc. It’s not the device that is important. The really important thing is to set the volume correctly at each step of the way.
Question 1. Don’t listen to a hearing aid specialist. He is not trained in what you need which is Hyperacusis Retraining Therapy. Just the fact that he advised ear plugs 24/7 shows how ignorant he is of the proper treatment. (Of course, to the uninitiated, if you have hyperacusis, wearing ear plugs all the time sounds like the logical and correct solution–but it is totally wrong.)
Question 2. VERY BAD. If you want to get back to normal, you’ll have to do as Adam did and expose your ears to a bit louder sounds than you are comfortable with, and slowly increase the sound level as your ears can tolerate it. Remember, this is a slow process–with all his professional help, it still took Adam 8 or 9 months. Normally, it can take 2 or 3 years.
With overprotection, your brain turns up its internal volume so when you take the ear plugs out–sounds are even louder than they were before you used the ear protectors. It just makes things worse and worse. That is why you need to use the correct amount of protection and only when needed.
Question 3. As I said above, I think Adam followed a very good protocol–and the proof of it is that it worked so well for him. If I had hyperacusis, I’d do much the same thing.
Let me reiterate Adam’s 6 main points–and I agree totally with them all.
1. Do not overprotect your ears by wearing ear protectors in normal hearing environments.
2. Enrich your environment with sound following the TRT treatment protocols listening to white noise when I’m in silent environments and sleeping. I’d add that rather than white noise, you could use pink noise. It is more natural sounding and less stressful as there is not so much energy in the high frequency sounds that gives a mild equivalent of scratching your fingernails on a blackboard. It’s hard to relax with that sound.
3. Know and take to heart the fact that normal sounds under 80 dB cannot and will not cause any further damage to your hearing.
4. Stop hyper-monitoring and relax your body instead of bracing youyself for sounds like a door shutting.
5. Modify your lifestyle in order to find ways to get back to what you did in the past (besides the use of ear protection in normal sound environments)
6. Quit researching and reading forums which lead to it consuming all your thoughts about your hyperacusis. Instead, focus on the loves of your life and let your hyperacusis fade away.
Cordially,
Neil
Thanks neil for taking the time to read my post and what adam said.
What is really staggering me and confusing me is: Adam said that he pretty much lived like a normal person he would go running at night time 2-4 times a week,, he would go to restaurants, he would go to the gym, all while keeping it below 85db or lower so he didnt get furthur hearing damage. I’m so confused because if you re-read everything he says its like hes saying it like he was able to do everything without going over 85db or higher and he never once mentnioned wearing ear plugs or ear protection he actually said to throw them away.
So how do you think he was able to do everything without going higher than 85db.
“I have a question that i really need to know you say sounds 85db or lower wont hurt or damage ears but what if your out in a restaurant and a construction worker accidentally turns on a loud tool or a firework goes off or a child screams. How did you just manage 85db and 85db below only there are so many things that can destroy your ears outside and give you hearing damage without ear plugs. Please could anyone answer i just dont understand Adams 85db or lower wont damage ears so no need for ear plugs and hearing protection there are so many loud things that can happen without ear plugs its impossible to go outside and just keep it 85db and below.”
I’m just so confused on this part, I want to understand how he did it and how he managed to do everrything without going over 85db he even said throw away ear plugs.
What do you think Neil? Thank you!
Hi Aaron:
Maybe he lives in a relatively quiet environment. But what’s so hard to understand? If it becomes louder than 80 – 85 dB simply put in ear protectors that will bring the level to below 80 dB, but not lower than about 60 dB so your brain still has adequate sound.
If you are out and a sudden loud sound occurs, you clap your hands over your ears immediately until the loud sound stops or you can get away from the sound. You’ll notice that these things happened to Adam from time to time and set him back, but he just carried on. It just takes longer–two steps forward, one step back, but he persevered and ultimately succeeded.
Also notice that he deliberately relaxed in the presence of louder sounds–didn’t tense up. Hard to do, but apparently necessary.
Cordially,
Neil
Hi Neil,
It is aaron again back with a few questions.
So I’ve been hyperacusis now since December 2016 4 months now.
I have declined badly, my hyperacusis has gotten ALOT worst and ive become alot more sensitive to sound and most sounds startle me and make me jump out my seat even sounds not so loud.
I don’t know what exactly to do. I have become worst because my mentally ill little brother keeps slamming doors because he hates me. My parents try to talk to him but he wont listen, he does sometimes but then he goes back to slamming again shortly after. I’ve become worst in hyperacusis.
I don’t know what to do i can’t really move out because i don’t have any family outside this house or cant afford it either. And my brother who is sick wont be asked to leave he is too young and sick and hates me.
I’ve been crying because i think my life is over. My hyperacusis is only getting more and more worst because his slamming. My parents tell him to stop slamming but he wont listen. I only can hope he slams less. He has made my hyperacusis so much worst ive been really down and depressed im having trouble just staying alive hearing everyday sounds that hurt so much now and only getting worst because his slamming.
I’m still trying anyway to the last breath of life. I bought a white noise machine that offers brown noise, pink noise, and white noise.
I just wanted to ask:
1) How long should i listen to brown noise, pink noise, or white noise?
2) Should i just go with white noise?
3) How long should i listen to white noise for per day?
4) How do i know when to increase the white noise volume and go up more?
5) Should I just listen to white noise in day time since hes slamming and then at night time dont listen to anything and try to get some rest while hes asleep? This is such a complicated situation for me, for most people, their families are cooperateive and they get better/more better with time and things work out for them for me its so complicated the time schedule of listening to white noise, every second of the day fearing slamming, 🙁
Thank you Neil.
Hi Aaron:
You need to find a tinnitus and hyperacusis center and seek professional help there. And you need to do it soon. Putting it off is only putting you into a worse and worse condition and it will just take much longer to get things reversed and back to normal.
Because you have severe hyperacusis, you need to listen to the white or pink noise ALL the time 24/7.
You increase the white noise as you can stand it. You push the envelope to increase your collapsed dynamic range–but just push–not go higher than you can stand.
But you really need to get hands-on professional help.
Cordially,
Neil
Hi Neil,
I have a question:
In Adam’s treatment for hyperacusis.
https://docs.google.com/document/d/1Xr5SJDL1RYtKDEiTQrlmVd5RdUr4J73LiAADxHtfBt8/edit
“The first treatment is called tinnitus retraining therapy which uses a form of sound enrichment through the use of in ear sound generators that would play white noise.. Basically it was a device that looked like an iPod where I would use special headphones to listen to white noise (which is similar to tv static) and I would listen to the white noise at first at low levels and slowly bring up the volume little by little to retrain my brain to raise my sound tolerance all while masking my tinnitus.”
“So after 2 months of a slight improvement, my audiologist called me in for an appointment because she received a trt device for me to use. The device was called the soundcure serenade. She fitted me and personalized the tone specifically based on my tinnitus frequency. I was supposed to use the device for a specific amount of time each day and when I felt my ears were being bothered by sound. After a couple months of using the trt sound generators, each week I would bring up the volume little by little.”
The second tip was that I should listen to white or pink noise either through laptop speakers or through a white noise masker machine when I go to sleep or when sitting in a silent room because sound enrichment is very important for the auditory system and being in silent environments starves my auditory system from sound which in turn would make my sound sensitivity even worse – so basically I need to avoid both completely silent environments and environments that exceed 85db.
1) I’m confused is TRT different from a white noise machine?
Adam says his doctor gave him a trt device that look like a ipod with “special headphones” .
2) Where can I get these “special headphones” is it the special headphones that make trt different when delivering white noise? (Because going on to question #3)
And then he said his doctor said to listen to white noise from a seperate white noise machine on his laptop speaker when he sleeps.
3) Why does he need to listen to white noise on his laptop speaker or from a white noise machine? Why cant he just use his trt device and headphones when he sleeps at night his trt device is white noise isnt it? (I’m confused is trt device white noise different from any other white noise you can get like on a Smartphone Application? — I just dont get why his doctor is saying to play white noise on laptop speaker or from a white noise machine on speaker — Why does he need to buy another white noise machine when his trt device and headphones is white noise? Can’t he just use his trt device and headphones when he sleeps?
4) Is TRT different than any other white noise i can get on a smartphone application, youtube white noise video?
5) I’m just terrified of doing this all wrong because you said i don’t need the expensive doctors and i can do it all by myself downloading white noise on my smartphone or putting downloaded white noise to my ipod. There seems to be all types of treatments and i’m so confused!
http://www.eardoctor.org/conditions-and-treatments/other-conditions/hyperacusis/
If you scroll down the bottom “Treatments”
Is the first bulletin sound therapy white noise? How does it work?
Is the second bulletin Tinnitus Retraining Therapy different from the first bulletin? (Is it white noise? I think so. ? )
The third bulletin Tinnitus Masking Device hearing aid that delivers white noise to the ear. (I’m confused is this so really needed doesnt a TRT device with headphones is enough why would anyone need this? Why is this a treatment plan/third treatment plan?)
Fourth bulletin Neuromonics is it white noise? What do you think of Neurmonics Neil?
—-
I’m sorry Neil for the complicated questions I’m just so worried and really want to do this right.
I read horror stories of people doing white noise and their tinnitus and hyperacusis getting worst and i so fear that will happen to me so i wanted to be very knowledgable more towards treatment plans i guess.
http://www.chat-hyperacusis.net/post/pink-noise-vs-white-noise-1343282
Like this person who listened to white noise and got worst in hyperacusis and tinnitus. I’m so fearful to make my hyperacusis and tinnitus bad its already bad.
I really hope you can help me answer my questions badly and shed some light for me and my worries and curiosity.
Thank you for your time Neil.
Hi Aaron:
1. TRT is a treatment protocol for tinnitus. One of the things it uses is a white noise machine or hearing aids that have white noise generators built in. The second component of TRT is directive counseling in order to teach you how to properly deal with your tinnitus.
Hyperacusis Retraining Therapy (HRT) is similar to TRT but also a bit different as it treats hyperacusis, not tinnitus. But generally, the concepts are the same–retraining your brain to accommodate these two different conditions.
2. You get the appropriate devices from a health care professional (typically and audiologist that specializes in treating people who have tinnitus and/or hyperacusis. But yes, you can use other devices that you might already have yourself. However, you need the expertise of the health care professionals (remember Adam used three different professionals to help him get on track) to guide you properly. Without his “helpers”, Adam would not have been successful.
3. White noise is white noise–no matter which device produces it. The reason you don’t wear earphones to bed is twofold in my opinion. First they can be uncomfortable if you lay on your side and “squish” one ear. Second, you don’t want the sound always forced right into your ears–so having the sound produced by a device sitting on your bedside table lets you hear both the white noise and any other sounds around you–while letting your ears rest by not having the sound forced right down your ear canals.
4. Already answered above.
5. You CAN do it all yourself, BUT it’s probably not wise. You do need guidance so you don’t make any serious mistakes. And especially so because you are “terrified” of making mistakes. In order for these treatments to be successful you have to learn to be calm and get out of fight or flight mode–and you are definitely in fight or flight mode–so you should seek professional help.
Sound therapy is basically listening to sounds whether it be white noise, or fractal sounds or other music, etc.
TRT uses just white noise.
Tinnitus masking is a protocol that sets a sound louder than your tinnitus so you don’t hear your tinnitus. It basically hides your tinnitus, not get rid of it like the TRT and Neuromonic protocols set out to do. Tinnitus masker can use white or pink noise, fractal music, or other sounds.
Neuromonics doesn’t use white noise, but special music. If you want to know more about Neuromonics and how this treatment protocol works, read my article on the subject at http://hearinglosshelp.com/blog/neuromonics-is-it-for-real/ .
The horror stories you are reading are not helping you at all. They are making you more fearful, not calmer. That is why I STRONGLY suggest you go to a tinnitus and hyperacusis clinic where the professionals know how to help you and can guide you in your ongoing treatments at home.
You seem to be under the impression that treating tinnitus or hyperacusis is tied to a sound device. That is only half of the program. The other half is the directive counseling you also need in order to be successful. Hyperacusis is both a physical and psychological condition–in other words it is a psychosomatic condition and thus needs treatment for BOTH your body (sound therapy of whatever kind) and your mind (directive counseling). You are just focusing on the physical and leaving out the most important part–the psychological counseling that you so desperately need.
Cordially,
Neil
Hi.
I’ve read this page and found it very useful. Thank you so much. I am 31 year old man from Finland. I am musician and also hunting is my hobby. In year 2012 I’ve been diagnosed small hearing loss between 4-5khz. The doctor said that is not so bad and it hasn’t bothered me at all.
11 weeks ago I was in metal factory hall. That was a very loud place, but I think it wasn’t infernal. I was there about 1 min and yeah I realize that loud was high but I didn’t understand to go away from there. After that I have had a serious problems. I’ve noticed a mild tinnitus (which I can handle). But worst is that there is pain especially in my left ear and also sometimes in right ear. It doesn’t occur every moment. Some days are better than others. The pain level is something like 3 (if 10 is the most awful pain and 5 is normal headache). It is very annoying still and I’m very worried about it, is it going to be permanent. I can sleep normally and I think there are not so much pain when I’m at the bed than standing.. I’m not sure.
Also I got hyperacusia. For example fork against the plate and other certain frequency sounds are uncomfort. I can play piano, normally talk with people and watch movies, move in the streets and so on.. But those certain frequency levels are uncomfort and also they affect some acoustic reflex in my left ear. My ear is trying to protect itself with “whum” sound, I think. Like my ear is going to close itself when hearing certain frequencies no matter are they low or high decibels.
I try to keep calm and hope time will help the situation. I’ve been in doctor and tried acupuncture to ease pain. My hearing loss is at same level now what it was in year 2012. It hasnt got worse. I hear normally. What do you think of my situation? I’m so angry to myself if I destroyed my ear with this.
After that incident, I’ve been protected my ears in every loud situation. I have also used ear protection before with my hobbies (but not all the time).
I try to think positive and somewho understand the situation. What do you think my possibilities are and what do I have to do, to heal myself with the best way?
Thank you so much for answer.
Hi Olli:
The hearing loss you have at 4 kHz is what they call a “Noise Notch”. It typically occurs at that frequency indicating that you have damaged your ears from exposing them to loud sounds. Now new loud sounds are just making things worse–but things have been going bad for some time already.
When you went into the loud hall, you just made things worse and thus more noticeable. Very often noise damage results in hearing loss, tinnitus, hyperacusis and ear pain to some degree. And like you have discovered, certain frequencies of sound really hurt–even those sounds may not be very loud at all. I know all about it!
You are doing well trying to keep calm and letting time take care of it. Your hearing may not have gotten worse as shown on your audiogram, but you have definitely damaged some of the underlying structures in the spiral ganglion and their synapses and this makes it much harder to understand speech in the presence of background sound.
You are doing the right thing to protect your ears whenever you are in louder environments. You have to be consistent as just one loud sound can set you back again. But it is not the end of the world. Just continue on and it will slowly get better again.
At the same time, you must be careful to not wear ear protection when you don’t need it or you will make your hyperacusis worse. So you tread a fine line–protect your ears when the sounds exceed 80 dB (or maybe even less if those sounds hurt), yet not overprotect your ears when the sound level is such that it is below 80 dB or doesn’t hurt.
It will take time, months to a couple of years or so, but persevere and you will notice improvement as time goes by.
Cordially,
Neil
Thank you for your advices. I was thinking that there are so much voices in every day life which can be louder than 80 db. These voices are short ones like dog barking or if you use hammer to put nail to the wall for painting. What do you recommend, do I have to avoid these kind of sounds even if they are very short ones? Cutting crass or something like that it’s of course that kind of thing that I definitely wear ear protection. But I think it’s gonna be quite hard to avoid for example dog barking. I don’t think this level could make damage to my ears, but could it slow the healing process….? I have two dogs which sometimes bark.. And if I try to avoid them, that is I have to use ear plugs all time and it’s gonna worse the hyperacusia like you said…
Also I am thinking can I ever hunt again. I have hunting ear protection system, which decreases voice level about 25 db. But is this enough because shotgun db-level is so high. Also if I’m going to watch some rock concerts or play own gig, maybe the levels could be 100 db. I have ordered Elacin earplugs with 9dB and 15dB filters. I was thinking is that enough for me now on… There are also 25 db filters available. All I want that I can handle this situation and have a quite normal rest of my life. I like to believe that this is gonna be better some day. Also I’m thinking I have to stop worrying this thing all the time, even if this pain reminds me every day. So I think when I got some plan of how to protect my ears, I’ll keep doing that, and try to forget the whole thing and stay positive. Thank you once again for your encouraging words.
Hi Olli:
I know what you mean about dogs barking (they take the top of my head off they are so loud) and pounding nails. For dogs, I just clap my hands over my ears until they have stopped. With nails–if they are small ones, the tapping doesn’t bother me, but for larger nails and spikes, I always wear ear protection or my ears instantly ring louder.
For hunting, I’d get the best protection you can. For example, use ear plug kind of protectors and then wear big earmuff protectors on top of that. That’s all you can do. See if that bothers your ears. If not, then have fun hunting.
With Rock concerts, do the same–double protection if needed.
You have the right idea–take prudent precautions–and stop worrying about the rest. Worry often makes ear conditions worse. So just focus on the loves of your life.
Cordially,
Neil
Hi Dr, I am 23 years old and I shot a 9 mm pistol on Christmas eve. It has been ringing for about two weeks now. I tried to let it go away but I was getting so worried that I went and saw an ENT specialist. They did a hearing test and I have suffered no hearing loss. She actually said that my hearing was perfect. This was one of the only times I have ever shot a gun. I can almost ignore it while I’m at work but when I lay down it is pretty constant. Am I going to have to deal with this for the rest of my life???
Hi John:
Your hearing may appear to be perfect, but the loud shot did do some damage to the underlying structures. This damage is not measured in normal hearing testing. That is why it is appropriately called hidden hearing loss. The fact that you have tinnitus is another indication that there is some degree of underlying damage.
The best way to deal with you tinnitus is learn to totally ignore your it. You can only do this when you understand that tinnitus is NOT a threat to your well-being in any way, and thus you treat it as you would any other unimportant background sound (such as the sounds your fridge makes). When you do this you will find you tinnitus becomes less and less intrusive and fades into the background so that hours can go by without your even realizing you have tinnitus.
If you tinnitus bothers you at night when it is quiet, you can add some background sounds to help you get to sleep. Some people just put a fan in the bedroom. Others listen to CDs of environmental sounds–rain, waves on the beach, night sounds in the forest, etc. Still others listen to soothing music. You may find one of these really helps you. Or you may find that you don’t even need anything.
Cordially,
Neil
Dear Neil,
I have never had a problem with my ears until I had an emergency c-section to deliver my baby. I ended up with extremely high blood pressure & was given medication for this. The day after my operation I became extremely sensitive to the sound of my own & other peoples voices. This gradually got worse where I found high pitched noise unbearable e.g. putting down cuttlery, rustling paper, my babies high pitched cry etc.
I went to the doctors & they checked my ears & noticed i had impacted ear wax which I then got syringed.
I would say that my sensitivity to sounds did slightly improve after this, however in the past few wks i’ve felt like i have pressure in my ears & the need to ‘pop’ them. My sensitivity to sounds is also back & sometimes I feel dizzy. I am awaiting an appointment with ENT but wondered if you could help me in any way?
Hi Paula:
Which blood pressure meds did you take? They could be responsible for your ear problems.
Your sensitivity to sounds is called hyperacusis. Some drugs can cause this.
The pressure in your ears could indicate you have some hearing loss. It would be wise to have a complete audiological evaluation by an audiologist.
Another possibility is that you put your upper cervical vertebrae out of proper alignment during your labor before the C-section. Upper cervical spine chiropractors (not conventional chiropractors) can check you for proper alignment and realign if necessary. This can fix the feeling of pressure in your middle ears.
Cordially,
Neil
Dear Neil,
Ever since two months ago I noticed that the back of my head and ears start hurting even though the sounds I listen to are below 85 db. I found that this occured mostly when I played music on my laptop’s speakers rather than anything else. It also got to the point where even playing music through my laptop’s speakers at an extremely quiet volume hurt my ears and back of my head. This then led to me the next day and presently to hear almost every sound loudly especially high pitched sounds.
I had an MRI scan done on my brain to rule out any possibility of tumor, etc. Because of the occipital head pain and my ENT specialist found nothing. However he didn’t bother telling how I could’ve got it in the first place as I don’t remember hearing anything extremely loud besides constantly being exposed to my laptop’s speakers that were not over 85 db.
I’m scared that I’ll never be able to listen to music again because I noticed that everything was loud after listening to music even at a low volume.
Will I ever be able to listen to music again through speakers or is my ears damaged to the point where even quiet sounds will damage it leading to to hyperacusis.
H Sorin:
As I see it, you already have hyperacusis. The real question is how did you get it? Typically you get it from noise trauma, but there are other ways. For example, certain drugs and medications can cause hyperacusis? It is also tied into your emotional system.
If you need professional help, then I’d suggest going to a tinnitus and hyperacusis clinic. Taking hyperacusis retraining therapy can get you back to normal–but it will take time–1 to 3 years depending on how things go.
Cordially,
Neil
Dear Neil,
On December 3 2017 I needed a release after as a nightmarish year was coming to an end (my wife forced a separation and I later got fired from my job). I went to a concert and stupidly did not wear ear protection and the music was loud.
The good news is that I have a new, better job…and my wife and I are starting down the reconciliation road.
The bad news is that since the concert I have a feeling of aural fullness/pressure in both ears. I also have a tension in my temples (like a rubber band is inside my skull), a vague sense of jaw tightness (I only notice this occasionally), and (very occasionally) a slight sense of “soreness” in my ears. Sound sensitivity went away fairly quickly after the concert. No tinnitus.
I have been examined by an Audiologist and there is no change from my previous baseline audiology test. I have bilateral conductive hearing loss in both ears due to repeated ear infections and related tube surgeries from when I was a kid.
My question: Am I suffering from hyperacusis? Should I expect to recover from these symptoms in a matter of months? Is there anything I should be doing to improve? I’m wondering about massage for the temple “tightness”.
Hi Brian:
Yes, you needed a release, but you still have to do it wisely–and protect your ears in the process.
So glad things are now looking up for you.
Your symptoms don’t sound like classic hyperacusis, but there is no doubt that you damaged your ears. You should read my recent article on Hidden Hearing Loss at http://hearinglosshelp.com/blog/hidden-hearing-loss/ . It will help you understand how you can damage your ears and yet still have the same audiogram.
If you go the massage route, I’d suggest not only the temple area, but your face, neck and upper back (shoulders) to get all the muscles relaxed and all the knots out so they work properly in unison, not pulling against each other.
Let me know how it goes.
Cordially,
Neil
Hi Neil
I have hyperacusis and tinnitus. This is the second time I have had hyperacusis and the first time was after a loud and long concert. This lasted for 6 months. I was prescribed anti-depressants for anxiety and depression as the whole situation was really getting to me. Shortly after I started taking them the hyperacusis settled and I had no further problems until two years later (5 weeks ago) when I was in my car and the door slammed very loudly. My question is do you think it was the anti-depressants that got rid of it the first time (I am still on them) or is it a coincidence? I like to think the latter and then its just a matter of time before it fades off again.
Thanks
Claire
Hi Claire:
If you protect your ears from further loud sounds, it is not unusual for hyperacusis to slowly fade away without any treatment. However, it can instantly come back when you experience another loud sound (such as the door slamming). So, it may fade away again like last time, but each time youdo this, it may take longer and finally not go away.
My feeling is that the drugs tend to make you not worry about your hyperacusis, but do not make it go away as such.
Cordially,
Neil
I have an unusual situation: I’m hard of hearing, and wear BTE hearing aids at work, in a call center, using the telecoil switches and hearing aid compatible headset. I’ve done this for about 10 years now. Recently, I had an incident where a caller yelled into the microphone (they thought they were being helpful) which caused me to jump out of my chair and throw my headset off. I had several days of strong headaches (the pounding kind) and nausea, and dull ache/burning deep inside my ears. Also every sound was painful, especially high frequency sounds and the vibration of my own voice bothered me. I saw an ENT, no physical damage, and my hearing loss didn’t change but my speech sensitivity was limited to 40db instead of 70 db from testing the year before. I was told to avoid phone, hearing aids for now and have been out of work for a week now. After walking the dog last night, (I did a light jog to keep warm), my symptoms were exacerbated for about 6 hours. Including headache, scalp (?) jaw and neck discomfort. Ive been reading about acoustic trauma, but mine was a nicely targeted blast inside my earcanals due to the telecoil/hearing aids, and my hearing loss was not changed, just the sensitivity (therefore speech recognition ability) Should I be concerned about fractures or TBI or anything? And beyond an audiogram, would any specialized testing be beneficial? Appreciate feedback.
Hi Karen:
That episode gave you acoustic trauma and now you have hyperacusis. Your ENT may not have seen any physical damage–but what could he really see besides a ruptured eardrum? You have sustained physical damage–but it is not visible. But if they could examine the synapses connecting your hair cells to your auditory nerve, they would see that there are a lot of synapses not firing properly or at all now. This is known as hidden hearing loss.
Your dynamic range has collapsed even more than it was before this incident. Thus louder sounds go through the top of your dynamic range and hurt. The secret is not to avoid all sounds, just the louder sounds. You want to push the upper limits, but not so much that it hurts you.
I don’t think you have any fractures or TBI or that kind of thing.
I also don’t think you need further testing as such. You already know what the problem is. You need to rest your ears–protect them from louder sounds. Maybe you need your hearing aids adjusted. They should have been set to limit the “shouting” to a level that would not have hurt your ears. Get your audiologist to check this out and set them properly for your hearing.
You might also want to read my recent article on hidden hearing loss. It will help you understand what goes on behind the scenes. You can read it at http://hearinglosshelp.com/blog/hidden-hearing-loss/.
Cordially,
Neil
Thank you for your response. I am copying the article you referenced. A tricky question: if my current job is to be on the phones 90% of the time, 7 hours a day, using the telecoil, there is often unpredictable loud sounds that come in such as fax machines, angry callers, people calling from their cars on the highway, etc. Wouldn’t I be risking more damage or sensitivity due to this unpredictability? Also, hearing aids have a noise dampening feature for loud unexpected sounds, but does this function while using the telecoil feature?
Hi Karen:
Any noise dampening features in your hearing aids should work just as well in T-coil mode as they do in microphone mode. They just have to be set up properly. Since different memories can be programmed differently, the memory you use for T-coil mode may not be programmed with proper compression to compensate for your hearing sensitivity.
You need to get your audiologist to “screw down” the compression to a level where louder sounds do not bother you, yet amplify softer sounds enough that you can hear them well.
Cordially,
Neil
Hello again, have shared your articles with my physicans and attorney. It comes in handy when trying to explain why the “audiogram didn’t change.” Now some direction about treatment. Can you reference some recent research about treatment for Hyperacusis and (worsened) tinnitus? I’m doing research myself, but most of it is way too neurologically descriptive. Where are the “Hyperacusis/tinnitus expert centers” I could contact for information? Specifically, I’m sure WC would want to know what is the treatment, how long does it take, how effective is it. Leads appreciated.
Hi Karen:
Probably the best tinnitus/hyperacusis clinic is run by Pawel Jastreboff down in Atlanta, GA.
Cordially,
Neil
Hi Neil,
Reading some of the comments on here has helped me a bit to not feel so distressed about this hyperacusis but I hope you can explain to me exactly what’s going on with my hearing and whether or not I’ll recover from this.
The background to this is that six months ago I sustained a concussion. I had post-concussion symptoms for several months, and one of those was that my ears became sensitive to high-pitched noises. All normal noises were fine, except for occasionally the high pitched beeps on my cooker would feel as though they were piercing into my ears. Nothing major. Then just over a month ago I attended a concert, and mistakenly forgot to purchase ear plugs. The actual volume of the concert seemed ok but there was one part where the guitarist was playing some particularly high pitched notes, and this felt like it was penetrating my ears. It probably went for about a minute. I didn’t experience any problems after that, or the next day until I got on my flight home and the plane engine was extremely loud in my ears! My ears felt kind of blocked after that and the ‘ding ding ding’ noise that they play in the plane to get your attention felt high pitched in my ears too (whereas I hadn’t experienced these problems the previous day when I flew to the concert). Still, I experienced no problems with normal sounds and the high pitched beep on my cooker only bothered me occasionally.
Now, two weeks ago I bumped my head again very lightly but hadn’t noticed anything in particular with my hearing except the usual being sensitive to high pitched noises, which I’ve been trying to avoid. I seemed to be fully recovered from the very minor concussion apart from the high pitched noise thing. But two days ago my washing machine went completely stupid as I had loaded it with one heavy item which started to bang around heavily and vibrate very loudly. It was so loud it vibrated into my head. It made me tired and I just didn’t feel good. Ever since then, my hearing is extremely sensitive to normal everyday sounds. I made some bread in the bread maker yesterday and the whirring of the breadmaker made my ears feel hurt. At one point last night the sensation completely went away, until I heard a high pitched noise again.
Today if a bus rumbles past my house I can kind of feel it vibrating. I will of course visit my doctor but right now I’m scared to get on a noisy bus to actually go there.
My question is, what sort of damage has been done, and will this eventually go away? Is it a concussion problem, an ear problem, or both? Also, I’m supposed to attend a concert in two weeks, and then another one four weeks later (which also involves flying – loud plane engine). I’m probably going to skip the first of these concerts now, as I know it will be loud and high pitched. The second one, in six weeks’ time, is worrying me now. Will it be safe to attend it if I use ear plugs, or am I better off to not attend it at all? Is six weeks too soon, even with earplugs?
Music is a big part of my life and if it’s still possible to safely attend live events then I would still like to maintain this part of my life. The question is whether it’s possible to do this without worsening this problem? I find all of this very scary.
Thank you very much for any help you can give me!
Also, apart from the issue of music and attending concerts, my main concern is whether this whole issue will improve so that life will be normal again? I’m so worried. Thank you very much!
Also, sorry for all the posts, but I wondered if it’s a good sign that there was one point last night where my ears felt completely better? (However the symptoms have come back again).
Sorry again for all the updates. Tonight it improved a lot! But now that it’s later in the evening my ears feel a bit sensitive again. Can this problem clear up quickly in some cases? Thank you!
Hi AB:
I suppose it is possible, but don’t bet on it. It normally takes a number of months or even years to get back to normal again.
Cordially,
Neil
Hi AB:
It’s always a good sign when you ears go back to feeling completely normal again. But just because your ears feel normal for some hours doesn’t mean that the problem is cured. You will have some good days and some bad days. Over time you can expect the good days to begin to outnumber the bad days.
Cordially,
Neil
Hi AB:
Yes, you can do things to get your ears back on track. You can be normal again.
Cordially,
Neil
Hi AB:
Sorry to be so long in getting back to you, but I had some issues and thus fell way behind in answering. I’m trying to get caught up now.
Hyperacusis commonly happens when you have ear trauma such as exposing your ears to loud sounds. It could also have happened because of your concussion in this sense that banging your head vibrates your middle ear bones just like exposing your ears to a very loud sound. So you might think of concussion as causing the same kind of damage as loud noise.
Let me say here that you can treat your hyperacusis successfully and in time get back to normal hearing again. That’s the good news. It will take time and effort on your part, but you can do it.
Part of the secret to doing this is to protect your ears from loud sounds that cause your hyperacusis to get worse, but never, and I emphasize never, over protect your ears when you don’t need to. This will just make your hyperacusis worse.
Another thing you need to do is always work to expand your dynamic range again so that you can stand louder sounds. In other words, you are always pushing the envelope to get your hearing back to where it used to be.
Furthermore, you always want to be listening to sounds. Do not live in silence. You may want to listen to background music, background TV, pink noise, white noise, environmental sounds on CDs etc. You want to do this all the time while you are recovering.
You need to read my new book on the subject. I was hoping to have it out back in March,, but health issues and other things prevented that so it is still only half done. I still need to do more research, but I know you can be successful.
You would do well to read an article that a young man (Adam) wrote about his experience with hyperacusis. Eventually he did things right and today his hearing is back to normal. It is a 2-part U-tube video that starts at https://www.youtube.com/watch?v=9vcApqcbrtc .
You can still listen to and enjoy your music–but you will always hawe to be careful of your ears and NEVER listen to loud music without ear protectors to bring the volume down to 80 dB or below. And really loud music will vibrate your skull and you’ll hear via bone conduction, even with ear plugs in. If this is a problem, then you will have to avoid venues where there are such loud sounds.
Cordially,
Neil
Dear dr Bauman,
Almost 6 weeks ago I got tinnitus and hyperacusis after the new alarmsystem (120dB )in my house went off. I think it was no longer than a couple of seconds but unfortunedly I ended up with ringing in my head and hyperacusis. After a month of depressed feelings and emotions, I bought your e-book about Tinnitus which really helped me a lot. Thank you for that! I now know that my ears need a lot of time to heal and that I must try not to pay intention to the tinnitus (which sometimes still is hard to do). After 5 weeks I noticed some change: my tinnitus has become intermittent. Sometimes there is a day where the ringing is nearly gone. The next day it’s there again. Do you think it’s a sign of healing? And when it is a sign of healing, why is it that another day I wake up with tinnitus again. It isn’t because I pay more intention to it or that I’m stresssed out or something. I simply just wake up with more ringing than the day before. Or I wake up with no ringing at all. I don’t know what the cause is. Is the intermittent tinnitus a possible sign that it might be temporary eventually? Thank you for your answer!
Hi Marian:
I never sayignoring tinnitus is easy–I just say you need to do it. And I think you are doing well. Any time your tinnitus becomes intermittent, I think that is a very good sign that you are getting your tinnitus under control. Hopefully as the weeks pass, you’ll find more and more days without tinnitus, and with softer tinnitus as well–but some days will be bad. Don’t worry about them. They are not really setbacks–unless you exposed your ears to loud sounds–but just part of the healing process. That’s how it works for some people. Focus on the good days.
Cordially,
Neil
This is a similar case to mine.Some mornings I wake up with no T other mornings with high T.I thing it depends if you wake up after a heavy sleep or light sleep. In my case if I wake up without T and try to sleep for extra 5 minutes it goes High again.
Hi Neil,
I wrote to you in the last week because I had terrible sensitivity to normal sounds after my washing machine got extremely loud (banging and vibrating) just over a week ago. It’s calmed down a lot since then but very loud noises still seem very loud and I’m trying to avoid and/or protect from them. High pitched noises are still hurting my ears., but normal talking and cars going by is ok now.
I’m so worried about this getting worse again, especially since I know it hasn’t totally healed yet. The thing is that I’m supposed to go to a loud concert in a week from now and I’m totally freaked out about it.
I was going to buy some earplugs today but they had a warning on them saying that removing them too fast can damage the eardrums, and I’m worried about using them now.
I also have a question. Will earplugs block out high pitched sounds? Even quiet high pitched sounds are troubling me, and this concert I’m going to includes flute and electric guitar. I don’t want to attend it if earplugs won’t protect my ears from high pitched sounds. Basically I’m highly anxious about causing damage. I’ve also felt tired since this happened just over a week ago and it’s got me wondering whether the loud sound could have caused any other health issues or worsened a previous concussion.
Can you help me with any advice?
Also my hairdryer triggered some tinnitus the other day which hasn’t fully gone away yet. Do you have any advice on this?
Thank you!
“AB”
Hi AB:
It’s good that your ears are calming down. That is a very good sign.
The secret to removing earplugs is to do it very slowly and let some air sneak past them to fill the vacuum behind them when you pull them out. If you just yank them out quickly, you create quite a vacuum that sucks your eardrum out. As soon as the air rushes in, your eardrums snap back. The result is just as if you’d experienced a very loud sound or an explosion. Hence the need to slowly let the air sneak past the ear protectors into your ear canal. This only takes a second or so. We’re talking about slowly slowly slowly.
Most common ear protectors block low-frequency sounds more than high-frequency sounds because most of the energy is in those low-frequency sounds. Musicians ear protectors, on the other hand, allow all frequencies of sound to go through but at reduced volume.
Hair dryers are notorious for producing loud high-frequency sounds. So if your ears are particularly sensitive to this frequency of sound, it would be good to wear ear protectors when you are using the hairdryer, especially because you use it so close to your ears.
Cordially,
Neil
An update to my previous post and I really hope you can help me. I had a hearing test done and it turns out my hearing is very good – however the audiologist did diagnose me with hyperacusis which she says is probably from my concussions, as there is no damage to my actual ears. I was recommended musician earplugs for attending concerts, so I purchased some pricey ones today and tried them out. HOWEVER, I only had them in for about 30 seconds (with no loud noises around me, only one person talking) and when I took them out my hyperacusis had worsened! I had improved by a huge amount in the last week, but after using these musician earplugs for 30 seconds I am worsened several hours later – it feels as though my ears kind of hurt and normal talking is loud in my ears. I’m so upset about this after I had made good progress! If the recommended earplugs make me worse, then what am I supposed to do? Would foam earplugs (that basically block all sounds by 30 dB) be better than the musician ones that allow you to hear music and talking clearly? I’m extremely confused and I need some advice. I’m supposed to be going to a concert on Tuesday and I’m very worried because of all of this. I’m considering trying to see a neurologist this is worrying me so much.
I really hope you can answer and give me some advice.
“AB”.
Hi AB:
Most audiologists only test your hearing to 8000 Hz, yet hearing typically goes up to around 20,000 Hz. Thus, you could have a significant hearing loss in the very high frequencies, yet your audiologists tells you that you have normal hearing, when in fact, you really have a significant loss in the very high frequencies.
Another thing that you may have, because you exposed your ears to loud noise that caused this trauma in the first place, is that you have what is known as hidden hearing loss. Hidden hearing loss, as its name suggests, does not show up on conventional audiograms. Therefore your audiologists could have erroneously told you that you have normal hearing when in fact you don’t. They have to do special testing in order to discover hidden hearing loss.
When you wear earplugs when you don’t need to, such as when you are just talking to one person in a relatively quiet room, your brain turns up its internal volume to try to hear better. The result is when you remove the earplugs, all of a sudden everything is too loud. In other words, you just made your hyperacusis worse. That is why it is important to only wear earplugs when you actually need them and take them out as soon as you no longer need them.
personally, it doesn’t seem right that musicians earplugs caused her hyperacusis to get worse after wearing them for only 30 seconds, unless you suddenly yanked them out rather than pulling them out slowly.
Cordially,
Neil
Hi Neil,
Thanks so much for this page and all your work writing detailed responses.
One week ago I attended a business dinner at a restaurant where they put about 25 of us in a small room. I found it incredibly loud, and left as soon as I could. But when I left I knew the damage was done; my ears were on fire and my hearing was shot.
Since then I’ve been reading about hyperacusis and realize that not only does it fit my symptoms now, but I’ve had it for 20 years. When young I use to crank the music and developed a high sensitivity to loud sounds in my right ear (hearing tests at the time indicated no loss). So from my own experience I know that my sensitivity has gone up and down over the years. I’ve been pretty darn careful with my ears since, covering them around loud sounds, bringing earplugs with me during travel, etc. But this dinner was an example where my obligations ran up against my body. Also, I now understand why it was loud for me but nobody else seemed to mind.
But since last week I have had pain in both ears and very high loudness sensitivity in my right (not just clanging dishes, but conversation, lawnmowers outside, etc.). The pain has settled a bit on the left, and I have an ENT appt next week. I plan to follow your advice re protecting myself from loud sounds in future, am keeping ambient sound going all the time, and will try and end up with a hyperacusis specialist somehow.
My questions for you are about earplugs and sleeping. For several years now I have been wearing earplugs during sleep. I also have a fan running in the bedroom to further mask sound. (This is all to mask sounds around me so I don’t wake which used to be a problem) So I’m wondering: 1) has wearing these earplugs every night exacerbated my problem/sensitivity to loud sounds? and 2) should I try to wean off the earplugs during sleep now? What if I had some pink noise going next to me while wearing the plugs at night?
Thanks,
joe
Hi Joe:
I would say that wearing the ear plugs while you are sleeping is definitely a bad idea and could well have contributed to your worsening hyperacusis. On the other hand, having a fan running (or other constant sound source) while you sleep is definitely a good idea in terms of controlling your hyperacusis.
I would not use both noise and ear plugs at the same time at night. Just have constant sounds that are not too loud that they bother you, but loud enough for you to hear while you sleep.
Typically, you want a sound that is meaningless to you so you don’t focus on it. Or you can use pleasant fractal music–because fractal music never repeats itself so you don’t tend to focus on it like you would with a familiar piece of music.
Cordially,
Neil
Dear Neil,
Please I need your help can you tell me whats happening to me?
Well basically i took your advice and i went to a hyperacusis specialist.
I went here exactly:
http://www.eardoctor.org/conditions-and-treatments/other-conditions/hyperacusis/
It’s a rich area where I saw a Audiologist, and a Neurotologist. The exam cost $550 for a hearing test and hyperacusis/tinnitus assessment.
I need help badly. I’m confused. I took youradvice and went to a hyperacusis specialist (Shohet Ear Doctor Assosicates the link above) I went to their Seal Beach Location and had a hearing test and a hyperacusis/tinnitus assessment.
What they told me exactly after the hearing test and hyperacusis/tinnitus assessment is that I don’t have any hearing loss and i don’t have any damage to the hair inside my ears. They told me to stop wearing ear plugs when I go outside that its making my ears more sensitive to sound. (I know this goes completely against your advice Neil that I should wear ear plugs when going outside with noises 85db or higher) I don’t know I followed the Hyperacusis specialist advice though anyway she said to stop wearing ear plugs and you need to get use to the sound outside and something like your brain has lots of plasticity and you’re young (I’m 26).
So I took the Hyperacusis specialist doctors advice I stop wearing ear plugs for 4 days and went outside without ear plugs and lived my life like i didn’t have hyperacusis. The pain was really bad when going outside and hearing loud noises, trucks, car mufflers, babies crying, but i done it anyway for 4 days then i decided to stop after 4 days because the pain was too bad. (I never wear ear plugs inside the house just ear plugs when i go out… I took the doctors advice to not wear ear plugs going outside for 4 days).
Ever since going outside without ear plugs for 4 days I notice now i can’t talk louder then a very low whisper or i get extreme ear pain. I perfer to actually just not talk at all now. And my sensitvity to sound has gotten worst its like some louder sounds i can tolerate but its weird like when i hear a car coming by quietly it gives me a weird soft pain and a shock in the head.
I’m really sad because I can’t talk louder than a very low whisper or get extreme ear pain before i could talk normal sorta maybe talk slightly lower than normal but i could talk. Now i cant talk other than a very low whisper or extreme ear pain. I can tolerate some sounds but some reason when some sounds are sort of quiet like a car coming by not with mufflers or anything just coming by kind of quietly it seems to give me a weird soft pain and tremor in my ear and painful shock in my head.
Was I wrong Neil not following your advice? Your advice of wearing ear plugs and avoiding sounds 85db or higher and to listen to white noise and slowly bring the knob up etc. I took the hyperacusis specialist doctors advice to not wear ear plugs anymore when going outside or to not wear them anymore in general because they said i didnt have any hearing loss or any damage to hair in my ears and nothing mechncially wrong wtih my ear they said.
I don’t know what to do i followed the hyperacusis spceialist doctors advice because you recommended i go see one asap. Their advice was different from yours.
1) What is happening to me? 🙁
2) What do you recommend I do?
3) Should I go back and see them again? Do you think they gave bad advice and i should go see a different doctor they dont seem to know their stuff? (Their advice was complete opposite from your recommendations).
http://www.eardoctor.org/conditions-and-treatments/other-conditions/hyperacusis/ (I went here to Shohet Ear Associates in their Seal Beach Location in California.)
Hi Aaron:
Sorry to be so long in getting back to you, but I had some issues I had to deal with so I’m just way behind in answering everyone.
The place you went to, from their website, it appears they specialize more in tinnitus than in hyperacusis. Furthermore, it appears that they use basically the same treatment for both tinnitus and hyperacusis, and I don’t think that’s the best approach.
I disagree with their approach, telling you not to wear earplugs when you’re in environments where the sound is greater than 85 dB. The proof of this is that you didn’t improve when you follow their advice.. In fact, things got worse. Therefore, I think what you were doing before is the right approach, when you’re in loud sound environments where ear protection enough that it brings the sound down to below 80 dB or so.
It’s very true that if you over-protect your ears, you are going to make your hyperacusis worse. I guess the difference between us is that their idea of loud environments is a lot louder than what I believe is safe when you have hyperacusis.
Another thing you should be doing, is always exposing your ears to sound. For example, you could listen to pink noise or white noise or to TV or MP3 player or whatever. What you want to do is listen to it at a level that does not cause you distress. Then you want to slowly increase the volume–this is over weeks or months–so that you can expand your dynamic range again. In time, you should be able to stand louder sounds without distress.
I think another thing you should modify is exactly when you wear your your protection. Just because you are outside doesn’t mean you need ear protection. You only need it when you’re around louder sounds. Furthermore, if you are around screaming babies, even though you’re inside, you need to wear your ear protectors at that point.
I don’t think the place you went to really understands how to properly treat hyperacusis, so I wouldn’t go back there again if I were you.
How is your hyperacusis doing now? Give me an update.
Cordially,
Neil
Hi Dr. Bauman,
A week ago I suffered from an acoustic trauma while deflating an aircraft tire. The sound of high air pressure made my right ear, which was nearest to the valve, irritating after 4 minutes of exposure. As soon as the irritation set in and became uncomfortable I stopped and put some ear plugs. Unfortunately the damage had been done by then. I felt my right ear blocked and pressurized, same feeling you get in an aircraft during climb. That pressure/ear fullness discomfort had reduced significantly a day later but I’d say fullness was there by 10-20% compared to my left ear which was crystal clear. I visited my GP the next day who ran an inspection of both ears. He told me both ear drums looked shiny and no perforation was visible, which was a good sign. He told me not to worry and wait for a week as it might get unblocked by itself. A day later (48 hours after the incident), the miracle happened. My right ear felt clear and nearly as perfect as my left one. I was over excited and thought everything was back to normal. I noticed though that I was quite sensitive to high frequency sounds and loud noises, (plates shuffling, sirens, doors slamming etc). My ear didn’t like loud noises and was getting stuffed again every time one was nearby as a response to it. The very next day I accidentally kicked a plank wood which was on the floor which in turn hit a wooden door in close proximity. The noise from the loud bang had as a result to clog my ear once again and pressure and fullness came back this time only to remain for the past 6 days with no improvement what so ever. I visited another GP yesterday who also had my ears checked and told me that my right ear drum looked slight dull. He referred me to an ENT specialist which I should be seeing in two weeks’ time.
I have also observed that when I put wax ear plugs and keep them for a long time, as soon as I take them out my right ear feels clearer, only to feel clogged again couple of minutes later. Sometimes I get my left ear (the good one) to slightly feel pressurized more than the right but it returns to normal. The bottom line is that my right ear feels full by I’d say 10-20% and lacks the clarity my left ear has, sounds are more muffled in general. Sound sensitivity also still remains. Am I suffering for a permanent hearing loss on my right ear? Are there any chances of things getting any better?
Many thanks for your time
George
Hi George:
When you exposed your ear to the air coming out of the tire, you suffered a temporary threshold shift. That’s just a fancy way of saying you have a temporary hearing loss. That’s why your ear felt stuffed or clogged. It’s not that you ear is physically clogged with fluid, but it’s a sensation you have when you have a sudden temporary hearing loss.
When you’re hearing returns, the clogged feeling goes away. however, at the same time the acoustic truck trauma caused two things. One is hidden hearing loss, so it doesn’t affect your audiogram,, but it is there nevertheless. Second, it made your ears super-sensitive to normal sounds such as sirens, doors slamming, dogs barking and so on. This is called hyperacusis.
Unfortunately, the second episode with the plank just made things worse. It’s like getting a bruise one day, and then the next day accidentally whacking the bruise again. You just compound the problem.
Since sounds still seem muffled, that indicates you still have a hearing loss. This may be permanent loss rather than the temporary threshold shift you had at the beginning.
How is your hearing now since it’s been a few weeks since this happened?
Cordially,
Neil
Hello,
About four years ago I was listening to music with headphones and heard a popping noise in my ear, which resulted in discomfort and a feeling of fullness in my ears for a few weeks- my ENT said I had an acoustic trauma. From this point on, whenever I was working in the studio for long hours or at a concert my ears would get a little tingly afterward, and I could experience that feeling of fullness. I was often able to gauge the ‘tipping point’ that it was a completely manageable situation.
About three or four months ago, after several weeks of studio time and a loud concert, I felt the same intense feeling of fullness and now pain in my right ear to the point where I couldn’t work on music. I immediately stopped and over the course of a few weeks allowed my ears to heal. During this time, I experienced pain, discomfort, a feeling of fullness and itchiness in my right and sometimes left ear. I couldn’t listen to music on speakers and the sound of cutlery on plates or unexpected impact sounds could trigger those feelings again. Went to an ENT and Audiologist for tests – my hearing was fine, no tinnitus or any ears problems they could see. Eventually it went mostly away and I could work on music for a few days – then one night I wore headphones and bam, the same thing happened.
I’m now back to square one with the same kind of uncomfortable feeling in my ear, which can extend all the way down my neck too. It REALLY sucks because I love music and making music. I can also hear a little bit of ringing in my ears sometimes, but nothing severe – I imagine it’s some low-level tinnitus. The tinnitus can be triggered by sounds.
Just wondering what the next step is here – I can just avoid music for a while, but what happens if it return to listening to music (at a moderate level) or hear a loud sound in a few months’ time and relapse? I figure I have some kind of hyperacusis or tensor timpani syndrome – really aggravating stuff. Listening to music on speakers for 30 mins caused a lot of pain for me just the other day.
Hi Dan:
Your symptoms certainly sound like you have hyperacusis resulting from exposing your ears to excessively loud sounds for long periods of time. You basically have to tone it down–not stopping listening to music, but keeping the volume down to the same level as you hear people talking. There is no need to listen to music any louder than that.
Your ears are pretty sensitive now, so you want to be careful not to expose them to louder sounds until the heal–and that could take a number of weeks or months.
You also no doubt have hidden hearing loss from all the noise damage your ears have incurred. This hidden hearing loss doesn’t show up on audiograms–hence its name, but you can notice its results when you have trouble hearing people speaking in noisy situations.
Cordially,
Neil
Hi Neil ,
3 days back during a fire drill after the fire alarm went off , i was exposed to the loud sound for 40 seconds or so after that i did not feel anything untill that night i woke up with a ringing in my ears and it it went away and after that i went to see a ENT doctor everything was but i had minimal hearing loss in right ear and nothing in left ear for the last three days i have got extreme sensitivity to some frequencies of sounds like horns , AC machine sound and wheel screeching sounds , cutlery sounds and the ringing in my ears is no more but this sounds are driving me nuts any help or suggestions?
Hi Sravan:
The fire alarm caused your ears to suffer from ear trauma. The result is that now you have hyperacusis and are super-sensitive to certain pitches of sound. Normally, you can expect that this sensitivity will slowly go away. It just takes time. Give it several months.
In the meantime, you want to be careful not to expose your ears to loud sounds. You need to give your ears a chance to heal. Don’t overprotect them though or you’ll make things even worse. Just protect them from sounds that cause you to wince or jump.
Cordially,
Neil
Hi Neil,
I hope you are well,
I just came across this blog post and wanted to get your input on my condition.
I had a noise traumatic experience about a year ago and since then, I have experienced sensitivity to mainly the sound of car brakes which almost makes me “aware” of a certain car when it slows down.
Almost like a startle but not quite as bad, my hearing feels a little distorted by a particular frequency I guess.
I experience no pain in the ears or tinnitus, just higher frequency sounds that startle me as outlines above so I guess this is kind of mild compared to what I have read.
I have since then unfortunately begun to anticipate sounds before they happen , almost like expecting cars to cause this startle as I know this sound is what will most likely make me jump..
While I started to improve, after my holiday I noticed a little sensitivity crept in despite my best efforts to protect my hearing. So the cause of my sensitivity creeping back in is a little of an unknown!
Is this something you would call sound sensitivity or tonic typani synrome? I’m not entirely what is the difference.
Will time help me improve in this , or do you think or would listening to these offending noises over and over again help desensitise them?
Would be interesting to hear your thoughts on this.
thanks
Thomas
Hi Tom:
I think your noise trauma resulted in hyperacusis. That is why you are sensitive to certain sounds like car brakes squealing.
Now comes the insidious part. You are anticipating these sounds and thus you are becoming more and more sensitive to these sounds. This is just making things worse.Next you will develop a dislike to this sounds and then an aversion and then avoid them.
You need to nip this in the bud while it is still relatively easy to do. Treat this sounds like any other normal sound–just accept that they are louder than normal–but it is no big deal and go on with your life. In other words, don’t think of these sounds as being a threat (mild mind you at this point) to your well-being in any way.
I don’t think your problem is so much needing to protect your ears (although you do need to protect your ears from loud sounds), but your emotional (psychological) response to hearing those sounds.
To answer you question–this is sound sensitivity (hyperacusis), not TTTS.
Listening to these sounds over and over may desensitize your response to them, but only IF you have your emotions under control so you don’t consider them a threat to your well-being and something to be worried about or afraid of. THIS is what I think is making things worse for you and what you need to work on.
You don’t get “upset” when some unimportant sound comes on such as the sounds your fridge makes. Rather, you totally ignore them. Do the same with your brake squeals. Make it a non-issue.
Cordially,
Neil
Hi Neil,
Many thanks for your response.
Yes I would definitively say a majority of my sensitivity comes from my emotional response to car brakes and higher frequency sounds.
My main issue is that I am unsure of when sounds are too loud (e.g dogs barking, car horns) and when they actually are dangerously loud.
For example I have a friend who has a dog that barks a lot, I got very nervous when I was over there causing me to put my hands over my ears.
The same went with a car horn that beeped right next to me, my fear of ear damage has made me very wary of doing anything in the outdoors – which I know is not healthy!
Do you believe that given time of accepting these noises, my sensitivity will slowly fade or does something like this stay with you forever?
Many thanks,
Thomas
Hi Thomas:
The easy way to know whether a sound is ear damaging or not is to use a sound level meter. There are a number of apps for smart phones that are pretty good (and free). Just keep sounds below peaks of 85 dB or so and you should be good. That means that a car honking close to you, or a dog barking close to you would exceed those levels and you should put your hands over your ears, but more distant sounds should be ok.
And yes, when you mentally accept that certain sounds–although they sound too loud to you–are not dangerously loud, then you will slowly lose your sound sensitivity. It should not stay with you forever–unless you continue to see such sounds as a threat to your ears/sanity.
Cordially,
Neil
Hey Neil,
I have always taken care of my senses, however a week ago me and a friend did something really stupid. I’ve realized playing with explosives is never good, even though they are just firecrackers. I did protect my ear with my finger, however as the firecracker didn’t go off, I let go for a few seconds, which was when it decided to go off. My friend had experienced with a similar explosion earlier and measured 128dB, which is somewhat similar to what I experienced in my right ear.
Anyways, here I am, a week later. My ear is ringing, it’s disturbing my sleep, I’ve been depressed the whole time.
I decided to go to the doctor the day after the event. He sent me to the hospital for hearing tests. It looked normal, my hearing was actually pretty good, though I know from hearing tests online, I can’t hear over 11000Hz on my right ear. I have had tinnitus since the event, and it has really been tearing me apart. The doctor told me I might have permanent tinnitus, and that if I’m not better in two weeks, I should contact them for a “tinnitus talk” with an audiologist I believe. Only time will tell I suppose.
After the explosion, everyone told me I would be fine, just give it some time. My doctor, family, friends, etc. all told me I would be fine. I didn’t believe them. I was reading on forums every day, which only made it worse. Whenever I was stressed out, I tried finding support, however, it usually made it worse.
After reading your replies here, I have been feeling happier. It finally feels like hyperacusis is temporary, instead of permanent as everybody else says. I feel like I’ve had the right mindset the last few days, by exposing myself to normal noise, I never use ear protection except when it is loud enough to damage ears. I went to a movie with a friend, and it was so loud that I left. I could handle the sound, but it was too uncomfortable. I left the movies and explained why to my friend. He understood and agreed that the movie was very loud, and I’m glad I left. It’s not like these sounds are painful. They are just annoying. They kind of trigger my tinnitus, making it louder and higher frequent. Anyways, it hasnt been long after the incident, and I still believe there is a chance it might get better soon. Keeping a strong mind and staying away from negative thoughts is really the best treatment yet.
My hyperacusis is nowhere as bad as many of the people here. As I mentioned, It’s just annoying, it’s stressing, causing tension, but not directly painful. I try to stay positive, I’m only 18, and hopefully have a long life in front of me.
I have a question:
How loud should the pink noise be? I don’t want any more hearing damage, but I want to get better, and being in a quiet enviroment doesnt help either.
Thank you for calming answers. I’m really hoping this turns out well. It must turn out well.
Hi Simon:
When you expose your ears to sudden loud sounds like you did, it’s normal to get tinnitus and often hyperacusis. But you’ll also have done some permanent damage to your hearing although it didn’t show up on the hearing testing you had. That’s why they call it “hidden hearing loss”. You’ll notice it in noisy situations where your ears cant pick out speech from the background sounds like you once could.
You want to be very careful of your ears for some months now to let them recover. Going to a loud movie wasn’t a wise decision, but it was wise to leave when you realized that the sound was too loud. You don’t want to “push the envelope” but be more conservative it what you consider loud during this time.
By focusing on your tinnitus, you are just making things worse. Learn to totally ignore your tinnitus as much as you can. But what is critical is not thinking of your tinnitus as a threat to your well-being in any way. If you think your tinnitus will affect your mental/emotional health and thus stress out about it, you will only make it worse.
To reduce the contrast between silence and your tinnitus, listening to sounds–and pink noise is a good choice if you like it–is a good choice. You don’t need to “drown out” your tinnitus as that could be exposing your ears to too much sound. A good rule of thumb is set the volume no louder than you hear people talking. But you may find that you don’t even need it that loud. You just need it loud enough that it helps take your mind of your tinnitus. Then focus on the loves of your life and let your tinnitus fade into the background.
Cordially,
Neil
Hi
I have developed tinnitus 2,5 months ago, and shortly thereafter hyperacusis in a milder degree. I have been advised to use sound enrichment during the night which i have done for the last 6 weeks or so…..yesterday i noticed my hyperacusis have gotten worse all of a sudden, even clicking the mouse on laptop or turning a page in a book or magazine fast, gives me a little pain in the ears…..louder sounds, clacking dishes ect. makes me cringe and is a more sharp pain.
I am beyond scared, and feel like my life is spiraling downwards….i dont even feel like being social anymore, because i feel like a burden to people when i have to tell them to be quiet and lower there voice around me.
Will it get better in time??
Hi Sandra:
What happened 2.5 months ago that resulted in the tinnitus and hyperacusis?
Are you taking any drugs or medications?
How bad is your tinnitus? Is it so loud it prevents you from sleeping without sound enrichment?
Was there any changes in the past week that might have accounted for your hyperacusis getting worse? Did you expose your ears to any loud sounds or listen to loud music? etc.?
I need to know much more about your situation before I can help you.
Cordially,
Neil
Hi Neil.
a year ago, i’ve got ear pain in my ears and could not tolerate loud sounds anymore, been to 3 different doctors, including a special ear doctor. None of them knew what hyperacusis was, i first found out that it was hyperacusis around christmas time, and then I followed your advice after seeing you block in january this year, avoid loud sounds (80-85db+) and don’t use ear plugs, get lot of natural sounds and I hear around 2 hours of music every day around 60-65db. Some days the ear pain are allmost gone for a week then again I have ear pain for a week, and I still can’t tolerate plates sounds in a kitchen, many other sounds do bother me as well, I still think I only have low to a little more moderate hyperacuisis, when reading other stories on the internet how bad it can really get.
My story, for 2 and a half month up until i got this, I’ve heard headphones 2-3 hours every day with a volume on around 75-80%. It was full size closed headphones. I don’t think it was that loud, but it must have been enough, anyway I sold them and will never touch anything that goes in my ear with music again in my life.
The big question is, since I started having pain in my ear a year ago, I haven’t heard music over 85db, I bought a sound meter to mesaure how loud I hear music, it’s only around 70-75db when loudest on normal speakers.
Will this pain ever go away, or at least get 50% or so better with time, and will I be aible to enjoy louder sounds with time?
I hate avoiding clubs, cinema’s, and such things, I will probably by some special ear plugs for those occasions soon, but it still anoying, to be so aware of it all the time, even in less noisy enviroments that diden’t bother me at all before that.
I heard you said it can take years to get better, but if it is so I will just wait, the are no places to go in my country Denmark for a threatment for this I think, I guess I just have to wait and see?
Thanks.
Hi TK:
You are doing a lot of things right. But you have to overcome all the abuse your ears have received over the years from noises that were too loud. So this can take time.
As you understand, it is a combination of protecting your ears from louder sounds, giving them adequate sounds all the time, AND having the right mental attitude towards sounds that are not too loud–no matter how loud you perceive them. When you mentally adjust to the fact that sounds less than 80 dB are not dangerous to your ears–even though they may seem so–and thus you learn to accept them, then you are well on your way to recovery.
I see good things in your future since you already have gotten to the point that a week can go by without problems. You have good days and not so good days. This is normal. Keep working on having more and more good days, and fewer and fewer bad days as the months go by.
You may always be more sensitive to certain sounds, but hopefully, they will not be as bothersome as time goes by.
Cordially,
Neil
Hi,
I walked right by a fire alarm 2 weeks ago. My right ear got very sensitive to high noises from like spekars or my cell phone. I did not experience hearing loss, but the inside of my right ear got red and irritated. What do you recommend?
Hi Gabriel:
Protect your ears from loud sounds in the future and give your ear time to recover. It can take some weeks or months for the sound sensitivity to go back to normal.
It’s always a wise idea to cover your ears with your hands when near fire alarms that are ringing so such things don’t happen in the future.
Cordially,
Neil
Hi , 1st sorry for the bad English . 1 day I woke up with really sore throat and I notice my right ear is buzzing and feeling really dizzy (kinda lose balance) . So I went to see my GP next day he checked and say my ear is fine no infection . But he discribe amoxicillin for my throat . After taking the med for. Week my throat got better but my ear still feel pulsating ,hot and sensitive to sound like tv at mid volume I have to turn it to low like 4-5 ,or sound that high pitch like bowl hitting each other when doing dishes or cooking when metal scoop hit the pan . Iam really worry should I go see a specialist? It been 2 week since my ear start sensitive to sound .
Hi Paul:
What I think happened is that the cold virus attacked your inner ears and gave you temporary balance problems (dizziness) as well as distorting what you hear and making your ears sensitive to ordinary sounds. This sound sensitivity is called hyperacusis.
I doubt that going to an ear specialist will help much. He will probably say that you have hyperacusis–and send you on your way. You already know that.
If you sore throat is back to normal and the cold is gone away, the virus is probably long since gone so it won’t cause any more damage.
Typically, it takes time for the effects of hyperacusis to go away–several months or so, so you need to be patient. During this time you want to do a couple of things.
First, protect your ears from louder sounds–not the normal, everyday sounds that now seem too loud–but sounds that are loud. At the same time, don’t overprotect your ears by wearing ear protectors all the time or you will just make your hyperacusis worse. For example, if an emergency vehicle has its siren on, you can clap your hands over your ears.
Second, don’t worry about your hyperacusis and that normal sounds will damage your ears and make things worse. They won’t. But if you focus on this, your limbic system will take note, and it will be very hard for your hyperacusis to go away.
Cordially,
Neil
I have no hearing loss at all and have been tested a lot over the last 7 months. But I have a faint tinnitus and cannot tolerate loud noises. My children screaming, forks clainging hurt my ears. Even if I talk too loudly, I can get dizzy and my ears feel full. Can stress cause this?
Hi Sarah:
What you are experiencing is called hyperacusis, as well as tinnitus. Hyperacusis is often caused by exposing your ears to a single loud sound or a loud episode such as a concert, etc.
For example, if one of your kids screamed in your ear, that could result in hyperacusis.
Certainly stress can make it much harder to deal with your hyperacusis. You need to protect your ears from loud sounds and let them heal. It can take several months for this to happen. If you need professional help, see a tinnitus and hyperacusis clinic.
Cordially,
Neil
Hello! this is hard for me to write but i feel like i should start utilizing this forum as a resource. Here is my situation:
I live in Chicago and play guitar in a loud punk band. I almost always wear earplugs but i have traumatized my right ear from one time not using them. We played one gig where a PA speaker blew out and was about 10 feet away from my right ear, causing a little pain. Hindsight is 20/20 but i should have stopped the set to put in my earplugs. This was just around one month ago.
Sine then i have had pretty sharp burning earaches in the right ear, along with moderate noise sensitivity. At first I had really bad ear fullness as well. I went to the emergency room about three weeks ago. The dr said i had lots of fluid behind my ears and gave me sudafed. since then the fullness went away.
I saw an ENT and audiologist. The audiogram showed a slight dip in 4000hz in my right ear. i was told by the ENT that the earache should get better with time. Its not so much sound sensitivity that is my problem. its really the earaches. ive noticed some extremely minor tinnitus as well. the ent gave me a week long dose of steroids but they dont seem to have solved anything. i am going to have a follow-up this friday.
any advice on what to say to the ENT? is a month still too early to tell if im on the path to recovery? it is hard to tell at this point whether i am slowly getting better, or my anxiety over the situation is making everything worse. i have been avoiding loud noises,headphones.
Hi Jeff:
You ear has suffered noise trauma and it takes time to heal. You are doing the right thing in avoiding loud sounds and wearing ear protectors when you have to be in loud situations.
Noise damage can take time to heal–so give it more like 3 months before you worry about the pain not going away.
Cordially,
Neil
good advice! one other thing i forgot to mention. two things seem to make my ear feel worse: taking a shower, and not wearing a “beanie” hat over my ears. should i continue to shower less frequently and take off the hat? could these things my psycho-somatic? maybe wear earplugs in the shower?
Hi Jeff:
Wearing ear protectors in the shower would be a good idea until your ears can tolerate the sounds of the shower.
Wearing the beanie cap over your ears is another way of protecting them from louder sounds. You don’t want to do this unnecessarily or it will just make matter worse. Wear it only when you really need it (in place of ear protectors) since it works for you–but definitely don’t wear it most/all the time.
Cordially,
Neil
Hello again Dr Neil.
So it’s been three months since my noise trauma and I am still feeling intermittant pain. Is this still early? There are some days that are better than others. I cut my work hours to about half; I feel better on my days off. Is the fact that sensations are changing a good or a bad sign? I developed tinnitus about a month ago but that seems to have basically gone away. I’m able to watch tv and listen to records at a semi normal volume but there is still a constant pressure and sensitivity. Yesterday I was driving with my friend in the passenger side and I had to ask him to keep his voice down. I’m worried is that the noise exposure just totally burnt out all the hair cells in my cochlea and I’m stuck like this now. I feel like I’ve been robbed of being a musician, which is a huge part of my life.
Now that it’s been three months are there any suggestions you have for me. I’m not sure if my H is considered moderate or severe, since some days I feel like a normal person, while
other days I feel like I’m totally debilitated.
Thank you
Hi, stumbled across this site and just looking for info on Tinnitis, hyperacusis? And maybe effects of migraines on it all?
For a month or so I’ve noticed slight ringing in right ear, maybe due to a concert, maybe due to meds.
Last week or so iv let myself get too stressed out, anxious over a huge list of things (cancer diagnosis for my dad, work stresses, then 10 days ago a new baby who doesn’t sleep). Things were getting on top of me and last week I had booked an ENT appointment for today as i noticed tinnitus and a sound sensitivity.
Anyway, Sunday afternoon i developed a blazing headache. Very unusual for me, despite pills it got worse and worse over night, still there the next day. Last night i was feeling shivery and sick, today totally wiped out. I think I’ve got myself in such a state iv brought on this migraine.
ENT said it sounded like a migraine – my first one! Which brings me to the question, what is the hyperacusis sound sensitivity like? I’m having issues with certain sounds. It doesn’t frighten me or sound loud but i get what feels like a sound wave/pulse through my ears. Its not sore, its just this wave and happens with the sound. Same one as if I’m yawning/straining my jaws, sometimes even touching my face or even talking myself I get the same effect if that makes any sense? Its hard to explain. Don’t think ENT understood. Although he was very nice and has booked me in an audiologist appointment then follow up with him.
This noise sensitivity definitely started late last week a few days before the headache. I’m trying to work out if its all connected to my migraine debut and hopefully going to ease off/get better. Or if it is the hyperacusis?
I’m unconvinced or maybe just hopeful it is not hyperacusis as I seem to be fine out walking in loud environments, big vehicles anything going past. This is more sharp sounds in a quiet environment, and as I said, its not painful that people report, just more of a wave or pulse. I’m an engineer, not a doctor but if I hadn’t seen a specialist I would think this sound thing is related to congestion or something somewhere as I can make the same thing happen with a yawn, a movement of the jaws or touching my face, even without sound.
This sensitivity is worse than dealing with the headache or T, as I’ve got two young kids, so I’m a bit anxious that it is something which is going to affect me.
Also, note that last week when I was in full anxiety mode I went for a big swim as I usually do to work out my issues, and when I got home both the T ringing and the sound sensitivity were so much worse.
Sorry about the long first post.
Hi Chris:
Hyperacusis makes normal sounds louder and often much “sharper” so that, for example, when someone drops a spoon on the counter, you wince because it is so loud/sharp. Or you jump when someone shuts the door because it now sounds so loud to you–but no one else hears it an differently from before.
When you yawn, move your jaws or even touch your face, this is typically caused by a pinched nerve in your neck affecting the nerves in your head.
I think what has happened is that your tension has put pressure on your cervical vertebrae and they are a bit out of proper alignment. This, in turn, puts pressure on these nerves and now they are hypersensitive and send abnormal signals to your brain where they are interpreted wrongly as sound signals to some degree.
The “cure” is to relax and get the tension out of your head and neck, etc. You may find it useful to go to a chiropractor and/or a massage therapist to get the muscles relaxed and your bones properly aligned.
I think this is basically your problem and it is giving you all these different symptoms.
Cordially,
Neil
Neil,
Thanks for taking the time to get back to me. Before i had even read your response my wife had sent me away for 2massages to relieve stress. Im feeling much better. The tinnitus is greatly reduced and the sound wave i was getting is almost away. Iv also calmed down a good bit. I think stress had a hold of me.
The ENT has signed me up for an audiologyexam to check nothing else to worry about. I have noticed the last few days iv needed to have a good blow to repressure and clear my ears. Im not letting myself stress about that and am assuming its natural.
Chris
So I damaged my ears a few months back. I developed Tinnitus and Hyperacusis. And possibly hearing loss. It’s hard to say because my audiogram says I’m fine but one ear doesn’t hear soft sounds while the other does. Go figure. But I’m over the whole doom and gloom that Tinnitus, hyperacusis and this so called hearing loss give.
My Hyperacusis and Tinnitus have gotten a lot better. My Tinnitus went from intrusive being heard over everything to a nice baseline which is masked easy but spikes slightly with sound and coffee. (I refuse to give up coffee. Or any foods for the matter. Since alas I know theyre always temporary spikes.) My Hyperacusis has decreased a lot, going from severe to a high mild which I’m quite thankful and happy about. But I was wondering if it’ll ever go away ON ITS OWN to a point where I only notice it when sounds are very loud? Or if to reach such a level I’ll need TRT?
I must say Tinnitustalk has helped me quite a lot in my journey. I’m new here. Infact this is my first post.
🙂 Please respond.
Hi Taylor:
It looks like you are well on your way to recovery–both from tinnitus and hyperacusis. I don’t see any reason that your hyperacusis won’t keep on reducing over time and eventually you’ll not notice it. This assumes, of course, that you protect your ears from loud sounds in the future, or else it can come back with a vengeance. And when that happens it takes even longer to get it under control.
Also, you want to basically ignore your tinnitus–treat it as a useless and meaningless background sound. With your hyperacusis, you want to slowly expand your collapsed dynamic range–emphasis on the slowly. And don’t become anxious/afraid of the louder hyperacusis sounds. If a certain sound bothers you, it is so easy to become annoyed then afraid of it and this just makes things much worse.
So protect your ears from loud sounds, but do not overprotect them or wear protection when you don’t really need to, or you will make things worse.
I wish you well.
Cordially,
Neil
So, i have tinnitus since i was a kid (now i’m 22). I treated it, but if i’m too stressed i get an acute pain in my ear that can last up to 2 minutes and then it disappears. However, since last year i started being highly sensitive to any type of sound. I’m an undergraduate so that means that i need to go to lectures. But, all of my classmates use laptops to write their notes which doesn’t allow me to go to lectures. Luckily, all my lectures are recorded. I must say that i’ve been diagnosed with Generalised Anxiety Disorder and i’ve been referred to an Asperger Syndrome diagnosis. The latter didn’t work, however my GP still thinks that what i have is Asperger Syndrome. My mother treats autism and she nurture me so that i could be independent. I never felt disabled until i left my house (i’m living by myself and in another country). Because the NHS has long waiting times and my cause , my GP decided to refer me to a Mental Advisory team so that they could give me coping skills. He has no hopes on me getting a diagnosis as my case is special. Some people suggested me to use a Roger Pen so that i can isolate the sound from my lecturer and attend the lectures.
What else can i do?
Hi Maria:
What brought on your sensitivity to sound–exposure to loud noise?–head trauma?–excess stress/anxiety? or is it related to autism–although I doubt this as it should have shown up years ago if it were true?
Are you saying that your sensitivity to sound (hyperacusis) is so bad that the typing sounds in the classroom is too much for you?
What are you so anxious about? Trying to get good grades?
If you want to just focus on the teacher’s voice in class and cut out other sounds, using a Roger Pen if you have Phonak hearing aids, or any FM system for that matter may be a good solution. Then, with good headphone, you could largely block out the sounds around you and just hear the professor’s voice. He’d have to wear the FM remote microphone and you have the FM receiver. You could set the volume to a level that doesn’t bother you.
I think this idea is certainly worth trying out and see if it solves your main problem. That’s probably a good first step. Then, if it doesn’t work for you, we can discuss other possible solutions.
Cordially,
Neil
Hi Neil,
Thank you for patiently responding to every question and providing information. This really creates a public awareness, leading to a healthier society. You are really appreciated.
I’m a musician & sound artist & sound engineer, which means music and the sound phenomenon are everywhere in my life. It’s not just I live with them, they are also the biggest part of how I perceive the world. And it was only few weeks ago I realized my ears were the most precious things to me as I also realized that I abused and hurt them.
A month ago, after a series of intense music production days, I realized my ears were ringing. At least 15 hours a day, I always worked with my headphones in those days. I thought I was protecting my ears by paying attention to the volume level as I was aware that I was working for long hours, but apparently it wasn’t enough. And to be honest, volume level was not that low all the time. I usually kept it a few degrees under the possible max value. And unfortunately I experienced some serious clipping several times, which means the digital sound signal went way above the “0 db reference level”, thus resulting in a very loud noise in my headphones. After 2 days from all these, I woke up with a strong and a very high pitched ringing in the morning. I remember now the most loud and harmful sound that I heard in the headphones was a high pitched chord, may be that’s why I have a high frequency tinnitus right now. And also I felt that my ears were less tolerant and more sensitive to sounds. Especially high pitched sounds with a sharp attack. So I went to my ENT doctor and we made some tests which resulted that I have no hearing loss and my db toleration was normal. But I am sure my ears are less tolerant now as I know how I perceive sounds before this condition. There isn’t any pain or intolerable discomfort, but I feel like sounds above a certain db (75-80 db) and sounds between certain frequencies (2k – 4k) now somehow disturb and kind of “tickle” my ears although they didn’t disturb before at all.
So I know this is not any close to hyperacusis, but would you recommend a similar treatment? I mean hyperacusis patients listen to pink or white noise by gradually increasing the listening volume level, so that they increase their tolerance to sound. And one golden rule for them is not to unnecessarily protect their ears otherwise their intolerance would be worse. So I thought may be these are also true for my condition, may be I can overcome my sensitivity by listening those bothering frequencies at low volumes and then gradually increase the volume.
Do you think I should do the same thing to get rid of this sensitivity?
If this is logical, do you think I should apply this therapy for the frequencies that bother me most (2k to 5k)?
I don’t listen to anything with headphones and I keep myself off from the sounds that is above 80 db. I am using the drug Betaserc and vitamins B1, B6, B12 as my doctor prescribed them.
I can say my ears got better through the weeks but I am ready to do anything to have them better, as I often find myself experiencing difficulties concentrating, listening, and tolerating to music & sounds although they are pretty much mean everything to me, including my career! I am very depressed actually.
Looking forward to hearing from you and thanks much,
Ercan
Hi Ercan:
If you want to preserve your hearing for the rest of your life, you’d do well to lower the level you expose your ears to sound from 80 dB to 70 dB. That is the accepted level that supposedly will not damage your ears over time. The 80 dB figure will still allow your hearing to deteriorate over a period of 30 years.
So use a sound meter and keep the volume of the music to an average of 70 dB in the future to best protect your ears. It doesn’t really matter whether you wear earphones or not–as long as you keep the average to 70 dB.
Having said that, if there were a sudden loud burst of sound–you had the volume set wrong for example, and you were wearing headphones–there isn’t any place for the energy of the sound waves to disperse before they hit your eardrums like there would be if you were listening to loudspeakers in a room. So loudspeakers have a bit of a safety factor built in.
But if you know the volume is not going to accidentally spike, then wearing headphones is perfectly acceptable as far as I am concerned.
The fact that you now have tinnitus from exposing your ears to loud sounds shows that you have both hearing loss and hyperacusis–in spite what you ENT said. You, yourself, can tell the difference so you know it is there.
The reason the ENT’s testing didn’t show up any hearing loss is that you have “hidden” hearing loss and I’ll bet he never tested for that. And your noise tolerance is within “normal” limits–but that doesn’t mean it has not been damaged. You can hear the difference so that proves it.
And being a musician, you are less tolerant of deviations from normal that other people might not notice.
Typically, the frequency you hear your tinnitus is close to the frequency of maximum hearing loss so I’m not surprised that you have high-frequency tinnitus.
I think you do have hyperacusis–but a mild case compared to some people to be sure.
My suggestion is to just give your ears a rest–let them recover from the trauma they have experienced. To do that, just keep the volume down. If you are around louder sounds, then wear ear protection. Hopefully, in 2 or 3 months, your ears will be closer to normal than they are now. I don’t really think that using white/pink noise is necessary at this point.
If the music is bothering you–difficulty concentrating, listening and tolerating music, just turn the volume down to where it no longer bothers you. Does people talking bother your ears? If not, listen to your music at the same volume you hear people talking. Then it shouldn’t bother you either–although you may be more sensitive to higher-frequency sounds in your music.
Now that you are aware of the damage noise can do to your ears, I know you’ll keep the volume down. But at the same time, don’t obsess about your hyperacusis or you can make it worse just by obsessing about it.
Cordially,
Neil
Hi Neil.
Dunno if you still reply, but i have a question.
I have a weird symptom, where i hear like an “echo”, every time i hear some specific sounds, like dishes, plates, my own voice, someone else’s voices (depending on their pitch).
I googled some examples of hyperacusis, and that doesn’t seem to be my problem, because it doesn’t look like i hear those sounds louder, it’s just like a reaction (like a vibration that sounds almost like when you smash a piece of paper pretty fast) to those specific sounds. It’s doesn’t happen at the same time the sounds does, that’s why i called it an echo, because it happens right after (like 0,1s after). What could it be? Is it still hyperacusis? Should i try pink noise or something?
I went to an ENT (for something else) and i had no hearing loss, everything was 0-25 (in the hear where i have that problem), and 0-30db in the other hear.
Thanks in advance!
Hi Ricardo:
What you are experiencing is called diplacusis–or double hearing. There are 4 kinds of diplacusis. In your case you are experiencing Diplacusis echoica.
Here is a quote from my article on diplacusis.
“Diplacusis echoica (eh-KOE-ih-ka), as it’s name implies, is where you hear the same sound repeated—thus you hear the original sound followed by an “echo” of the original sound. This occurs when the timing of tones is slightly different in each ear. As a result, you hear the sound in one ear and a fraction of a second later in the other ear—thus you perceive this second sound as though it were an echo.”
You can learn more about diplacusis in my article on the subject at http://hearinglosshelp.com/blog/diplacusisthe-strange-world-of-people-with-double-hearing/
I think you’ll find it fascinating.
Normally diplacusis occurs in people with hearing loss. Although your hearing is considered by doctors to be “normal” you still have some hearing loss–or else you’d be hearing at 0 dB, not at 25 and 30 dB. So you have enough hearing loss to account for your diplacusis.
Cordially,
Neil
Hi again.
Thanks for replying so fast, and thanks for the help. It’s the first time i can “name” my condition, because everything i googled led me to different results.
I read your article, and it’s pretty interesting because i am a musician myself, so everything makes sense.
I will check with my doctor and tell him what i think. Thanks once again for helping me understand my problem.
Hope you have a nice day.
Thanks!
Ricardo
Hi,
i developed a mild case of tinnitus after a nasty case of otitis media at age of 10…it almost left me deaf until the good doctor prescribed me some medication for it….after many months i was fine again except my now constant tinnitus…its not so bad, i can tolerate it well and ignore it…..im 38 ys old now and a couple years ago i suffered a sudden onset of a strange acoustic phenomenon: loud ringing in both ears(louder than normal), fullness and slight pain…also i couldnt stand low sounds,like the bass in a rock song, or low frequency speech..my poor father had to tolerate my sour mood these days because his deep voice hurt so much and i yelled at him to stop…anyway, this ‘thing’ was intermittent, i had it like every other day for a year, then after a case of flu it disappeared…during this time i visited many doctors and took an audiogram which showed i lost some of my hearing in the middle range of the audio spectrum (because of my work, many noisy production copiers and gadgets)..but either than that nobody could explain what it was….anyway..i was relieved it passed but recently it came back again!(note:i hate loud sounds from childhood and my ears are very sensitive…ive never been to concerts or other noisy amusement places so severe acoustic trauma isnt very possible…..)the deep sound and enviroment ‘hum’ drills my ear which flutters and hurts…this last for a day or so then dissapears..and between this and my other ear annoyances (tinnitus, clogged eustachians from allergies)bothers me.Is what i suffer from Hyperacusis?what can i do to make it better?
Thank you
Hi Helen:
I think you may have hyperacusis along with misophonia (a dislike of certain sounds that trigger a reaction in you). Along with this the ear pain and fluttering sound like you also have tonic tensor tympani syndrome.
Together these have a physical component, an autonomic nervous system component and an emotional (limbic system) component.
I’m in the middle of rewriting my book, “Supersensitive to Sound?”. When done, it will address what is going on and how you can gain the victory over all this. Unfortunately, I’m so busy helping people that I don’t have much time to get this book finished. I know it will really help you when you read it.
In the meantime, you may find a lot of help in reading the book “Understanding and Overcoming Misophonia” by Thomas Dozier. You can get it on Amazon.
Cordially,
Neil
Thank you so much!i think you are correct about TTTS, and i also forgot to mention i suffer from Temporomandibular Joint Disorder, my jaw clicks and locks frequently and its annoying…the bad thing is i have silent reflux and i have to chew gum so it can help my throat and stomach..as you know gum is a no no for TJD..but i cant help it, my normal PPIs dont help much….also i get stressed easily, financial and family problems are my worst nightmare….anyway….from what i gather the solution is not to shy from the sounds that bother me but try to adapt to them….and id like a digital copy of your book once you finish it!
Best regards, Helen
after having fluid and light ringing in my ear for 2 months it went full blow ringing ,screeching with no help from the ent things are slowly getting better ,I had ETD so they gave me methylprednisolone that helped drain my ears but I still have tinnitus and my ears are super sensitive to sound ttts? so sensitive that when I ride in a car or go outside they start to ring or his really bad ,,Dr thinks I’m crazy is there any help with what to do to get them to be normal sensitive.
Hi David:
You haven’t given me near enough information to try to figure out what your ears problems are. If your ears are supersensitive to sound, you probably have hyperacusis and maybe misophonia. If the hyperacusis is coupled with tinnitus, you may have reactive tinnitus.
The good news is that there is help for all these conditions. To start with, what caused you to be sensitive to sounds–noise trauma, drugs, anxiety, or what?
Cordially,
Neil
Hi, first of all, let me thank you so much for the generous way in which you’re sharing all this hard-to-come-by information. Thanks to all the good advice, I have gained more trust that my Hyperacusis will eventually get better. I was submitted to an extremely loud stand up comedy event and due to a fear of appearing rude, did not have the presence of mind to move away from the front row. I also suffer from connective tissue disorder and fibromyalgia and am generally more prone to feeling sensitive about sounds. It’s obvious that I damaged my ears as there’s a pressure like pain and a permanent hissing noise, tinnitus, in my head. What I have not been able to figure out from all the posts I’ve read here is whether the pain usually goes away even if the tinnitus doesn’t? The pressure and pain is there 24/7 though I also expereince more sound induced pain on top of this. It goes without saying that I’m taking measures to bring protection with me wherever I go henceforth and will follow the advice you’ve offered in previous posts. Many thanks! Vivi
Hi Vivi:
I’m not sure what you are describing when you refer to a “pressure like pain”. Is this a dull pain as opposed to a sharp stabbing pain. And totally different from the pain from louder sounds?
Many people when they experience a sudden hearing loss from exposing their ears to loud sounds complain of a pressure like feeling, or describe it as a blocked feeling. This is due to hearing loss. When your brain doesn’t hear like it normally did, it assumes that your ears are “blocked” or else sound would get in as it normally did. This feeling typically goes away in time as your brain gets used to the new normal.
Cordially,
Neil
So yesterday night I was practicing violin when I listening to a REALLY scratchy loud recording kinda close to my right ear, and for a couple hours I just did my stuff and didn’t notice anything then a few minutes after I went to bed, like at 10:00 pm, a whirring sound protruded from my right ear and felt really weird. It also felt full, like when your ears are plugged, so I tried to unplug it by holding my nose and pushing air out of my nose but I did it like 100 times (really powerfully) and it made it worse and I accidentally plugged my left ear, so that morning I cleaned both my ears with a q-tip to get rid of excess wax and after I did my left ear I felt air flowing out of my left ear and it was back to normal except everything is super loud. My right ear is STILL plugged and I can’t play the violin well ‘cause I seem super loud and nasally and it’s messing me up. This will completely mess up my musical career! How do I unplug my right ear and get my left ear to hear normal?
Hi Lex:
Your ears are not plugged up so holding your nose and blowing isn’t the answer. What really happened is that the loud music your were listening to for some hours caused you to have a temporary hearing loss. This feels like a blocked or clogged ear, but it’s not physically blocked. Rather it is a psychological feeling of your ear being blocked because you have a sudden hearing loss.
As your hearing returns, this blocked feeling will go away–assuming this isn’t a permanent hearing loss.
When you damage your ears by exposing them to loud sounds, not only can you get hearing loss (whether temporary or permanent), but often you also get hyperacusis (where everything now sounds much too loud).
You need to give your ears a rest of ALL loud sounds–wear ear protectors around louder sounds. This may take several months. Just don’t overprotect your ears or you can make the hyperacusis even worse.
You can’t rush this. It takes time. Think of a bruise. It takes time to heal. Ditto for your ears.
Cordially,
Neil
Hello. I’ve been reading through the questions and comments. I have a question of my own. I saw the audiologist today and she said there is nothing that can be done about my hyperacusis. Since music is a big part of my life, this saddens me deeply. My question is: Have you ever heard of this condition lasting for 10 years or more? I know I’ve been having symptoms for over 10 years and it seems to be getting worse. Any advice would be more than appreciated. Thank you.
Hi Carolyn:
Your audiologist is wrong. Something CAN be done about your hyperacusis. It’s just that your audiologist is ignorant of what that something is.
Hyperacusis is often caused by exposing your ears to loud sounds. Since you love music, I daresay that you have exposed your ears to loud music for far too long–and the result is hyperacusis. You should not listen to music any louder than you hear people talking if you want to preserve your hearing and avoid hyperacusis.
Since you have had your hyperacusis so long, I’d recommend you find a tinnitus and hyperacusis treatment center and let them help you. This is not a fast treatment–expect it to take up to 2 years to get things under control.
In the future you need to protect your ears from louder sounds until your ears recover. However, you tread a fine line. If you overprotect your ears, you’ll make your hyperacusis worse. Ditto if you don’t protect your ears enough. What you want to do is slowly build up your tolerance to normal sounds again. It can be done. You just need direction in how to do it.
Cordially,
Neil
Hi Neil,
Hope you can help me out.
I hurt my ears celebrating New year’s at a club even though I wore earplugs. I went to an ENT and audiologist and both told me my hearing was fine and that my pain and ringing was TMJ/anxiety related or that I was just too sensitive to sounds. I reluctantly accepted their diagnosis even though I could tell my hearing wasn’t quite the same. Since then, I noticed an increase in sensitivity to loud places. Even as a kid I was always extra sensitive to sound but now I was wearing earplugs to movies, restaurants and the mall.
A month ago, I went to a bar with music but I felt comfortable enough not to wear earplugs. However, after getting home, a horrible ear pain/burning started and everything sounded muffled. The ringing also became much louder. I went to a different ENT but she also said my hearing was fine and that this was all TMJ/anxiety related. This is despite telling her I was having problems hearing my coworkers, especially in busy rooms.
Not happy with my diagnosis, I went online and found out about acoustic trauma, hyperacusis and hidden hearing loss which fit perfectly with my symptoms.
It’s been a month and my tolerance to sounds and hearing has improved. The main problem I have right now is voices including my own “vibrate” which irritates my ear and makes it “swell up” and hurt. I can’t tolerate voices on the phone either.
I went to an audiologist referred by the Hyperacusis network and he confirmed my hyperacusis and said the vibrating voices are related to the tonic tensor tympani. He recommended I do the Retraining therapy (TRT). This treatment costs $4,000, so I want to know if you think I really need it or if there’s any alternate treatments I can try.
Finally, I’ve had severe chronic problems with my neck the last three years (C6 and C7). Is it possible my hyperacusis is related to my neck problems?
Hi Karla:
If you are very sensitive to sound, maybe the ear plugs you wore weren’t powerful enough, or perhaps you didn’t have them inserted properly.
In any case, damage come from a product of noise level times the length of time you were exposed to that level.
Theoretically, ear protectors with a protection factor of 30 dB should have protected you for about 8 hours of exposure to sounds at 115 dB. I doubt the party was noisier than that.
But if your ears are more sensitive than average, you could have suffered noise trauma–and by what you say, I think you did. I wouldn’t say it was TMJ pain, etc. That’s a cop-out unless you had TMJ pain before the party.
Your hearing can test normal and yet still be impaired for at least two reasons. First, they only test you to 8,000 Hz, yet normal hearing goes up to around 20,000 Hz. So you could have massive hearing loss in the high frequencies they don’t test. That is why you could have a hearing loss and yet be given a clean bill of health hearingwise.
The second reason is that you have a different kind of hearing loss where the synapses on the nerve fibers that are activated when you listen to sounds in noisy environments are damaged or destroyed. When this happens, you can hear perfectly fine in quiet, but can’t understand well at all when there is background noise present.
Both of these problems could apply to you now.
Now, let’s look at your hyperacusis. Wearing ear protectors too much just makes hyperacusis worse. You need to protect your ears in loud environments, but NOT when they are not needed. So if you wear them too much when not really needed, your hyperacusis will continue to get worse and worse.
I can’t see TRT helping your TTTS, but if modified for hyperacusis, it could help your hyperacusis. Having said that, there are other treatments.
I’m assuming you’ve read my article on tonic tensor tympani syndrome and how to treat it? If not go to http://hearinglosshelp.com/blog/do-i-have-tonic-tensor-tympani-syndrome-ttts/ .
If your neck is out, it could affect a lot of the symptoms you mention. I’d go to an upper cervical spine chiropractor (NOT a conventional chiropractor) and get your neck (especially C1 and C2) properly aligned, along with the other vertebrae in your neck. See how this helps with the TTTS.
You also want to get any anxiety under control which just makes all this worse.
You also want to work on expanding your dynamic range in your hearing (the “distance” between the softest sound you can hear and the loudest sound you can stand without problems). This is where wearing ear protectors when you don’t really need to causes problems. You want to slowly stretch your ears’ capability to tolerate louder sounds without problems.
So there are some things to work on before you consider spending the big bucks on TRT.
Cordially,
Neil
Hi Dr. Neil,
I got tinnitus 3 weeks ago while working with a hammer and chisel removing a piece of tile from under a cabinet. The sound echoed in the cabinet, but it didn’t hurt at the time and I thought nothing of it. As soon as I pulled my head out of the cabinet I hear the ringing. I am already used to it, but the sounds/frequency seems to change within a range throughout the day. One odd thing is that my ears have some discomfort right outside the eardrum area which occurs in quite and louder environments, as well as when I wear ear plugs and muffs together (only done to test this issue). It doesn’t seem to correspond to any specific sound event . Do you have any idea why I have this discomfort feeling in the ears>
Hi Josh:
Your ears suffered noise trauma–hence the ringing in your ears. I don’t know exactly what causes the feeling of discomfort. It could be that your eardrum and tiny muscles that attach to it were “sprained” so to speak from the eardrum vibrating so violently from the impact sounds. If that is all it is, just give it time to “heal”.
If the discomfort you feel is more of a blocked feeling (it’s hard to know exactly what people are trying to describe), then that could be the result of a temporary (or permanent) sudden hearing loss as a result of the noise trauma. It should go away as your hearing returns (assuming it does), or as your brain gets used to not hearing as much as formerly.
Those are my two best guesses given the information you have given me.
Cordially,
Neil
Hi Doctor,
Sorry to bother you… I went through a series of events with my right ear, and I’m not sure if they are linked or not. I hope you are able to provide some explanations!
For 3 years, I have been playing in a school orchestra, which can get very loud with the percussion and woodwinds. I also play the piano on my own. For the 3 years I have been regularly practicing piano and orchestra.
On the 1st year in the orchestra, my ears felt fine.
In the middle of the 2nd year I suddenly had high pitched tinnitus in my right ear, and loud sounds made it ring. I got it checked at the ENT and the doctor removed earwax and my tinnitus went away completely. However, 1 month later the tinnitus was back but it was a different sound – a lower pitch. My ear also became more sensitive to loud and high pitched sounds so I went back to the doctor, they did hearing tests, looked at my eardrum, cleared earwax, gave me Vitamin B, MRI, but they said everything seemed fine so there was nothing they could do about it.
It’s almost the end of the 3rd year now. I have had the sensitivity to loud and high pitched sounds for 1 year. Not sure if I have gotten used to the tinnitus or it got softer, but the tinnitus doesn’t bother me so much now. I’m just very affected by sensitivity. When I play loudly on the low notes of the piano, I feel fine but I can just play at a moderate volume on the higher notes and the sound is literally ear-piercing, making my right ear ring. It’s like the sound is boring into my eardrum. The volumes at the cinemas make my right ear very sensitive, and I find the ringing of bells, people screaming very uncomfortable.
I can only practice piano with earplugs if I want to be comfortable. I should also mention that when I hear water rushing from taps (eg when showering) OR piano without earplugs I get this thumping/fluttering feeling in my right ear, which is really strange. When I turn the tap off I don’t feel it anymore but when I turn it back on it’s there.
I really don’t know if all this is because of being in the orchestra and piano, because how come people who are so much nearer the loud instruments don’t get issues, and professional pianists who practice on a grand piano (much louder than my upright piano) daily don’t get issues?
I’m worried that my ear will get worse or lose hearing. I’m only 17 and I really don’t want to lose my hearing so young. I love music and I want to be able to play comfortably without cringing when it’s loud 🙁
I hope you are able to give me some suggestions or explanations! Thank you in advance!
Hi YT:
I can tell you exactly what is happening to your ears–and yes, they are all related. Your ENT should have told you what I am going to be telling you below. He is totally ignorant about your ear issues and I’d never go back to him because he has allowed your condition to become worse by his uncaring ignorance.
While it is true that there is nothing he can do about your condition MEDICALLY, there was lots he could, and should, have told you in order to prevent things from getting worse over the past two years.
First, he should have told you that playing in an orchestra without wearing ear protection was just asking for trouble. He should have explained that when you are playing, you should have been wearing musicians ear protectors. That is what professional musicians wear to protect their hearing–at least the smart ones do. That would have prevented everything that you are now suffering from.
Musicians ear protectors are quite expensive because they are designed to attenuate all frequencies of sound equally so music sounds “right” to you. In contrast, regular industrial ear protectors (the foam ones you can get at any drugstore for $2 or $3 cut the low frequency (industrial) noise more than the higher-frequency speech sounds. That way you protect your ears from the loud low-frequency sounds while still being able to understand speech. So getting musicians ear protectors is well worth the extra money if you are going to remain a musician.
Second, he should have told you that continually exposing your ears to loud sounds without wearing ear protection would almost certainly eventually lead to ear trauma such as you now have. The hypersensitivity you have to the mostly higher-frequency sounds is called hyperacusis.
Your ears can only stand so much abuse before they start messing up. Some people have more “robust” ears than others, thus they can stand more abuse than your ears can. Your ears may be more sensitive to loud sounds. That is why you got through your first year of orchestra without any NOTICEABLE problems (but you were still damaging some underlying structures in your inner ears. But the cumulative effects of the loud music began to show up in your 2nd year and have continued to get worse in your 3rd year.
The thumping/fluttering you feel in your right ear is another symptom of noise trauma. It is called tonic tensor tympani syndrome or TTTS for short. This is where your tensor tympani muscle that pulls your eardrum away from the hammer bone to soften loud sounds goes into spasm and you experience it as that thumping and fluttering feeling.
I’m glad you are finally worried about your ears because now you are willing to do what you need to do to protect your precious ears so you can continue playing in the future.
What do you need to do?
First, get musician’s ear protectors and wear them when you are playing in the orchestra or band–where the sounds are too loud.
Second, you may find that for awhile you’ll also need to wear them when playing the piano. BUT, take them off whenever you don’t need them because if you don’t, you will make your condition even worse. So there is a fine line you need to tread–protect your ears from louder sounds, but don’t overprotect your ears when there are no louder sounds present.
Think of hyperacusis as analogous to a bad bruise. Someone whacked you (loud sounds) and you get a bruise (hyperacusis). It takes time for a bruise to heal–ditto for your hyperacusis. Now, if someone whacks the bruise before it is fully healing it causes even more bruising and takes even longer to heal (ditto with hyperacusis).
You don’t have severe hyperacusis yet–you can be thankful for that–but you’re heading in that direction. Apart from giving your ears a rest from louder sounds, you also want to exposure your ears to soft sounds so you are never in the quiet so your ears can slowly recover their lost dynamic range and thus won’t be sensitive to louder high-frequency sounds. Some people use fans running in their bedrooms or play environmental sounds in the background so you are never in totally quiet situations.
At the same time, you need to cease worrying about your ears. The more you focus on them and the problems–the TTTS for example, the worse it becomes. Forget about it and focus instead on the loves of your life. That will do a lot to let your TTTS fade away. Ditto for your hyperacusis. And ditto for your tinnitus. Fortunately your tinnitus isn’t bothering you much. So treat it like some unimportant background sound you hear and completely ignore. This gives your brain (limbic system) permission to ignore that sound and it will fade into the background.
I’m sure I’ve snowed you under by now, so absorb what I have told you, and then if you have more questions, feel free to contact me again.
I wish you well in your musical career.
Cordially,
Neil
A family member of mine has developed hypersensitivity to specific sounds like other people’s chewing, mouth noises, etc. She used ear plugs to be able to sit at the dinner table and has extended the use of them in more environments like the lunch room at school and just being in a restaurant. She has become very anxious, is easily angered and says people “think I’m wierd”. She was evaluated and received a diagnosis of misophonia. The treatment suggestion is a hearing aid device that , I believe, generates white noise.
Can you please give me some advise about the treatment for misophonia? I can’t seem to find reliable research about this diagnosis and treatment of it.
Hi Ann:
From what you say, she has a classic case of misophonia. How old is she? How long ago did this all begin? I assume that it is getting worse and worse–that she is developing more and more sound sensitivities (trigger sounds) as time goes on–correct?
White (or pink) noise sound generators are one part of misophonia treatment. But that is not all–nor even the most important aspect of treating misophonia. It requires counseling by a counselor experienced in dealing with people with misophonia. Another important aspect is learning to relax the muscle(s) that are affected by the triggering sound. Learning progressive (and total) muscle relaxation is a good start.
Wearing ear plugs is ultimately counter-productive as it can make things worse. Much better to arrange things so she does not experience the triggering sounds so much. Having background sounds on all the time–both day and night really helps so she doesn’t hear the triggering sounds as loudly as she does in the quiet.
Unfortunately, my book on the subject isn’t quite ready. I’m hoping to get it finished this winter. In the meantime, I recommend reading the second edition of Tom Dozier’s book, “Understanding and Overcoming Misophonia” You can get it on Amazon at https://www.amazon.com/Understanding-Overcoming-Misophonia-2nd-Conditioned/dp/1548328693/ref=sr_1_1?ie=UTF8&qid=1541806477&sr=8-1&keywords=misophonia&dpID=512uEyo%252Bv6L&preST=_SY291_BO1,204,203,200_QL40_&dpSrc=srch. I don’t necessarily agree with everything Tom says, but it is still the best currently-available book on the subject and you will learn a lot and how to deal with it.
Cordially,
Neil
Hello Dr. Bauman,
I made a big mistake recently. I had been drinking and was invited to a VERY loud rock show at a bar. I already have tinnitus and understand the risks, so I always wear earplugs to concerts, but I didn’t have them with me. What I did have was a pair of earbuds, for listening to music, and I inserted those and they seemed to help enough at the time.
I now realize this was a big mistake, and I blame the alcohol for my bad judgment – probably part of the reason hearing problems are so common in music. I now have a louder frequency of tinnitus, hyperacusis for sharp noises, and trouble hearing voices in a crowd. It has been 3 days.
Is there hope that this might improve with time, if I take better care from now on? Or did that one night’s mistake ruin my hearing for the rest of my life? How long should I give it before I panic?
Hi Dean:
Yes, there is hope for you, but at the same time, there is a measure of permanent damage you caused to your underlying inner ear structures. And you should NEVER panic. It won’t help matters and is almost certain to make matters worse since hyperacusis and tinnitus are both psychosomatic conditions–which just means that your emotions play a large part in their persistence or cure.
Hyperacusis can take several months to settle down–so don’t expect things to get back to normal in only a few days. Take better care of your ears. Give your ears a rest from the really loud sounds, but don’t overprotect your ears by wearing ear protectors when you don’t need to as that will just make your hyperacusis worse. Learn to ignore your tinnitus by focusing on the loves of your life and let your tinnitus fade into the background.
If you continue to have trouble hearing speech in noise after say three months, you’ll know you have done permanent damage to your hearing. Not understanding speech in noise is one of the first symptoms of this kind of hearing loss.
Cordially,
Neil
Hi Doc ,
I am 26
I have a mild tinnitus and a little bit of hyperactive for 2 weeks now after a loud concert (first time ). doctor put me on cortisone for the 1rst week and my hearing test show nothing abnormal . In fact I can hear really . I also had acupuncture . What should I do . My doctor told me to come back in 6 weeks . I there any hope or after 2 weeks it will be permanent
Hi Alex:
If you have a bit of tinnitus and hyperacusis after going to just one concert, I’d hope that things would return to normal in a few weeks, but there are no guarantees. These things need time to resolve. In the meantime, don’t expose your ears to loud sounds without ear protection.
Also, learn to ignore your tinnitus and focus on the loves of your life, NOT on your tinnitus. If you treat your tinnitus as a totally unimportant, useless background sound, this gives your limbic system permission to let it fade away into the background so you don’t hear it. On the other hand, if you focus on your tinnitus, just the opposite happens–and you don’t want that.
Cordially,
Neil
Hi Doc ,
I also have a couple other questions .
1- What is the timeframe to know your tinnitus and hyperacusis is permanent ?
2- I dont’ want to over protect my ears . What type of noise should I stay away from and (people , laughing , music at church etc.)
3- I am now taking St Johns wort -pills to keep my sanity through all this . It works well because I fell I I don’ care anymore about these conditions . Should I keep taking them ? For how long
4- I feel like scheduling another appointment with my ENT is worthless because they generally can do nothing
5 -What do you think about acupuncture ?
Thank for all you doing . You dont know how much wellness you provide with your insights and comments . Thank you again
Hi Alex:
1. There is no set time frame for tinnitus, not should you really care. For example, I’ve had tinnitus for more than 60 years, but I don’t let it bother me–so whether I hear it (like right now while I am thinking about it) or when it fades into the background and I’m not even aware I have tinnitus doesn’t really matter to me. I just ignore it and go about my day.
As for hyperacusis, if it doesn’t go away on its own, you need to actively deal with it and get rid of it.
2. Typically, I’d stay away from sounds greater than 80 dB. Over 90 dB and you want to wear ear protectors. But remember that damage is the product of noise level times the length of time your ears are exposed to it. The rule is that for every 3 db increase in volume, you cut the time exposure in half. With hyperacusis, this doesn’t apply. You normally keep the sound level down to below where you perceive sounds as being too loud. But you need to know that loud PERCEIVED sounds do not hurt your ears–only real, loud sounds.
3. St. John’s Wort is good for depression, not for anxiety. However, if it is working for you, go for it. You can take it for as long as you need it. It is not “addictive”.
4. Right. If there is nothing medically they can do, you get the brush-off. Tinnitus and hyperacusis are not “medical” conditions so ENTs typically don’t (can’t) help you. An audiologist that has a tinnitus and hyperacusis clinic is the person that can really help you if you need professional help.
5. Ive never tried acupuncture. From what I have heard, it is not particularly effective for people with tinnitus or hyperacusis, but it is not harmful either. So, if it works for you, fine. If not, stop it.
Cordially,
Neil
Hi Neil ,
1-I still have tinnitus and hyperacusis after a month but they have gone down until yesterday I had a fever and I felt like both got increase . Is that normal ?
2- Please tell me more about sound level . I dont know what to stay away from is 83 decibels ok for someone with tinnitus and hyperacusis
Hi Alex:
It’s great that your tinnitus and hyperacusis have gone down. I wouldn’t be surprised if the fever has caused the increase in your tinnitus and hyperacusis–especially if the virus got into your inner ears.
As for sound levels, that is not cut and dried–it depends on you. For example, if exposing your ears to 83 dB sounds makes your tinnitus or hyperacusis worse, then you know that is too loud. With hyperacusis, if the sound is uncomfortably loud, then it is too loud for you at this point. If the sound is comfortable at that level, then it should be ok.
You want to expand your collapsed sound tolerance, so you want to stretch the upper limit a bit–but the trick is to do so slowly as you can stand it. But you never want to cause ear pain, just a wee bit uncomfortable.
Cordially,
Neil
Hi Neil ,
Some people recover totally from tinniitus and hyperacusis after 6 months , 8 months , some after a year or many years according to some blogs but i some of your posts you said after 2 months it is permament , Can you please claify ? are you talking about people with hearing loss+tinnitus +hyperacusis ?
Hi Alex:
Actually, I am specifically talking about people that get tinnitus from taking drugs and then do nothing about their tinnitus. They want to know whether their tinnitus will be permanent or not. With some drugs, tinnitus goes away in a few days or a couple of weeks or longer. So, if they give it 2 months and they still have their tinnitus, the chances are it will prove to be permanent.
That is not to say that they can do something about their tinnitus and have it fade into the background. Those people can and do have much better results with their tinnitus.
Note: when I say the above, I am not talking about people that have reactive tinnitus or hyperacusis. Those conditions take much longer, as you have noted.
And for people with tinnitus due to hearing loss, typically the tinnitus lasts as long as the hearing loss. In my case, that’s all my life–65+ years that I can remember so far. But the good news is that I do not let my tinnitus bother me–so whether I have it or not is a non-issue.
As you can see, it’s all in the details.
Cordially,
Neil
Hi 9 months ago I had surgery for grommets when I woke up my hearing on my left ear had almost completely being lost, three months later hyperacusis started along with tinnitus. I have hear (lol) that it is possible for the nerve to be removed is this a viable option as I have little to no hearing in it anyway? Would it stop it? Jay
Hi Jay:
What does your audiogram show for your left ear? Is your hearing loss conductive or sensorineural?
I’m not surprised that you have tinnitus now as tinnitus very often accompanies hearing loss. But hyperacusis normally comes from exposing your ears to loud noise. Is that what happened in your case?
Note that surgery to cut your auditory nerve will not get rid of tinnitus as tinnitus is basically generated in your brain–not in your ears. I don’t recommend get the nerve cut for either tinnitus or hyperacusis. There are better ways to deal with these conditions.
Cordially,
Neil
Hi Neil conductive I believe, no I went in to have grommets fitted due to glue ear and it occurred straight after surgery I woke up from the surgery like it. My ear feels full, I have tinitus and hyperacusis followed three months later, it was said it was acute sensory sensitivity by the surgeon but the audiologist called it hyperacusis so is acute sensory sensitivity just another name for hyperacusis? They are absolutely useless with giving me any help just suggested apps for sound relief. And it’s driving me nuts!! I am desperate for help.
Hi Jay:
So you had the feeling of fullness right after the surgery, then you noticed the tinnitus, but the hyperacusis didn’t start until 3 months later–correct?
Did you take any drugs in that three-month period? Expose your ears to any loud sounds, particularly sudden loud sounds?
Acute sensory sensitivity is just doctor-speak for anything that revs up one or more of your senses–in this case your hearing. This is just a very general term. Hyperacusis is specific to your ears–so is a better term. So essentially they mean the same in your case.
In order to get specific help you probably need to go to a clinic (typically run by audiologists) that treats tinnitus and hyperacusis. Unfortunately, good ones are hard to find. Start by looking for something like “Tinnitus and Hyperacusis Clinic” or equivalent.
Cordially,
Neil
Hi yes that’s correct. Thanks for clearing that up for me, yes your right it is hard to find a good audiologist and unfortunately it means going private which I am not in the position to do. I was on medication but had been on all of them for years there had been n o changes to them, I had a operation only 18months before that and all went fine, no problems and I was on those meds then Metformin, fluoxtine, bisprolol and gliclizide. But as said had been on these for at least 4 yes.
Sorry I didn’t answer the question about loud sounds no none at all not beforehand or after I wonder whether seen as I had had glue ear for so many years that when they operated it may have been a shock to my system the noises around me but I don’t know it seems to be a bit of a mystery to my surgeon and the audiologist and most definitely to me!!
Kind regards Jay.
Hi Jay:
The 4 drugs you mention can all cause tinnitus, but the risk is low for most, but Fluoxetine is the worst of the bunch. Who knows what the combination of drugs might cause? Sometimes tinnitus from drugs doesn’t occur until months or years have gone by.
Cordially,
Neil
Thank you for your help and advice it’s much appreciated. Kind regards Jay
I listen to music at work with earphones at about 30-40% volume for several hours 5 days a week. I have been doing this for a few years. I believe this has caused tinnitus and mild hypercusis. Both started 6 days ago. My left ear always feels “full”. but I don’t have any pain. I seem to be more sensitive to noises like traffic, referigerator hum’s, kitchen facet running and car brakes. I also hear some crickets chirping and /or buzzing- that is most likely the tinnitus. The other day I went to dinner with some co workers at a small restaurant. There were a lot of people and I felt uncomfortable after 30 minutes. I think I will bring ear plus next time I go to a crowded restaurant, at least for a few months until my ears start to “heal”.
I saw an ENT and my ear looked great and hearing was normal. He said stay away from loud noises. I was prescribed prednisone and was told to come back if it doesnt improve.Would do you think my best approach would be?
Thank you for taking the time to reply to everyone.
Hi Mitchell:
If you are listening to music at a low level–about the same level as you would listen to speech, you should never have tinnitus and hyperacusis as a result. You may think it was low, but compare it to the level you’d listen to a recorded speech via earphones–did you keep the music volume to that level? That’s what you should be aiming for, if you want to protect your ears for the long term.
Your symptoms–feeling of fullness, sounds “sharp” rather than normal, tinnitus are typical of people that have exposed their ears to sounds that are too loud. It could be a sudden loud sound resulting in acoustic shock syndrome, or it could be spread over days or weeks or months resulting in much the same symptoms.
It seems the restaurant was the final straw.
Your ENT has given you good advice–protect your ears from loud sounds and give them time to heal. The prednisone may or may not help, but it could be worth the try.
If you want to try some vitamins, minerals and other natural things, read what I suggest in the following two articles.
http://hearinglosshelp.com/blog/loud-music-and-hearing-loss/
http://hearinglosshelp.com/blog/vitamins-a-c-e-combined-with-magnesium-help-prevent-noise-induced-hearing-loss/
Cordially,
Neil
Hello Doctor Neil Bauman
I did terrible mistake which resulted in developing hyperacusis. I have had tinnitus from 27 april 2017 until now. In the first 5-6 month I had difficult time with this problem but after many months I finally habituated and somehow I was ignoring tinnitus. Sure there was times when I felt depresed but nothing like at the beggining. My stupidity happened in 14 octomber 2018 when I decided to go inside shooting range and I shooted 40 bullets with glock ( 160 db level infront of gun and 157 db at my position ) and I had double protection, ear muffs and earplugs = combined I had protection of 36 reduced db level. Also my mom shooted 10 bullets 1 feet away from me then she moved 3 feets and shooted 40 more bullets. One friend of mine also shooted 40-50 bullets and he was at some distance away from me. I was stupid to think that 28+33 offers 61db protection beacuse I didnt know db protection is measured in logaritmic scale. So I was exposed to 40 bullets of 123 db level and the bullets that my mom shoot and my friend which were maybe lower db but still they added a fuel to make theproblem even more. Next day after the shooting nothing happened, then 2 days after the shooting I had terrible spike in my tinnitus which lasted for 10 days. Then next 3-4 days nothing, my T was calmer and suddenly I have noticed pain from sounds,hyperacusis. Everything was so loud and my ears hurt, noices like normal voice, toilet flush, car brakes and even clicking mouse and keyboard were painfull for me. AFter 3 weeks my H improved and normal voices or even louder voices wasnt hurting me soo much, also other sharp noices was improved ( sharp noices with high frequency are the worst ) like when youichange the temperature on air conditioner ding ding, elevator sound ding ding, women noice and etc. However this improvement lasted for 2 and a half weeks, maybe 3 then I had worsening in my hyperacusis. This setback isnt like my worst first 3 weeks with H but still they are somewhere close to that level and are worse then my second period with H which was much better then now .. One strange thing Ive noticed is that my body is stressed out when some loud noice occurs from outside. For example I sit in front of my laptop and I watch something with low volume then some car horn outside my body instantly get stressed out. I live at the 4th floor in flat and Im far away from the street. Also situation when my dog kick the door in the room next to me just a little bit a still jump out of my chair . I saw this symptom from one guy post on one forum. He say this is collapsed dinamic range so this may be the case in my situation. One thing that I dont understand is why this stress from those sounds had been happening in the last 3 weeks, it wasnt present before in the other periods of time with hyperacusis.. Is this means that I’m getting worse then the opposite ? So many bullets that day, 40 bullets from my gun and 90-100 bullets from other 2 guns indoors .. I cant imagine what have I done. I think this is serious damage to my ears and I will never improve this symptom which is far worse then tinnitus .This is making my life miserable and depressed . I dont know what to do. Btw I dont overprotect my ears even If I have pain most of the times, I use earplugs only when is really loud. However one thing that is bothering me are car horns. Someone said to me this sound has 115 db level and I was recenlty exposed to them. I think I already writed about my problem in your forum but I cant find it anywhere. Maybe it was not published or maybe I cant find it but I think its not published. Sorry for my bad english Doctor Neil, my english writing is not that good. I feel very bad about my problem and I dont know what to do.. I feel suicidial at times and I need some help asap.
Hi Marko:
Your ears have suffered from the loud gunshots with the result that you have Acoustic Shock Syndrome. This includes effects such as hyperacusis, tinnitus and ear pain among others. No doubt, you also have hidden hearing loss where the synapses in your inner ear have broken. They may heal in time, but if they don’t, then the hair cells they are connected to also die–and you will have further hearing loss/distortion of hearing.
All the symptoms don’t have to show up right away–some come later as you have experienced. This is just the way it is.
What you need to do now is not expose your ears to loud sounds. If you have to be around loud sounds, wear ear protection. Your ears need time to heal as much as they can. This will take time. It could take 2 years–so don’t give up.
It is good that you are not wearing ear protection all the time, but at the same time, you don’t want to suffer with louder sounds giving you pain. What you really want to do is always have background sounds around you. It could just be white or pink noise or low-level music or environmental sounds. You want to do this day and night. Set the level so these sounds don’t cause you undue discomfort, but loud enough for you to hear. Then, as your brain accepts this level of sound, turn the sound up a bit more and let your brain get used to that, and so on, and eventually, you should be able to hear normal levels of sound again without discomfort. Again, I emphasize, this takes time so don’t try to rush it.
If you inadvertently expose your ears to a loud sound–a horn honking on the street for example, it can set you back and you have to start over with softer sounds to some degree. Just accept it, and continue on with the program. I know that is frustrating and depressing, and it will take even longer to get back to normal–but do it so you will get better. And if you hear a horn (or other loud sounds) immediately clap your hands over your ears to protect them as much as possible. Putting your hands over you ears doesn’t give really good protection–much better to push the tragus (the “bump” of skin at the opening to your ear canal) shut with your index fingers. This blocks sounds the best.
Your English is pretty good. I can certainly understand you. Just one word stands out–the past tense of shoot is shot, not shooted.
Horns can be loud, but the volume drops quickly as the distance increases–so standing beside a truck that blows his horn is LOUD, but being 100 feet or more away, while still loud, is not near as loud and damaging as standing right next to it. So if you happen to be close to a loud sound (such as a horn blowing, quickly put your fingers in your ears to block it as much as you can.
Cordially,
Neil
Thank you Doctor Neil for such a detailed answer and opinion about my problem, I really appreciate it.
One thing I’m confused about is the part where you say that ” No doubt, you also have hidden hearing loss where the synapses in your inner ear have broken. They may heal in time, but if they don’t, then the hair cells they are connected to also die–and you will have further hearing loss/distortion of hearing. ”
1. Does this mean that right now I still cant be sure exactly that my synapses in my inner ear are broken, I will know this maybe after some time ? If so, after how much time can I notice this ? I mean how much time ( months, weeks ) . Or you wanted to say that right now Im already in that position, that’s being said these symptoms Im having currently ( severe hyperacusis, hidden hearing loss and etc ) shows that my synapses are broken which result in hair cells being dead already ? I have had hyperacusis for 2 months and 3 weeks, maybe 3 months . By now I should have experienced all of those symptoms that you have told me right? I cant any worse ?
2. Also to ask one more thing. By having delayed effects which results in a hearing loss we are speaking about hidden hearing loss, not normal hearing loss ? If whatever happened or will happen only hidden hearing loss can change not the normal one ? For example my audiogram is fine. I also tested my hearing on high frequency sounds ( above 8000 , almost to 16000)and I heared them good . However I tested this on one site with some quality earphones and I cant say for sure that this is accurate . Im just not sure about my hearing with background noices, like when I speak with someone I dont hear them that good but I understand them what they talk and usually I dont have problems with that. Sorry If Im being boring with 2nd question but I wanted to understand clearly about some parts of your advice.
I now have extreme sensitivity to sound because of my loud guitar playing in different bands. I have had tinnitus for as long as I can remember But was still able to play at a loud volume. For the last year my tinnitus has been so loud I am concerned about going crazy and am severely depressed. I no longer play in any band because of the pain. I have lost very little hearing according to my doctors. As a start to lose more of my hearing will my tinnitus get
even louder? I have hearing aid maskers but stopped using them almost right away. They seemed to make the ringing louder. My CPAP machine seems to make the ringing louder as well so I stopped using that..
Hi Jim:
You probably have quite a significant hearing loss already, in spite of what your doctors said. This is because they only test to 8,000 Hz and your natural hearing goes up to 20,000 Hz. So you could have a lot of “hidden” hearing loss up there. Your brain knows that and since tinnitus very often accompanies hearing loss, you have tinnitus from that. Then, too, exposing your ears to loud sounds can cause another kind of hidden hearing loss due to synaptopathy in the structures underlying your hair cells. That too, is not tested for.
Since your tinnitus is already pretty loud, I don’t think that your tinnitus will have to get worse as you lose further hearing. It may, or may not.
If your tinnitus gets louder with sounds, that is called reactive tinnitus which is a combination of tinnitus and hyperacusis.
You would do well to read my book on tinnitus and learn how to properly deal with it. You can get it at http://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/ or seek out professional help. Also, read my article on Reactive Tinnitus at http://hearinglosshelp.com/blog/reactive-tinnitus/ .
If you want to learn more about hidden hearing loss, read my article on it at http://hearinglosshelp.com/blog/hidden-hearing-loss/ .
Hi Neil, I have had tinnitus for about a month along with sensitivity to sound. I recently saw a doctor, followed his protocal and the tinnitus is much better, almost gone for most times. When I go to places with higher sounds, though, the tinnitus starts. Today I had no tinnitus, went to a fast food restaurant and was exposed to louder sounds. The tinnitus started, I left the restaurant and in about 15 minutes the tinnitus was gone. Last week I actually invested in some quality musician earplugs, should I take them with me and when I go to a louder atmosphere I should just put the musician earplugs on, and take them off when I am not longer exposed to louder noises? Can this improve?
Hi Ed:
You have the right idea. Any place that is loud enough to give you tinnitus is a place where you need to wear ear protectors. Just remember to take them off as soon as you no longer need them. Then it should be ok.
Cordially,
Neil
Hi; thanks for the reply Neil. I noticed that I have no tinnitus until I am exposed to louder noises. anything can be done with hyperacusis? I have read very positive reports on the neuromonics devise. Also I have read that there has been work by a Dr. David Eddins for several years and now his unit for hyperacusis will be available very soon. Any comments on this?
if somehow my hyperacusis gets much better should my tinnitus also get much lower, if at all. Again, I have extended periods with no tinnitus until I am exposed to louder noise
Thanks Neil.
Hi Ed:
If you have tinnitus that gets louder with louder sounds, then you have what is called reactive tinnitus. Reactive tinnitus is actually a combination of tinnitus and hyperacusis.
You normally treat hyperacusis with softer background sounds both day and night at a level just below your discomfort level, and then slowly increase the volume as you can bear it. Over time, this typically raises your decreased tolerance to sound.
This new device is being developed by Dr. Craig Formby and Dr. David Eddins. Until it is released or reports come out on the results of trials, we don’t know much about this device and how well it will work for those with hyperacusis. Let’s hope it works well.
Once your hyperacusis is under control, you likely will find your tinnitus is under control too.
Cordially,
Neil
hi Neil, thanks for the valuable information. I was just wondering if you have any comments on the Neuromonics devise for hyperacusis.
Hi Ed:
I’ve not had any experience with people using it for hyperacusis, but it certainly works well for people with tinnitus. I don’t see why it also shouldn’t work. The idea with hyperacusis is to surround yourself with sound and the Neuromonics device could certainly do that–but it is expensive.
Cordially,
Neil
Hi Neil, there was an article written by a Dr. Timothy Hain about hyperacusis. Here is the article:
https://dizziness-and-balance.com/disorders/hearing/hyperacusis.htm
About 80% down he makes the comment:
A new treatment for hyperacusis that we have had some success with in our clinical practice in Chicago is insertion of specialized, heavy, ear tubes. With these tubes that reduce input from the higher pitches, something like semi-permanent ear plugs, some of our patients have had remarkable improvement.
Dr. Hain is a very established dizzy doctor. Any comments on this? Can PE tubes help?
Hi Ed:
My question to Dr. Hain’s PE tubes is whether this is a permanent solution, or if the brain cranks up the central gain again in response to the reduced sound input.
In my opinion, you want to do things that work in the long term to get rid of hyperacusis, not do something in the short term that seems to make it better, but in the long term makes it worse. For example, wearing ear protectors all the time helps in the short term but ultimately makes your hyperacusis worse and worse.
Cordially,
Neil
Hi Neil,
I found your blog and quite enjoy it. Hoping you can provide some advice regarding my situation. I am a drummer and do some mixing and mastering for local bands on the side. I consider myself an audiophile with the ability to accurately hear across the frequency spectrum. Over the years I have developed light tinnitus in both ears, but it hasn’t really affected my ability to hear. I always play drums using closed-back head phones so that I can hear a low-volume monitor mix to protect my hearing. But on Nov 10, 2018 I was involved in a car accident where the side air bag deployed next to my left ear. As a result of the loud sound, I had immediate loud ringing in my left ear. Since then, the tinnitus in my left ear has improved, but the ringing in my left ear is louder than my right ear. I’ve also noticed that certain frequencies now seem to sound distorted in my left ear. Some examples are the sound of my girlfriend sneezing, laughter, and even the sound of my own voice sometimes. I notice that the ringing in my left ear seems to gets louder when I clench my jaw. In addition, I have found that I cannot seem to hear high frequencies as well in my left ear. When I cover my good ear, I cannot seem to hear much above 8 kHz in my bad ear. I now find that I have to listen to music at low volumes since if I turn it up any louder, my left ear starts to distort. I’ve had my left ear examined by a doctor and an ENT. Both say that my ear and hearing tests appeared normal. From reading your blog, it sounds like the air bag explosion exacerbated the tinnitus in my left ear and caused hyperacusis.
This has been very frustrating for me since I cannot trust the accuracy of my hearing in the left ear to mix or master music, and I cannot comfortably listen to music except at a very low volume. My question is, can expect that this will improve over time or is there other treatment I should seek out? I’ve read that some people have experienced improvement of sensorineural hearing loss using steroid treatment such as oral prednisolone for 7-14 days. What are your thoughts on this?
Greg
Hi Greg:
That air bag going off close to your left ear caused acoustic trauma to your left ear. And some of the results are louder tinnitus, distorted hearing, hyperacusis, etc. And probably hearing loss–both hidden and high-frequency.
I take it that your ENT only tested your hearing up to 8 kHz and like you have discovered, your hearing above 8 kHz is no longer normal. This could be one cause of your increased tinnitus.
Many people have stiff necks and jaws. This causes your tinnitus to increase when you clench your jaw or twist your neck all the way left or right. This is somatic tinnitus, and is a component of your tinnitus. Going to an upper cervical spine chiropractor and getting your C1 and C2 vertebrae realigned properly can often take care of this. You can find one of the special chiropractors at http://www.upcspine.com/ and then click on “practitioners”. This may also fix some other ear problems related to the accident as whiplash often put out the C1 and C2 vertebrae.
With hyperacusis, you need to give your ears time to recover–and that can take several months. During this time you don’t want to expose your ears to loud sounds–but at the same time, you want to expose your ears to normal sounds so you can slowly build up your tolerance to louder sounds again.
Steroid treatment can work–but you have to do it within 2 weeks, and preferably sooner, of the accident. It is now far too late for it to be effective.
I’d continue to protect your ears from loud sounds and hopefully in time, your hyperacusis and distortion will normalize–at least to a large degree. But be aware that your ears will always be more sensitive to sounds that before. Thus, you need to learn to listen to music at reasonable levels. Normally, you should listen to music at about the same volume as you hear people talking. Then you won’t wreck your ears due to noise trauma.
Cordially,
Neil
Hi Neil; previously you had mentioned that the Neuromonis device is expensive. Several years ago it was over $5,000. I am actually trying a demo from an audiologist and the price of the Oasis model (supposedly their best unit). is now $2,000. Still costly, but much more affordable.
Hi Neil, I have read that a Dr. Silverstein in Flroida has for the last few years done a minimally evasive hyperacusis surgery that has provided very good results. Have you heard of Dr. Silverstein’s work?
Hi Ed:
Yes, but I don’t like it. It doesn’t address the cause of hyperacusis or how a person can work to control their hyperacusis. It is more of a band-aid approach in my opinion. In fact, it really is a “band-aid”. What they do is cover/stiffen the oval and round windows separating your middle ear from your inner ear. Essentially, they give you a mild hearing loss which reduces the volume of everything, including your hyperacusis. But if your brain retaliates and turns the internal volume up even more, it will undo the good the “band-aid” tried to do.
That is why I think it is better to work to control your hyperacusis–as that fundamentally changes the underlying cause, not put a band-aid on the results.
Cordially,
Neil
hello I don’t know where I start but I was sensitive to sounds since I was a kid but when i get 19 everything change I became sensitive to every sound came honestly I was wearing headphone when I go to sleep i sleep with them for 2 years but after those 2 years everything change headphone destroyed my ears I became hear so load soo load and every sound came with a pain it drove me crazy after that I get stomachache I mean I get irritable bowel syndrome sorry for my English i try to explain but i think you get it that my ears destroyed me destroyed my life
Hi Cisco:
It sounds like you have hyperacusis.
I’m not sure what you were saying about wearing headphones when you went to sleep. But if you were wearing headphones and listening at loud volumes and left them on all night–that would be extremely bad for your ears and could make the hyperacusis worse. So could wearing headphones with the sound off and not letting your ears get enough sound so your brain turned up its internal volume.
The good news is that you can treat hyperacusis and get it under control so you can live a reasonably normal life again. I’m working on a book that will help you when I get it finished. I wish it were finished now so you could read it and see that there is hope for you if you have what I think you have.
Cordially,
Neil
Hi Neil, I hope you can help.
My symptoms started in June this year. I had an itchy Left ear for a week, which I itched. Like I have always done and not had any problems.
I then decided to put some ‘Savlone’ in the ear canal. I have done this before, again no problem.
Then the next day I woke up and could hear my ‘Heart Beat’ in my ear and the sound of rushing liquid in my left ear – which sounded like it was coming from the back of my head. I figured this was blood I could hear moving like a stream of water.
I didn’t look to much into it as normally everything I get goes. Then came across ‘Pulsatile Tinnitus’. The noise of the liquid rushing subsided but the pulsing il line with my heart beat was still there, so I went to my GP and she looked in my ears with the Otoscope and said I can’t see anything wrong – but can see wax – which looks normal.
A fews past and my symptoms where still there so I told my GP and was referred for an MRI. Which would be on the 22nd June.
A few days later I decided to see an Audiologist as they a specialists in this. So I went to ‘Specsavers’ here in the UK & she used a camera and told me you have impacted earwax.
I was so distressed with the noise & and asked if she could remove it abs explained I was waiting to have an MRI in a few days. She said that it’s too hard to remove and her machine ‘Microsuction’ could make the Tinnitus worse. She advised that I wait for the results of the MRI and she would be contacting my GP as a matter of emergency.
My audiologist said to use some drops to soften the earwax. So I went a bought some ear drops.
They contained 5% Hydrogen Peroxide and Urea.
I used these drops for a week -one a day 5/6 drops in each ear.
At this point I had no sensitivity or eardrum flutter to certain frequencies of noise.
So after I had the results of the MRI – all they found was a ‘Vascular Loop Invaginating the Right Interior Audio Meateus’.
My GP then thought maybe this would be normal for me however would want an ENT to clarify.
I told my Audiologist and she said okay let’s remove the earwax. So I went to have this done on the 7th July 2020.
Microsuction was done – she was only in my ear for about 8 seconds for each ear. Had to go in again on my left ear. Again only in for a matter of seconds.
Now – two/three days later the sensitivity went through the roof – cutlery/plates and spoons etc felt so sensitive. Didn’t hurt but felt the sensation in both my ears.
Then then my right ear felt like it was amplified. Like having a speaker which is connected to an amplifier turned to full volume but no input. So you get the slight hum/buzz noise coming from the speaker.
This has gone now.
However both ears are sensitive to ‘Human Speech’ more so when in a room and certainly more sensitive to female voices inside a room. Which is not good.
My Right Eardrum also flutters to certain frequencies of sound – such as a knife hiting/scrapping on a glass cutting board. Also when scraping the knife of toast to butter bread for example.
Furthermore – when you shut a lid on a container or the lid touches the container as you go to tighten it, this too makes my right eardrum flutter.
Also when people are talking if I touch the right side of my face, the ear drum will flutter – like rub my right eye/ to such the right side of my mouth/cheek.
The sensitivity seems to get worse if I am indoors all day and no noise then the next day out and about.
I have been trying to expose my ears to as much sound as possible. I have been using a DB noise level app when listening to music in the car. Have been able to tolerate 90db.
I have had 5 hearing tests and all come back normal. What I did find is that when I sat in the hearing booth with noise cancelling headphone on – there are times I couldn’t hear the buzzing sound in my left ear.
Other times I could hear my pulse.
Now I have found if I use ‘Dymista’ nasal spray to buzzing doesn’t improve nor does the fluttering in the right ear when triggered by the certain frequencies. (The flutter is not constant)
I have been to see an ENT twice. He mentioned that it could be a shared nerve – so when I touch parts of my face – it causes the eardrum to flutter. However I found your information on TTS syndrome. And told him and he came back with ‘Middle ear Myoclonus’.
I have found that if I blow my noise it makes the buzzing sound worse.
What I spotted on my left eardrum was a large white long patch – which seems to have been changing since July and now they (ENT & Audiologists) say it is a very small scar.
Prior to all these problems I never had any problems with my hearing or exposed to loud music.
I’m wondering if the Microsuction & Hydrogen Peroxide Drops caused the Sensitivity and Fluttering sensations?
The sensitivity is getting better but I am not at the stage like I was before. The Tinnitus buzzing noise is a noise which sounds similar to a pulsating sound. Like a sound with a break in it. So not a constant sound – but this sound is pretty much always there.
The only time I cannot hear it is when I’m outside.
I have to sleep with the fan on still – since symptoms started in June.
I would like your thoughts on the matter please.
Thank you Kindly,
Mevin.
Hi Mevin:
Your ENT is right that it can be a shared somatosensory nerve that picks up signals of various senses and sends them to your brain where multitasking neurons can send the wrong signals to the wrong place. Thus it could send tactile (touch) signals to your auditory circuits and you’d hear a tinnitus sound when you touch that place.
As for the microsuction causing your eardrum to flutter, it all depends on whether when getting the wax out it pulled your ear drum out in the process and then let it snap back as the wax “let go” and air rushed in. This is the same as exposing your ears to a sudden loud sound. That could account for the TTTS.
After the wax was taken out, if your ear canals were blocked totally, it would be normal to hear everything as too loud for a few days. But you describe a different kind of sound sensitivity–and mostly in the higher frequencies. This is consistent with having loud hyperacusis as well as TTTS. Often they can accompany each other.
Since the sensitivity is getting better, leave things alone. Just don’t expose you ears to louder sounds–i.e. don’t expose your ears to 90 dB sounds even just in testing. Keep all music and other sounds down to a level that is approximately the same level as speech. Give it another couple of months and see how much things improve in that time.
And don’t be anxious and worry about your ears. That just makes it worse. All these conditions have a psychological (emotional) component to them that makes them worse, keeps them from going away, etc. So you want to keep your emotions neutral to your ear conditions and let them fade away.
If you want more information on all these sound sensitivities, get and read my brand new book just out last week called “Hypersensitive to Sound?”. You can get it at https://hearinglosshelp.com/shop/hypersensitive-to-sound/ . If you want this book, get the eBook version as postage to the UK is ridiculously high–about $50.00 US$. The contents are identical.
Cordially,
Neil
Hi Neil,
Thank you for your reply.
I have found that when I have been inside for two days and not been out, my ears are sensitive to female voices – as such my wife’s voice but only when she is talking on the phone. As her voice frequency changes.
As for the Tinnitus the symptoms, the sound is constantly changing – which is always very low buzz – like from a subwoofer.
Again it is a sound that has a break in it – close to a pulsing sound but not.
As for the fluttering sensation in the ear, if I touch/rub those parts of my face and there is no noise, then I don’t get the symptoms only when inside and people are talking and I touch the same areas I get the sensation? What is causing this, is it the Hyperacusis?
Do you think the Tinnitus will go? As when I put my finger on my ‘Tragus’ the noise goes.
As for the Hyperacusis – will that go away and will my ears return to normal – it’s been 4 months now – abs symptoms have improved.
At first I had to block on ear – either the left of right to stop the sensitivity when people were talking – now I don’t.
As for the Hearing tests all have been done upto 8,000hz.
All come back normal – between 5 & 10 & even -10 at 4,000.
Tympanometery done twice came back normal. Pressure and Ear Canals well ventilated.
The sensitivity has been affecting my life as I am not able to work at the moment.
The last time I had my ears touched – earwax removed was when I was about 6 or 8 years old – and that was done with water.
Thanks Neil in advance.
Hi Mevin:
I don’t know why your ears are so sensitive to female voices after you’ve been inside for a couple of days. I’ve never run across something like that before. Obviously, your ears are sensitive to certain frequencies, especially the higher frequencies, which is very common with hyperacusis.
From what you say, your tinnitus is not pulsatile tinnitus. In other words, it is not related to your body functions. It seems what you have is what we might call a pseudo-pulsatile tinnitus because it’s not in unison with your heartbeat, but sort of sounds like it is.
The fluttering sensation is tonic tensor timpani syndrome (TTTS). It is not hyperacusis, but TTTS can be associated with hyperacusis.
Remember that tinnitus, hyperacusis and TTTS are all psychosomatic conditions. Thus, your emotions are involved. As long as your emotions are involved, this condition will persist. That is why treatment for these conditions involves both a “physical” treatment component and a “psychological” treatment component. You need help with the psychological component in order to bring things under control. Focusing on these three conditions is exactly the opposite of what you really need. And definitely any anxiety or worry you feel over these conditions is just making things worse.
When you have an almost perfect audiogram, and when one or more of the numbers is above the zero dB line, that is often indicative of loudness hyperacusis. You don’t really have better than normal hearing, it’s that your perception of sounds is now off and that is why you get these abnormally good audiograms.
As I said before, you would do well to read my new book, “Hypersensitive to Sound?” as this book goes into much more detail about the physical and psychological components of hyperacusis and TTTS and other related things.
Cordially,
Neil
Hello doctor Neil.
First of all i would like to thank you for spending some lf your precious time answering all of these people.
I have had hyperacusis for 2 years, got it from listenning to loud music over my headphones.
I have developped Tinnitus over the last couple months and would like to know if it’s okay to listen to music on very low volume on my earphones or am I just taking risk of getting my Tinnitus louder.
Thank you so very much.
Hi Adam:
If you keep your music down to a level equivalent to the level you comfortably hear people talking, you should not make your tinnitus worse. It’s the volume of sound going into your ears, not the fact you are wearing headphones or not that matters. If it makes your tinnitus worse, you know you have the volume up way to high.
Cordially,
Neil
Hi Niel
I came across this site and your opinion is appreciated.
I have had tinnitus now for more than 20 years, which was due to playing in bands, going to concert/clubs and listening to Walkman. I’ve been able to cope with it and it has not bothered me much and at concerts, movies etc. I have always used my earplugs for protection.
However, all this changed for 2,5 weeks ago where I went to try a vertical wind tunnel (simulating skydiving). Somehow my guards were down for the risk. I knew the wind tunnel was generating a lot of noise (120db) But I thought that using foam earplugs would be protected as I thought these were the best for noise protection.
The day after the event I started to feel really bad. Pain in both ears and a high pitch very notable tinnitus. After a few days I went to an ENT. I apparently had a lot of earwax in both ears, which the ENT removed. Instant relief but tinnitus and other symptoms were still present. After some days I visited the ENT again. Nothing to see from the outside. Hearing normal for my age but a little drop in 8000 HZ as was also present 20 years ago.
I am coping a little better here 2 weeks after but I am experiencing different sounds and symptoms, which I didn’t have before the incident. First of all the high pitch tinnitus is loud. But in addition I also have a low pitch vent-kind of noise, which feels a little like my eardrum is vibrating. Does this make sense? I wouldn’t say that I have hyperacusis as such but all sounds seem to aggravate and increase the tinnitus sounds instead of outshouting them. It is also hard to be among a lot of people for example at lunch when the canteen at my work is full. In a pain scale from 0-100 I would say that I’m feeling a 2-3 pain in my ears like they have been bruised. Besides that I am feeling beside myself and get easily tired. After a workday (office) I feel exhausted. I have not been able to sleep without taking medication and am currently on a dose of anti histamine Prometazin “actavis”.
I am trying to take one day a time but feel is difficult. Have you encountered others with the same symptoms? Will time heal my ears and can I do anything myself? Seeing an audiologist next week.
Thanks
A
Hi Andreas:
If your eardrum feels sort of like it is vibrating, you may now have tonic tensor tympani syndrome (TTTS). This can result from exposing your ears to loud sounds. Read my article on the subject at http://hearinglosshelp.com/blog/do-i-have-tonic-tensor-tympani-syndrome-ttts/ and see whether this describes what you are feeling.
If your tinnitus interacts (reacts) to sounds, then I’d say you have reactive tinnitus which is basically hyperacusis interacting with your tinnitus to some degree. You can read my article on it at http://hearinglosshelp.com/blog/reactive-tinnitus/ .
See if these two articles get you on the right track.
Cordially,
Neil
Dr. Neil,
My name is Vatche and I have developed tinnitus and hearing lose when I was 22 or 23 years old, Lucy after suffering for few years I can’t remember my tinnitus gone it self and I was living happily until age 33 last year where my tinnitus came back and in severe way it been almost one year as of for now, however, when I went to ENT dr he proceed hearing test nothing was changed since then left hear high peach hearing lost 4000 sever at 70d and 8000 around 50d.
However, I have learned how to live with tinnitus and I’m so optimistic that it will go away as it happen 15 years ago.
My concern is now different, past one month I think I’m suffering from miner hyperacusis symptoms i fill light pain in my left ear and some fullness and irritation when I’m listening to the radio in my car or talking of the phone.
How long you need to cure hypercusis and what should I do to prevent it ?
Hi Vatche:
It’s good that you have learned how to ignore your tinnitus and let it fade into the background and not bother you.
Since you have a significant hearing loss, your tinnitus is likely permanent, so you are doing well with your way of coping with your tinnitus.
However, hyperacusis is another matter. Probably the most common cause of hyperacusis is exposing your ears to loud sounds/music. (This can cause hearing loss and tinnitus too.) So, if you have been exposing your ears to loud sounds, you first need to stop doing that. If you have to be in noisy areas, then wear ear protectors.
A number of drugs can also cause hyperacusis, but so can hearing loss itself.
I think protecting your ears when in noisy venues is probably the best thing you can do. However, don’t overprotect your ears or you can make your hyperacusis worse. So take your ear protectors off as soon as you do not need to wear them.
Hyperacusis typically doesn’t go away fast–it needs a number of months for your ears/brain to return to normal again. Some people take several years.
Cordially,
Neil
Hi Neil; I have a story that has happened to me that I hope you can comment on. Approximately in mid to late October 2018 I started to get a very low tinnitus sound in my left ear. It was low and lasted for about an hour or so. About a week later it came back again, very low and short. During November I started to get ear pain a felt a little off balance. I saw my ear doctor who looked at my ears and saw nothing abd did nothing even though I mentioned I had ear pain. About a week later I had another bout of tinnitus that lased several hours before it stopped. All of these tinnitus episodes were in my left ear only. In early December I took my nephew bowling. Bowling is not terribly loud but but for some reason I began to have tinnitus in my left ear. I also have been experiencing that sensitivity to sound. I decided to see the ENT again and lo and behold he found an ear infection called “otitis media”. I was given anti biotics to treat the infection and about a week later the infection was gone (at least by the human eye). For the first few weeks the tinnitus was bearable, probably 40% of the time not there. Slowly, though, the tinnitus has been getting worst and now steady. The hyperacusis is also there (which is related to tinnitus-they go hand in hand). I went to see a new ENT and he ordered a Ct. Scan (much quiter than an MRI.) This will happen in about 10 days or so. Do you have any comments about my story. Can 30 minutes of bowling literally cause such terrible symptoms? Is it possible that the otitis media, while cleared by the human eye, may have caused some sort of ear condition? Any reply is appreciated. Thanks Neil
Hi Ed:
Otitis media isn’t the name of the infection–it is the location of the infection–in your middle (media) ear (oto). The actual infection may be any “bug”.
Go back to last October and November when your tinnitus first started. At that time were you on any drugs? Had you recently started taking any? That could be one common cause of what began happening.
Also, back then, had you exposed your ears to any loud sounds, especially sudden loud sounds? And did you continue to listen to loud sounds? It almost seems that way.
Then, when you went bowling, the sound of the balls hitting the pins has a sharp component to it. I think that was what pushed your ears over the edge, but the underlying damage was done earlier.
Otitis media could have been responsible for some of your ear problems, but I don’t think it was the whole answer, or even the major part of the answer.
And worrying about your tinnitus/hyperacusis isn’t helping either. The more you check to see if your tinnitus is there and how bad it is, the worse it gets because you keep focusing on it. You want to learn to totally ignore your tinnitus.
Get back to me with the answers to my questions and lets see what turns up. Add anything else that you feel is pertinent.
Cordially,
Neil
I got Tinnitus in November it progressed and in January I developed Hyperacusis. ENT put me on Xanax for 7 days. I’m still suffering from withdrawal symptoms.
My Tinnitus got mild and Hyperacusis went away slowly until last night I got exposed to some loud music for 5 mins. and now my Tinnitus has spiked and Hyperacusis is back. I feel very discomfort to loud noise.
I think I’ve ruined the progress made. Will this go away or should I take Xanax again?
Xanax is very bad drug and I’m still suffering from withdrawal symptoms.
Hi Raiz:
With tinnitus and hyperacusis, exposing your ears to loud sounds can set you back, but this doesn’t mean you stop progressing. You just start again from where you are and keep on progressing. This just means it will take longer to get things under control.
I’m with you about the Xanax or any other drugs. Use them as little as possible. Seek other natural (herbal) solutions if you can.
It’s a good idea to carry ear protectors in your pocket so if you suddenly find yourself in a noisy place, you can put them in your ears–this will help you avoid setbacks while your ears heal.
Cordially,
Neil
Hi Neil,
I have had tinnitus for a few months now. Both ringing and pulsing. The MRI shows no issues except for Sphenoid Sinusitus which the dr gave me 10 days of amoxicillin for 2 times a day that I just finished today. I was sensitive to sound before this when the tinnitus began, but now it seems like it is worse. To make it even worse, my ears still feel full and my ear will spasm with almost every sound I hear. It was just my left ear at first, but now its both ears. Just last night after a hot shower, my right ear went on a continual spasm and had fleeting tinnitus going in and out about 5 or 6 times. I never had ear problems prior to the tinnitus which I can only assume was caused by stress. I don’t listen to loud music or subject myself to anything loud. I was wondering if I should see an Neurologist since both my ENT doctors don’t see an issue. Do you think this will go away on its own or any ideas?
Thanks
Tracy
Hi Tracy:
When you say you have a pulsing tinnitus–are you meaning pulsatile tinnitus which is in time with each heartbeat?
Or are you meaning ear spasms–a fluttering of your eardrum kind of thing? Just the way you say things, I’m wondering if you really have tonic tensor tympani syndrome (TTTS). Read my article on the subject and see if this rings a bell with you.
You can read it at http://hearinglosshelp.com/blog/do-i-have-tonic-tensor-tympani-syndrome-ttts/ .
Cordially,
Neil
Hi Neil,
It’s more of a spasm in the ear. It’s not in time with my heartbeat. The spasms happen every so often. The ENT told me to listen to pink noise since my hearing is sensitive to normal sounds, and he gave me cyclobenzaprine to relax the muscle. Every time my ear spasms I get really nervous and panic that it won’t stop. The ENT also said I have TMJ but I’m not sure since my jaw doesn’t really hurt and I don’t grind my teeth. But my feels full towards the end of the day. And slight ringing in the left ear. I’m just trying to find the right path to go down and try to prevent it from getting worse. Do you know what the best option for me?
Thanks
Tracy
Hi Tracy:
If the spasms are not TTTS, and if you supposedly have TMJ and your ears feel full at the end of the day, I am wondering whether your Eustachian tubes are also not working properly. If all of the above are true, then the only thing I can think of is that your C1 and C2 vertebrae may be out of proper alignment. If this is so, you need to go to a special kind of chiropractor called an upper cervical spine chiropractor and make sure you are in proper alignment. When this is done, if your symptoms go away or change, you know this is the problem or part of the problem. You can find these special chiropractors at http://www.upcspine.com/ .
Cordially,
Neil
Hi, I am suffering a vestibular migraine
It was brought on by been inside a boat as a trigger if now found out.
This has resulted in me been sensitive to sounds,
I’m not sure if it’s my ear or my head that picks up the discomfort but things like packaging been taken off drives me crazy creaking floor boards, so it doesn’t have to be that load, I’ve found myself having to sit with headphone on else I’m driven mad with migraine pain, I’ve also got dizzyness
I’m now under a neurologist who has put me on propranolol and I’m up to 160mg a day sumatriptan naproxen betahistine
and progressing onto trapiromate.
I’ve hD this for 11 weeks and my sound sensitivity is getting worse, I’ll call it vibration sensitivity as it’s not only sound it’s my speech vibration and actually walking vibration as well. I just exist at present and since I have vertigo and this condition has a trigger of eye balance to ear balance Miss co-ordination I’m
Thinking the vertigo aspect it causes will permanently be retriggering the condition. How do I get out of this situation please and will my sensitivity go ?
Hi Kevin:
Tell me more about how you developed vestibular migraines from being inside a boat. Are we talking about a small pleasure boat or a big freighter. Were you in a noisy engine room or what?
Also, when did the dizziness and vertigo develop–before you began taking all these drugs or after. Hundreds of people get vertigo from taking Propranolol, and thousands develop dizziness.
So can Sumatriptan–but at a rate of about half that of Propranolol. Naproxen has a rate about double of Propranolol. Topiramate has a rate about the same as Propranolol.
What I am saying is that these drugs can cause dizziness and vertigo or make it worse.
Migraines can certainly cause you to be sound sensitive. So can Topiramate and so can Propranolol and Sumatriptan at a lesser rate, and so can Naproxen at an even lesser rate.
And all these drugs can cause hyperacusis (sound sensitivity). So you need to consider all these drugs as they can be causing your symptoms or making them worse.
Tell me more about your situation and I’ll see if anything jumps out at me.
Cordially,
Neil
I was on holiday in Australia during December for Christmas,
It wasn’t noisy really.
There was a generator on board but nothing you really noticed running more background noise.
I was inside the house boat in the corridor between the bedrooms and a speed boat shot past pulling water skiers. I didn’t know they went past and as the wake hit the boat I was thrown forward in the corridor as the boat moved, the size of the boat was like a small ferry 8 bedroom and a living room st the front and a living room at the back with two decks. As the boat moved I said to my partner what was that as I was thrown forward she told me it was the water skiers, I know a vestibular migraine can be caused by a vestibular ocular mismatch so I’m just making the assumption here that my vestibular system realised my balance changed but my ocular system still saw the same square rooms the same way and my skeletal muscular system will have realised the my body had been Jared so I’ve just made an assumption that it’s that as the premod period of 48 hours fits for that even works in for the start of my symptoms.
So there was no real loud music going but there was some music on the boat from one small bose portable travel speaker
We did swim in the Murray river which after we arrived home had reported blue algae blooms because of the Extream temperatures we had of 40 degrees going to 50 after we left.
This hating event happens on the last day and we then started or journey back home which took roughly two days then I started with this condition
It first felt like I was bouncing with each step the sort of feeling you get from an elevator when it stops
Each movement had that gravity deceleration sort of essence to it. I’d speak and I’d feel a vibration inside my head like a buzzing but I would not hear a buzzing just feel one.
It was like my funny bone been vibrated if it existed inside my skull.
My doctor thought it would just pass and said give it some time, I booke an ENT specialist and he said I had Mdds but I said I do t have the symptoms of that disorder and it’s rare and it’s predominantly women as well he insisted I did regardless even though at that point I did have sound sensitivity and he said about cochlea infections making sounds irritable and I said I have sound sensitivity he just dismissed it.
I went back to the GP informed him of the ENT result and said I wasn’t confident as I didn’t rock bob or sway when I was still which is what you did with Mdds when I’m still I’m still once I’ve settled that is.
Is if o go lay on my bed I’m still if I walk around for 1 minute I’m dizzy but if I stand of go lay down again after about 1 minute I’m no longer dizzy. So it’s only while I do things and until it settles after I’ve stopped.
When I eat I get dissy as my head is up and down chewing
When I talk I get dizzy but if I whisper I don’t do there is something to do with the base vibration of my voice.
So my sound sensitivity started before the medicines but the medicines have made it much worse of seam to have.
So along with this bouncy walking think I also had tinitus
Which came with it.
6 weeks later after seeing a neurologist who put me on propranolol the sound of my tinitus changed and then my sensitivity to sound changed it got worse
The neurologist upped my propranolol he doubled it and for three days the sensitivity seamed better the tinitus sound changed and then the sensitivity to sound became even worse he doubled it again. Now I was on 160mg propranolol a day I got to the point I could not get my hand into a bread loaf packet without the noise of the rustling packet hurting me. I kept reporting this Back to him he said seethe advice of an ENT so back to another ENT who has just advised to stop all medicine baring one I said which one and he said you choose the neurologist increased the betahistine to 16mg and that does seamed to have helped
A tiny bit.
So I can stop all the meds
So really what are the chances I’m permanently damaged or should I recover I can hear and I can watch tv, listening to people speak in a normal voice is painful for me.
Is my issue one one a migraine and will be corrected when my migraine goes or do I have a real hyperacoustis issue going on and a vestibular migraine doesn’t have to give you a headache so as in the beginning this did it isn’t now but this could be down to the tablets or maybe it isn’t a vestibular migraine and my headache was down to an ear infection but I would appreciate any light you can shine on it for me please
Kind regards
Kevin
Hi Kevin:
When you were “thrown forward” did you hit your head on anything, or bang your body into a wall or anything? Or was it more like a stumble forward without hitting anything?
If you balance function on both sides is damaged you can get oscillopsia which is often called “bouncing vision” because with every step you take, your vision bounces up and down as though your eyeballs were on springs. This wasn’t your experience, was it? I’m trying to relate what you say to various conditions that I know to see if anything fits.
Is this “bouncing” over now, or do you still have it?
Normally, if you have MDDS, it goes away in a few days or so–but it can last forever too in some unfortunate people.
Have you been to a balance clinic and had your vestibular function evaluated on each side. This is one thing I think you need to do. After testing, they can tell you how much balance function you have on each side. That way you’d know what you are dealing with if it is a vestibular problem and not a cochlear problem.
Another possibility is that the otoconia (rocks in your head) got knocked out of place and thus affect your balance. This is known as benign paroxysmal positional vertigo (BPPV), but you don’t seem to have the vertigo–just an imbalance. If this is the problem, doing the Epley maneuver can put them all back into place and you should get your balance back. Did your ENT suggest this as a possibility?
What is happening to your sound sensitivity (hyperacusis) now? Any changes?
Anything I’ve said above ring a bell?
Cordially,
Neil
Sorry also how do I stop retriggering my self
Ie
Balance issue
So my ear thinks different to the actual but my eye sees real will this not just keep recreating the same trigger that started the even in the first instance.
Kind regards
Kevin
Hi Kevin:
Balance testing should reveal whether your vestibulo-ocular reflex is working properly or not.
Cordially,
Neil
I’ve stopped taking the sumatriptan and since I’ve read the side effects of naproxen can make you deaf I’ve just stopped them right now as well. Tiny letters split across columns, should be big and bold something that drastic really. I’ve reduced the propranolol to 120mg but it will take a while to get off that.
If I come off all of these could having a vestibular migraine damage you at all ?
As I hear it can constrict your blood vessels
Hi Kevin:
I know next to nothing about vestibular migraines. However, I know that some migraines, and some vestibular problems as well as some hearing problems arise from certain cranial nerves being compressed and going to a upper cervical chiropractor, not a conventional chiropractor to have precision adjustments of your top two vertebrae (C1 & C2) can do wonders for some people. This could be a possibility as you lurching forward could have thrown your C1 and C2 out of proper alignment. You can find upper cervical chiropractors at http://www.upcspine.com/ and then click on “practitioners”. This is another strong possibility that I’d try if nothing else seems to work.
Cordially,
Neil
Sorry I missed a couple of my symptoms out, during the onset of this I also started to get burned vision and then I ended on getting double vision in the right eye only
I have nearly all the time earache in the right ear only and also often feel a sort of burning warm feeling inside I’d even describe it as raw and slightly swollen I do t know if some on the web call the fullness or not but it feel warm and a bit swollen to me. When I go to sleep on a night now my brain feels like it’s also shaking shivering this could be side effects from meds maybe doctor said trapped nerve but inside my head, they are all trapped in there lol, I looked up migraine and something called ET tremors it could be thous.
This has been going on now for 3 months I was a well man for 51 years before this now it has me like a disabled person
This condition also is playing up my eye strain, I’m 51 and need reading glasses, they male my eyes hurt now so this is doing something to my eyes as well I’ve been to the opticians and am now wearing contact lenses which are better but can still feel the strain of lenses in the eyes and sometimes moving things on my phone screen makes me feel like my head has been knocked so there is some ocular balance thing going on as well and I guess if it goes on for much longer my work will get rid of me.
Really need as much help as possible getting to the bottom of this.
Kind regards
Kevin
Hi Kevin:
I don’t know what your doctor meant by a trapped nerve either.
So far the two things I think you need to have checked out are your balance function from a balance clinic and see an upper cervical spine chiropractor to be sure your C1 and C2 are in proper alignment. Once you know the answers to both of those, then you should know in what direction to go to resolve your issues–or at least have a much better idea.
Cordially,
Neil
Dr. Bauman, I attended a fireworks show last night and wore Mack’s wax ear protection, I put my hood on and held my hands over my ears. I think I was at least 20 meters away. But there were lots of m80s! The day after my it seems like sounds are louder in my left ear. Is this acoustic shock and will it go away?
Hi Jessie:
It’s possible that you have some acoustic shock from the fireworks. Obviously you have some degree of noise trauma from the event. I would expect things to return to normal (near normal) in a few days to a couple of weeks.
Cordially,
Neil
Hey doctor I been having issues with my ears for over a month now. I think it’s probably from years of noise exposure. I did go to s restaurant and play music in headphones over a crowd woke up the next day and my hearing was reduced. I got my ears cleaned the next day and everything was fine. I continued on with my life listening to music not via headphones though. I sleep with white noise at night cause I been had tinnitus.. Anyways I woke up out if my sleep because my hears started stinging and the volume reduced. They been been hurting nonstop since then. My ears are bubbly, they tingle, their numb, I have ear tightness, incomplete yawns. And my hearing gets duller day by day. I seen ENTs they blew me off. My audiogram came back good. It’s not the same, I’m aware I have hidden hearing loss because I can’t hear good in crowds, gathering etc. Noise overpower my voice my voice sounds buried.. the symptoms don’t stop either.
Do you know what this can be?
Hi Erin:
As you unfortunately are now aware, you can’t expose your ears to excessive noise for a long time and not expect them to end up damaged.
Noise trauma can result in tinnitus, which you have, and hearing loss–hidden in your case since a regular audiogram apparently didn’t show any problems. These are the two common symptoms most people think of when they think of noise damage.
But there are other ear problems that arise. One of them is ear pain, another is numbness around your ear, another is a feeling of fullness that isn’t relieved by yawning. You wouldn’t expect these kinds of symptoms from noise trauma–but they are all relatively-common symptoms. You can also get loudness hyperacusis where certain sounds are now too sharp and louder than normal. And of course, you can get distorted hearing.
Note: these symptoms don’t have to occur immediately after loud noise exposure–but they can. However, some of them only show up a few days to a few weeks later.
This is all part and parcel of noise trauma.
Ear pain and numbness can be a part of sudden, unexpected, loud sounds that causes what they call Acoustic Shock Disorder (ASD). The pain can become chronic and thus persists because of a pain loop that gets established. Treatment can be the same as for any other pain loop.
What you need to do is give your ears a rest from louder sounds–basically sounds louder than normal speech. They need a couple of months or more to “heal”. So if you have to be around louder sounds, wear ear protectors during that time. However, don’t wear them when you don’t need to as that will only cause worse problems such as loudness hyperacusis.
Cordially,
Neil
Hi doctor, nine days ago now, I went to a concert and afterward my ears have been ringing in silent settings and I have new sensitivity to sounds. Would you say this is Hyperacusis? This sensitivity is especially prone to artificial sounds like the ones created by my iPad whether it’s from the speaker of ear buds. Even when I listen to music at low volumes well below what could physically damage my ears, it still bothers. I was wondering how I should go about retraining my ears to get used to listening to music again. Furthermore, I sing in a chorus, should I wear ear protection when in rehearsal? I’m basically trying to figure out how not to overprotect my ears while also ensuring their safety. Also, I was wondering if this being a new thing (only nine days or so), are the chances good that with proper care, my Hyperacusis will go away if that is what it is? Because I don’t think I have any hearing loss I hear just fine, just with some sensitivity. Thanks a lot.
Hi Keith:
The ringing is tinnitus and the sensitivity to sound is mild hyperacusis. Typically, hyperacusis is more sensitive to higher frequency sounds which a lot of “artificial” sounds are.
Just listen to music at lower volumes for a month or so. This gives your ears a chance to heal. Once they are healed, then you can slowly increase the volume again as you can stand it until you hear normally once more.
If singing in the choir doesn’t bother you and your ears, you don’t need ear protection.
I’d say your chances of overcoming your hyperacusis are very good. It just takes time. You just want to protect your ears from really loud sounds, because they can set you back. But normal sounds, if they don’t really bother you, shouldn’t be a problem. You should notice the sensitivity to certain sounds fading as time goes by–as long as you don’t focus on it and thus make an issue of it.
Cordially,
Neil
Thanks a lot for the words of advice. So I had a few more things I wanted to mention. For starters, while other sounds aren’t as irritating as music, my ears still feel sore after a while of talking to people. Would you still consider that mild?
Also, I have anxiety and depression. I’ve read on your site that can harm my recovery. How do I avoid thinking about the hyperacusis (I’m not so concerned about the tinnitus since it doesn’t hurt really). Thanks again for taking the time, this has been really stressing me out snd even led to suicidal thoughts. So ur optimism is very comforting.
Hi Keith:
It’s mild in comparison to those people who refuse to leave their houses and have to talk in whispers due to their severe hyperacusis. I called your mild based on what you said before that some sounds were a bit louder than normal. Perhaps your hyperacusis is moderate. Actually, the degree of loudness doesn’t define the degree of hyperacusis. Rather, it is your reaction to it. Using tinnitus as an example, one person may have extremely loud tinnitus and tell me its no big deal, whereas another person has tinnitus so soft she can only hear it in complete silence, yet she goes ballistic.
The best way to avoid thinking about your hyperacusis or tinnitus is to focus all your energies on something else. Do something you love doing when your hyperacusis or tinnitus is trying to get the best of you.
Also, when you have hyperacusis, you always want to surround yourself with low-level sound. Set the level so it doesn’t annoy you. Have this sound around you 24/7. It will help you with your hyperacusis even while you are sleeping.
You can get over this if you persevere, but you have to do the work. It is something you do for yourself, not something that someone does to you. Remember, there is an emotional component–and stress and anxiety are two things that bring it on and/or make it worse. So you want to get your anxiety under control. The same with your depression.
Cordially,
Neil
And two more things, would listening to pink noise at night be helpful? I read that it might. And where I live is getting cold, is protecting my ears from the cold important to this process? Thanks a lot doctor
Hi Keith:
Yes, pink noise is good if it is not annoying to you. You want to pick a sound that is not annoying. Other good sounds are water sounds–waves on the beach, waterfalls, rainfall, water in creeks, etc.
I don’t think in makes any difference as long as you are not freezing them! If you notice a difference, then act accordingly.
Cordially,
Neil
Hi Doctor Bauman, so I was born with severe hearing loss in both of my ears and I currently wearing BTE hearing aids in both ears. Recently, I was playing a video game on my computer and the game was unusually loud and i use this device that connects the audio directly to my hearing aids. So I was playing this game for like a week straight with loud volume (I know im an idiot what was i doing) and now my hearing is acting weird. It hasnt gone low or anything but tinnitus has increased and ive noticed that everytime i use audio connected directly to my ears, my ears seem to act up as if they are sensitive to the noises even though i never had that problem before in my life. Is this something serious or will my hearing eventually recover from exposure to loud noises while gaming in a few weeks?
And also the clarity of my hearing as been acting weird. It is not normal for sure though so the loud volume i was exposed to definetly did something to my hearing. I just hope it will recover eventually and that it wont be something permanent. Otherwise i would be very sad cuz i already have major hearing loss from birth lol
Thanks
Hi Ray:
I know what it is like to have severe hearing loss from birth. I’m in the same boat.
When you play sounds too loud for too long, you cause acoustic trauma. If you had played your games the same volume, but just for an hour at a time with lots of rest times in between, I doubt you’d have the problems you now have.
The tinnitus is a sign you were playing your game too loud. And along with it, you now have some degree of loudness hyperacusis–also typically caused by loud sounds. Hyperacusis means your ears are more sensitive to sounds and you perceive them as louder than they really are.
The good news is that if you give you ears a rest for some weeks from these loud sounds, hopefully your hyperacusis will fade away. But don’t expect this to keep on happening if you expose them to more loud sounds in the future. You need to turn the volume down so you don’t get increased tinnitus or hyperacusis because the more you do it, the less chances you have of getting them under control.
Cordially,
Neil
It has been about a month and my ears are still not back to normal. I have not listened to audio for awhile. Perhaps the hearing aids is making it worse and I should take it off to enforce the recovery? I dont know and i am getting very worried that this hyperacusis is something permanent
Hi Ray:
If your ears are progressing towards normality, that is a good sign. In that case, just give them time. It can take months, so don’t get impatient.
If your hearing aids are making sounds seem too loud, then that may be a possibility, but if your hearing aids don’t make sounds uncomfortably loud, I doubt the hearing aids are a problem.
Remember, patience is a virtue. Some people take 2 or more years to get back to normal, so don’t give up and don’t worry about it.
Cordially,
Neil
Wow this is really sad… So basically i have to isolate myself from movies, tv shows, music, and video games until my hyperacusis fully recover which you mention might take couple of years…. I cannot believe that it does not take much to damage my hearing for a long period of time. I definitely cannot hold any longer without having some sort of entertainment and I am also extremly stressed thanks to school and this is getting really depressing for me lol. My life is really cursed.
Hi Ray:
You completely missed the point. All I said was to keep the volume down to a level that doesn’t bother your ears. You don’t have to stop any of those things–just keep the volume down to a level approximately the same as you hear people talking. You don’t have to listen to music any louder than that to enjoy it.
As one wise person said, “Whether you think your life is blessed or cursed, you’re right.” So look at your blessings. We all have problems in life–but look on the bright side. It’s ever so much nicer that way.
Cordially,
Neil
Hi Dr. Bauman,
I am 34 years old. I went to an extremely loud rock concert 16 days ago which took place in a small venue. Regretfully, I did not wear any ear protection. I was near the front, closer to the left speaker. There was a girl with a very high pitched voice behind me to the left screaming for much of the night. Every time she screamed, I felt mild pain in my ears. I stayed at the concert for 3 hours. My ears were muffled and had loud ringing after the concert. It was louder in my left ear. The loud ringing subsided after about 4 days, however I am still experiencing intermittent and moderate noise in my ears, as well as sensitivity to loud noise. I also made the mistake of going to work after those 4 days, only to hear a loud bang from someone dropping a board behind me. My friend who was also at the concert, had the typical ringing, and was perfectly fine the next day. Perhaps he has not yet accumulated as much damage and crossed the hearing loss threshold as I just have? I have been to about 7 concerts in my life and it has never taken that long to recover. In the past, it was usually less than a day. This time, the ringing has persisted and I have heard everything including ringing, buzzing, crickets, clicking, and hissing sounds. My left ear also has a Morse code like beeping sound. The volume can go from very faint to relatively loud. It tends to flare up when I’m trying to concentrate on my work (programming) and it is very distracting. It is also loudest when the room is quiet, at night before I sleep and in the morning when I wake up. It is very uncomfortable for me to be in moderately loud places like a restaurant, driving on the highway, or being in a grocery store, which never bothered me before. My left ear feels a bit sore sometimes. A week ago, my family doctor said I have hearing loss in my left ear as I am only able to hear 2 out of the 4 tones from the device. I have been overwhelmingly anxious and depressed over these turn of events, as it has affected my work and overall quality of life. The thought of this being permanent, especially the constant ringing, is unbearable. I also am quite devastated by the fact that all it took was one concert and all this could have been prevented. I have started taking magnesium, as well as other vitamins in hopes that it will help with the healing process, based on some things I read online. I have also begun listening to pink noise at a low volume which seems to help. And I bring ear plugs and over ear headphones with me wherever I go in case I encounter some loud situations. I saw an ENT last week. He said damage to the hair cells is permanent and irreversible. And recommended I do a hearing test with an Audiologist later this week to determine the extent of the damage. Should I be avoiding loud places and traveling for a while? What are my chances of recovery? How long will recovery take? And is there anything I can do to help recovery? Any advice would be greatly appreciated.
Thanks,
Travis
Hi Travis:
What’s done is done. As you know, it was not wise to expose your ears to such extreme sounds and for so long. If you had got up and left in the first 5 or 10 minutes, your ears likely would have returned to normal by now. But 3 hours of loud music and screaming was too much for your ears. Now you have to live with the effects of this choice.
Now you have several ear conditions including hearing loss, tinnitus, ear pain and loudness hyperacusis. No doubt you also have some hidden hearing loss and probably so degree of acoustic shock.
What can you do about all this now? Getting a comprehensive audiological evaluation is a good first step. Then you’ll know what the damage is. Second, you need to protect your ears from louder sounds for the next few months and hopefully your hyperacusis will disappear. However, you don’t want to overprotect your ears or you will make your hyperacusis worse. So wear ear protectors when around sounds that are uncomfortable to you, but take them off as soon as possible afterward. And DON’T expose your ears to truly loud sounds. Your ears need time to recover from all this trauma.
If the tinnitus bothers you, play pink noise or fractal music or environmental sounds when it is quiet so your brain has something real to listen to instead of just your tinnitus. The sound doesn’t have to be loud–just loud enough to hear. One good environmental sound that helps many people is one of the various sounds of water–waves lapping on the beach, waterfalls, rain falling, creek running, etc. This can both help mask your tinnitus and also help calm you down.
Your depression and anxiety sure isn’t helping matters. You need to get them under control. Learn to relax and focus on things other than your tinnitus.
Taking magnesium, particularly magnesium threonate since it is more bioavailable, is a good step.
You are doing a number of things right. You just have to realize that it is going to take time–maybe a year or two so don’t get discouraged when you don’t see the changes you want right now.
Wear ear protectors when in louder places like stores and when traveling. Just be careful not to block out all sounds as that will just fuel your hyperacusis. If putting in ear protectors blocks out too much sound, maybe wear them a bit loosely–so they only block out annoyingly loud sounds and lets all other sounds through.
In the future, NEVER EVER, and not even that often, go to loud venues without wearing good ear protectors and stay back from the loudspeakers.
You may have permanent hearing loss but hopefully the hyperacusis will go and your tinnitus will fade into the background in time. Again, you’re looking at the long haul–up to 2 years or so.
Cordially,
Neil
Hi Dr Bauman,
Can i ask your advice please? Two months ago i came down with constant, high pitched tinnitus in my left ear. An audiology test confirmed no hearing loss in that ear but mild/moderate hearing loss at high frequency in my right ear. ENT consultant said the right ear loss was a “red herring” and could be due to an infection suffered when i was younger (I had a bad case of mumps when i was 4/5yrs old, for example). In the last week hyperacusis has kicked in – things are much louder and difficult to tolerate. I visited an audiology clinic who did some pure tone testing and LDL testing. Surprisingly my LDL levels were normal (110db or maxed out without a response) but my normal left ear pure tone result was higher in the normal band – from around 10-15HL to negative decibel level. I havent had any loud noise incidents recently and dont listen to music much, I have only been to 3 concerts. However i have been in nightclubs a fee years ago so acknowledge there may be some underlying damage. My question i guess is – would i still be diagnosed with hyperacusis if my LDL range is normal across all frequencies (even though my normal hearing test result is better)? I wonder if this could be triggered from anxiety having had to adjust to tinnitus but it feels bad enough for that not to be the cause. Would the pink noise treatment still help if the LDL thresholds have not been impacted? Thanks in advance for your help.
Hi Craig:
What was going on in your life two months ago that caused the tinnitus? That’s always the first thing I need to know. Tinnitus may seem to come out of the blue, but it doesn’t really. There is always a cause–whether you or your doctor can find it or not.
Also, what happened that caused the hyperacusis to kick in? Again, it doesn’t happen without reason. Typically it is from exposing your ears to loud sounds, taking various drugs, or stress and anxiety. It could have been because you are worrying about your tinnitus for example.
How bad is your hyperacusis? If it’s not too bad, your LDLs may appear to be normal. However, a clue that you have it is in those negative numbers on your audiogram. When it appears you have “too good” a hearing, that can be an indication you really have hyperacusis.
I’ll bet if nothing else shows up that your hyperacusis is from worrying about your tinnitus.
What are you hyperacusis symptoms? What makes you think you have hyperacusis?
What are you doing about your tinnitus–besides worrying about it?
Cordially,
Neil
Hi Neil,
Thanks for your response. The Tinnitus came on after a period of stress (redundancy), life with a young family is busy in any case – however I have to say that the redundancy did not phase me too much (financially we are fine), but i guess subconsciously it could. My hyperacusis came on around 10 days ago suddenly, the shower was almost too loud to get in and i had to abort a job interview as the noise of conversation was too loud. I have 4 young children so the house is noisy in any case which maybe isnt ideal! I can tell my perception isnt right as i need to have my phone on quiet, the tv slightly lower and im distracted more by soft noises e.g the computer humming. I can hear the clock tickingg when inwasnt able to previously. The flip side is that the tinnitus seems to be much less noticeable as its becoming easily masked. Having read your advice i havent used any ear protection at all despite being tempted to (which combined with normal LDL’s suggest its more of a mild case but still distressing). Fortunately yesterday i noticed an improvement (around 10 days after onset), things remain louder but i find the tv and car radio less annoying at a slightly higher level. Its still short of what i remember to be normal though. In terms of the Tinnitus, i have to say it initially bothered me greatly (mine is constant, high-pitched) but can be masked. We have a white noise machine on through the night. I use white noise on low as a background behind the television noise which means that during any breaks in conversation the TV i hear the white noise not the ringing. This has given me enjoyment back in watching the TV. I dont hear it much when im out and about unless i focus on it. I use music on low to help concentrate when im working. I cant sleep on the Tinnitus ear side as it increases the noise so sleep facing the other way. My Tinnitus increases with movement (bending down, moving jaw or neck etc). I read this meant there may be somatic causes/exaggorators. I had a TMJ assessment which showed no issues. I will probably see a chiropractor once hyperacusis is under control. The thing that strikes me is that on one hand it would appear that i could have some form of HHL and this has triggered Tinnitus and Hyperacusis (through auditory central gain). I have always noticed i struggle more than others to hear conversation against a loud background noise e.g in bars since my early twenties. I also as you mention has seen an improvement in my normal decibel to minus levels since the Hyperacusis (im lucky i suppose that i had two hearing tests done as part of the Tinnitus investigation). What confuses me is that in almost every research study i see those eith Hyperacusis have reduced LDL levels and often if its noise/hearing loss related there is a one off trauma. This isnt the case for me. Its been an anxious time dealing with the Tinnitus as im the type of person to dwell on it to find solutions – but was just about through this and starting to adjust well.
I start some CBT therapy next week and am booked in for a consultation with a Tinnitus clinic. My thinking is that if sound therapy will help for the Hyperacusis i should start it (although i am encouraged by the slight improvement ive seen in the first 10 days). I do feel more anxious though than before as I felt the Tinnitus symptoms if mild/moderate could be controlled well, the Hyperacusis has the potential to be more debilitating (although i can still function reasonably well, its just very annoying and my ears can feel a little bit full/sore by the end of the day). Thanks to your previous responses ive now downloaded a decibel app on my phone and have used ear plugs whenever noise exceeds 80db. I’ll be very careful going forward my concern is around finding whether i have Hyperacusis, what caused it, if treated how will we measure if its working (given LDL’s are normal) and how can you avoid relapses. Im also really encouraged in the long term about advances in hearing restoration therapies which give me real hope that in the future (if HHL is the cause) that this could be improved/cured. Although i would guess that if input to the brain improves any Hyperacusis would then need to be treated again to turn the volume down?! Would be interested to know your thoughts.
One more thing – how long do you think it is before we are able to diagnose HHL? I know ultra high frequency, waveband testing could suggest this but it doesnt seem to be widely available and even if it was would it be fair to say insufficient research has been conducted to establish what would be a “normal” benchmark?
Thanks Neil
Hi Neil-
I attended a festival at the end of September where the music was extremely loud. I felt fine that night, but for two days after I had ringing in my ears and noticed some sound sensitivity. It wasn’t too bad until after I went to an ENT a few days later and had a hearing test. The next day I had severe ear pain and symptoms have gotten better and worse since then. But I’ve had almost constant ear pain along with tinnitus and sound sensitivity. At the moment I have pain in both ears, pressure, fullness and hissing tinnitus. I was overwhelmed being in a store with sounds yesterday. I saw three ENTs who said my ears are fine. Brain MRI was normal. One said I have hyperacusis that should resolve on its own and prescribed a regimen of NAC for tinnitus. I was told to see a neurologist for pain and have an appointment next week. I’m hoping it’s something other than hyperacusis, but I’m not sure who to see or what to do at this point. I’m in so much pain I’m finding it difficult to take care of the most basic tasks.
Hi Linda:
Your ears suffered acoustic shock back in September and now you have several problems that are associated with acoustic shock disorder (ASD) including loudness hyperacusis, pain hyperacusis, tinnitus and possibly some symptoms of Tonic Tensor Tympani Syndrome (TTTS).
When the ENT or audiologist did the hearing testing, did they also do the Uncomfortable Loudness Level test (UCL)? You mention that that day the severe pain, etc started in earnest. If you have suffered acoustic shock, audiologists should NEVER (and not even that often) perform uncomfortable loudness level testing and acoustic reflex testing because it just makes things worse.
I doubt that the neurologist will find anything wrong either. I wouldn’t be surprised that your trigeminal nerve is now hyperactive and causing a lot of the pain.
Few doctors seem to know much if anything about the various forms of hyperacusis and associated conditions, so going to them is largely a waste of time unless you find one who really knows what he is doing.
You really need to read my new book on the subject. Unfortunately, it’s not finished yet–which doesn’t help you at all at this point.
One thing you need to do is stay away from louder sounds and give your ears/brain a chance to “heal”. So when you are in louder venues, wear ear protectors to get the sound down to a level where you can stand it. However, don’t wear ear protectors where you don’t need to, or else you’ll just make things even worse.
There isn’t any one definitive treatment for Acoustic Shock Disorder. Rather, you need to treat each of the bothersome symptoms you experience. Thus, if you experience severe pain, your doctor may recommend treating it the same as for trigeminal neuralgia and/or refer you to a pain management clinic.
Massage of nerve and muscular trigger points around your neck and shoulders may also help reduce any pain there. This is a common technique if you have pain associated with temporomandibular dysfunction.
If loudness hyperacusis is a real problem for you, then following the treatment techniques for treating loudness hyperacusis will help you get both your loudness hyperacusis and possibly your tinnitus under control.
This should be enough to get you started on the right track. You can always write me back for further help.
Cordially,
Neil
You are right. I have not been able to find an ENT in my area who knows what he or she is doing. What are the techniques for treating loudness hyperacusis? Are you speaking about TRT or are there other treatment methods for loudness hyperacusis? If this is what you suggest, how do I find an experienced audiologist ? Are you saying an audiologist should not do LDL/UDL or other testing at this point either? I don’t think the tests you mention were done during the initial audiology test. Are there other treatment methods besides sound therapy? I am scheduling a session with a chiropractor who deals with cervical and cranial issues, does craniosacral therapy and has apparently treated patients similar to me. I’m hoping she can tone down any trigeminal nerve hyperactivity. No doctor has indicated I have a TMJ issue however. You are correct that the neurologist did not find anything, but supposed it could be nerve pain. He prescribed gabapentin which gave me horrible side effects and did nothing for pain. At the current time, the tinnitus seems to have become louder and the ear pain (burning, stabbing, feeling like foreign object is in the ear) continues even if in a quiet room. The ear pain does not seem to have a relation to noise. In addition, almost all sound bothers me, including TV even at low level, my own refrigerator motor, cat snoring, talking on the phone and my own voice to name a few things. My ears seem to be hyper vigilant to sounds like dripping, clocks ticking, etc.
Hi there,
I found your blog a few weeks ago and I’ve been reading through some of the responses that are making a lot of sense to me. I’m a tinnitus sufferer, I have been since early last year. But it was never really a bother in my life until a few months ago, following a particularly bad week of anxiety and it’s skyrocketed since. Not only do I have a ringing in my ear but a sound coming from the left side of my brain (same side as my bad ear), and uncomfortableness with loud sounds, accompanied by mild pain — and the occasional blockage and crackling of my ears, it’s almost like they’re trying to equalise sound. Do you think it’s possible it’s hyperacusis and I’m just perceiving my tinnitus sound so much louder than usual? I haven’t really been exposed to any loud sounds recently, I do use headphones occasionally but nothing that I can think of that would have made my tinnitus this bad. Do you equally think my anxiety could be linked to the sudden influx in sound, because my brain hasn’t been able to let it go since it happened.
Thanks!
Hi Ashley:
Anxiety can make tinnitus worse. Ditto for hyperacusis. In fact, hyperacusis is mostly due to stress and anxiety.
What kind of “sound” do you hear in your brain? Is it one of the many tinnitus sounds? Note that tinnitus doesn’t have to seem to come from one or the other ear, but can just be “in your head” without reference to either ear. And it can change from hour to hour. Sometimes my tinnitus is in one ear, sometimes in the other ear, sometimes in both ears and sometimes just in my head. Furthermore, I can hear different sounds in each ear, or even multiple sounds in one ear. Such is the nature of tinnitus.
What you need to do is get your anxiety under control. Learn techniques to relax and properly deal with your anxiety.
Cordially,
Neil
Hi Doctor
I have been taking .125 mg of clonazepam to help me sleep every night For 14 years. 3 weeks ago i decided to cut the dose in half. A week later i noticed tinnitus and a week after that sensitivity to sound. I had a zoom call with the ent and he gave me 2 weeks of prednisone. I am on day 6 with no relief. Do you have any suggestions or advice.
Thanks- Eric
Hi Eric:
Cutting the dose in half after 14 years is just asking for trouble. Normally, a safe taper is 1/3 of 1 percent a day–taking 300 days to get off the drug safely, or another protocol is a 10% taper per month on the reducing balance which will take at least a year to get to a safe dose to “jump off”.
Tinnitus and hyperacusis are two nasty side effects of stopping a Benzodiazepine like Clonazepam too fast.
You have two options. First, to tough it out at the level you are at and when the side effects go away, then continue tapering, but slowly this time. The second option is to go back to the full dose and stabalize at that level for a month or so and see whether your tinnitus and hyperacusis will go away, THEN do a proper slow taper.
Unfortunately, there is no guarantee that the tinnitus and hyperacusis will go away if you go back to the original dose, and you’ve already toughed it out for 3 weeks, so you may want to do the first option, rather than the second. The choice is yours. Personally, I don’t think the Prednisone will do anything much.
Cordially,
Neil
Hi Dr. Bauman,
I’m a music producer and work out of my bedroom. I noticed last month that certain mid-hi frequencies (like hi-hats and clap sounds) were irritating my ear.
I would stop for awhile and try to start again but eventually the pain would return after a bit. After looking online I realized the studio monitors I was using were harsher in the higher frequencies and could be causing this, so I got rid of them. I also re-arranged my room so as to not have my monitors in the corner where I could get some nasty sounds pinging into my ears, as that is fairly common. My room is not acoustically treated at all.
It’s been a month or so and I’m still having some hyperacusis and slight ringing in my ears from it. The only sounds that irritate me are generally higher frequencies like dishes and such. My ears are also sore inside and are doing a lot of popping/crackling. I can’t really listen to any music for more than a few minutes without soreness, and thus have completely stopped producing at the moment.
Any words of wisdom would be much appreciated. I’m supposed to start music school online at the end of May and am a bit worried.
Thanks so much in advance!
Hi Alex:
What has happened is that you are developing loudness hyperacusis, probably from playing the music too loud and for too long. It is normal for hyperacusis to bother you more in the higher frequencies than in the lows.
What you need to do is listen to your music at a lower volume–at a level that doesn’t bother your ears.
And give your ears a rest from louder sounds. Your ears should heal in time–but it could be a few months–depending on how you deal with your hyperacusis and tinnitus. You don’t have to stop listening to music–just keep the volume down below where it bothers your ears and let them heal.
Cordially,
Neil
Thank you so much for replying! I’ve been driving myself crazy…
The sensitivity to dishes, etc. seems to have toned down quite a bit since, but now my ears will start crackling at random times and get really full, especially when i play music. Its like the sound is filling up my ears. It’s worse in the right ear.
Also, I noticed that when i am making/listening to music, i get weird pain in my jaw and sometimes even near my temple as well as my neck. There’s also still some pain in the inner ear.
Are these things all characteristic of hyperacusis? Am I setting myself back further by continuing to produce music or is this normal for healing?
Hi Alex:
Ear pain (and facial pain, etc) often accompany hyperacusis. So does the feeling of fullness in your ears.
It’s good that your sound sensitivity is going down. But the other two symptoms indicate you still are making/playing/listening to your music to loud for your ears at his point. You need to keep the volume down to below where these symptoms show up until your ears can tolerate these sounds and then slowly increase the volume as your ears can stand it.
Also, give your ears lots of “down time” to help them recover. Remember, these things can take months to heal–so don’t worry when it doesn’t seem to move as fast as you want it to.
Cordially,
Neil
Got it. It’s just tough because I’m making music at a very very low volume and the ears are still filling up.
Is it better to push through slight discomfort or avoid any discomfort at all?
Sorry for the million questions. I appreciate your time very much!
Hi Alex:
That question has two sides. If you are having a really hard time dealing with your hyperacusis, then you may choose to avoid any discomfort for awhile if that is possible. However, if you want to get better, and if you read the success stories of those that got their hyperacusis under control, you’ll notice a common theme–and that is that they all push through some discomfort–and slowly they get better.
Once you realize that hyperacusis isn’t physically harming your ears–it is only your perception of sound levels, not real sound levels, then that free you so you are not afraid to push through.
Cordially,
Neil
Hi Neil,
Understood. Is that a normal characteristic of healing when the sound sensitivity begins to fade first?
The crackling symptoms and fullness in the ear are relatively new-ish symptoms. They have become more prominent as the inner ear pain and sensitivity to certain sounds has started to become (slightly) less of an issue. I wonder if this is something you typically see?
I also wonder, is the acoustics of my room potentially a factor here?
Sorry for the million questions. As I mentioned I start a music production school on the 26th of May and am reasonably concerned/trying to evaluate whether I’m going to be able to follow through with it.
Thanks for taking the time to respond on here. It certainly has helped me from completely plunging off the deep end in my worries.
Best regards,
Alex
Hi Alex:
When the sound sensitivity begins to fade, that is a good sign whether it happens first, last or in between.
I think you can begin your music production–just keep sounds down to where they don’t make your conditions worse, and maybe give your ears lots of rest breaks too.
Cordially,
Neil
Hello Dr. Bauman,
I’ve had noise-induced (loud music) tinnitus for years, which doesn’t bother me. Though I’ve again been in a situation – on an extremely loud subway – a couple of months ago. My hearing seems fine, though I’ve started to get distortion to loud sounds, even to my own voice. Can this get better?
Doing a lot of reading on this, I’m confused on therapies, and on white/pink noise use. I read on the JAMA site that white/pink noise may not be best, that ”Perhaps the most straightforward alternative to sound therapy with
unstructured noise is to simply replace the masking stimulus with a structured (nonrandom) acoustic signal, such as music or speech.”
Have you come across this research, and can you advise, as I’m worried of making this worse?
regards,
Dorian
Hi Dorian:
If your distortion is a result of loud noise, yes, I believe it can get better. Often all it takes is to give your ears rest from such loud sounds. If the subway is too noisy, then wearing ear protectors while you are riding the subway would be a good idea. Just don’t wear them when you don’t really need them or you can make things worse.
I’ve read the research on broadband noise and how it supposedly affects brain plasticity. There may be some truth in it, but there are some flaws in the research according to others.
Using broadband noise to treat tinnitus habituation is not designed to induce brain plasticity. And it works and has worked for a number of decades. So there is a body of evidence that it is not harmful like these studies suggest.
However, personally I don’t like listening to either white or pink noise. There are other sounds you could listen to in tinnitus reduction therapy. One is fractal music. You see, the idea is that you are training your brain to ignore your tinnitus, so you have another sound that it ignores and thus also ignores your tinnitus. In order to ignore a sound, it has to be meaningless and unimportant to you. Thus random noise works, whereas listening to real music or speech has meaning–so it can’t produce the desired effect.
Fractal music (which sounds a lot like wind chimes) is basically random so you can’t figure out what comes next and thus want to focus on it (sing along to the music for example). That is why it is a good choice. You want sounds that you passively hear, not sounds that you actively listen to in order to habituate to your tinnitus.
Even better in my opinion is listening to water sounds–waves lapping on the beach, babbling brook sounds, rainfall, waterfalls, etc. These sounds are also broadband and random so you don’t actively listen to them. But they have one big advantage over other sounds–they are natural and relaxing. So they help calm you down if your tinnitus is bothering you.
I’d choose sounds that work for you. They mustn’t annoy you in any way or you won’t be able to ignore them–and white and pink noise would annoy me so are not my choice.
Actually, I don’t listen to anything for my tinnitus. I just think of other things. But I can’t always do that–for example, right now I am thinking about tinnitus in answering your post–so guess what? My ears are really ringing away–pretty loud. But I don’t let my tinnitus bother me. And I know that because I am so habituated to it, within 5 minutes of finishing this post, I won’t even be aware I have tinnitus.
Cordially,
Neil
Hi doctor
I took mdma drug first time in my life with friends at my mates apartment and my body didn’t react well to the drug I had panic attack and anxiety and anxious when I took the drug almost fainted lucky I had friends that helped me that day the very next day I went home trying to recover then I had a shower and went to bed to sleep then I noticed my right ear started with tinnitus it has been with me since January till today been 5 months so far went to doctors and ent they said everything is fine got my ears cleaned out from wax then after 3 weeks I got better I developed HyperCasus and my tinnitus kind of went away but I can hear it hear and there if I think about it then 2 months later I got tinnitus again due to my anxiety symptoms and hasn’t went away since got my ears cleaned of wax again and now hypercasus is gone worse and my tinnitus isn’t any better now what can I do doctor help please
Hi John:
In retrospect, I’m sure you realize that taking MDMA wasn’t a wise decision. It has caused you to be anxious and anxiety has made your tinnitus and hyperacusis worse. So the first thing I’d do is get my anxiety under control. Once you have done that, then you can see whether your tinnitus and hyperacusis are a problem or if you need help with them.
Cordially,
Neil
Hi Neil
I developed hypercasus after syringing my ears does that mean my ears won’t get better
Also I know it wasn’t a good choice but I made a mistake and I regret it
But while I was on the mdma my mouth was wide open for couple hours and after when the effect faded I realised My jaws was hurting and couldn’t even chew but now my jaw is fine do u think it’s a tmj problem that caused my tinnitus
Thanks
John
Hi John:
Hyperacusis typically gets better with time–as long as you are not anxious over it. If you worry and obsess over it, that’s a different matter.
One clue is to clench your teeth. If your tinnitus shoots up momentarily TMJ could be the culprit. Ditto if you turn your head all the way left and all the way right. Or it could indicate that your neck is out of alignment, causing the tinnitus.
Cordially,
Neil
Hi Neil
I realised when I open my mouth wide now my tinnitus gets louder abit and faster I tried looking left and right it’s still the same
I clinched my teeth and it changes a little bit my tinnitus
Thanks
John
So does that mean it’s a tmj problem
Hi John:
Probably its a TMJ problem–at least in part. It could also be due to your neck being out.
Cordially,
Neil
Hi, I started developing hyperacusis after listening to loud music with my in-ear earbuds during quarantine. First, ears only hurt after using my earbuds even if now I was listening to them in a low volume, so I eventually stopped using them altogether. Listening to music with speakers wasn’t a problem at all but like 2 weeks after, listening with speakers was also hurting. Anyways, I stopped listening to music and then a week after I we t to an ENT and he gave me Betahistine and I’ve been taking it for a week and a half now. I made a huge improvement after the first week but 3 days ago thinking that I was already fine I showered with my speakers just like I used to before. Few hours after my ears started hurting and got somewhat sensitive all over again and today (3 days after) my ears still hurt. So, you say that we shouldn’t expose ourselves to loud sounds in the meantine until we have resolved the hyperacusis. But my big question is, how are we ever supposed to know we are ready for regular sounds/music again? Who would tell me the ‘meantime’ is already over? This might sound dumb cause I know I only rested for two weeks but how will I ever know I’m ready again without risking that maybe I wasn’t really ready and turn the situation into a setback?
Forgot to say that I was thinking that maybe what specifically got me in this situation was the the fact that 2 times in which I had my headphones in I accidentally pressed play with the full volume (turned down the volume immediately after) and my ears really hurted after both times. So, first I had the phase where using earbuds started to hurt even if I was now using a low volume; then I stopped using them and speakers didn’t hurt but then they also did. I want to say that if I listened to my speakers 3 days ago was bc during my apt my ENT told me that ‘in a week’ I would be ready to do so and that it would also let me see to if I had already resolved the H
Hi Anna:
When you accidentally exposed your ears to the full volume music, you certainly weren’t expecting that loud volume and thus your ears experienced acoustic shock. The hyperacusis came out of the acoustic shock.
One ofthe things about acoustic shock and hyperacusis is that although you damaged your ears at the time of the incident, often it takes a few days or a week or two before you begin to notice hyperacusis developing. It doesn’t necessarily happen right away, so you may not think you damaged your ears. But your ears are very sensitive to more noise damage at this point.
Your ears need time to recover–and you thought a week or two would be enough. In actual fact, it may take several months. I think your biggest mistake was listening to your music again at full volume. You should have begun by listening to it at a low volume and then over a few weeks slowly increased the volume as your ears could handle it.
If at any time during this process your ears start to “act up” again, you know you are increasing the volume too much too fast and have to slow down again.
The other problem is that you expect your ears to be able to handle loud music again. The truth is that they have been damaged by the loud sounds, and your ears are not as robust as before, so they cannot stand the same loud sounds as before without problems.
You should never listen to music louder than an average of 70 to 80 dB. Louder than that and you are asking for ear problems including permanent hearing loss. A good level to listen to music is at the same level you hear people taking to you. It doesn’t NEED to be so loud the walls are going in and out with the vibration!
Cordially,
Neil
Hi Neil, I’m so grateful that you answered. I just wanna say that I didn’t listen to my speakers at full volume a week ago when I was showering as you pointed out, but of course I think you were referring to ‘a volume too high for my present situation’. Anyways, I got extremely worried when you said ‘you expect your ears to be able to handle loud music again’, and I hope you are just referring to the time being until I recover from H, right? I’m not saying I wanna do damaging levels ever again but I used to shower with my speakers at the regular volume that most people do and same thing goes for the car stereo so, when I’m saying that last week I used my speakers again I was only using them in this ‘regular’ way; so, I hope I will still be able to handle this ‘regular’ volume of speakers once again in a few months once I recover from H, (obviously being careful and not like before) (and obviously I’m not planning on using earbuds ever again). What do you think about it? Another new ENT I just went to today gave me a diprospan injection, hope it helps too. Also forgot to point out than on two unique occasions (first time being the very first day that I ever got ear pain in late May, and second time being the night of the day that I listened to my speakers again a week ago – both of these days I experienced like two or three seconds of tinnitus-ringing before sleeping, (just on that very first day of the pain and the other time on this infamous day of last week I’ve been talking about), just wanted to add that.. May God continue to bless you, and thankyou for helping so many people.
Hi Anna:
Right–I was using hyperbole–meaning you had the volume too high for your ears in their present condition.
I don’t know how loud “most” people have their music set, but I can tell you it is often MUCH too loud and can damage ears. So you have to set it to a reasonable level and not follow what others do. Reasonable as I mentioned before is about the same level you hear people talking.
I have no problems with ear buds–BUT you have to keep the volume to a “talking” level, not so loud that your eardrums beat together inside your head! I’d consider that a bit excessive.
Since everyone’s ears are different, you need to keep the volume such that it doesn’t cause tinnitus, hyperacusis, ear pain, etc. after you’ve been listening awhile. If it does, you know it is too loud for your ears and you need to keep the volume lower (or if you can’t, wear ear protectors).
Cordially,
Neil
Hi, two days ago I went to a new ENT who told me that most certainly my ear problems are caused by a TMJ problem. After analysing the whole situation I realised that yeah, most certainly I have a TMJ problem since my orthodontist has always said that I grind my teeth and have also been hearing some kind of ‘pop sound’ when I big open my mouth whilst trying to ‘declog my ears’ (‘ear fullness’ is a symptom I have been feeling with the hyperacusis along with some ear itchiness). Anyways, I literally got my braces removed a day before going to this new ENT and was already waiting for the night guard the dentist gives you after he removes the braces, so I told this to the ENT and he told me that that night guard was fully going to fix my problem. Then yesterday I went to the orthodontist because my night guard was already ready and I told my orthodontist about my ENT visit and my ear problems and he told me that most certainly the night guard would relieve ear pain. So, what do you know about TMJ causing hyperacusis and ear itching? (I also want to add that the previous ENTs I had gone to were telling that I had otomycosis along with the hyperacusis and this is the first ENT who sees no otomycosis but I guess that is maybe cause the otomycosis has already resolved and now I only have the hyperacusis left).
Can I have damaged my ears if I just listened to 2 seconds of music at full volume with my iPhone 11 (no headphones, it was just plain iPhone) (I have read the iPhone 11 has 100 decibels at max volume when listening to music)
Hi Anna:
If you have “average” ears, then 2 seconds at 100 dB shouldn’t damage your ears.
Cordially,
Neil
Dear Dr. Neil,
I would like to have your opinion about the following situation.
Background: I had an acoustic trauma 5 years ago from an alarm, which gave me immediate ear pain and fullness feeling. Several days later, I developed hyperacusis and tinnitus, which subsided after a few months. I still use earplugs for some situations, but I could manage pretty well the situation.
Unfortunately, last week I had a car accident (front collision), which deployed the driver and passenger airbags (I was driving). Luckily, I was wearing earplugs, which were not very deeply inserted, but still gave a significant amount of protection. At the time of the accident, I was very worried about any hearing damage, but I didn’t feel any pain or fullness feeling. I also didn’t notice any increase in my tinnitus and hyperacusis. Nothing. Everything was normal. Therefore, I was very happy because of this. However, 3 days ago (7 days after the accident) I start noticing fullness feeling in my ears and I fell more sensitive to sounds. These symptoms are not constant, they came and go several times a day.
Do you think this is related to the accident? Or do you think it could be related to my anxiety due to other health issues I have been dealing since the accident, namely dizziness caused by the head concussion against the airbag? or any other think?
PS.: the day before this symptoms appeared, a car honked 3 meters away from me, but I was wearing earplugs and I didn’t feel any pain. Also, I didn’t feel the sound was very loud. I think it was not the cause either.
Best regards,
Joao
Hi Joao:
Did you have your side window(s) open when the air bags went off? If they were open, it lets some of the pressure (and sound) escape so it doesn’t build up and push on your eardrums.
Wearing the ear plugs should have protected you, at least to a large extent. As an aside, it seems you are wearing your ear plugs too much which makes it hard to get over your hyperacusis–but in this case it was fortunate that you were wearing them.
The symptoms of acoustic trauma are not always immediate, but in fact, often occur in the days following the incident. So your increased symptoms could indeed be linked to the accident.
The fact that they come and go leads me to believe that they will fade away in time.
What’s this about concussion? Any time you have concussion, who knows what other damage was done. Dizziness could be from a number of things related to your ears, one of which is whiplash. That could account for all of your symptoms too.
And certainly anxiety can make these ear conditions worse. So it may be a combination of your anxiety AND complications from the accident.
Probably the horn honking incident wasn’t a factor–especially since you were wearing ear plugs.
How are things going now–any changes?
Cordially,
Neil
Dear Dr. Neil.
Reading all the comments made it clear that i have hyperacusis.i hope god pays you in full for all the good work you are doing. I felt sounds were suddenly too loud a week ago. I used to get head/ear ache on using headphones since 2012. But i never stopped using earphones completely. Now upon waking up i feel everything too loud after 1 hr of waking up only dishes and some noises feel loud. Whats truly killing me is anxiety related to this situation. Can you tell me how bad will my anxiety/stress affect my recovery time? I often bang the utensils my self to check if its hurting. My hyperacusis sometimes decreases then increases. Can you tell me what should i expect as recovery time?
Hi Abhishek:
It seems you have caused your hyperacusis by listening to your music (or whatever) at too loud a volume (and probably for too long a time). Or by listening to music that has sudden loud “clashes” that overpower your hearing mechanism.
You shouldn’t be listening to anything louder than the level you hear people speaking. Then you won’t have these kinds of problems.
Your ears need a rest now for a few weeks (or months) where you don’t expose them to louder sounds, and particularly not sudden louder sounds.
After a quiet night’s sleep, the early morning sounds can then sound too loud. For some, it decreases as your ears get used to hearing louder sounds again.
Dishes and cutlery sounds are two common problem sounds. Don’t bang them just to check how loud they are. This is just aggravating your ears more.
You don’t need to be anxious. Just calm down and give your ears time to recover. If you don’t expose your ears to louder sounds, and let them slowly recover, I’d expect that you’d notice a distinct improvement as the weeks go by. It could happen faster, but I’d give it at least 2 months.
Unfortunately, you’ll likely have setbacks where you accidentally expose your ears to a louder sound that causes your hyperacusis to get worse again. Don’t worry about this. Just continue on and in time, your ears will return to normal or near normal. They may always be a bit more sensitive to certain sounds than they were before, but this is due to permanent damage caused by exposing them to loud sounds in the first place.
The more you worry and are anxious about your hyperacusis, the worse it can get–so CALM down and take in easy.
Cordially,
Neil
Hello doctor,
Since i got hyperacusis (more than one week ago approx) i was also getting symptoms of tinitis but it only lasted for a few minutes at a time.one peculiar thing i noticed was if i would put something on my ears to cover them like earplugs, noise cancelling headphones, pillows then i would start getting tinitis.(mild ringing )So instead of using any ear protection i tried to avoid any noisy location. But yesterday i woke up with a head ache and ringing in my left ear that didn’t go away even after sleeping.I still have it and its been more than 24 hrs. My tinitis increases when i laydown flat or bend down or go to sleep.my hyperacusis also seems to have gotten bit worse(it was recovering nicely). I don’t remember getting exposed to dangerous sounds.(a bike horn did blew paat me but it was not painful but did bother me, crickets chirp all day and night around my house can they be the culprit) or did it happen because of my anxiety and improper sleep(working on improving them)So will my tinitis go away because i was getting comfortable with my hyperacusis then this thing came along.also how much time should i expect for tinitis recovery? One last thing i am taking Rebagen-Otic and Absolute 3G because my ent prescribed them for a month. Are there any cheaper medicine with same composition that i can take.Also should i try putting warm oil in my ears?
Thank you
Hi Doc,
Its been around a month since i got hyperacusis and tinnitus. I stay at home and i don’t use ear protection. Every now and then construction work takes place around my building (that doesn’t hurt my ears but i think it increases my hyperacusis) listening to electronic devices affect my ear even at low volume.I am not doing anything special to treat my condition , i just try to avoid loud noise. Is that enough or i should do TRT(its hard to find a good doctor for this) My tinnitus sometimes decreases and fades in background but then comes back after sometime. My hyperacusis is bad and shows no improvement (dishes , tik-tak noise of light switches, etc. Sounds sharp and causes immediate pain/feels like schock)Can u please tell me if i am doing anything wrong??
Hi Abhishek:
If your real problem is your hyperacusis, not your tinnitus, then you want to treat the hyperacusis, not the tinnitus to start with. Actually, it sounds like your tinnitus is already fading away. You get good days and bad days–this is normal.
When you have loudness hyperacusis, you want to have low-level sounds around you 24/7. You set the volume to a level just below where it begins to bother you and listen to that for a week to a month, then you readjust the volume upwards a wee bit–but again below the level where it begins to bother you. Slowly, over time, you can rebuild your tolerance to louder sounds again.
You want to listen to “boring” sounds–recordings of pink noise, fractal music, water sounds such as waves lapping on the beach, rainfall, babbling brook sounds, waterfalls, etc. These sounds have no real meaning so you don’t actively listen to them. You just hear them passively in the background and your brain slowly resets its auditory filters to the correct levels as time goes by.
Try to avoid those sounds that bother your hyperacusis as much as possible until your hyperacusis improves and you can stand them.
And don’t forget to learn to relax and not worry about your ears. Anxiety is an enemy of getting better. So work on controlling it. Breathing exercises, physical exercise, and relaxation exercises are all good coping strategies.
If you are in loud places, you NEED to wear ear protectors, but take them off as soon as you don’t need them.
This should get you started on the right track.
Cordially,
Neil
Hello Dr. Neil
I had an acoustic trauma 6 months ago which resulted in tinnitus and pain hyperacusis. At the beginning , only a few sounds bothered me, but after a few setbacks with sounds (like being in a grocery store, a too long/louder conversation outside, a bowl dropped on a granite countertop etc) I lost more sound tolerance
. I try to tolerate every day sounds in the house without protection and have tried ambient sounds (rain) but I end up with pain (burning in head an ears) . This also continues when I am in a quieter environment. Will this ever get better? Is there anything I can do to help myself?
Hi Linda:
what kind of acoustic shock to to have six months ago the caused the tinnitus and pain hyperacusis if you don’t mind my asking?
Setbacks can really set you back and make things worse than they were before as you have found out. And so many of those to mention are hard to avoid. It’s good that you’re trying to avoid wearing ear protectors, but at times you need to use them to give your ears what you might call on safe zone because too much noise at a time can set you back again.
When you have loudness hyperacusis or pain hyperacusis, you want to have constant background sounds but the trick is that the sounds must be so soft that they do not exacerbate your hyperacusis. Thus the sounds may be very soft to start with. I think you are setting the background sounds too loud to start with. True, you want to push the envelope, but not at the start. Your first step is to work on things so that it doesn’t continue getting worse. Once you’ve got it stopped, then you can start working on getting it better.
You would do well to read my new book called “hypersensitive to sound” and read not only chapter 18 on pain hyperacusis but many of the other chapters and you will see how to best deal with your hyperacusis. You can see this book at https://hearinglosshelp.com/shop/hypersensitive-to-sound/ .
As you’ll learn, treatment is a twofold process. You have to treat the “physical” component with sound therapy. Just as importantly, or even more importantly, you need to treat the emotional/psychological component. In this book can various chapters I go into considerable detail on this emotional/psychological component.
In the good news is “yes, you can get better” and you can do many things to help yourself. That is why I recommend getting this new book, it’s comprehensive so you’ll get many of your questions answered as she read it.
Cordially,
Neil
I have tinnitus and pain hyperacusis for 7 months now. At first, only a few sounds seemed louder. After a setback, I had burning pain on top/back of head and in ears. This got somewhat better but never went away. After a too long conversation a few weeks ago, I have burning pain most of my waking hours. I had tried to not overprotect from everyday sounds. How do I help myself to get rid of the pain?
Hi L:
what happened seven months ago they gave you the pain hyperacusis? Was it exposing your ears to louder sounds, or was it due to acoustic shock?
I’m thinking that probably ear pain may be due to your trigeminal nerve being irritated. Since your trigeminal nerve control areas around your ear and face it just seems the likely culprit. If so, your Dr. may want to teach you the same as he would if you had trigeminal neuralgia.
At the same time, because all forms of hyperacusis including pain hyperacusis have a psychological component it would be an excellent idea to also find a counselor for cognitive behavioral therapy (CBT) and work through that program modified for your specific pain condition at the same time that you are going through the pain treatment for trigeminal neuralgia.
You don’t want to overprotect your ears as you know, but you still need to protect them so that the pain component doesn’t get worse. Do you find that the sounds in the kitchen pots and pans clattering in cutlery clinking so on exacerbates your pain hyperacusis?
Perhaps one good strategy in your case is to limit the length of telephone conversations rather than a two hour conversation for example split it into two one-hour ones and separated by couple of hours so that your ears have a chance to rest. That would apply also to any other sustained sounds that are not so loud that they heard ears but there are loud enough that they exacerbate your pain.
You might also want to read my new book on hyperacusis and other hypersensitivities to sound it has a big chapter on pain hyperacusis that you might find very useful.you can get this book at https://hearinglosshelp.com/shop/hypersensitive-to-sound/ if you are interested.
Cordially,
Neil
Hi Doctor,
A few months ago I fainted due to a bit of anxiety because of a surgery I had.
Since then I’ve a bit of sensitivity to loud noises which. I’ve had the surgery about 2 months ago however the sensitivity never didn’t really leave and I’d say it’s gotten a bit worse and also I feel like there’s also a combination with tinnitus, since about 2 weeks. In addition I clench my teeth for multiple years now and I can actually hear a bit of a crackling noise whenever I chew.
Haven’t gone to an ENT doctor yet but planning to do it soon. Some days are better than others.
Based on the whole story what do you think I have and what would be the best treatment?
Thank you so much in advance for your help.
Hi Shan:
It’s possible that the sensitivity to sound you now have is due to one or more of the drugs you took at the time of your surgery and afterwards. If you tell me which drugs you had, I can tell you if they are known to cause ear sensitivity.
Where was this surgery? If on your head or neck, that could also cause hearing sensitivity in some people.
If you worry about this sound sensitivity, that can make it worse. The more you can ignore it and not worry about it, the better off you’ll be.
Cordially,
Neil
Hi Doctor,
Thank you for the response. I didn’t take that many drugs. Only drugs I took was ibuprofen twice after the surgery for the pain.
Surgery was on the left buttock so don’t think that had anything to do with it.
Could it be caused by the clenching of the teeth? Especially leading up to the surgery I had a lot of anxiety. At the moment I don’t really feel I’m that stressed out anymore, but I’m probably still clenching my teeth. Also when I chew or I guess move my jaw there’s a light crackling noise I hear in my ear.
Thanks so much for your help.
Shan
Hi Shan:
Ibuprofen can, and does, cause tinnitus in a lot of people. It can also cause hyperacusis (sound sensitivity). But since you only took it a couple of times probably that wasn’t the cause, unless, looking back, you can see a connection.
it’s possible the clenching your teeth can cause the hypersensitivity. It certainly shows that you are tense and that can lead to various problems in your ears. just for general health, if for nothing else, it would be good to get this attended to so you can relax properly.
Cordially,
Neil
Hi Doctor,
I listened to music at a very loud volume for few times that caused my right ear to hurt. Now my right ear hurts whenever I hear daily sounds like lawn mowers, hair dryers, vacuum cleaners etc. I think I also have hyperacusis because at school my teacher’s voice sounds louder then what everyone else hears. I do not have tinnitus and I use earplugs now whenever I am in a noisy environment. I don’t think I have any hearing loss since my hearing has not changed and I have also taken many online hearing tests that say that my hearing is fine. Do you think my right ear will be fine and become normal after a while?
I am also very confused to why my right ear was affected and not my left.
Hi Again Doc,
I was using earphones that caused my ear problem. The volume was at 100% despite my phone warning me I continued to listen and disregarded the pain for the first few times.
I was wondering how many db would 100% volume be blasting into my ear?
Please reply.
Thanks
Hi John:
Any time sounds cause you ear pain, you know it is too loud and you need to get it down NOW unless you want to live the rest of your life with ear pain, hearing loss, hyperacusis, etc. Once you’ve wrecked your ears–they are permanently wrecked to some degree.
I’m sure the volume would have been an average of 95 dB or so, and the peaks could have been considerably higher. The threshold of pain is usually around 120 dB. Does your phone have its volume limited?
Cordially,
Neil
Hi Doctor,
Thank you for replying. My phone does have a volume limit feature that warns you if you are going above the recommended level. Now I make sure that I don’t exceed 30% volume on every device that I use. Do you think that is good enough or should I go lower to like 15% or 20%. And if I protect my ears for the next 2 months will my hearing and hyperacusis return to normal or close to normal?
Thank you so much.
Hi John:
I”d think that 30% would be low enough. A good rule of thumb is to set the volume for music and other sounds at the same volume you find comfortable when chatting with someone.
If you protect your ears, but not overprotect them, and don’t worry about your hearing and hyperacusis, and surround yourself with low-level sound, by the end of a couple of months you should see definite improvement.
Cordially,
Neil
Hi John:
What you’ve done by listening to such loud sounds is that your ears have suffered acoustic trauma that seems to be turning into acoustic shock syndrome. Two of the symptoms include ear pain and loudness hyperacusis.
Your ears need a rest from all loud sounds for a couple of months so they can recover. You want to wear earplugs around truly loud sounds, but you don’t want to overuse earplugs or you will just make your hyperacusis worse. So will worrying about your hyperacusis. If you are going to listen to any music, you need to keep the volume down to the level of normal speech, not any louder.
Your right ear may be affected because it got the brunt of the loud sounds–say your right ear was facing a loudspeaker and your left was facing away from it. But sometimes one ear has the symptoms first and the other ear develops the same symptoms a week or two later. This happens quite often actually.
Cordially,
Neil
Hi Doctor,
I suffered a concussion from a fall to my left temple three weeks ago that I still haven’t healed from. One of my worsening symptoms is ear pressure and pain in my left ear anytime I hear certain low frequencies of sounds such as male voices, or continuous noises like laughter or music. Could my ear have been damaged in the fall and is this something that will heal without treatment? Is there anything I can to do to help alleviate the pain?
Hi Samantha:
Recovering from head injuries can take time. They also can come with a host of unexpected problem like the ear symptoms you are experiencing.
What you are experiencing is called pain hyperacusis. Few doctors have a clue what you are talking about if you mention you have this condition as it is not well-known.
You may have damaged some components of your inner ear due to the shock of the concession and also have irritated your trigeminal nerve. This inflammation can cause the pain you are feeling and the pressure in your ears. And your sound sensitivity to certain sounds.
What can you do about it? Calming down your trigeminal nerve is probably a key component. But also, calming down your anxiety is just as important. You need to learn more about your condition and what is going on behind the scenes. Fortunately for you, I have just completed a comprehensive book on the subject of the various kinds of hypersensitivities our ears can have. Pain hyperacusis is one of those conditions. Chapter 18 in this book covers that subject. You’d do well to get and read this book so you understand what may be going on. Then you’ll have a much better idea exactly what your problem is and can zero in on correctly treating it. After you have read it, if you still have questions, I’ll try to help you so you can get back to normal. It does not have to be a lifetime sentence with proper treatment.
You can get this book at https://hearinglosshelp.com/shop/hypersensitive-to-sound/
Cordially,
Neil
Hi Doctor Neil,
It’s me John again. I am very thankful for your advice. I have been protecting my ears from sounds that are loud and I am already noticing that my hyperacusis is fading and I am able to tolerate tolerate sounds without my ear hurting. But a few days ago I was at my school library and I accidentally dropped a really big and heavy book on the floor and it caused a very loud sound. I didn’t really think much of it because it didn’t cause my ear any pain but then a day later my ear started hurting again from sounds that didn’t bother me before and my hyperacusis got worse. Now my ear hurts when I am in my class and the announcements are playing. I try my best to cover my ears with my hand but the pain just comes even from the slightest sound. This is causing me a lot of stress and I can’t focus on my studies.
I really need your advice on this because I am really worried if this is going to become permanent. I was doing so well before and then all of the sudden it comes back. Will my ear be ok? or is this serious.
Hi John:
It’s great that you’re hyperacusis is improving as you protect your ears from loud sounds.
When you expose your ears to loud sounds like dropping the book in the library, you don’t necessarily have immediate reactions. It can take one to three days or maybe even a bit longer before they start to show up like your ear pain has.
This is what they call a setback. You can expect that setbacks will occur from time to time. Of course you try to prevent them but accidents do happen like the book falling on the floor that made your hyperacusis temporarily worse.
Your ears are just now more sensitive to sound than they were before, but the treatment is still the same. It’s just going to take longer because you were in effect set back to square one and now you gotta continue all over again.
What you need to do is have low level sound around you 24 seven but below the level work causes you pain so it may be very soft and you slowly increase it as the weeks and months go by. You protect your ears from overly loud sounds and even some of the louder ones that you could normally stand but now because of your pain hyperacusis and lightness hyperacusis you may have to protect them from some of these sounds. But always remember you’re trying to decrease your sensitivity to sound so you always push the envelope a little bit in regards to sounds rather than tending to overprotect them.
So take hope this is just a temporary setback obedient and seems to be rather serious setback to discontinue on the program and you will get better.
Cordially,
Neil
Hello Dr. Bauman,
I think it’s amazing what you’re doing here. Your continual support for those of us distressed about our hearing loss is really heartwarming to see.
My story is somewhat complex, but it started with listening to very loud bass music through a pair of open back earphones I have. I would estimate the dB range at above 100, at least. Shortly after I started, I noticed a dull pain in my left eardrum that radiated down to my jaw/node area. I immediately stopped listening and the pain went away around two hours later. Noise was dulled in that ear for a couple days from my recollection, but seemingly returned to normal. I had tinnitus in both ears for over a month, but that subsided as well back to normal levels (I’ve always had slight tinnitus).
All was seemingly well until maybe a week after I had induced the pain, at which point I believe I got an upper respiratory infection which eventually spread to my ears. I went to the doctor and he found no signs of rupture and prescribed antibiotics for them. He told me the eardrums were inflamed. The medicine didn’t seem to work, but the pain went away shortly after the course. It may be important to note that he couldn’t initially see the TM because of all the wax. He used a tool and vigorously scraped the sides of my canals in a pretty painful manner – to the point where I thought he might have done some serious damage. The soreness went away eventually and everything was relatively normal.
Some weeks after that, I noticed that my hearing was worsening in the left ear that I had originally done damage to. Around this same time I had been experiencing inflammation in the canal which had been cleared up with swimmers eardrops and more antibiotics from my GP (which were probably unnecessary). I’ve noticed that my left ear isn’t popping very normally like it usually does, and it’s overall very difficult to force pressure equalization through various methods like the valsalva maneuver, etc.
Oddly, my hearing seems to be more muffled now than I remember it being even directly after I had induced the pain to begin with. Higher frequencies seem cut off, the sound is definitely less “rich” and full than my good ear, and speech is slightly more difficult to comprehend. Pure tones are also pitched slightly differently in both ears, the left being lower in most cases. I can’t tell if my left ear has declined, my right ear is now more sensitive to higher pitches, or some combination of the two. When I use an EQ to adjust sounds, there seems to be a ~5dB deficit in the 2-16k range in my left ear.
It’s clear that I damaged my left ear, specifically, by acoustic trauma. My questions are as follows: Why would the pain and subsequent frequency loss only be in my left ear? And why did my hearing only begin to decline 1-2 months after the event occurred? In fact, it seems like most of the loss has occurred in the span of the past week or so, during which I was dealing with the canal inflammation. Is it possible my canal is swollen, or that I’m dealing with Eustachian issues? Is it possible I’m experiencing sudden sensorineural hearing loss in that ear?
I know this is a long query and that you’re answering these questions free of charge, so any guidance at all is immensely appreciated. I thank you for your kindness and service to this community.
Ethan Z.
Hi Ethan:
Thanks for your kind words.
To answer your questions. I think your left ear had the pain, etc. because either the earphones were fitting tighter on your left ear than on your right ear and thus more sound was pumped it it than to your right ear, or you had more wax in your right ear that blocked some of the sound, or maybe if you were listening to stereo sound, there was more sound on the left channel than the right, etc. And maybe your left ear had been damaged in the past so was just more sensitive to sound that your right ear. There are any number of possibilities–or maybe several all contributed their share at the same time.
There are at least a couple of reasons why your hearing declined 2 month later. First, you said you had inflammation in your left ear canal. If it was because of a cold or flu virus, it could have gotten into your inner ear and given you some degree of hearing loss. And if you had clogged middle ears and Eustachian tubes, you’d not hear as well (muffled hearing) until the gunk drained out.
A second possibility is that you had hidden hearing loss two months before when wearing the earphones. What happens is that the loud sounds break the synapses in the support cells underlying the hair cells in your inner ear. Some of these synapses fix themselves (to some degree) and hearing seems to come back in a few days.
However, those synapses that don’t repair themselves and thus don’t work lead to the death of the underlying support cells and thus to the hair cells above them. When this happens, you have a permanent hearing loss at that frequency. This doesn’t happen overnight, but typically takes 2 or 3 months or so–so that could also explain this lapse before you noticed the hearing loss.
If your left ear has more hearing loss than your right ear, you can sometimes detect a pitch difference. This is called diplacusis.
Along with everything else, you could have had noise damage in the higher frequencies–particularly in your left ear.
And all of the above could have happened–each contributing some to the hearing loss you now experience. So that’s my take on your experience. As I’m sure you’re aware, you need to keep the volume down to a reasonable level. A good rule of thumb is to listen to music at the same level you listen to normal conversation. Then you won’t hurt your ears.
Cordially,
Neil
My problem began aproximately a month ago, after an MRI. A few days after the MRI I noticed that I have sound sensitivity. Loud noises bother me, and even soft but continuous noises bother me and I even feel nauseous ( for example the computer fan). I can’t listen to music, it sounds different as before. Then, about 2 weeks after I noticed soun d sensitivity I also noticed I have tinnitus. It is usually like static sound and I hear it when it’s silence. It is usually reactive, it becomes louder after exposure to noises. In the mornings, after a good night sleep it is almost gone even in silence, but it becomes louder as the day progresses. By the time I have to go to sleep it is like a ring and it is mostly in my right ear.Because of the tinnitus I have truble sleeping, I wake up often. The last few days seemed to be getting better. Because the tinnitus and hyperacusis are the result of acoustic trauma, is it possible that it will get better in time? The MRI lasted one hour and I was wearing ear plugs, but it seems it was not enough… What do I do ? This situation is very troubling to me. I’m waiting for your kind advice, and thank you very much in advance! Anna
Hi Anna:
Numbers of people tell me a story similar to yours–getting tinnitus/loudness hyperacusis after having an MRI.
This shouldn’t happen if you wear properly-inserted ear plugs, and for insurance, ear muffs over them.
Note: do not wear headphones where they can pipe in music for you to listen to. That can be too loud. Ask for plain ear muffs. This is for your information in case you ever need another MRI.
What’s done is done. Now you want to learn how to best treat/deal with the resulting tinnitus/hyperacusis you have.
It is a very good sign that you are getting better recently. Sometimes all you need is time to let your ears “heal”. During this time, don’t expose them to louder sounds. They need a rest–but definitely not total silence. And if you have to be around louder sounds, it is ok to wear ear plugs for the duration of the louder sounds, then take them off. In a few weeks, hopefully you won’t need to protect you ears this way.
You may find that you benefit from having low-level background sounds around you all the time–day and night so your ears always have something to listen to.
It’s great that your problems go away overnight so you can start the day fresh. But the cumulative effects of too much noise all day can wear you out so it slowly gets louder as the day progresses.
One thing for sure that you DON’T want to do is worry and be anxious about your tinnitus/hyperacusis. Instead, you want to stay calm and relaxed. This greatly helps the tinnitus/hyperacusis to fade away.
Practice relaxing during the day–you can do relaxation exercises without anyone knowing you are doing them. The Internet has good sites to teach you such things. One easy to do and totally unobtrusive set of exercises is practice breathing exercises that relax you and calm you down.
If you do the above, I think you’ll find that in a few weeks (or months) your ears will go back to normal.
Cordially,
Neil
Dr. Neil,
You have answered this question many times in this blog, so I do not want to belabor the inquiry with more clarifications on hypercusis, but I did have a question regarding the neuropathology of the condition as it relates to acoustic trauma. This will help me to understand what I am going through and how the improvement actually occurs.
A week ago, in the course of my work, I was exposed to a flashbang device (reduced charge) that denotated at waist level and directed upwards towards my ears. I immediately experienced loud ringing in both ears and a high pitched ring each time I spoke or someone else spoke.
The first day was intense, and I assumed it would get better with time… hearing tests are showing no hearing loss in the speech frequencies, a DPOAE that indicated presence in both ears, and a tympanometry indicated no damage.
A few days past, and I began experiencing an extremely high pitched sound accompanied by pressure any time sounds were present regardless of amplitude. In particular, running water, plastic bags rustling, and fabrics rubbing against each other caused the most distress.
Not understanding what this was, I believed it to be tinnitus at an insane level… I did not sleep for 70 hours and practically went psychotic.
After failed visits at ENT’s and no information from doctors to indicate a way forward or even what I was experiencing, I delved into deep research and found that I am suffering from hyperacusis.
Sorry for the long background, but I wanted to provide you with as much information as possible – hyperacusis onset, and the method in which it appears, seems to have different paths to treatment… even ever so slight.
I suffered acoustic trauma from a charge that was equivalent to about 135db in an enclosed space – with the hyperacusis, what exactly is damaged and is it something that actual “heals” or do I just learn to habituate? I have had many ENT doctors tell me that I have to just allow some time for my ears to heal… all giving different advice. What exactly is the neuropathology of hyperacusis when exposed to a very loud on-off sound and what needs to “heal?”
Thank you for everything you have already contributed and thank you for taking the time to read my post!
Special Agent
Hi K S:
I’m not surprised that your ears rang from a flash-bang that close. That can be quite an acoustic trauma. And part of it is the added tinnitus to your voice or other sounds.
Although the tests you had don’t show hearing loss, I wouldn’t be surprised if you don’t already have, or will soon develop, some degree of hidden hearing loss. It’s called hidden hearing loss because it doesn’t show up on standard audiometric tests. In your case, it is likely that some of the synapses underlying your hair cells were broken and no longer function. Sometimes they heal and all is (reasonably) well, but those that do not heal cause the overlying hair cells to die with consequent permanent hearing loss.
You may also have hidden hearing loss because they didn’t test your hearing above 8 kHz. So these “super” high frequencies may have a lot of hearing loss, but don’t show up on the audiogram because they don’t test those frequencies.
Thus your high-frequency dynamic range is collapsed to some degree. The result is that higher-frequency sounds are distorted and bother you the most.
This is indeed “insane levels” of tinnitus combined with loudness hyperacusis. You might have some reactive tinnitus too. It’s a bit early to tell as it takes some time for your ears to heal–this can take some weeks or months. During this time you want to protect your ears from louder sounds or you will just make things worse.
A sound of 140 dB can give you instant hearing loss–and you were right up close to that. It depends on how “robust” your ears are. Some people have pretty sensitive ears and other people have robust ears so don’t suffer damage as readily.
There can be some physical damage–some permanent and some that will heal in time. But there is also the psychological damage and that needs to “heal” too. It is this psychological damage that you “habituate” to.
In your case, I would first–protect your ears from all louder sounds for some weeks while your ears “heal”. You’ll know they are “healing” as you will be able to stand louder and louder sounds without side effects like making your tinnitus or hyperacusis worse. This is typically a slow process. You might want to wear ear protectors around these louder sounds. Just be careful to take them off as soon as you are away from these louder sounds. If you don’t, you’ll make your hyperacusis worse.
Keep a positive attitude. You can expect some setbacks along the road to recovery. For example, a sudden loud sounds that occurs unexpectedly that catches you unawares so you don’t have ear protectors on. Your ears may “flare up”, but just keep on the path to recovery. All that will happen is that it will take longer to recover. When you know this ahead of time, it won’t throw you for a loop when it happens.
It is important (actually very important) that you don’t treat louder sounds as threats to your well-being and thus become anxious over them because this prevents you from habituating to them. Instead, treat them as useless, background sounds that you can safely ignore as long as they are not really loud sounds such that everyone should wear ear protectors.
It’s hard to say exactly what structures need to “heal” because your ears are very complex organs and so are the auditory pathways in your brain–and these need to heal as well. Just think of it as a psychosomatic condition–there is a “physical” and an “emotional” or psychological component and both work together and so both need to heal together.
Cordially,
Neil
Thank you so much Dr. Neil… is there a possibility that the sounds I’m hearing have a physiological connection to the broken synapses and they may actually eventually heal or should
I look at starting a TRT or something immediately? Also – a doc recommended niacin – is that something good to use?
Hi Kuan:
I don’t know whether there is a specific physiological connection with the sounds you now hear and broken synapses, but you inner ears and brain are such a complex system that there are many parts that all work together, and several of them combined are likely the source of your tinnitus and distorted hearing.
Personally, I wouldn’t do anything right now–give your ears a chance to heal by avoiding louder sounds. When they “calm down” a bit from the trauma, then I’d go to someone that is knowledgeable in treating loudness hyperacusis (and tinnitus). You may need a modified TRT program, but in the meantime, you may find it helpful to surround yourself with low-level background sound 24/7. The big thing is to not become emotionally involved with your hyperacusis/tinnitus–don’t worry or be anxious or depressed about it. Treat it as a condition that is safe to ignore, then ignore it as much as possible.
There is nothing wrong with taking Niacin. It is a vasodilator. The idea is that it will allow more blood flow to your inner ears so your ears can heal themselves better/faster. I wouldn’t expect miracles, but it could help.
Cordially,
Neil
Dr. Neil,
I think I speak for everyone when I say that you are AMAZING, and I thank you for taking so much time to answer questions and provide insightful information that other medical professionals do not.
It has been 13 days, and my issues have not seemed to improve, but… through independent research and “trial & error analysis,” I’ve come to learn more about my condition and would like to borrow your ear (no pun intended… however, I’d take anyone’s ear at this point) in entertaining some descriptions of what I’m experiencing.
My tinnitus is ultra-high frequency with some intermittent tones that appear to pepper in once in a while… without any hearing protection, some environmental sounds tend to provoke a lower tone that seems like something that is actually in the distance….
When I completely plug my ears for a few minutes and then return to full sound, it seems that everything is normal – it isn’t until certain sounds begin to provoke a high pitched tinnitus that becomes very pervasive and requiring total silence again to mitigate it.
I tested my own hearing in both ears using an iPhone app specific to tinnitus and found that my left ear can detect 12,400Hz max while my right ear can detect 13,800 Hz max.
The reason why I am so persistent in understanding what is happening is because sometimes I can carry on a conversation, and just deal with tinnitus, while today I’m having auditory fatigue and need to constantly “reset” by putting plugs in and then removing….. there are specific sounds that are unbearable (no pain it seems… more of a high pitch screech that accompanies) such as plastic bags, water running, the refrigerator motor, and jacket fabric rubbing.
I requested and began prednisone three days ago to begin treatment in the HOPES that perhaps this condition is related to recoverable damage (hearing sensitivity) and that I can have some relief (and hope) from this torment.
Sorry for the long post.. the question is – with all of this information, would you be willing to provide me with your unofficial opinion of what is happening? Is this something that will never subside or is there a chance that this is acoustic trauma and related to recoverable damage in the inner ear? Should I request any other tests or specific professional assistance?
Hi Kuan:
I don’t know whether the prednisone will help you or not. You are still within the timeframe where it can help.
If you can only hear to 12 or 13 kHz, you have considerable hearing loss in the very high frequencies and that could account for a lot of your tinnitus. If this is the case, then I doubt your tinnitus will ever go away completely, but if you learn to habituate to your tinnitus it will not be a problem it will fade into the background and hours may go by without your even being aware you have tinnitus.
As your ears heal, you will have good days (or at least better days) and bad (or worse) days. This is normal. Don’t lose heart on the worse days. Better days are around the corner.
You are still early in the healing process. It can takes several months or longer for things to get back to normal.
Having low-level background around you 24/7 can help your ears normalize. As your ears can take it, you can slowly raise the background sound until your ears are back to normal or as close as they will ever be.
I don’t see that having other tests at this point is worth it. The four things you need are time, protecting your ears from louder sounds, surrounding yourself with softer background sounds and not treating your ear conditions as threats to your well-being. Instead learn to ignore them by focusing on the loves of your life when the going gets hard.
Cordially,
Neil
Dr Niel,
I have been suffering from Hyperacusis and Tinitus for 5 months now. Compared to the first month my hyperacusis and tinnitus have healed a little bit, but i have made sacrifice for it ( i completely gave up TV, mobile,Music, any kind of electronic noise). I also gave up a job as an online coding instructor which required me to use headphones. Now i have an opportunity to work as Tech support (yes i am from india) which also requires me to make telephones call all day. Talking to people on mobile for few minutes even at low volume increases my hyperacusis gives me ear/head ache . What should i do. If i took the job i won’t be able to medically prove that i have a ear condition.
Hi Abhishek:
If your ears are still too sensitive to sound to stand you wearing headphones, then they are not ready to be on the phone all day. That can be very hard on your ears as I explain in my book “Hypersensitive to Sound?”
Here is a quote from it and notice it specifically pertains to call center workers in India. That’s why I’d be very cautious about taking such a position until your ears are fully recovered and are robust again. This is talking about “Acoustic Shock Disorder”.
“Researchers first identified Acoustic Shock Disorder in call-center employees who had been subjected to unexpected louder sounds through their telephone headsets. These sounds were not necessarily the dangerously-loud sounds that you’d expect would harm your auditory system. What distinguished the sounds that resulted in acoustic shock was their very short rise time or suddenness.
However, in some cases, ASD symptoms can develop as a result of the cumulative exposure to sustained headset use without a specific acoustic incident being identified as causing it. This apparently occurs as a result of something triggering the protective reflex function of the tensor timpani muscle.
One study of call-center employees in India found 28% had experienced acoustic shock symptoms at least once during their career. The reason for the high numbers of call-center workers developing acoustic shock is because working in a call center is particularly demanding on the auditory system. For example, call-center workers typically wear headsets close to their ears, need to focus exclusively on their auditory sense without any help from visual cues, and from time to time experience unexpected, sudden, loud sounds.
The sounds call-center workers experienced that resulted in ASD included incorrectly-dialed FAX tones, faults on the telephone line that caused loud shrieks, maliciously-generated noises from people screaming or blowing a whistle into their handsets, mobile phone interference, and callers that deliberately or otherwise dropped their handsets on their desks.”
It’s something to think about.
Cordially,
Neil
I saw a neuro-otologist who believes that the tinnitus may be a result of inflammation in the inner ear and prescribed 60mg prednisone a day for 14 days… is this common with acoustic trauma?
Hi Kuan:
Prednisone seems to be the doctor’s answer to many ear conditions. It may help, or it may not help. You’ll only know after taking it.
If you had contacted me the next day, I would have told you to take N-acetyl-cysteine (NAC) and that probably would have helped significantly because any such ear trauma as you had creates a lot of free radicals that damage/kill the hair cells in your inner ears. Your body uses the NAC to create its most powerful antioxidant–Glutathione.
I’d also supplement with zinc and magnesium as your ears need both in adequate quantities to heal themselves and for proper operation.
Cordially,
Neil
hi
I’m a music producer it’s been my hoby for about 6 years most of the time i have to clean some harsh mixes especially on the highs frequencies 7000hz to 14000hz for the clients.Lately i started to notice that i have high pitch sensitivty i can’t stand high pitch sounds any more they sound so annoying also i feel like they hurt my ear when other people just feel them normaly.also i don’t have any ringing on my ears and no other pain besides listening to high pitch noises example:phone ringing,loud voices…
Hi Aymane:
I think you are developing loudness hyperacusis from listening to higher-frequency sounds at excessively loud volumes (at least more than your ears can now stand). You need to keep the volume down in the future so you don’t aggravate your ears more. If you don’t, you can expect the hyperacusis to get worse as time goes on.
Cordially,
Neil
Hello, Dr Neil. Hope you are doing good. I have gained so much information from this page and I am truly grateful.
About 1 month ago, I got tinnitus and mild hyperacusis from listening to loud music with earphones. 2 weeks later both of them faded away but, I listened to music at a lower volume and they both came back. Am I going to be that sensitive to music in the future or will It ever go away completely? Thanks in advance.
Hi Elena:
Whenever you get tinnitus and hyperacusis, you know you have been listening to music too loud. It takes times for your ears to heal and become robust again–I’m talking in terms of a number of months, not just 2 weeks.
So listening to music at a lower volume is good–but apparently it was still too loud for your ears to handle. Remember, you should only listen to music at the same volume as you hear people talking–but most people seem to think they have to listen to music at levels far higher than the level at which people talk. And that damages your ears.
So for the next few months keep the volume down such that you don’t exacerbate your tinnitus/hyperacusis and as your ears can stand it, you can raise the volume, but keep it down to a level that won’t damage your ears in the future.
Cordially,
Neil
Thank you so much Dc Neil! I have 3 more questions 1)how many months would you give my ears to fully recover? 2) Can I use cotton instead of earplugs in noisy environments? cause I find taking off earplugs very difficult to manage.3) I take serc and I think that is the reason why my ear ( I have tinnitus/hyperacusis in my left ear only) got better. Do you think serc can real work? Thank you so much one more time. You help hundreds of people.
Hi Elena:
1. There is no way to know since everyone is different and the circumstances are different. For some people it may only take a couple of months and for others it can take several years. Only time will tell. Assume it will take “longer” so be prepared for the long haul and you won’t get so impatient at the slow progress.
2. cotton balls are NOT good filters of sound. They actually don’t reduce the sound volume by much at all so are basically not useful. You should use proper ear protectors–the foam ones are pretty cheap and work well.
3. Studies have not found that Betahistine (Serc) works any better than a placebo for helping people with tinnitus. But don’t discount the placebo effect in seeming to help tinnitus.
Cordially,
Neil
I have also ear fullness and my ear sometimes tickles. Is It because of tinnitus/hyperacusis or is it something more. Thanks one more time Dc Neil.
Hi Elena:
The ear fullness and tickling sensation are likely due to the acoustic trauma and are side effects just as are the tinnitus and hyperacusis and not due to the latter two side effects.
Cordially,
Neil
Hi doc,
Sorry to write so many times.
As of now i have completed 5-6 months of my hyperacusis journey. I have made progress i am able to withstand lot more every day sounds(people talking,dishes,etc) now. However i am not able to listen to electronic sounds (phone,tv,music,etc) and background noises (humming refrigerator,etc). These sounds causes me headache and temporarily increases my hyperacusis. Please tell me how to proceed further with my treatment.i am not doing sound therapy because electronic sounds hurts. Should i start sound therapy.
Hi Abhishek:
You are progressing well. I’m not sure why you can’t seem to stand electronic sounds–perhaps because they have too much high-frequency gain that makes it harder to tolerate.
If this is the problem, try turning down the treble all the way and turning up the bass and see if this makes a difference. If so, then your procedure from here on would be to slowly turn up the treble over time as your ears can stand it. And be sure to keep the volume down to a level just below where your hyperacusis begins to kick in. You don’t want too aggravate your hyperacusis in the process.
Cordially,
Neil
Dear Dr. Bauman,
Firstly, thank you so much for your time and for offering your expertise to others. My situation is that I blew a whistle (with peak db of ~115) off and on for about 20 minutes five weeks ago and have since developed mild but persistent tinnitus. I also now experience some irritation from high-pitched sounds (hyperacusis?). The severity of both conditions began subsiding slightly at 2 weeks past the date of noise exposure, and have definitely continued to decline, albeit slowly. Aside from protecting my ears from further harm, do you have any recommendations for assisting the healing process?
Very best regards!
Hi Ehren:
You are doing the right thing in protecting your ears from louder sounds while your ears heal.
In the future, when you need to blow the whistle, wear foam ear protectors (or equivalent) and that should not happen again.
I don’t think you need to do anything else–the healing is a slow process–so just keep on doing what you are doing now.
If you want to take any supplements, I’d suggest two minerals zinc and magnesium as both of these minerals are critical to ear function and many people are low in one or both. My preferred forms of these minerals are zinc picolinate and magnesium threonate as they are the forms your body can utilize particularly well. I take both every day just for general health.
Cordially,
Neil
Dear Dr. Bauman,
I appreciate your input. I take magnesium glycinate, and I haven’t heard of the threonate form but I’ll look for that as well as zinc picolinate. From what I’ve read on the topic, it appears that a leading hypothesis on the proximal cause of noise-induced hair cell damage is that it is due to free radicals released in the cochlea following exposure to loud sound. That concept makes me wonder whether there might be any value to taking certain forms of antioxidants to speed the healing of ear trauma.
All the best,
Ehren
Hi Ehren:
I didn’t mention free radicals in my reply because so much time had passed that I figured they had already done all the damage they were going to do. But for the future, if you take anti-oxidant supplements right away and for a week or so afterwards, they can certainly do a lot of good.
Your body’s most powerful antioxidant is glutathione–so either get glutathione injections, or take N-acetyl-cysteine (NAC), one of the main building blocks of glutathione so your body can make more. There is no point in taking glutathione by mouth as your stomach juices break it down so you are just wasting your time. That is why taking NAC is a good alternative if you take it soon enough–preferably the same day or the next day at the latest.
Cordially,
Neil
Hello, Dc Neil, thank you so much for your answers. I am so happy to find your website.
I got tinnitus/hyperacusis 1 month ago,(from listening to music for hours) 2 weeks later both of them faded away. Then I listened to music at lower volume but I listened to It for a long time(couple of hours) so my tinnitus/hyperacusis came back. After that, I started taking your advice (protecting from very loud sounds) in 2 weeks tinnitus and hyperacusis faded away again. I was very happy but, couple of days ago, I was walking in the street and suddenly, my neighbor shot the gun while I was walking. I was not close to him but It still caused my tinnitus to come back again not hyperacusis anymore(not yet at least) I have 2 questions If you would not mind answering 1)Can I have a hope that if it went away twice, It can go away again? 2) Will my ear( I have it only in my left ear) ever be as healthy and strong as in the past, when I attended concerts and I did not get tinnitus-hyperacusis, or will my ear be always more sensitive even after recovery? Thank you very much one more time. You help lots of people, I don’t even know how to express my respect about you.
Hi Elena:
1. Yes, I think it will go away again if you give your ears a rest from loud sounds again. The gunshot was unexpected and you can’t protect against such unexpected loud sounds. So they can set you back a bit, but if/when such events occur, again give your ears a rest from louder sounds and do what you have been doing and your ears should heal again but it may take a bit longer the more often such event occur.
2. I think there is cumulative damage to your ears with repeated loud sound exposure. (This damage may be hidden so it doesn’t show up on standard audiograms.) Thus, your ears may go back to normal (or near normal) robustness the first few times they are exposed to loud noise, but eventually you’ll notice that your ears are not as robust as they used to be and thus won’t stand loud concerts without ear protection, or you’ll get worse tinnitus and likely hyperacusis.
I’d always carry foam ear protectors that you can put in your ears if you encounter louder venues so you don’t damage your ears further.
Cordially,
Neil
Hello Dr. Bauman,
Thanks for mentioning the more in-depth information regarding antioxidants. Our ears are fascinating organs, and as I’m finding, so very delicate. It still really baffles me that merely blowing a whistle, outside no less, could result in this experience with tinnitus and heightened sound sensitivity. But I am heartened by reading numerous stories of people who have had this condition fade away within some months or years. My heart goes out to referees and traffic cops who I suspect also deal with this unexpected interruption to life.
Best regards,
Ehren
Hi Ehren:
Not only are our ears fascinating and delicate organs, they are the most complex organ in our bodies apart from our brains.
Blowing a whistle once is highly unlikely to be the sole cause of messing up your ears. It could be the final straw that broke the camel’s back if your ears have been absorbing excess noise over the years.
And police and fire personnel can have problems with their ears from hearing all the sirens all the time. And for firemen, the fire alarms in buildings is a real problem–and they are not allowed to turn them off until they can guarantee that everyone is out of the building and “guards” are placed at all the doors so no one can sneak back in.
It’s really hard on the ears when you have to be firefighting close to a blaring alarm. Been there, done that–when I was a volunteer firefighter.
Cordially,
Neil
Hello Dc Neil, hope you are doing great! Thank you very much for so many answers. I am sorry for asking so many times, just your answers mean everything to me.
I got tinnitus/ mild hyperacusis from listening to music (not very loud but It had many ups and downs, also the song was very harsh and uclear with low quality) my tinnitus and hyperacusis often go away but as I heard something like a gunshot in a movie (at about 60-65 Dc not louder, my tinnitus keeps coming back all over again. From your commnets I realized that I have reactive tinnitus and I have 2 questions about this.
1) Will my tinnitus ever lose the reactivity?
2) I work as an online teacher and I listen to a lot of unclear sounds coming from my laptom while giving lessons. Do you think should I use earplugs/ear protectors while having lessons or will my ears get used to that sounds?
Thank you in so much in advance! You help me a lot.
Hi Elena:
1. As your ears “heal” your reactive tinnitus should fade away. You treat the hyperacusis component first, not the tinnitus component when you have reactive tinnitus.
2. If the sounds from your computer are bothering you, I’d just turn the volume down enough so they don’t bother you while you are teaching and just turn the volume up when you need to hear one of your students. If you have a tone control, I’d adjust the tone to eliminate as much of the “sharpness” from the sound track as you can. That should also make the sounds easier to stand.
When you have reactive tinnitus, your ears won’t just get used to the sounds that are causing the reaction. You need to lower the volume to just below where sounds begin to react and then SLOWLY turn the volume up as your ears can stand it. That’s the way to properly deal with it.
Cordially,
Neil
Dr. Bauman,
Just following up on our exchange. What is the current thinking regarding how ears actually “heal” over time? For example, my ringing and reactivity has subsided significantly over the past 2 months of tinnitus onset, yet how is that possible given that cochlear hair cells do not regenerate? Is this all neural “re-wiring”?
Wishing you a peaceful weekend.
Best regards,
Ehren
Hi Ehren:
You are right–it is all neural “re-wiring” in your brain. It has nothing to do with the state of your inner ear hair cells–whether alive or dead.
Cordially,
Neil
Dr. Bauman,
Again, quite fascinating!
I have a question regarding a painful “inner-ear” sensation that I have had a number of times recently. It feels a fleeting soreness, as if I had bruised tissue deep inside my ear, but this pain appears and disappears without any associated external sound, and it is always a very brief sensation. I have worn earplugs quite a lot in my noisy workplace this week, so I wonder if I have maybe compacted earwax in my ear. Any thoughts on the matter would be very appreciated.
All the best,
Ehren
Hi Ehren:
I wouldn’t worry about the fleeting soreness. It could be due to wearing the earplugs. It could be that your ears are still healing and need more time.
If it is ear wax, go to your audiologist or doctor and have them check it out–and remove any wax present, but I rather doubt it is wax. But the only way you’ll know is to have a doctor have a look and see.
Cordially,
Neil
Hello, Dc Neil, hope you are doing good. Thank you one more time for so many answers.
I am back after a little while , my hyperacusis faded away almost completely(85-90/100) I feel no longer sensitive to sounds, as for my tinnitus, it faded away for 4 times already, but It still keeps coming back. It goes away and then as I hear some sharp sounds like book drop, door slam e.tc.(not very loud) It comes back again, especially at night when my roommates make some noise in another room.
I have a few questions if you would not mind answering.
1) When my tinnitus comes back after the noise, does it mean that my recovery starts all over again or is it just part of its recovery?
2)Do you think that I should use earplugs all night long ? because I can’t control the noise (I always control decibels of noise during the day times)
3) Can my tinnitus reactivity be permanent, or will it go away completely in give time?
4) Will I ever be able to listen to music at 80-90 decibels without getting tinnitus, or do I have to stay at 60 decibels for the rest of my life?
Thank you so much Dc Neil, I am so happy (like so many people on thins website) that I found you.
Hi Elena:
1. It means that you are not totally recovered yet, so your ears are still healing and need more time. The sharp sounds indicate that your hyperacusis/tinnitus are fading, but just not there yet. You are not going back to square 1 or you’d have the loud hyperacusis/tinnitus again, but think of it 2 steps forward, one step back. You are making excellent progress. Just give it more time. These things typically take months to completely heal.
2. No. You don’t want to wear earplugs unless you really need them. Wearing earplugs just makes hyperacusis worse. Your ears need sounds to challenge them–just that the sounds need to be below where they aggravate you hyperacusis.
3. It can be permanent, or temporary. I think yours is going to be temporary as you have made wonderful progress so far. Just give it time.
4. Once your ears fully recover, you should be able to, just don’t push it or you will set yourself back. You can slowly raise the level as your ears are able to bear it. Always better to err on the soft side, not on the loud side as you don’t want to have to go through this whole process again in the future. Your ears may always be more sensitive to sound that they were before so they probably won’t be able to stand the loud sounds like they did before. But they should be better than they are now. Again, give it time. No rush.
Cordially,
Neil
Dear Dr. Bauman,
I have a question if I may ask you yet another. I find that I don’t sleep as well with white noise, but that the tinnitus is more quiet during mornings when I have had the white noise playing at medium-volume. However, the tinnitus seems louder at night when the white noise is on rather than off. Would you suggest that I should continue to play white noise at night regardless of these details?
All the best,
Ehren
Hi Ehren:
The simple answer is do what works best for you. What I’d suggest is you experiment with other sounds and see if you can find one that both quietens your tinnitus and lets you sleep.
Here are some choices–try pink noise rather than white noise. It is more natural sounding to our ears and still works for tinnitus.
Try water sounds. They are natural sounds and easy to habituate to (along with your tinnitus). You can use water sounds such as waves lapping on the beach, babbling brook sounds, surf sounds, waterfall sounds, rainfall sounds, etc. See which work best for you.
You can also use music–ideally random music sounds such as fractal music, which sounds much like wind chimes.
And don’t make the volume too loud. You are NOT trying to drown out your tinnitus, just mix the sounds with your tinnitus.
Cordially,
Neil
Hello, Dr Neil, I want to tell you say thank you one more time for your help, I have no words to fully express my respect and a admiration that I have about You.
My tinnitus faded away for 6 times in 2 months,(I got it from listening to music) 3 days ago It was gone again, but yesterday night, I was walking in the street and someone shot the gun twice, it was so loud that hurt my ears, my tinnitus came back and now it’s as loud as it was 2 months ago, at the beginning, I am so nervous right now I even find writing this so difficult. I have a few questions if you would not mind.
1)Do you think that in this case, my tinnitus can become permanent because it’s 6th time for it to come back, especially so loud, or can it go away again?
2) I fit goes away, will there be time when even after gunshot, my tinnitus will not be back?
3)Do you think that I should wear earplugs while walking so I can protect from this unexpected sounds?
4)Can I use earphones and listen to music? or will it damage my ears even more?
Thanks in advance, hope you are doing good, Dr Neil.
Hi Elena:
Those gunshots have set you back, no doubt about it, but it is just a setback. So you pick yourself up and continue on the same path you were on before (because it obviously is working for you). I believe in time you will get back to where you were before the gunshots.
1. Your tinnitus can fade away again. There’s no law that says 6 times and your’re out. The more you protect your ears from loud sounds, the more they will continue to heal.
2. I can’t say it will never come back, but it will likely be temporary as long as you do not treat it as a threat to your well-being. It may be just soft in the background where it will not bother you.
3. Wearing earplugs “just in case” is not a good idea. But wear them where there is a high probability of really loud sounds. The more you wear ear plugs unnecessarily, the greater the risk of getting loudness hyperacusis or making existing hyperacusis worse. And it can make tinnitus worse for the same reason–your brain turns up its internal volume so it can hear better. Thus when you take them off, you hear all sounds as too loud, including your tinnitus.
You can’t protect against all the sudden unknowns in life. That is a risk of living. You just try to put the odds in your favor–and if something unexpected comes up and makes your tinnitus worse again, treat it as a setback and carry on and let it fade away again.
4. Sure, why not? Just keep the volume down to the same level you’d use if you were listening to a lecture or person talking. It’s not the music that hurts your ears–but the volume. Keeping the volume below 70 dB shouldn’t hurt your ears at all. Unfortunately, too many people are addicted to listening to music at very loud levels and that is what causes the problems.
Cordially,
Neil
Hello, Dr Neil, thank you so much one more time.
I have one more question if you wouldn’t mind answering.
I didn’t have an appointment with an audiologist, (because there is not any in my hometown or near my hometown) do you think that it’s necessary for me to go and check my hearing with an audiologist?
Can it be something serious,? cause I have it only in my left ear.
Thank you so much in advance!
Hi Elena:
Why do you want your hearing checked by an audiologist? Are you suspecting you have a hearing loss, or what? What is it that you want the audiologist to tell you?
What is “it” that you only have in your left ear? tinnitus? hyperacusis? or what?
Cordially,
Neil
No, I don’t feel any hearing loss, I have tinnitus only in my left ear, and some people say that it can be serious, caused by a tumor or it can be a signs of heart/back problems. I am almost sure that mine is caused my my earphones, but I got scared, can it really be something more serious and would you advice me to have an appointment with an audiologist?
Thank you so much one more time. You help me a lot.
Hi Elena:
Tinnitus in one ear–depending on the kind of tinnitus it is–can be indicative of those problems, but it is not likely given what I know about your situation.
Whenever doctors see differences between ears, they always suspect the worst. In actual fact, you can get tinnitus in one ear just because that ear absorbed most of the loud sound. Ditto for hearing loss.
If it was me, I sure wouldn’t worry about just having tinnitus in one ear. In fact, sometimes my tinnitus is in one ear, sometimes the other, sometimes in both, and sometimes just inside my head without reference to either ear. It’s all the same tinnitus. No big deal.
The time to worry is when you have several symptoms in one ear at the same time that are not in the other ear.
Cordially,
Neil
Thank you once again, Dr Neil.
I had several symptoms in my left ear, Tinnitus, ear fullness, hyperacusis and popping sounds in my left ear only,(after listening to music) that’s the reason I got scared, but my hyperacusis, ear fullness and the popping sounds’ve gone already. I have only tinnitus now, so do you think that if something more serious had been the reason these symptoms wouldn’t have been gone?
Thank you one more time, I have no words to express my admiration about your kind personality. You help hundreds of people.
Hi Elena:
I think all your symptoms were due to noise exposure and not to “something dreadful” in your head. Tinnitus is often the last symptom to go. I think you are going to be just fine.
Cordially,
Neil
Dear Dr. Bauman,
I have an opportunity to partake in a clinical trial for an emerging drug for tinnitus called OTO-313 (by Otonomy). I am about 10 weeks into the onset of tinnitus, and while the symptoms have subsided some, it is of course hard to know whether they will continue to subside. My question is whether you would recommend against partaking in the study since my symptoms HAVE subsided some, and thus let time do its work, or partake in this study (which incidentally carries the potential side effect of causing tinnitus as a result of an intratympanic drug delivery).
I realize that you are not my official doctor and have no obligation to answer this delicate question, so I will treat any thoughts you might provide here as thoughtful discussion material, not recommendations.
From the following article: “43% of OTO-313 patients were responders at both Day 29 and Day 57 compared to 13% of placebo patients. A responder is a patient whose TFI score decreases by 13-points or more from their baseline score, a change considered clinically meaningful based on the TFI instrument validation.”
https://www.bloomberg.com/press-releases/2020-07-06/otonomy-reports-positive-top-line-results-from-phase-1-2-clinical-trial-of-oto-313-in-patients-with-tinnitus
Hi Ehren:
As a general rule, Worst Pills/Best Pills says not to take any drug until after it has been on the market for 7 years. This is because many/most side effects are not discovered during the trial period, but only surface after the drug has been on the market for a few years. So unless you like being a guinea pig for a drug with undiscovered side effects and questionable efficacy at that point, you will wait until you know the side effects and proven results.
Furthermore, since your tinnitus is still improving, you’d never know whether continued improvement was due to the drug or your body’s continued improvement of your tinnitus.
Now let’s look at the published results of this drug so far (taken from your link and from https://tinnitusmag.com/oto-313/.
1. Notice the percent of participants helped. Only 43% were responders out to 57 days. That means that 57% were not responders–i.e. they were not helped. So obviously this drug only helps a minority of people with tinnitus–and these people were specifically picked to have the best chance of succeeding. Thus real-life results will be even less.
2. Of these 43% that were helped, how much help did they really get for their tinnitus? To be a responder you had to have a minuscule 13% improvement in your TFI score. And the best was up to 30% (The TFI score is basically a percentage). So this means that no one in the study got rid of their tinnitus, their tinnitus was reduced by only 13% to 30%–not exactly a rousing success story in my book (but it is a step in the right direction).
3. There’s something fishy about the placebo. They reported “there was a lower incidence of adverse events than in the placebo group.” How can that make sense since the placebo is supposed to be an inert substance–and thus shouldn’t have ANY adverse side effects. This shows that the placebo wasn’t a true placebo, but was likely another drug. This is a dirty secret in many drug trials. They compare the new drug against an existing drug in order to hide as many side effects as possible as then they only report the side effects that occur more than they do in the “placebo-drug”, rather than reporting ALL the side effects.
So looking at it overall, would you really want to test a drug that only helps up to 43% of the people taking it, and then only reduces their tinnitus up to 30%, has unknown side effects, especially in light that there is something funny about the placebo?
You need to carefully look at studies to see what they really mean, and then make up your mind whether to participate. I’m sticking with Worst Pills/Best Pills recommendation of waiting until it has been on the market for 7 years before I’d even consider taking it.
Cordially,
Neil
Dear Dr. Bauman,
Thanks very much for your thoughtful and thorough reply.
Another way I’ve thought about this is that a trial participant has only a 50% chance of being assigned to the treatment, and with a drug efficacy of only 43%, under the best case scenario there is only a ~22% chance of experiencing any improvement at all. And then there is the issue of the miniscule improvement in TFI that you mentioned. All considered, I will pass on the trial and let my body do the heavy lifting of healing this condition. That said, I certainly do hope the trial finds suitable participants, as of course that is the only way effective drugs can be developed and become FDA approved.
All the best to you,
Ehren
Hello Dr Neil, I hope you are doing great. Thank you so much for all of your answers.
I am back after a little while. After the gunshot my tinnitus was reduced a little bit, but yesterday night there was a thunder storm that woke me up in the midnight (not very loud) and my tinnitus got worst. I have a few questions if you don’t mind answering.
1) If there are thunder storms and gunshots everyday, does it mean that my tinnitus will get severe and permanent? or will it just make my recovery longer and longer but tinnitus will stay the same?
2)I tried to use my earphones 2 days ago, (at a low volume5/100) and my tinnitus flared up, does it mean that I will never be able to listen to music with earphones again?
3) Do you think that noise canceling headphone is a better idea?
4)Earplugs reduce only 20-25 DB, at the concert, the music sound can be 100-120, that it mean that even with earplugs I will not be able to go to the concerts? because I can still get 100 decibels of the music.
5) Here in my country (Georgia) every ear doctor prescribes Serc, can it really work for tinnitus?
Thank you so much Dr Neil, sorry for asking so many questions, just here, in my country none of the doctors have any idea about neither reactive tinnitus nor hyperacusis. You are my only hope.
Hi Elena:
In answer to your questions.
1. Unless these loud sounds happen every day and really set you back each time, I don’t think they will cause your tinnitus to become more severe or permanent. They just will set you back a bit, but hopefully, as time goes on, your ears will be able to stand such sounds better, but they won’t like really loud sounds–ever.
2. I’d wait a couple of more months before wearing your earphones again to give you ears more time to recover. Sound waves get trapped in your ear canals when you wear earphones so this makes sounds louder to your ears than if you were listening to something at the same volume via loudspeakers. Easy and slowly does it. But at the same time, you have to “push your ears a bit” by slowly increasing the background sounds–the trick is not to push them too much at a time, especially when they are not ready.
3. All noise-cancelling headphones do is block outside sounds–they do nothing to fix the problem of the sound waves being trapped in your ear canals. So wearing sound-cancelling headphones when listening to something via earphones when you are in a noisy environment will help, but not otherwise.
4. Basically, that is correct. Your ears will not tolerate loud sounds like that. If you go to a concert, you need to stay as far away from the speakers as possible so the volume is already greatly reduced–and then wear your earplugs. That would work–at least at outdoor concerts where you can get away from the loud sounds.
5. Betahistine (Serc) is not used over here. That should tell you that it either doesn’t work, or gives limited help. It’s probably not going to make things worse (unless you are particularly sensitive to this drug), but it’s probably not going to help much either.
Cordially,
Neil
Hello Dr Neil, thank you so much one more time.
I would like to ask a few more questions if you don’t mind answering.
1) Do you think that in 6-8 months I will be able to use my earphones?
2)Will I ever be able to stand closer to the speakers(with earplugs) at the concerts again I mean, will my ears ever be able to tolerate 90-100 decibels in the future (in 3-4 years)
3) In near future, (5-6 months, can I go to the wedding (with earplugs) or will it still be too loud for my ears?
4)What is the maximum time of tinnitus, so after that time it means that it’s permanent?
Thank you so much Dr Neil, I hope you are doing great.
Best wishes,
Elena.
Hi Elena:
1. I would think so. Or even before. As I said, you need to push the envelope a bit–just not too much and too fast.
2. I can’t answer that. It depends on a number of factors. One would be how much damage your ears have had to date. I daresay that your ears will never be as robust as before, so the more you keep the level to a reasonable level, the better off your ears will be in the future.
3. Again, it depends on the sound level. If the DJ keeps the volume to a reasonable level, you should be able to go, but if it is ridiculously high like most seem to like it, you may be able to stand the racket for a few minutes, but not for several hours.
4. You can always treat tinnitus no matter how long you’ve had it. If you expect it to go away completely, I say that would happen in the first couple of months. After that, you could say it is permanent–but with treatment, you can habituate to it so it won’t bother you even if you do hear it, but hours may go by without your being aware you even have tinnitus. That is the way my tinnitus has been for the past 70 years.
Cordially,
Neil
Hello Dr Neil, thank you so much for your kind answers, no one would ever help so many people for free. I have no words to fully express my admiration.
After the thunder storm, my tinnitus started reducing again, but yesterday night some one from other streets shot the gun again and the sound was very loud, my ear started hurting and it still hurts right now, despite of the hurting feeling my tinnitus didn’t get louder after the gun shot for the first time during these 2,5 months. I have a few questions if you would not mind.
1) Can my tinnitus not getting louder with loud sound be a sign that it starts losing reactivity?
2) Can my ear mean that I should be concern about my hyperacusis will come back, the last time I got ear pain my hyperacusis came back.
3) Here in my downtown, there is a forest nearby, and so many hunters kill poor birds so they shot their guns for 3-4 times in a week, do you think that in this condition I can’t heal completely, as my ears can’t be protected from these unexpected sounds? or it can still heal but slower?
Thank you so much one more time. I hope you are doing great.
Best wishes,
Elena.
Hi Elena:
1. It would seem so in your case. But wait a few days to be sure, as the results of acoustic trauma don’t necessarily appear immediately.
2. Although hyperacusis, or acoustic shock can (and often are) accompanied by ear pain, there is no law that says it has to be this way.
3. Good question. If the sounds are too loud–like more than 85 or 90 dB or so, then it could make it hard for your ears to heal, unless the setbacks you experience only last a day or two. If the setbacks last a week or two, you’d be getting setbacks faster than your ears are healing.
Now that you know what is happening with your ears, you are less anxious and so the emotional component of the acoustic shock won’t be as great and therefore, such sounds won’t bother you as much either.
I think you will slowly heal as long as you don’t expose your ears to really loud sounds.
Cordially,
Neil
Hello Dr Neil, hope you are doing great.
For the last 5 days, my tinnitus almost faded away, it was so low that I could barely hear the sound. (only before my sleep) but yesterday night, I was listening to music at a low volume 60/70 DB but the music had a lot of ups and downs, couple of minutes later my tinnitus got louder and my ear got plugged. I have a few questions if you don’t mind answering.
1) Can even low music make my tinnitus flare up?
2) When I hear really loud sounds (gun shots, fireworks) my ear starts hurting (especially my eardrum) does it happen because of TTTS because I get nervous? or does it happen because those really loud sounds can actually damage my ear?
3) Does my tinnitus getting louder with loud sounds mean I have reactive tinnitus? or every tinnitus gets louder with such sounds?
4)Can I ever have time when my tinnitus will stay the same and not get any louder?
5) If I hear gunshots only once in a week, do you think that it is setback or worse than a setback, something that can’t let my ear heal because it’s too often?
Thank you so much Dr Neil one more time, I can’t express enough how much your answers mean to me.
Hi Elena:
1. If you only have pure tinnitus, soft music shouldn’t make your tinnitus flare up. However, if you have reactive tinnitus, or some degree of hyperacusis, yes, then it can flare up even with low levels of sound.
2. The answer is yes to both parts of your question. Really loud sounds can damage your ears–we’re talking louder than 120 dB–which is what you may be hearing the gunshots at–even that short burst of sound can be damaging. The pain can also be from the startle reaction and your TTTS kicking into gear. In that case, remaining calm will help. Actually, remaining calm most of the time is a good idea for both physical and mental health.
3. Normally, with reactive tinnitus you don’t need really loud sounds. Your tinnitus will get louder with normal, everyday sounds. If the sound is really loud, then you’d expect your tinnitus to get louder even without having hyperacusis.
4. Once your ears heal and your hyperacusis goes away totally, then your tinnitus (if any is left) should more or less stay the same–unless really loud sounds are nearby. Just be aware that tinnitus can change volume for no obvious reason, just like it can get softer or disappear at times. This is normal.
5. That’s hard to say. So much depends on your emotional state/attitude towards the gunshot sounds, and how loud they are. They may continue to set you back at least in the short term. If you keep working on your program of getting your hyperacusis and tinnitus under control, I think in the long term, they won’t bother you anymore.
Cordially,
Neil
Dear Dr. Bauman,
I have a question regarding how to treat myself following exposure to a loud sound. Today I was hiking with a friend and his dog when my friend unexpected whistled loudly but briefly to his dog from about 6 feet from me. I asked him to warn me when he might whistle, but sadly he must have forgotten. I was very startled and it seemed like I felt dizzy for only a split-second, but my pre-existing tinnitus sounded very quiet for a few moments following the noise. I did not feel any pain whatsoever as a result of the whistle sound. It has now been about 8 hours after the incident, and I have not experienced a threshold shift or a change in my tinnitus sounds. Nevertheless, I am anxious about the sound exposure since it has been only 3 months since the acoustic trauma that originally caused my tinnitus symptoms to develop, and I am wondering if I should double my NAC intake and perhaps seek prednisone ASAP to counteract potential damage.
Many thanks for any input and suggestions you might provide.
All the best,
Ehren
Hi Ehren:
If you don’t have any change in symptoms or no new ones, I wouldn’t worry about it. And, as you know, anxiety over the incident can make things worse. So if you still don’t see any problems since it is a day or so later now, I’d just forget about it and get on with your life. Doubling your NAC for a few days may be a good idea if you are worried and anything has changed. I wouldn’t take Prednisone unless you have serious problems.
Cordially,
Neil
Thank you very much for your reply, Dr. Bauman.
Best regards,
Ehren
Hello Dr Neil, thank you so much for all of your answers. Wrds can’t express enough how much you helped/help me. My tinnitus didn’t fade away anymore, but it stayed the same law pitched sound that I can only hear at night. (in previous weeks I could hear it at anytime not only nights) I have a few questions if you would not mind answering.
1)For the last 5 days, I heard gunshots for 4-5 times but my tinnitus stayed the same, didn’t get any louder. Do you think that it’s because the gunshots were not close enough to damage my ears or my ear started getting robust again.
2)should I be worried that my tinnitus can get ouder in 5-10 days as sometimes symptoms of acoustic trauma don’t appear right away but in couple of days.?
3)some people say they got hyperacusis after their tinnitus in 2-3 months as a follow of their tinnitus. Can my hyperacusis came back in 2-3- months again?
Thank you so much Dr Neil one more time, hope you are doing great! You deserve all the best things.
Best wishes,
Elena.
Hi Elena:
1. It could be both–only you know how loud they were in comparison to the past. If they were not as loud, it could be the reason your tinnitus is not flaring up, but it could be because your ears are healing. It could also be because your emotions are not as strong. You are not so worried about them.
2. You don’t want to be worried–period. I wouldn’t look for trouble. It is always possible tinnitus could show up later, but I tend to think this won’t happen in this case.
3. Loudness hyperacusis typically occurs when you expose your ears to loud sounds, just like tinnitus does. But if you had NO loud noise exposure for 2 or 3 months, then I think it is highly unlikely that you will get delayed hyperacusis. I think the people you mention exposed their ears to loud sounds in that interval and consequently got hyperacusis. It wasn’t from the tinnitus 2 or 3 months previously. And remember, hyperacusis is a psychosomatic condition–so if you worry about getting hyperacusis, you might find it a self-fulfilling prophecy. When you remain calm, the chances of getting hyperacusis are a lot less.
Cordially,
Neil
Hello Dr Neil, thank you so much one more time for your help. No one would help so many people for free. I always look forward to reading your kind answers. I gained so much information from you. I can’t express enough how grateful I am. I have a few questions if you wouldn’t mind answering.
1) My tinnitus doesn’t react at the gunshots anymore. My emotional state is also normal. I try to stay as calm as I can. But when I work for many hours in a day, tinnitus gets so loud that I find it hard to sleep. When I rest my brain then it drops the sound. Is it normal for tinnitus to flare up after working for many hours?
2) I listen to music at a low volume again (at 60-70 DB) Is it the only level of sound that I am capable of listening for the rest of my life, or can my ear stand 90-100 decibels in given time even if my tinnitus stays ?
3)My neighbor is a musician and he said, he has had tinnitus for more than 23 years ( he got it from music) but he still plays the drums with ear protections. Is it possible to stand the loud drums even if you have tinnitus?
4)My ear somehow got used to facing loud sounds, but I can’t listen to music with a lot of ups and downs in rhythm. Does it mean that I will never be able to listen that kind of music?
Thank you so much Dr Neil, one more time. Hope you are doing great.
Best wishes,
Elena.
Hi Elena:
1. Tinnitus can flair up when you are tired or stressed and that can be the case after you have worked for a number of hours. It doesn’t have to be this way. My tinnitus seldom changes volume due to those factors. For me, it is thinking about tinnitus (which I so often do it helping people deal with their tinnitus).
2. If you work on your loudness hyperacusis you can slowly raise the level that your ears can stand. You may never get completely normal, but you can approach normal loudness levels so you can listen to music–at least the peaks–without causing your hyperacusis to kick in. It is a slow process–one that you don’t want to rush so you don’t set yourself back. You can try pushing the volume up a couple of dB at a time–say from 62 to 72, then if your ears can stand that level, then push it up a bit more to 64-74 and so on. But you should not be listening to sounds greater than 85 dB without ear protectors. That is getting to be too loud and remember, your ears will likely remain more sensitive to sounds that before they were damaged.
3. The rules are the same for drums as for any other musical instrument (or sound), keep the volume down to a reasonable level or wear ear protectors. If it makes your tinnitus worse, it is too loud.
4. When you have hyperacusis, you can find exactly what you have found–that your ears are not able to handle sudden changes in volume, but they can stand louder sounds if they sustain that volume. As your ears heal, they should be able to better handle these changes in volume.
Cordially,
Neil
Hello Dr Neil, thank you very much for answering. I have 2 more questions, if you wouldn’t mind answering.
1)Do you think that I shouldn’t work for that many hours as it makes my tinnitus flare up, or it just flares up but it will get used to my routine so I can work ?
2)sometimes, when I eat, laugh, speak or do something else my tinnitus gets loud suddenly (especially If I think about my ear for a minute) Is it normal to happen?
Thank you so much one more time, you help me a lot.
Best wishes,
Elena.
Hi Elena:
You need to listen to your body. If you push it too much, you just end up with health problems, including, in your case, worse tinnitus. Find ways to work without impacting your tinnitus–maybe take breaks as you need them.
It is normal for your tinnitus to get louder whenever you think, talk, read about tinnitus because you are temporarily focusing on it. But it should drop to its old level when you do something else.
Cordially,
Neil
Thank you Dc Neil, you are right when I don’t think about it I can’t even hear tinnitus. I have three more questions if you wouldn’t mind.
1) Sometimes, I don’t even think about my tinnitus but it still gets louder without a reason. Is it normal?
2)If I listen to 80-85 decibels now, do you think that my tinnitus will get worse and my hyperacusis may come back?
3)When I touch my eardrum, it starts making clicking sounds, can It improve in time or it will stay like my tinnitus?
Thank you so much Dr Neil, and I am sorry for asking so many questions.
Hope you are doing great.
Best wishes,
Elena.
Hi Elena:
1. Yes, sometimes tinnitus just decides to get louder for a bit without any identifiable reason. Mine does that from time to time, but it goes back to baseline in typically less than an hour or so. When this happens just continue to ignore it and focus on something else and eventually you realize you don’t hear it anymore.
2. If sound at that level doesn’t bother your ears I’d say your ears are pretty close to normal now. But you don’t want to listen to music any louder than that because above that level you risk damaging your ears.
3. Are you meaning your eardrum or you earlobe? Anything touching your eardrum like a hair or a bit of wax can cause it to go into spasm and it can sound like clicking or fluttering.
Touching your earlobe or other places around your ear can activate certain nerves that cause your tympani muscles to spasm, thus resulting in Tonic Tensor Tympani syndrome.
Explain in more detail what you are touching and how long this clicking persists so I can understand your situation.
Cordially,
Neil
Hello Dr Neil, thank you so much for all of your answers. I mean my eardrum not earlobe. When I touch my eardrum (for example when I use my Q-tips) eardrum starts making clicking sounds it sometimes feels like there is water inside my ear. When I touch my earlobe nothing changes.
I thought this was TTTs, do you think that it can be something different?
Hi Elena:
When you touch your eardrum with a Q-tip, your eardrum tries to pull away and then when it does the sensation goes away so it relaxes and comes back into contact with the Q-tip again so pulls away again. This is essentially TTTS, but from an external source (Q-tip). You really shouldn’t be pushing the Q-tip in that far so it touches your eardrum. Wax is only produced in the front half of your ear canal–not the back half.
Cordially,
Neil
When I touch it (my eardrum even with my finger) it starts making this clicking sensation, sometimes it’s getting hot, it only lasts for a minute then when I take my hand out and stop touching it, it stops and my ear feels normal.
Hello Dr Neil, thank you one more time!
My right ear (which is normal) never does the same think. And sometimes, when my tinnitus fades away and then I touch my eardrum,(my left ear) It doesn’t make that clicking sensation, when my tinnitus comes back, then it also comes back.
1) Do you think that it’s TTTs or can it be something else?
I think I may confuse the word ear canal with the word eardrum. My ear canal is clicking not my eardrum.
Thank you so much Dr Neil.
Best wishes,
Elena.
Hi Elena:
So you are saying when you put your finger in your ear canal, sometimes that ear begins clicking? If so, I’d say that is TTTS kicking in due to over-activating the sensory nerves in your ear canal. At least that is what it seems like to me.
Cordially,
Neil
Hello Dr. Bauman,
I have now experienced tinnitus and hyperacusis symptoms for about 4 months, and I am curious to know your thoughts on the following. The volume and annoyance of tinnitus is greatest when I am around external sound. Would you call that reactive tinnitus? If it is reactive tinnitus, I gather that it is important that I surround myself with pink noise or some similar sound at all times to reduce that reactivity. Is that correct? It is counterintuitive to surround myself with noise given that the tinnitus is often not very noticeable in quiet places. I am happy to say that I am noticing the tinnitus in social situations less than I did during my first couple of months. That seems like a good sign that it is receding in my awareness or perhaps actually going away. Relatively loud sounds still sometimes strike me as strangely abrasive and loud though, and I am also wondering if that sensation can be expected to fade in time.
Best regards,
Ehren
Hi Ehren:
Reactive tinnitus is where your tinnitus increases as the background sound level increases.
It’s the treatment for hyperacusis where you surround yourself with a more or less constant background sound. But from what you say, it seems that your hyperacusis and tinnitus are slowly getting better with what you are doing now. If so, I’d just continue on doing the same and not worry about doing anything else. If you can ignore your tinnitus and let it fade into the background, great. Maybe that’s all you need to continue doing.
Louder sounds will still affect you to some degree and as your ears “heal” and strengthen, they should bother you less and less as time goes by until your ears are back to normal. Just remember that they will probably always be more sensitive to louder sounds than before.
Cordially,
Neil
Thank you for your reply, Dr. Bauman.
As always, I deeply value and appreciate your care and willingness to contribute to my understanding of how best to approach managing my symptoms.
Wishing you good health and a lovely week.
Ehren
Hello Dr Neil, thank you so much for all of your answers. I hope you are doing great. I have a few questions if you don’t mind answering.
1)My tinnitus reactivity was almost gone for 2 weeks. For the last two weeks my tinnitus didn’t get any louder after the gunshots, door slamming. But 3 days ago I was listening to music (with lot of ups and downs in the melody) my tinnitus didn’t react right away so I thought that was okay and continue listening. The next morning my tinnitus got louder, for the last three days my tinnitus is quiet loud, especially in the mornings. Does it mean that my tinnitus reactivity is coming back instead of fading away?
2) Can the reactivity stay always with me and not go away or will it go away sooner or later?
Thank you so much one more time, Dr Neil. I can’t express enough my admiration.
Love,
Elena.
Hi Elena:
It is interesting that when you have hyperacusis, your ear can sometimes stand louder continuous sounds, but softer sounds that have lots of ups and downs in volume can cause your hyperacusis to flare up. I think this is what happened when you listened to that music. I think your hyperacusis will settle down again, but you have to give it a bit of time.
Your reactivity should fade away in time, but this could take a couple of years. It just basically gets better and better until you are back to normal or near normal.
Think of how far you’ve come now–can stand the gunshots and doors slamming which you couldn’t do so a few weeks ago. So you really are making great progress, you just suffer setbacks from time to time–like you were blindsided with the up and down music.
Cordially,
Neil
Hello, Dr Neil. I hope you are doing great. Thank you so much for all of your answers.
My tinnitus was okay for a few days, but couple of days ago my orthodontist put hard elastics on my braces, after tightening my teeth my tinnitus got so much louder, in the mornings it sounds like a police siren. And it even reacts loud sounds again. I have a few questions about it, if you wouldn’t mind answering.
1) Could the elastics on my teeth cause my tinnitus to flare up?
2)If it could, do you think that It’s better for me to cancel my appointments with the orthodontist for the next 1-2 months?
3)There is a restaurant near my house ( in the next street) people sometimes celebrate Birthdays/Weddings and they light the fireworks. If I am in my sleep and don’t really pay any attention to these fireworks, can they effect on my hearing/tinnitus? or they can’t as long as my brain is sleeping so it doesn’t pay attention to those really loud sounds?
4)Does the fact that my tinnitus started reacting at loud sounds again mean that my reactivity is coming back?
Thank you so much, Dr Neil. I have no words to fully express how grateful I am for your kind answers.
Love,
Elena
Hi Elena:
1. I think that is what is happening. The elastics are putting pressure on your teeth and that is aggravating/overactivating the dental nerves. When these signals reach your brain, some somatosensory neurons are (mistakenly) sending the signals to your auditory system where you hear them as louder tinnitus.
2. Either that, or have “looser” elastics put on that don’t aggravate your tinnitus (and hyperacusis) if that is possible. You don’t want to do anything that makes your hyperacusis worse.
3. There are two things to consider. If these louder sounds don’t wake you up so you ignore them, then that won’t affect your emotional system to make it seem worse. However, loud sounds, whether you consciously hear them or not, can still damage your ears. I think if they are a block away, they wouldn’t be loud enough to do that.
4. Yes, but hopefully it’s only a setback–maybe from the orthodontic work. If you think that too, see 2 above and act accordingly.
Cordially,
Neil
Hi Dr. Bauman,
I have a question and observation I’d like to present. I have noticed that, recently, when I have days when I am around external noise, my symptoms seem better the next day. I have never yet experienced spiked in tinnitus. These observations lead me to wonder if it might be helpful to gradually increase the volume of the white noise I play while sleeping. Do you have thoughts on this observation?
All the best,
Ehren
Hi Ehren:
You could try experimenting and see what happens if you gradually raise the sound of your white noise at night.
But by the same token, you might want to gradually raise the level of sound you experience during the day and see how that affects your tinnitus. It might even be profitable to it both day and night. You want to do what works for you, no matter how it may affect other people in the same position.
Cordially,
Neil
Hello Dr Neil, I hope you are doing great. Thank you for all of your kind answers! I have a few questions if you wouldn’t mind.
1) My tinnitus for the last 10 days is so low that I can barely hear it before my sleep or during the day (even in the quit room) but in the mornings It is loud again, then as I stand up and go out it drops the sound. Why can it be so loud only in the mornings?
2)My tinnitus didn’t react on the song with lots of ups and downs, so I thought my ear was better and tried my earphones at a very low volume but my tinnitus got louder right away, so I took them off. Do you think that I may never be able to use my headphones/earphones?
3)What can be the maximum time of my hyperacusis/reactive tinnitus to lose this reactivity? some say it can be more than a year or more than three years. Can I have it for more than three years?
Thank you so much one more time Dr Neil, hope you are doing amazing. You deserve all the best things.
Love,
Elena.
Hi Elena:
There are two possibilities why you tinnitus can be loud in the morning and then quieten down once you get up and get moving and focused on the day’s activities.
First, if your tinnitus isn’t bad at night but is bad when you wake up, it could be that you have pinched a nerve in your neck as you sleep and getting up and moving around relieves the “pinch” and your tinnitus goes away.
Second, if you only have loud tinnitus for a few second or few minutes after you wake up, it can be normal and due to your brain getting active again after a night’s sleep. Here is how I explain it in my new tinnitus book (not out yet).
LOUD TINNITUS UPON WAKING UP
One person asked, “How do you explain the fact that my tinnitus is always worse when I wake in the morning? I’ve had many days that were ‘silent’, only to awaken to loud tinnitus.”
For numbers of people with tinnitus, it is common for them to experience increased tinnitus upon waking either in the morning or after a “catnap”. This is because your sensory systems, including your hearing, are put on high alert at the moment of waking. At the same time your brain’s neuronal activity greatly increases.
The reason for this is twofold. First, Threatening sounds are always amplified by your brain upon waking because they might have been what woke you up so you can take immediate action in order to protect yourself (survival strategy). In the case of your tinnitus, the meaning has been wrongly attributed to your tinnitus being a threat to your well-being. This is why it is so important to treat your tinnitus as an unimportant background sound, not as a threat to your well-being. Once your tinnitus is not a threat, you won’t experience this anymore.
Second, in the early morning as you wake up, your environment is likely relatively quiet, so it is not surprising that you instantly notice your tinnitus as other sounds are not partially masking it. Thus, it may seem especially intrusive at this time.
The reason why you may have problems wearing earphones, even though you can stand music with louder and softer parts when listening via loudspeakers is because when you wear earphones/earbuds, the sound waves are trapped in your ear canal, and thus they sound louder than they otherwise would. So you have to keep the sound below the level where you hear them react. This could be quite a soft sound to begin with.
But over time you should be able to slowly increase the volume without your ears reacting. This can take time–and depending on various factors, could take 1 to 3 years as you have heard. There is no time limit–its has more to do with what you do with the time. If you work hard at increasing your volume with your ears reacting, it can go faster, and if you basically do nothing and let them “heal” on their own, it can take longer.
Cordially,
Neil
Hello Dr Neil, thank you so much one more time! Your answer: “There is no time limit–its has more to do with what you do with the time. If you work hard at increasing your volume with your ears reacting, it can go faster, and if you basically do nothing and let them “heal” on their own, it can take longer.” Does it mean that I should listen to a bit louder music so my ears can get used to despite of the reacting or should I let my ear heal on its own? Thank you so much, I hope you are doing great!
Love,
Elena.
Hi Elena:
Typically, you want to slowly increase the volume of background music or white/pink noise, etc. by a just-noticeable amount as your ears are able to handle it. You don’t want to make your hyperacusis worse in the process, so go slowly, and just push the envelope a bit, then let your ears get used to it, then push it a bit more.You may need to stay at each tiny increase for a month or more, or you may be able to go faster. Just remember, going to fast will undo all the good that is happening and you’ll just have to start over again–so make haste slowly as the saying goes.
Cordially,
Neil
Hello Dr Neil, thank you so much for all of your answers! I hope you are doing great!
My tinnitus dropped the sound for the last two months, It no longer reacts on the music with lots of ups and downs, I listen to music at more than 70-75 DB and tinnitus stays the same quiet sound that I can barely notice (only If I concentrate) this is the first time my tinnitus is that quiet. I think that happens because I canceled my appointments with my orthodontist so nothing tightens my teeth anymore. In 2 weeks I have my appointment with my orthodontist, do you think that I should continue canceling or now can I go and tighten my teeth again?
Thank you so, very, very much one more time.
Love,
Elena.
Hi Elena:
I really don’t know whether having more orthodontic work will worsen your tinnitus or not. It looks like you are now habituated to your tinnitus and your hyperacusis is under control which is great. So you don’t want to upset the apple cart unnecessarily. You might want to try a bit of orthodontic work and see if you start to have any problems. If not, continue on with it, otherwise stop it.
Cordially,
Neil
Hello Dr Neil, hope you are doing great! for the last 2 months my tinnitus went completely and I could use my earphones (at a very low volume) and listen t music at high a high volume (75-80 Db) but couple of days ago I had a virus for only 3 days and tinnitus just came back. I don’t know it’s because of the virus or because of the earphones. It’s just like it always was, low pitched voice that I can hear in a quiet room. I have 2 questions if you wouldn’t mind answering.
1) Do I have to listen to music at not more than 60 Db again?
2) Do you think that my tinnitus can go away again or the more it comes back the longer it stays?
Thank you again one more time, I sometimes think that I found a miracle when I found you. Thanks a million! hope you stay healthy.
Love,
Elena.
Hi Elena:
Viral attacks in the inner ear can cause all sorts of side effects including tinnitus. So I’d give it more time for the virus to get out of your system and your ears return to normal. I wouldn’t be surprised if you tinnitus then goes away also.
It could also be you are listening to your music too loud again–or at least the peaks in the music are too loud. So while your ears are recovering from the virus (if indeed they are), it wouldn’t be a bad idea to keep the music to a lower level and see what happens.
As a general rule, tinnitus probably stays longer each time you “wreck” your ears, but even so, it is an individual thing–so your tinnitus will be different from everyone else’s tinnitus in how it specifically acts. But I think your tinnitus can go away again. I doubt you are past the point of no return. Just be careful to look after your ears in the future so you never reach that point.
Cordially,
Neil
Hi, about a month and a half ago I was at work and heard an alarm type sound that went off near my left ear. Immediately I started coughing and then gagging like I was gonna vomit (I didn’t.) ever since then loud sounds seem to bug my ear. Especially when I’m at work (I work in a warehouse) sometimes it will bug me so much that I feel kinda sick. But then I will go home and lay in bed where it’s quieter and I don’t feel sick anymore. I would say it usually bugs me at least a little bit all the time but it seems way worse at work vs when im at home on my days off. I’ve been to ENT doctor twice and they basically looked in my ear and said it looked fine and they also had me go back and get hearing tested and they said my hearing was about the same in each ear and sounded great so again they told me I was free to go. So I have no information on what could be happening and if it might go away eventually? Which is why I’m commenting. I’ve never noticed hearing loss (so far), my ear just feels kinda sensitive to certain loud sounds or even sometimes if someone is talking right next to me it might bug me and if I’m hearing loud noises all day (like at work) sometimes I’ll start feeling a little sick. Also when it first happened my ear felt very full all the time and like I could hear my voice louder then usual and sometimes I could even hear my heart beating. It doesn’t seem as full feeling as it did when this first started. What do you think could be going on and will it heal? Will the sound sensitivity go away over time? Thanks! I haven’t been able to find answers which is annoying.
Hi Kevin:
What you are experiencing is called Acoustic Shock Disorder (ASD). It began with the loud alarm sound suddenly blaring near your ear.
ASD has a number of symptoms–you may have only have one or several at the same time. Typically you get several as you have.
For example, you now notice certain sounds are louder than normal. This hypersensitivity to sound is called loudness hyperacusis. Typically, it will slowly fade away–but in order for this to happen, you have to protect your ears from louder sounds while your ears heal. This could take from 2 months to several years depending on how bad your loudness hyperacusis is.
The feeling of fullness in your ears is also a common symptom of ASD. As you are experiencing, it is also slowly going away.
So what do you do now? The big thing is to give it time as I said above. During this time, you need to do two things. One, don’t worry about and focus on your loudness hyperacusis as that just makes it worse. Two, protect your ears from louder sounds–those sounds that make your loudness hyperacusis worse. However, don’t overprotect your ears or you will make the loudness hyperacusis worse. So you walk a fine line between overprotecting and underprotecting your ears. Thus, in noisy situations, wear ear protectors and as soon as you leave the noisy area, take the ear protectors off. You ear NEED to hear adequate levels of sound in order to get better.
Cordially,
Neil
Hi. I commented last month. My ears sensitivity have felt so bad that I haven’t been to work in weeks. I’m on short term disability currently. Sometime after I last commented my right ear started hurting one day at work. Maybe I didn’t protect my left ear enough because I kept going to work where it’s loud. I still feel like it’s worse in my left ear but it’s somehow effecting my right ear now too and I’ve started getting migraines/headaches that don’t go away. The pain from the headaches and pressure in my ears got so bad s couple times that I went to the ER. They didn’t do anything tho besides give me meds. It hasn’t been ER worthy in recent weeks but the headaches still bug me all the time tho. Usually it seems to be induced from regular everyday sounds that bug me now. Not sure exactly what sounds. My question is that do you think it will still eventually heal itself and go away or have I gotten to a point of no return? Is there a way to help with the headaches that won’t go away? I’ve been having the headaches 3-4 weeks pretty much right after my right ear also started bugging me. But as a while my left ear problem has been at least 3 months now.
Hi Kevin:
When you “damage” one ear like you have done, some times your other ear later develops the same problems as the “damaged” ear. I think this is what is happening in your case.
Migraines are sometimes associated with Acoustic Shock Disorder and unfortunately you seem to have developed such migraines. I know of another man that had a similar experience with fire alarms that caused him to develop migraines too. Subsequently, louder sounds trigger new migraine episodes.
I don’t think you have gone beyond the point of no return. You need to protect your ears from louder sounds while they heal. This can take a number of months or up to 2 or 3 years. But you must not overprotect your ears or you will make things worse.
You need to find the level above which your sound sensitivity kicks in and stay in environments below that while your ear heal–and slowly increase the sound level as your ears can stand it. You always want to be “pushing the sound envelope” but just a wee bit at a time. Going to fast can just set you back to square 1.
You want to be careful that you don’t become a recluse and avoid sounds. Go about your regular life–but in sound environments you can stand and slowly take forays into louder environments, but only for very short periods until you know how your ears will react.
Cordially,
Neil
Kevin again. Sorry if I’m bothering but sounds at home set my ears off. Not only in loud environments. Sometimes my mom can cough and it’ll trigger my ear to hurt and my head to throb. Other times tho she can cough and it does nothing. Or the other day she dropped a coaster on the table and it seemed louder then it should have and really aggravated my ears I felt. Usually more so my left then right but both really. My point being that if sounds just at home are bugging me sometimes sporadically and not always the same ones every time then how do I try to avoid them to let my ears heal? Also I went to an ent doctor recently who had me get cat scan and he claims just based on the imaging that I have superior semicircular canal dehiscence in the left ear. Could that be causing this stuff? Also is it possible that the loud noise could have triggered the symptoms from sscd? Because I don’t know why If I had that that I never had symptoms until the loud noise. Also do you think sscd of only the left ear could cause me to have sound sensitivity in both ears?
Hi Kevin:
You can’t avoid all “normal” sounds, so when your mom drops a coaster, don’t form a negative reaction to it. Just accept it as being a bit too loud and move on without getting emotionally/psychologically involved with it.
Besides you want to keep pushing the envelope on how loud of sounds your ears can stand without hyperacusis kicking in.
It’s possible that you have superior canal dehiscence syndrome (SCDS). I’d get the CAT scans read by another doctor for a second opinion. If he also concurs, then that might be the problem.
And migraines are often associated with SCDS (about 80% of the time).
Have you had an audiologist test your hearing? If you do have SCDS, you would expect to find an air-bone gap on your audiogram in the frequencies below 2,000 Hz. So if you find that, plus your migraines and the CAT scan would be pretty strong evidence for having SCDS.
I’m not sure whether loud sound could “blow out” the dehiscence or not. Holding your nose and blowing to try to clear your ears could do it, if you tried that after the alarm fiasco.
Remember both ears were exposed to the alarm so you can have hypersensitivity in both ears but only have SCDS in one ear.
Cordially,
Neil
Dear Dr. Bauman,
I am interested in your thoughts on something that recently happened to me. If you’ll recall, we corresponded earlier this year on this forum regarding mild hyperacusis and tinnitus that I developed after exposure to a loud noise. Well, my symptoms have become increasingly tolerable and bother me less, though I still notice them…and two weeks ago, in the morning after my normal routine, I experienced a sudden random increase in the tinnitus accompanied by a drop in hearing sensitivity. I saw an audiologist that day, who said it was sudden sensorineural hearing loss, which was visible on the audiogram from that day. But within an hour of leaving the audiologist’s office, the tinnitus and my hearing returned to normal, and to my great joy I actually feel far less bothered by loud sounds than before the SSNH. The doctor prescribed prednisone, which seems to have decreased the volume of the tinnitus. Have you heard of other cases of a temporary SSNHL correlating to hyperacusis recovery? Seems odd…but then again, that’s life.
All the best,
Ehren
Hi Ehren:
I’ve heard of a number of weird things like people’s hearing turning off and at the same time loud tinnitus occurring for a few seconds, then their hearing comes back and their tinnitus goes away. This is sort of what you experienced, or like the episode below.
Or a bit differently, a doctor told me he would suddenly get loud tinnitus in one ear that seemed to come out of nowhere and for no reason. Then his hearing would begin to fade away. This would last an hour or two, then his tinnitus would fade away and his hearing would come back. This happened to him several times a year. In this case, I think it was due to his taking Atenolol.
Were you on any drugs at the time this happened?
I don’t think I have any stories about somewhat similar incidences associated with loudness hyperacusis though.
Cordially,
Neil
I don’t think
Hello Dr. NEIL BAUMAN,
I would appreciate taking the time to respond and providing some tips.
Since Last week I have sensitivity to loud sounds and hissing noise in both of my ears.
All of this was caused by a caloric test where they blown hot air in my ears.
Would you reckon I have some chance for recovery? Could you please provide any advice? I am fighting to sleep with this noise and the ear sensitivity is also not a pleasant thing to have.
I already visited otoneurologist who only prescribed me Grandaxin and Atarax. I did an audio test and seems I do not have any hearing loss.
He proposed to clear the earwax in both ears (which he claims is not so significant) but we agreed for me to put olive oil for some time and go for him to check.
Do you have any ideas what I could also try in this instance? IT has already been a week of this torture.
I would appreciate taking the time to respond.
Thank you and regards,
Danail
Hi Danail:
What exactly caused the problem–was it the sudden force of the hot air being blown into your ear canal? This is what I suspect.
This produced the same effect in your inner ear as if you had just experienced a sudden loud sound such as a gunshot or explosion, etc.
The result is that you now have both tinnitus (the hissing sound you hear) and loudness hyperacusis (sound sensitivity to sounds, typically higher frequency sounds).
The Grandaxin is potent medication that is used to treat anxiety and mental disorders. It does nothing to treat you ear problems. Atarax is used as a sedative to treat anxiety and tension. Again, nothing to do with treating your ears. So basically your doctor just drugged you so you don’t worry about your ear problems–but did nothing to help you properly deal with them.
Unless the wax is blocking your ear canals, I agree that it is basically not a factor.
Now, what can you do? First, calm down. Do not worry about this–that just makes things worse. You can successfully deal with it, but it will take time–typically a number of months so don’t get discouraged if nothing seems to be happening in the short term.
Depending on how loud your tinnitus is, you may find that sound therapy will help you. For many people, just having a fan running at night while you sleep provides enough sound distraction that you can fall asleep in spite of your tinnitus. Other people use other sounds. Good sounds you can download from the Internet are water sounds–waves on the beach, babbling brook, waterfall, water fountain, rainfall. These sounds not only help mask your tinnitus, they are also naturally soothing so it makes it easier to fall asleep. Keep the level of these sounds down. You are not trying to drown out your tinnitus, just make it not so noticeable.
Don’t actively listen to these sounds, basically just ignore them and in the process you will also learn to ignore your tinnitus sounds. As you do this, in time, they should fade into the background and no longer bother you.
For the sound sensitivity portion of your ear problems, you want to avoid louder situations for some months while your ears “heal”. As you ears can stand it, slowly increase the levels of sound you expose them to. Do not overprotect your ears by wearing ear protectors when it is not necessary or you can make things worse–but do wear them when your sound sensitivity is exacerbated by louder sounds, then take them off as soon as the sound stops or you move away from it.
Cordially,
Neil
Hello Dr Bauman,
I appreciate the detailed answer.
I did clean my earwax on both ears in the beginning of 2021 due to partial deafness and it resolved the problem. This time though I am afraid if I do that again, there is a change that things may get worse … Currently in both ears I have a high pitched hissing sound and another high one which I cannot describe exactly. Currently I would rate the tinnitus it 6.5 /10. I hear it with the TV on or sometimes even when I am outside.
I must mentioned that thinking way back, I may have had tinnitus all my life but it was barely noticeable and only sometimes at night – maybe 1/10 and did not bother me at all. I even though of it as something normal.
I am doing my best to cope with the situation but I am not going to lie that it is hard at the moment.
Do you think that this caloric test damaged my ears forever? Is there any chance that this may subside and what does this depend on? Is it worth the shot to have the wax cleaned and which method will be the safest one? Are there any other things I could try to deal with the situation?
There is no scientific evidence that this causes tinnitus, but I found many people on forums who claim they worsened their condition from the same test.
Best regards,
Danail
Hi Danail:
I don’t think the caloric test physically damaged your ears. It obviously precipitated your louder tinnitus, but that is not “physical” damage. What keeps your tinnitus loud and intrusive is your emotional attachment to your tinnitus.
To get rid of it, you need to remain emotionally unattached to your tinnitus–treat it as a totally unimportant, useless background sound that is safe to ignore–then ignore it and focus on the loves of your life.
If you (or your doctor) clean your ears properly, there is no danger unless you have a hole in your eardrum. If you are syringing your ears out, use water at around body temperature and DON’T use a lot of force. You have to have a gentle stream from the syringe. The danger is using too much force–and some doctors do indeed use too much force. I know, one of my former doctors did to my ears.
If you doctor uses tweezers and picks the wax out, the secret is to soften the wax first. If the wax is a solid block that seals your eardrum and he tries to pull it all out at once, it can pull your eardrum way out from the vacuum (or sticking to the eardrum) and when air finally rushes in, your eardrum snaps back–which to your inner ear is the same as hearing a loud explosion–and that can cause damage.
I don’t doubt that if done too forcefully, the caloric test can cause tinnitus. So can other tests audiologists do if not done properly having regard to the kind of ear problems you might have such as performing loudness tests on people that have severe loudness hyperacusis.
Cordially,
Neil
Hi Dr, Bauman,
Thank you once again.
Is it possible that the air from the caloric test pushed my earwax even further inside the ear and this is causing all the problems? Would you consider a good idea cleaning my wax now since the ears are much irritated or do I wait a certain time?
Is there a way to check for ear drum issue before cleaning the wax?
Best regards,
Danail
Hi Danail:
I rather doubt it, but it is a good idea to have your ears cleaned periodically, especially if you produce a lot of wax. When wearing hearing aids, they can push wax back so it never comes out. Some people need their ears cleaned every month as a result. Others can go 6 months or a year or longer. Everyone is different.
Gentle syringing shouldn’t irritate your ears as long as they keep the pressure down–that’s the secret.
If you have wax blocking your ear canal, there is no way to see if the ear drum is perforated or not. In that case, the doctor has to be very careful to pick away at the wax as you don’t want to syringe it out if there is a hole in your eardrum.
Cordially,
Neil
Hello Dr. Neil, hope you are doing great!
My tinnitus was okay for two months(it almost went away again) but I tightened my braces with my orthodontist and my loud tinnitus came back. It’s like a loud siren sound. sometimes It fades away and then I listen to music (at 60-70DB) and it gets louder again. I have a few questions if you would mind answering.
1) My tinnitus gets loud after listening to music, is it because of tinnitus or is hyperacusis kicking in?
2)I really want to straighten my teeth, If I don’t pay attention to my tinnitus flare-up and tighten braces anyway, will I end up with worse tinnitus/hyperacusis? or can my teeth get used to braces?
3) Can I go to the wedding (with ear protectors) or I am not ready yet, as my tinnitus still started flaring up after music?
Thank you so much, Dr. Neil! I haven’t got any word to fully express my admiration for you. Hope you are doing amazing.
Hi Elena:
I’m doing great. Finally completed adding to the 8th edition of my tinnitus book–doubling it in size. Now editing it and hopefully it will come out before the end of the year.
I think the problem is that your dentist tightened your braces too much at a time. This aggravated certain somatosensory nerves that resulted in louder tinnitus. He needs to tighten them in tiny increments so that doesn’t happen. Instead of tightening them in “big” steps less often, I think the secret is to tighten them in “tiny” steps (and probably this can be done more often).
You’ll need to work with him to find the amount of “tiny” tightening at a time that your ears can stand without greatly increasing your tinnitus.
Normally weddings themselves are not noisy, so that should be ok, but when they crank up the music at the reception, that’s when you have to be careful. If your ear protectors reduce the sound to levels that don’t aggravate your ears, that is fine, otherwise you need to get away at that point. You may find you can stand the increased sound levels with your ear protectors in for a short time, but then the sound starts to bother your ears–so at that point you want to leave before you set your ears back again.
Cordially,
Neil
Hello Dc. Neil. I am happy to hear that! Wish you best of luck. You deserve the best.
I have 2 more questions if you wouldn’t mind.
1)My front neighbor has tinnitus for more than 20 years, but when he goes to the concerts, (without protectors) it doesn’t get louder. Why does my tinnitus get louder because I have hiperacusis? I don’t really feel hiperacusis anymore, when someone shuts their gun, it feels like “normal” loud sound. But low music makes it flaring up.
2) In couple of years (1/2 years) do you think that I will be able to go to the weddings/parties with protectors and my tinnitus can stay the same?
Thank you so much one more time!
Best wishes,
Elena.
Hi Elena:
The reason your neighbor can stand the loud concerts without getting tinnitus/hyperacusis and you can’t is because he has more robust ears than you have. And you have weakened your ears by the damage they have sustained. It doesn’t seem fair, but some people just seem to have “cast iron” ears and it takes a LOT to damage them. Other people have delicate ears and they are damaged easily.
In time you should be able to go to concerts, etc., but you will almost certainly have to wear appropriate ear protectors or you will be set back at square one.
Cordially,
Neil
Hi Dr. Bauman,
A week ago an inexperienced ER doctor used a forceful plastic suction device not designed for the ears to clean them out after I visited for an unrelated issue. I’m considering a malpractice suit, as she omitted this in the after-visit report and I’ve had severe hyperacusis since the excruciatingly painful procedure.
Right now I’m unable to tolerate music at any volume for any amount of time, and everything else sounds much louder and higher-pitched. Raised voices, laundry machines, passing cars, and so on are also causing some irritation.
I’m a music curator with synesthesia, ADHD, and autism. I have a very special relationship with music and listening to it with headphones for 4-6 hours per day is how I maintain my internal world. I understand that it’s not a good idea to use headphones right now but tonight I played some music from my phone at 55 decibels with earmuffs on to block it and still got roaring tinnitus from a few minutes of that. I’m doing a course of steroid eardrops but don’t know how else to help myself.
The ENT I saw didn’t find abnormal hearing or anything more than a bruise on one eardrum. But the suction did something very bad, and I’m not sure what. The ER doctor mentioned the possibility of something like barotrauma, but the ENT dismissed that. Is there anything I can do so that I’ll be able to continue listening to music with headphones for several hours a day at some point?
I’m willing to consider other off-label medications/supplements, wearing hearing aids/earplugs under them if it isn’t going to cause more damage, surgery, etc. I don’t want to cause more damage to my ears as it seems I’m doing when the pain comes, but I also am looking for a go-around. What do you think?
Very Best,
N
Hi N:
Too much force when taking out earwax can indeed cause loudness hyperacusis and ear pain, etc. It takes time for things to return to normal. So during this time you need to protect your ears from louder sounds–sounds that cause your hyperacusis to get worse. This could easily take 6 months to a year or two depending on a number of factors.
There is nothing wrong with listening via earphones, just as there is nothing wrong with listening via loudspeakers. You just have to remember two things. First, you have to keep the volume way down. Second, since you have problems the longer you listen, you’re going to have to cut back the time to maybe 5 or 10 minutes and slowly as the weeks pass, increase the time you listen to your music. For example, you might want to start off at 5 minutes a day and increase the time by 2 minutes a day if your ears can stand it.
Then, after you can listen to your music for long periods, you can start increasing the volume in minute amounts–again as your ears can stand it. You keep on pushing the envelope–but never too fast or too much, or you can set yourself back.
And if that happens, it isn’t the end of the world–you just have to go back and start over again at wherever you ears are then–and continue the program.
Essentially, you suffered a sudden pressure change (barotrauma) that to your ears was the same as a sudden very loud sound hitting your eardrum–hence the hyperacusis.
I think if you do what I suggest above and protect your ears from loud (to you) sounds, over time you’ll get better and be able to listen to your music again for long periods. Just take it slow and easy so your ears can “heal”.
Cordially,
Neil
Hello Dr. Bauman,
I had a unique experience related to my healing journey with sound sensitivity. Out of nowhere about 2 months ago, I experienced a sudden drop in the sensitivity of my hearing in one ear accompanied by an increase in ambient tinnitus volume. It was alarming, and I immediately left work to go get an audiology exam and seek prednisone. The exam indeed showed a decrease in hearing in the affected ear, but about 30 minutes after the exam, my hearing returned to normal. I went for another exam right away, which confirmed that my hearing was back to normal. This all happened over the course of just 3-4 hours. Nevertheless, my ENT prescribed me a course of prednisone. Since that temporary shift in volume, my sound sensitivity has seemed less intense, though it isn’t completely back to how it was before my acoustic trauma almost 11 months ago.
I have been protecting my ears during any event that I expect to be uncomfortably loud. But last evening a friend played their grand piano fairly loudly for maybe 10 minutes. I did not put in my earplugs, and the sound was quite distorted, but not uncomfortable. My phone showed an average of 80-85 decibels. Of course, I am concerned that may have damaged my ears further because of how distorted the piano sounded. However, I am not experiencing a spike now, the day after the event. Do you think damage was likely, and does that warrant another course of prednisone or some other action, or am I overthinking it?
Many thanks in advance for your advice.
Ehren
Hi Ehren:
Interesting episode you had there. How much hearing loss did your audiogram show and at what frequencies? I’m wondering if your auditory filters were trying to reset themselves and did a pretty good job or getting your hypersensitivity close to normal now–as opposed to that hearing loss episode being a bad thing.
I doubt the piano playing hurt your ears at all. If it were me, I wouldn’t do anything such as taking Prednisone. I’d just leave your ears alone and let them continue on the healing process.
Cordially,
Neil
Hi Dr. Bauman,
Thank you for your response. I haven’t found my recent audiograms yet, but I believe the hearing loss shown in each was around 10-15 db. Not major, but outside of the realm of natural variation in the measurement technique, as I understand it.
I hope you have a nice weekend,
Ehren
I have come down with tinitus and hyperacusses 1 month ago. Took one Praziquental and after taking ir 1 and 1/2 hours later loud ringing to the very mild tinitus I already had. Started taking bioflavenoids and then hyperacusses started , a backache started before that to middle of spine. Quiting the bioflavenoids. Could this be related to my back?
Hi Deborah:
I’ve never heard of bioflavenoids causing either tinnitus or hyperacusis. Nor have I heard of hyperacusis associated with problems in the lower back. Now if the problem was in your neck, then hyperacusis could be a possibility.
Cordially,
Neil
Hello Dr. Neil, Merry Christmas!
I wish you and your loved ones a wonderful Christmas.
My tinnitus got so much better over time. Mostly, it’s like a background sound (very low sound). I listen to music at about 70-75 DB, not more, because I still worry that I am not ready yet. In January, here in my city, there will be a concert, and I want to go there. I was wondering if you thought I should go (with ear protectors) or if it would be better to avoid such loud sounds.
Thank you so very much, DR Neil. Your help is like a miracle for me.
Love, Elena.
Hi Elena:
You are doing great if you are able to listen to music at 70 to 75 dB now. Keep up the good work!
There is no rush–proceed at your own speed in “raising the ceiling” as you are comfortable.
You want to avoid loud sounds and concerts are typically really loud. So, if you go, definitely wear your ear protectors and sit as far away from the loudspeakers as you can. That way you can enjoy the concert and yet protect your ears.
Also, “listen” to your ears and if in spite of the above, your ears are beginning to have problems, don’t stick around, but get up and leave at that point. You don’t want to set yourself back and undo all the progress you have already made.
Cordially,
Neil
Good afternoon, Dr. Neil! I hope toy have a Happy New Year!
About a month and a week or so ago (11/17/2021), a Quaker parrot screamed into my right ear as it was perching. I read that once Cochlear hairs get broken, that’s that. However, I can still hear very tactile sounds (I.e. the bristles on a brush and rubbing my fingers), but they sound a little more high pitched.
The ENT that diagnosed me with hyperacusis said that it will get better over time, but, I’m wondering if my particular incident was severe enough to cause permanent damage to my hearing, because I read that hyperacusis has no treatment and no cure. Will my hypersensitivity ever go away? The ENT did a hearing test with high frequency response and noted that I do have a change of hearing in my right ear in the high frequencies. Will my ear ever heal on its own, or, is it likely that the little hairs in my cochlea broke and now I’m stuck with this condition forever? I’ve lost sleep and am now undergoing crisis therapy, so your response would really help.
Hi Matt:
A parrot’s loud squawk right by your ear can cause instant acoustic trauma which can turn into acoustic shock disorder if it hangs around for some time.
You have been reading old/outdated information about the tiny hairs (cilia) breaking off from loud noise. They used to say that, but it is not true. Basically, the hair cell dies and thus the cilia bundles on that hair cell die too. When the hair cell or the underlying support cell dies, that’s that as your doctor said.
One of the results of acoustic trauma is loudness hyperacusis. Sounds then can sound sharper, especially in the higher frequencies. They also sound louder than normal.
I don’t know where you are getting your information from, but it is NOT true that hyperacusis has no treatment and no cure. My recent comprehensive book on hyperacusis explains all about hyperacusis and how to successfully deal with it. You can get it at https://hearinglosshelp.com/shop/hypersensitive-to-sound/
When you read such falsehoods about hyperacusis, you become anxious and that just makes things worse.
It is true that you likely have suffered a certain amount of high frequency hearing loss (and some hidden hearing loss that doesn’t show up on an audiogram) from this incident that is permanent. But you can successfully deal with your hyperacusis so it no longer will bother you. So you need to calm down. It takes time, but when you do the right things, you can successfully treat your hyperacusis.
Cordially,
Neil
Thank you for your prompt reply, Dr. Bauman. I have noticed that my tinnitus is not as invasive as it was when the incident occurred. May I ask a follow-up question? Given enough time and slow, steady sound desensitization, will my hypersensitivity to tactile sounds ever get better or resolve over time (I. E. 6-12 months)? Does the analogy of a sprained ear that gets better over time apply to my scenario? The ENT that I initially visited was very confident that I would make a recovery over time, as I am able to discern speech and other sounds even in noisy situations. I just need some hope to this entire situation.
Hi Matt:
It’s a good sign when your tinnitus begins to reduce.
There is an excellent chance that given time and following correct hyperacusis-reducing protocols, your hyperacusis will mostly go away. It may never go away completely, but you could expect at least an 80% improvement, so it wouldn’t bother you in everyday living. This could take anywhere from say 3 months to 3 years, so be patient.
Cordially,
Neil
Hello Dr, Neil. Thank you so much for your answers!
I did not go to the concert as I felt it could make my tinnitus worse. I have just two more questions, if you wouldn’t mind answering.
1)I can’t understand my tinnitus is reactive or just tinnitus. When I listen to some kind of music (at low volume), my tinnitus doesn’t get any louder neither my ear feels bad but 5-6 hours later my tinnitus gets louder and I rest my ear for the next 2-3 days and it gets back to normal low volume again. I would like to ask you if it’s reactive tinnitus or every kind of tinnitus can react to even low volumes of sound (not while listening but after 6 hours or 10 hours)
2) If it’s reactive tinnitus how much time can reactivity take to finally go away? (if it’s possible to say)
Thank you so much one more time. Hope you are doing great!
Love, Elena.
Hi Elena:
Reactive tinnitus is just a combination of having both tinnitus and loudness hyperacusis that “work” together. Since you have both, at times you notice your tinnitus reacting to your hyperacusis and becoming louder. The sounds don’t have to be loud. Yes, they can be loud for a short time, or they can be softer and last for a longer time. Those are two basic subgroups of reactive tinnitus.
I’m not quite clear on what you are experiencing–was it that you listened to soft music for a while and then 6 to 10 hours later your tinnitus reacted, or are you meaning that you listen to music at a low level for 6 to 10 hours and then you notice your tinnitus reacting?
If the former, I’ve not heard of that before, but the second scenario is common if you have the “winding up” version of reactive tinnitus.
Reactive tinnitus lasts as long as you have hyperacusis. Once your hyperacusis disappears, so will your reactive tinnitus. Then you’d only have regular tinnitus. Your hyperacusis is going away so in time so too will your reactive tinnitus.
Cordially,
Neil
Hello Dr Neil, thank you so much for all of your answers.
When I listen to music at a low volume (music with lots of ups and downs in rythm) my tinnitus gets louder after I listened to music for maybe 1-2hours (it gets louder 5-6 later I finished listening.) but on the other hand If I listen to soft music even at loud sounds tinnitus stays the same. The most confusing thing for me is that I can no longer experience hypracysis, even when I hear gun shots they sound like “normal” loud sounds and not very/painfully loud anymore (as it used to be one year ago) Can It happen because hyperacusys is still there and I can’t notice? or does every kind of tinnitus get louder after the kind of music that has many ups and downs in the melody?
Thank you so much one more time Dr Neil, hope you are doing great! Happy Holidays!
Love, Elena.
Hi Elena:
When you have hyperacusis, you cannot stand lots of ups and downs in music volume (or other sounds) as well as you can stand sustained louder sounds. So music that keeps a more or less constant volume is easier on your ears when you have hyperacusis.
I know you think you hyperacusis is gone, but obviously it is not gone, it is just much milder than it was before. And your tinnitus reacts to the changes in sound levels because of your hyperacusis–thus you are experiencing a kind of reactive tinnitus.
Hopefully, this will continue to get better as time goes on and your hyperacusis and tinnitus fade away as you continue on your program of protecting your ears.
Cordially,
Neil
Hello Dr Neil. Hope you are doing great!
My tinnitus was getting better and better until 14th January. Here in Georgia, It’s a tradition that New Year lasts for 2 weeks. Every single day my neighbors were having fireworks during those weeks and despite the fact that I tried to protect my ears, my hyperacusis came back. it’s not as bad as it was before but it’s still there. I went back to 60DB music again. Even worse is that my next door neighbors have hens business and their roosters make so much noise all night long. I have a few questions if you wouldn’t mind answering.
1)Do you think that it’s the beginning again and do I have to go through all of the things one more time?
2)If my neighbors roosters go away (after a month, they’re gonna sell them.) my hearing will start healing again?
3) Do I have to protect my ears at night from roosters with ear protectors?
Thank you so much DR Neil one more time. All of your answers mean the world to me.
Love,
Elena.
Hi Elena:
1. You have certainly had a setback, but you don’t have to go all the way back to the beginning. Just go back to the point of protecting your ears where your hyperacusis bothers them and continue on from there. Hopefully, you can progress forward faster than last time.
2. I didn’t know roosters crowed all night. I thought it was just early in the morning. I’m surprised the sound would bother you. I assume that you don’t sleep with your window open in the winter. But if they bother your hyperacusis, then you have to take steps to protect your ears from them and slowly reduce the protection as your ears can once more accept the racket without problems. This is just another setback that you can overcome in time.
3. If you need to, wear the ear protectors–but just as little as you can get away with.
Cordially,
Neil
Hello Dr Neil, hope you are doing great! Thank you so much for all of your answers.
After resting my ears for a few days, my hyperacusis faded away again and I no longer fee it’s there. Tinnitus also dropped the sound. But I can no longer listen to loud music, I got back to 60Db again. I would like to ask you a few questions if you wouldn’t mind.
1)Is it true that the less you concentrate on hyperacusis the faster it gets better?
2) Can hyperacusis be permanent or is it always temporary just it needs time? (I don’t feel it but I know it’s there because I have reactive tinnitus)
3) DO you think that in a few years maybe in 3-4 years I can be able to go to the birthday parties and weddings (with ear protectors) again?
Thank you so much one more time Dr Neil.
Love,
Elena.
Hi Elena:
I’d say you still have hyperacusis since you can’t listen to music louder than 60 dB. It’s just not as bad as before–and that is great.
1. I’d say that typically that would be true. When you focus on other things your ears can heal on their own but when you focus on your hyperacusis and/or tinnitus, your brain builds more connections to those conditions–and you don’t want that.
2. It can be permanent if you don’t do the right things, but if you do the right things, it is typically temporary, but you may always have a bit when in really noisy situations so you may have to avoid them or wear ear protectors.
3. I don’t see any reason why not. Just always wear ear protectors when you know the sound level is up at ear damaging levels because your ears likely will always be more sensitive than they used to be.
Cordially,
Neil
Hello Dr. Neil,
First let me thank you for all the work you have done. I’ve purchased your book Hypersensitive to Sound and it has been a great help. If you could, I’d really appreciate your opinion on my personal situation.
A little over 6 weeks ago I attended long and very loud concert and stupidly did not wear earplugs. At one point during the event I felt a buzzing/electric sensation in my left ear. I learned later that this was acoustic shock.
5 days after the event, I was experiencing intense hyperacusis such that it hurt to hear other people talk and the sound of filling a water bottle even caused pain. 3 days after that I had a burning sensation in my left ear for several seconds, then it subsided. As of now, these symptoms have not reoccurred. A week and a half after the event I visited an audiologist for a hearing test, and the results came back with no issues.
Around week 3 I began experiencing ETD symptoms. I would hear clicking in my ears when I would swallow or yawn. I also began to experience ear pressure, fullness and muffled hearing. During week 4 I visited a GP for the ETD, and he confirmed fluid in my ears, but no infection. He then prescribed me Mucinex D and Flonase. I took these medications for the next week and a half and some of the symptoms have subsided, including ear fluid and uncontrolled pressure.
At the beginning of week 6 I visited an ENT with my primary concern being the ETD. He told me that medications might not really work anyway and just to wait it out. Most of the ETD symptoms have subsided right after this appointment. Around weeks 5 and 6 I’ve had 3 or 4 headaches which all lasted about 30-60 minutes.
As of today, I still have these primary symptoms:
Hyperacusis that manifests primarily when I am in quiet environments with percussive, higher frequency tones (knuckle cracking, cutlery, doors closing etc). When I am in louder environments, such as being outside or inside with background noise, the hyperacusis is usually not noticeable.
Occasional mild, dull ear pain when moving between different environments with different noise levels.
My eustachian tubes seem to be working ok for the past 2 days, although I still hear cracking and popping in my ear when I swallow or yawn.
The hearing in my left ear seems to be rather lacking compared to my right ear, even though it feels like there is no physical fluid or pressure in the ear. I notice this less when wearing headphones and more when I am just walking around and doing day to day things. It feels as though I am “off centered” or as if my ears are functioning “separately instead of together.” As I mentioned before, my hearing test with the audiologist came out fine. Additionally, I have done some self administered tests online using headphones and both ears appear to functioning properly and about the same (my range for both ears is between about 80-15,000 Hz, and I can’t detect any noise notches in either ear). This is an improvement from the first time I took the test 2 days ago, where I detected a drop in volume between about 2,800 and 5,000 Hz in my left ear. I’m thinking this is not a hidden hearing loss issue as I can hear up to 15,000 Hz and may have something to do with the condition of my middle ear. Also as I type this, this issue in my left ear seems to be better than it was for most of the day.
After reading parts of your book and other posts on here, all indications seem to point to the fact that I am on my way to recovery, although it may be no surprise after reading this that I am very anxious and distressed about this condition. I know I should try not to focus on this, as this should help me recover quicker, although this is quite a challenge for me.
If you would be so kind to share your thoughts about my current state I would be very grateful.
Many thanks for all you do.
Hi Evan:
Just so you know, loudness hyperacusis is affected more by sharp percussive sounds, even if they are softer, than by louder sounds that are more sustained in volume. Often the problem with loudness hyperacusis is the degree of change in volume rather than the actual loudness of the sound.
You are definitely making good progress–and in only 6 weeks too. So that bodes well for the future.
You may not have high-frequency hidden hearing loss, but I’ll bet you have hidden hearing loss in the speech frequencies that do not show up on audiograms because audiometry tests for the softest sounds you can still hear which uses the high-spontaneous-rate nerve fibers, not how well your ears work in noisier situations which uses low-spontaneous-rate nerve fibers.
You can experience cochlear synaptopathy (hearing loss) in the low-spontaneous-rate nerve fibers while still having a perfect audiogram showing the condition of the high-spontaneous-rate nerve fibers.
Here’s a bit more on this from my article “Hidden Hearing Loss”.
“There are two kinds of afferent auditory nerve fibers—high-spontaneous-rate and low-spontaneous-rate nerve fibers.
High-spontaneous-rate nerve fibers activate in quiet situations. They are responsible for your hearing sensitivity to quiet sounds, and are saturated by high-level background noise.
Low-spontaneous-rate nerve fibers activate in noisy situations and are critical for hearing in noisy environments due to their larger dynamic range, higher thresholds and their ability to follow the fast-changing amplitude of sound signals.
Unfortunately, low spontaneous rate auditory nerve fibers are more vulnerable to noise damage than are the high spontaneous rate fibers.
Knowing this is critical to understanding noise-induced hidden hearing loss.”
Anyway, there are a couple of things you need to do.
First, I know you are trying, but you need to get your anxiety under control and not worry about you ears.
Second, you need to protect your ears from loud sounds going forward. Probably your ears will recover 80 or 90% but may always be more sensitive to exposure to loud sounds. So, whenever you are in such situations, ALWAYS wear ear protectors, or get away from the loud sounds.
Cordially,
Neil
Hi Dr. Neil,
Thank you so much for the detailed reply. I’ve had considerable improvement over the past couple of days, especially regarding my perceived hearing differential between my left and right ears. I also think my anxiety has decreased significantly, although this is something I will continue to work on if symptoms fluctuate in the future. I’m looking forward to further recovery and will let you know how it goes. Thank you again for all your help.
Hi Neil,
I got diagnosed with unilateral sensorineural hearing loss (moderate to severe in right ear) about a week ago. Unfortunately I was misdiagnosed by a series of GP doctors initially and so this news only came just after a month into my symptoms. I was aware that I had lost high frequencies but was told it was temporary due to fluid in the ear (given antibiotics for apparent middle ear infection, and then that the effusion left over was causing my tinnitus and hearing problems)
I seem to have real trouble in the last week with road noise in my own car and human voices if they are close enough and particularly if facing the bad ear. These lower frequencies seem to distort and hurt my ear. It’s like a painful resonant spike. I also noticed now that my ear canal when plucked resonates like a metal tube at a certain frequency.
I noticed that when this whole thing first came on that I quickly found myself sensitive to sound in general and noticed that for a week or so any effort to put the phone up to the bad ear was pretty pointless as the voice was distorted, not just muffled. Then this aspect seem to improve quite a lot. The muffling was still there of course, due to the loss, but the distortion at least on a phone speaker wasn’t audible. In fact it sounded very similar to my good ear.
Now that distortion is back and I’ve tested a found that my ear is pitch shifting certain sounds, in some cases completely but in others just accentuating certain frequencies like the “S” sound.
I have a follow up audiogram in a few days but until then I’m trying to work out whether this is normal for this kind of distortion to fluctuate when (apparently) the loss doesn’t. Could it go away again? Is this my ears adjusting in the absence of a hearing aid (for now, I’m advised to wait until the next test to pursue that) I’m hoping I’m not stuck with that because the loss is hard enough to cope with.
I forgot to add the loss is of unknown origin, not from noise exposure. And my MRI was normal.
Hi Giles:
If you hearing loss is of unknown origin, how can you and your doctors conclude it is not from noise exposure? I see from your symptoms indications that it could well be from a certain kind of noise exposure, but it could be of other origin of course.
The first question I always want to know is what went on in the two weeks before you noticed any hearing loss. Was anything different from usual? For example, did you have any active cold or virus in your body back then? Did you receive any vaccines or booster shots? Were you taking any drugs or medications, or did you change the dose on any medications? Do you work in a call center? Do you wear headphones or earbuds when listening to music? Any other ideas?
Knowing the origin of your sudden loss gives clues as how to best treat it, so it is important to try to discover its origin.
How did your doctors know you had fluid in your middle ear? Or did they just assume you did and prescribe (useless) antibiotics? Did you have a cold or allergies and consequent congestion back then or just before the hearing loss?
You say you were “sensitive to sound in general”. What exactly did you mean? That normal sounds now sounded too loud? That they sounded “sharp”?
How were these sound distorted?
One common cause of pitch-shifting–everything sounding flat or sharp is taking certain drugs. It can also be from exposing you ear to sudden loud sounds–not sustained loud noise.
Audiograms typically only show hearing losses between 125 and 8,000 Hz. They do not show hearing losses between 8 and 20 kHz. Nor do they show hearing losses due to damage to your low spontaneous rate auditory nerve fibers (see my reply to Evan in this thread).
I’ve asked a lot of questions rather than answering your questions because my answers will depend on your answers. So fill me in and add anything else you think might be relevant.
Cordially,
Neil
Hi Neil, thanks for your detailed reply. I find it a little difficult to believe that the sudden loss was from noise as I am very careful with my ears, being a musician. I rarely expose my ears to noise and when I do I always wear earplugs. There have been 2 or 3 occasions where I did not wear them but these were over 20 years ago. I work in a quiet environment and tend not to listen to music too loud. I probably do overdo it in the car a little bit but there’s definitely been no loud noise exposure for years that I could pinpoint knowingly.
Of course I should have said I know I have some preexisting damage and I’m sure I can always be more careful..that was confirmed by a hearing test about 20 years ago, showing “slight sensorineural hearing loss” around the 4 khz region. I’m sure this would have been from those few times I was not careful enough. And I remember well when that happened, what led me to the test. I was easily able to pinpoint the weekend when it had happened because I noticed a change in sensitivity to sound then. That seemed to improve after a few weeks and as the damage was “slight” I didn’t panic too much, just vowed to always wear earplugs around loud noise, e.g. lawnmower, live music (which i rarely see).
Prior to to the most recent sudden hearing loss I was slightly unwell for a couple of days and then when it hit I was definitely unwell – dizziness, nausea, ear pain, fatigue etc. All familiar symptoms to me as I seem to get recurrent problems like this yearly over the last few years. Just never with a change to hearing. Usually I’m told it’s an inner ear infection because there’s no visible signs of infection to explain the dizziness and nausea. I’ve had three instances much like this in the last three years lasting about a week in duration. 20 years ago I had what I was told was probably viral labrynthitis that plagued me for 9 months, with similar symptoms of dizziness and ear pressure pain. That was prior to my hearing test and had no apparent effect on my hearing.
Whist the first couple of days puzzled doctors as they couldn’t see anything wrong with my ears to account for the dizziness, on about day 3 a doctor told me they could see the fluid when they examined my ear. They also said the right eardrum was red and bulging. This was not apparent on the first visit.
I had noticed that my eustachian tube seemed to have a hard time unblocking on the affected side and I was getting a fair amount of drainage when I popped it via the various methods of pinching the nose. I also had a feeling of fullness in the ear and some ear pain.
I had my booster shot a few weeks after this illness, once I’d started to feel better so it doesn’t seem like that would be the cause.
Also forgot to mention I was put on Prednisone as salvage treatment…50mg a day so I have only just gone onto the taper dose of 25mg.
When I say that sounds were distorted, I mean that when I play sounds through headphones on the bad ear, a well recorded voice sounds garbled sometimes the fundamental pitch changes on voices over the phone. I’ve tried testing sine waves and sometimes they change from ear to ear as well. The road noise was too loud but it seemed to resonate my ear at a specific set of frequencies. At the same time I noticed that any transient sounds made me startle easier. So yes as you say some degree of normal sounds being louder.
I’m not sure if that’s partly the anxiety though.
The distortion/pitch shifting/sensivity to specific sounds or startling easily that I developed to an extent whilst sick disappeared for several weeks this time around once I started to feel better. They only seemed to return when I went on the cortisone. The sensitivity to certain frequencies seems to be reduced in the last day along with some anxiety now that I am tapering.
Hi Giles:
From what you have said, I wouldn’t be at all surprised if your sudden hearing loss and distortion, etc. is the result of a viral infection. When a virus gets into your inner ears, it can cause all sorts of distortion as well as hearing loss, tinnitus and a host of balance problems. Depending on the virus and how bad it is, you may only experience mild and temporary symptoms, but it can range up to total sudden deafness. Most seem to be somewhere in between those extremes.
Viruses can attack one ear or both ears, but you can have viral infections/colds and not have them affect your ears at all.
If a virus causes a middle ear infection, it can also get into your inner ear and cause the sudden hearing loss and various kinds of distortions, such as you are experiencing. So, based on everything you have said, I’d put my money on a viral attack as the cause of your ear problems.
Cordially,
Neil
Dr. Bauman:
I appreciate any feedback you can provide.
My facts: I attended a veteran funeral service 2 weeks ago in which ceremonial gunfire was part of the cemetery internment process. 3 blank rifle rounds shooting 3 times simultaneously. I was approx. 12 feet to the right of this. Since then, my ringing has been slight and for a few days over the past two weeks it seemed close to going away but still lingering to keep me concerned and watchful
I was able to sleep like normal for the first two weeks or week and a half at least. Then I started hearing a faint beeping sound to my right. Kind of like the high pitch “eeeeeeeee” sound but chopped up so it sounded broken and random. Then I woke up at 12:30 this morning to use the restroom at witch point I noticed the full high pitch tone again. I masked it with a youtube video for about 30 seconds that emits a 7500hz tone so it could suppress my ringing for a min or enough so I could just fall asleep. That seemed to work enough so I could sleep, which I did until my alarm went off at 5:00am
So this past weekend and Monday I have been hearing a hissing sound but also just barley the “eeeee’ sound as well. Kind of like a boiling kettle tea pot. Also similar to air being let out of a bike tire. Then it may randomly go to the beeping sound (that comes and goes). Its odd since for a few days last week during the day it would seem as though it was 95% gone. Today I still seem to have some faint beeping, hissing and now more of a slightly tinny sound in my right ear like I’m listening through a seashell or tin can.
I am very distraught over all this and trying to educate myself and gain some reliable or accurate hope. I saw an ENT today and as expected he said we just don’t know if it will go away. He has seen it happen before and my noise exposure is still not that old (about two and half weeks ago), he said its a “wait and see game”. He said my hearing was normal. But maybe test again in 4 months since my right ear had a slight declivity on the results chart but still within conversational and normal levels. I’m not sure how engaged or concerned he was about my concerns. He was purely testing and then said wait and see. That’s it. Also, my ears feel a little full, just a little, Nothing too alarmingly though. They are also sensitive at times to sounds. So I have been keeping volume lower.
Also last Friday (2/4/22), I was checking out other hertz tones on my HP laptop through youtube. Partley because it seems to cancel out the tone in my head. Usually 8000hz or 7500hz does it. Even though it just comes back. I then played 18,000 and 20,000 hertz and noticed I could not hear it (I’m 44) which I now know is normal for my age. But I turned up the laptop volume at the time to about 80% to 90% just to make sure I could not hear anything. I wonder if that aggravated something even though I could not auditorily process any sound, but maybe the vibration had an impact nonetheless?
I have no close idea of what 90% volume on the laptop dial would equate to in decibels. I only turned it up that high for about 5 or 7 seconds at most. Again, I heard nothing. Later that night I noticed more ear ringing that came in and out. So I learned from that and I just hope it will subside or maybe heal again. Not sure. Curious for your thoughts on this too. I also used to use earpod head phones for music while cleaning and working out. But I largely stopped that about 2 months ago (prior to the hearing the firearms)
I know this is a lot. So thank you for any attention or experienced guidance you may be able to provide based on my experience so far. I also welcome any questions if clarity is needed.
Hi CW:
Tinnitus is a psychosomatic condition. Thus, the more you worry about and stress over your tinnitus, the worse it gets. This is because when you see your tinnitus as a threat to your well-being in some way, your brain turns up its internal volume so you can hear it better. Your brain is programmed to keep you aware of any threats, thus you cannot habituate to your tinnitus as long as you think of it as a threat to your well-being.
Furthermore, the more you strain to hear it in quiet places (to see if it is still there), the louder and more intrusive it becomes. This is because if you keep listening for it, your brain thinks it must be important and turns the volume up so you can’t miss it.
Thus, what you need to do is stop obsessing about your tinnitus, treat it as a totally unimportant, useless sound that is safe to ignore, then ignore it by focusing on the loves of your life. This gives your brain permission to let this sound fade into the background where it may totally fade away or at least not be a factor in your life.
When you play tones that are the same frequency as your tinnitus–even for a few minutes, you enable what is called residual inhibition. When you stop the sound, you find your tinnitus has disappeared for a time–typically only seconds, but it can be for minutes, hours or even days if you are lucky.
The gunshots caused several things to happen. You no doubt have some degree of tinnitus, hyperacusis (sensitivity to sounds–particularly higher-frequency sounds), ear pain, ear fullness, etc. and maybe even some hidden hearing loss that does not show up on your audiogram.
These should all fade away in time if you ignore them and focus on the loves of your life, but at the same time protect your ears from loud sounds while your ears heal. This can take several months.
Cordially,
Neil
I developed Tinnitus nov/2021. Then hyperacusis 1 month later. Trying to protect ears, but when hearing sounds at 60 or above including frying hamburger it is getting worse even though I am desensitizing with radio. When I hear sounds around 75-80 Very uncomfortable but no pain and at times I have startle response. Been having unexpected surprise noises around 78-90 dcb.is this making it worse? Like more brain nerve damage? No specialist around to help. Can I still heal? I have reactive T to. I am getting worse and very scared.
Also listened to 4000 hz on ata website. Had volume way down but still sounded loud and turned off after 3 seconds and T went up. Did this do damage?
Hi Deborah:
What caused your tinnitus back in November? And did your hyperacusis develop out of the tinnitus, or was there some other cause for it?
Sounds that startle you can make it worse, but mostly, I think, from how you respond to these startle episodes.
Listening to the 4 KHz tone didn’t physically damage your ears since the sound wasn’t loud–it’s just that you perceived the sound as much too loud.
Cordially,
Neil
I took praziquantel and then broke a bowl an hour later. The sound was so loud. Then about 30 min later loud ringing in ears 24/7 since then. For 4 months now.
It developed out of the tinnitus. So if I calmly ignore it, it may not make it worse? I also bought some Flare ear inserts, they have holes in them and enables you to tolerate sounds. Hopefully I can heal with these?
Also so if I hear a loud sound 78 decibels and I remain calm, it may not cause a setback?
Hi Deborah:
I do not have any information implicating Praziquantel as causing hyperacusis, but it can cause tinnitus.
Dropping the bowl produced a sudden, loud sound and that could have been the cause of your loudness hyperacusis–but probably not affected by the drug you took.
I have a similar report to yours that taking Praziquantel caused tinnitus to start 90 minutes later and persist and still be there a month later.
Remaining calm and neutral towards sounds that you now perceive as louder than normal is definitely a great step in overcoming hyperacusis.
I assume you are referring to the Flare Calmer devices, correct?
I’d not heard of them before, but after doing so research into them, I think that they have the potential to help people with hyperacusis that are most bothered with sounds in the higher frequencies (the normal case). I’d love to hear your experiences with them. I don’t think they would make hyperacusis worse at all, and most likely make a noticeable difference in certain sounds that bother you.
A sound of 78 dB doesn’t necessarily activate your hyperacusis–it depends on how severe your hyperacusis is. By remaining calm and not forming an emotional “attachment” to your hyperacusis goes a long ways to helping you recover from it.
Cordially,
Neil
I have had hyperacusis for 4 months. If a sound is too loud for me does that set me back from healing although it is under 85 decibels? Also a voicemail beep was very loud. Was this damaging?
Hi Deborah:
How loud you perceive a sound has little to do with the volume of the actual sound, but how your brain processes it and a lot of that depends on your emotional state.
The program for overcoming loudness hyperacusis is to slowly raise the ceiling on your dynamic range so that you can once more tolerate louder sounds. Sounds louder than you perceive as comfortable, but less than 85 dB won’t physically damage your ears, but may or may not cause you hyperacusis to temporarily get worse. If you become anxious over these “safe” sounds and dwell on them, that just makes things worse.
If the sound spikes your hyperacusis and then lets your perception of sound drop back to where it was before, you haven’t really set yourself back. It’s just that you don’t want to expose your ears to sudden loud sounds that spike your hyperacusis. You just want to continually “push the envelope” to raise the ceiling on sounds that you once found uncomfortable.
I doubt that a voice mail beep is ear damaging, but you perceive it as too loud because of your hyperacusis. Remember that sudden louder sounds can cause your hyperacusis to “act up” whereas even louder sustained sounds my not bother you.
Cordially,
Neil
Hello Dr Neil, hope you are doing great! I have a few questions if you would not mind. For the last two months my tinnitus was okay, it got back to quiet sound that no longer bothered me. I listened to music at a medium volume. not loud but not too low. Couple of days ago my neighbor’s dog was barking all night long. It didn’t stop barking even after 2-3 days and I concentrated on it all nights long. Now my tinnitus reactivity that had been gone before came back suddenly. When I listen to music at more than 60-65Db it starts reacting (later not right away.) It reacts especially when I lie down on bed and touch my ear with my elbow. I wanted to ask you a few questions.
1) When I listen to music (with lots of us and downs in the rythm) and my tinnitus gets starts reacting should I stop listening to that kind of music? or can I listen to it anyway and ignore my tinnitus reactivity?
2) It’s been a year since I got my tinnitus, after a year my ear feels so much better (but not always) do you think that my tinnitus can lose reactivity in 2-3 years or can it last forever?
3) should I use ear protectors when my neighbor’s dog starts barking or will my ear get used to it?
Thank you so much Dr Neil, you are my biggest hope. Hope you are healthy and feel great!
Love,
Elena.
Hi Elena:
I’m current recovering from surgery. Hope to be back to my usual self in a couple of weeks or so. We’ll see.
Glad to see the war hasn’t affected you–at least you’re alive and well.
1. When you listen to music that reacts, turn the volume down until it stops reacting. If you push the envelope too much, you just set yourself back. Also, remember that when you have hyperacusis, your ears can stand sudden changes in volume like they once could. So you could listen to sustained louder music with out reacting, but react to softer music that has many sudden changes in volume.
Having said that, you can listen to it for a few minutes, just don’t push it too much, but once it starts reacting, better to turn it down or off.
2. It all depends how you treat your ears in the meantime. The more you cause your ears to react and set you back, the longer it will take to totally go away. That is why the slow and stead approach is the best way to go until your ear are back to normal, or as normal as they will get–they may only go back to 80% to 90% of your old normal. If that happens you’ll have a degree of hyperacusis forever but it shouldn’t bother you except in really loud situations.
3. Once the dog’s barking is causing your ears to react, then it is a good idea to wear ear protectors for a while. You don’t want to force your ears to have to listen to reactive sounds for longer than they can stand.
Cordially,
Neil
Hello, Dr Neil, I am sorry to hear about the surgery, how are you feeling now? How did the surgery go?
Thank you so much for your good wishes. The war is close to my country but not effecting us. since 2008 20% of my country is occupied by Russia. Hope it will end soon.
I hope you are safe and healthy. Take care.
Love,
Elena.
Hello Dr Neil, Hope you are doing great! How is your recovery going?
My tinnitus got so much worse for the last wto weeks. I don’t know exactly why it happened, but I blame my rooster and ducks for this. They start making noise in the morning and it continues for wto-three hours. Their sounds are really loud 90-100DB maybe even more and my windows are wooden so they can’t really block out any noise. I would like to ask you a few questions if you wouldn’t mind.
1) Can their sound (roosters, dogs, ducks) really damage my hearing?
2) Does their sound set me back from recovering?
3) Is there anything I can do to help my ear ?
Hope you are safe and healthy, Dr Neil. Thank you so much for helping me with your answers.
Love,
Elena.
Hi Elena:
The first surgery didn’t do the job so I’m having a second surgery in 3 days. Then I’ll need to recover all over again so it takes time.
Why blame your rooster/ducks since you have had them all along? Why would they now be causing ear problems, and not before?
Unless the rooster crows right in your ears, or the dogs bark close to you, I doubt that their racket is ear-damaging. To me, ducks don’t produce ear-damaging sounds in the first place.
Furthermore, the sound drops off quickly with increasing distance. So if the sound were too loud at 1 meter, just moving 4 meters away from the sound would reduce its intensity by a factor of 16. Thus, moving away from the sound source, even just a few meters, can certainly help.
If your hyperacusis kicks in because of this racket, then either move further away or wear ear protectors for a bit until your ears can stand that level of noise.
Cordially,
Neil
Thank you so much Dr Neil. Hope your surgery goes well. Wish you a safe surgery. stay healthy. sending you lots of love.
Best wishes,
Elena.
Hi Dr. Neil,
I’ve been binge-reading your responses to people with hyperacusis; thank you so much for providing this information.
I am suffering from hyperacusis, but perhaps an offshoot of it (dysacusis) where I hear another sound on top of the perceived loud (normal) sound. For example when I run the sink it sounds like keys are being jingled in my left ear. Unrolling toilet paper, turning pages in a book, typing this now, my toddler’s voice, my own voice…
I can recall two incidents in January that sent me into this state. I am set to start HRT with an audiologist this Tuesday as it has been very debilitating.
One question I have is: If this was brought on by noise, why does it get worse when I open my jaw wide or get up fast? You mentioned to someone else that this could be an upper cervical nerve issue. If this is the case, will the Hyperacusis Retraining Therapy be useless?
Thank you so much for your insight!
Hi Zoe:
When you hear these secondary sounds, are they always the same sound, or do you have different secondary sounds depending on what the primary sound is?
What two incidents caused you to have hyperacusis? The more I know about the cause, the better I am able to help you.
The reason it can get worse (temporarily I assume) when you open your jaw wide has to do with other sensory nerves in your face/head/neck being activated. Your upper cervical spine could be out of proper alignment, but it could be due to your trigeminal or other sensory nerves being overactivated.
Is getting up too fast a balance issue, or just makes your hyperacusis worse?
And when you say “worse”, do you just mean the sounds are louder, or some other quality?
You haven’t told me enough to understand you situation so I can say whether HRT will be the best route for you at this time. Loudness hyperacusis is just one of the 7 kinds of hyperacusis and you want to tailor the treatment to the kind of hyperacusis you have–it’s not a matter of one size fits all.
Cordially,
Neil
Hi Neil,
Thank you so much for responding! The secondary sound I hear on top of certain aggravating sounds is always the same. It’s like a jingling of keys and only lasts as long as the pitch annoys me from whatever the sound is (unrolling toilet paper, my toddler’s voice, etc.).
The incident that made my baseline tinnitus elevate was a session of intense crying (and some yelling) after a family emergency. The next morning I woke up and noticed it was higher.
Over the subsequent weeks I noticed some sensitivity to sound but not with the overlaying sound. I continued on with normal life which included some louder sounds like music at the gym and life with my toddler and his friends.
Then, my toddler screamed directly in my ear. I think it was relatively soon after that that the overlay sound began. It took me a long time to ascertain whether it was movement or sound triggered. In the beginning it seemed to be more movement based, so the audiologist recommended I look into TMJ and to NOT wear earplugs.
Then I realized some of the movements were causing quiet sounds (the sound of my hair swishing on my coat, etc.) and determined it was way more sound related than movement related.
However, the jaw and neck movements do *sometimes* produce the same sound. Sometimes when I am eating, sometimes when I am putting my son to bed and move my head a certain way.
I have good days and bad days. Sometimes my affected ear (the left) rings really loudly at night, above and beyond the baseline but not sound reactive.
I really need some help. I have been googling and figuring this out on my own since early February. The ENT was of little help, however the prednisone that I took in late February did greatly reduce the reactive sound but it came back once I tapered off. He has put in for an MRI but I am very concerned about the noise level.
Based on this information: do you think I should give HRT a try? I really want to, as I have been totally stressed out by this, have lost a lot of weight, and just generally want professional help rather than trying to go it alone. It’s expensive but we can swing it.
Also, do you think I should forgo the MRI at this point?
Also, to follow up: when movement triggers it, it is the same sound that is made (jingling) when a sound triggers it.
Also, if I had to guess, I would say that the annoying high pitched jingling is about 85% due to sounds and 15% due to movement.
Thanks again!!!!
Hi Zoe:
Stress and anxiety can certainly cause your tinnitus to get worse. So I’m not surprised that your tinnitus got worse during the family emergency.
However, your toddler screaming in your ear is probably what really activated the hyperacusis as hyperacusis is often due to episodes of sudden loud sounds. The secondary sounds are related to your hyperacusis and not to tinnitus as such as I see it.
Loudness hyperacusis is caused by auditory sound processing problems. However, sometimes movements cause the somatosensory (non-auditory) nerves to generate signals that when they reach your brain are wrongly sent to auditory centers for processing so you hear them–even though initially they were not auditory signals at all. In your case, I wouldn’t expect upper cervical treatments to really help you.
You are right to be concerned about the noise of an MRI since you have hyperacusis. I’d advise against it UNLESS there is a definite reason for having it–not just a let’s look and see if we can see something. The chances of an MRI showing any problems related to your hyperacusis are pretty slim in my opinion.
It is normal to have good and bad days. Actually, that is a good sign–since good days show that your condition is not necessarily permanent–or you wouldn’t have good days–just more or less constant bad days.
The trick with loudness hyperacusis is to not expose your ears to sounds that make it worse. When sounds get too loud so that your hyperacusis kicks in, you need to get away from those sounds temporarily or wear ear protectors at that point.
Which is bothering you the most–your tinnitus, the reactive secondary sounds, or your loudness hyperacusis? Obviously you want to treat the worst condition first, but you have to be careful. For example, if your tinnitus is bothering you the most, if you take TRT to help your tinnitus it can make your hyperacusis worse as the masking (really mixing) level required for your tinnitus may be too loud for you hyperacusis. In that case, you have to treat your hyperacusis first.
If you take the HRT, what is the protocol that they are going to use on you? Let me know and let’s see if it makes good sense in your case.
Also, find out what their success ratio is for treating loudness hyperacusis.
Cordially,
Neil
Neil,
Thank you so much for all of this information. I was leaning toward not doing the MRI right now. It just seems too risky and I don’t have any other glaring symptoms that would indicate a tumor.
I am definitely most sent closer to the edge by the loudness hyperacusis and the secondary sound that is happening. The secondary sound seems to be at lower levels of sound that aggravate me, and when the sounds are even louder my ear can FEEL the effects of that, like a little bubble popping or a blown speaker. Others have mentioned that feeling in the previous posts.
I go tomorrow for my first session. They definitely know to treat my hyperacusis first. This is one of the only places in my city that does TRT/HRT and they seem to know what they are doing! I don’t know much about the specifics YET, but as far as I know they use sound generators and start with a sound lower than what triggers my hyperacusis and then tweak that as time goes on to desensitize my ear(s). It seems like they set you up with appropriate ear plugs and counsel you on how to heal this monster.
Is there anything specific related to the type of hyperacusis I have that I should ask them tomorrow before diving in? One question I know I want to ask is if the treatment should be done in both ears? Logic tells me they should, even though the left ear is the “bad” one.
Their sister clinic across town has really great reviews from people who were treated for hyperacusis and then tinnitus.
Please let me know what good questions to ask them to make sure I am being treated correctly. Thank you thank you thank you. This forum has been a bright light in a very very dark couple of months for me and my family.
PS- When I first got my initial tinnitus 12 years ago it was also from crying and yelling – guess I really need regular therapy to get that under control…!
Hi Zoe:
To answer your question, yes, you definitely want to treat both ears the same in order to keep your auditory system balanced. For both tinnitus and loudness hyperacusis you want to use sound generators or ear protectors in both ears at the same time.
Sounds like your clinic is indeed a good clinic.
Make sure you get adequate counseling as loudness hyperacusis is a psychosomatic condition so treating the psychological/emotional issues is every bit as important as treating the somatic (body or physical) issues (sound generators, etc). Much of the success of any hyperacusis program is related to how you think of you hyperacusis and how you deal with it day by day–so there is a lot that depends on you. Also, prepare yourself for the long haul–don’t expect quick results.
Cordially,
Neil
Thank you so very much. My family (and me!) couldn’t believe that a caring expert would actually answer in a timely way to address immediate concerns. I appreciate you so much.
Hi Neil,
Me again. I am all set up for my hyperacusis treatment. While the audiologist was positive about it being able to help me desensitize to loud noises, she was not familiar with what I was describing happening with the noise distortion that happens over lower volume sounds in my left ear (my voice, papers rustling, typing).
I notice you have dysacusis as a term in your glossary. From my own studies on the internet, it seems like that’s what I am experiencing in my left ear.
What do you know about it? What should I do?
Hi Zoe:
I think your noise distortion is all part and parcel of your hyperacusis. Thus, just successfully treating your hyperacusis should also (hopefully) take care of the distortion.
Dysacusis covers a broad range of “funny” hearing so what you are hearing falls under the general term of dysacusis.
Another term that produces distorted hearing is diplacusis. You can read my article on the subject at https://hearinglosshelp.com/blog/diplacusisthe-strange-world-of-people-with-double-hearing/ .
At this point, I’d just concentrate on your loudness hyperacusis and see whether that takes care of your distortion in the process.
Cordially,
Neil
Hi Neil, I first experienced hypercusis about 8 years ago. When exposed to sounds apprxmtly 80 db or louder, I would experience ear pain for anywhere from a day to many weeks and then the pain would dissipate. I was very careful protecting my ear with earplugs, etc. It was manageable for years. Now in the last year my tolerance level for noise has decreased and it seems like anything above 65 db (which isn’t very loud) is causing pain.why is this? Can it get progressively worse if you are protecting your ears well? Also, I have trouble believing that this condition is psychosomatic like everyone says. Thanks in advance, Paul
Hi Paul:
What happened to bring on the hyperacusis 8 years ago? And what is different now that is causing your hyperacusis to increase? Any ideas?
Actually, protecting your ears too well definitely makes your hyperacusis worse and worse as time goes by. Rather than overprotecting your ears with wearing ear protectors when you don’t really, really need to, you need to push the envelope a bit at a time by exposing your ears to louder and louder sounds without ear protectors. This is a gradual process to expand your dynamic range again. You do it in small steps over time.
It depends on how you think of psychosomatic–whether as a mental illness or otherwise. Psychosomatic just means that a given conditions has both a psychological (psychic) and a physical (somatic) component. It doesn’t connote mental health or lack of it.
Cordially,
Neil
I developed hypercusis 8 years ago from years of listening to music too loud, especially with headphones. I am not doing anything different now to make the condition worse. I probably wear earplugs more than I should so to your point, perhaps this is contributing to making it worse. It just seems like too extreme a difference for it to be caused by being a little extra protective ? Is it rare for it to just get naturally worse without exposure to damaging levels of sound? I will certainly try and wear the earplugs as little as possible.
Yes, psychosomatic is a fairly general term and it make sense that one’s emotional state could make it worse but for me it feels 100% physical. I can measure with db sound meter so precisely when it kicks in and it is always so consistent. Also, I dont let myself get emotional about it and have far less stress than I have had at any point in my life.
I will order your book to learn more and support this fantastic service you offer but what else might I do? Thanks again. Much appreciate, Paul
Hi Paul:
With loudness hyperacusis you mustn’t be extra protective. This just makes things worse–and I think that is what has been happening. It doesn’t take much. For example, some people develop loudness hyperacusis just from wearing ear protectors at night so they can sleep. The sounds that disrupt this sleep aren’t really all that loud, but, over time, they develop hyperacusis and the longer they do that, the worse their hyperacusis becomes.
Hyperacusis doesn’t get naturally worse. Either you expose your ears to too much sound, or you protect your ears too much from sounds that are not ear damaging. You have to walk the fine line between them if you want to successfully treat your hyperacusis.
Just focusing on your hyperacusis too much can cause problems, even without obvious emotional involvement. The more you focus on something, the more you tell your limbic system that the sounds on which you are focusing are important and therefore it needs to enhance them. So it doesn’t need to be strong emotional involvement, just focusing on the level of sounds all the time. But of course, any strong emotional involvement will make things worse too.
Read my book and you will learn a lot. Then if you still have questions, fire away.
Cordially,
Neil
This Hypercusis is certainly an interesting condition. So if I stop wearing the earplugs so often, I should return to how I was before, only experiencing pain when above 80-85 db?
I guess the idea is to only wear the ear plugs when the noise is at damaging level dbs (85 or higher).
Thanks so much for your insights. Much appreciation for shedding light on this very misunderstood condition!
Hi Paul:
If you stop wearing ear protectors unnecessarily and do the right things, yes, you should get rid of your hyperacusis.
And there is no reason why you couldn’t raise the ceiling on your dynamic range about 80 dB too.
No, the idea when you have hyperacusis is to wear ear protectors when the sounds reach a level that your hyperacusis kicks in and ramps up. Then slowly raise the ceiling over time which can be up to 3 years depending on the severity of your hyperacusis.
Normally, you (and everybody) should wear ear protectors when exposing their ears to loud sounds above 80 dB for any significant periods of time.
Cordially,
Neil
Hi Neil, I stopped wearing ear plugs at your suggestion and noticed a slight improvement within a couple of weeks. I only wear them now when I’m exposed to noise that makes me uncomfortable which has only been on a couple of occasions for only an hour or two since we spoke in April. After that initial improvement, things haven’t gotten much better. I know you said it takes quite a bit of time for the ears to heal but shouldn’t I have experienced a little more incremental improvement over the past four months or not necessarily? Thanks in advance for your insights, Paul
Hi Paul:
You are doing the right thing in reducing your use of ear protectors when not really needed. You say you have reached a plateau and your hyperacusis isn’t improving from there. What are you doing to make your hyperacusis improve? Are you slowly pushing the envelope to increase your ear’s tolerance to sounds. That may be the reason you are “stuck”. This is where sound therapy comes into play. Are you following what I suggest in my book?
Cordially,
Neil
I am. I can listen to music, audio, etc. at 60db comfortably and try increasing it just a bit beyond that every few days for 20 minutes or so and it invariably starts to hurt when it approaches the 20 minute mark. I really dont want to push it more than that unless you think I should? The major difference since I stopped wearing the ear plugs is the pain will usually subside in an hour or two whereas before when I would put ear plugs in, the pain would last for days on end. So, I’m thankful for that but of course the situation is still not great. Anything else I can do? Much gratitude, Paul
Hi Paul:
The idea of pushing the envelope is to push the volume a tiny bit that you can stand for hours, not just minutes. If you can only stand the increase for 20 minutes before pain, then I think you are pushing too hard and too fast. Are you having this background sound for hours or just for a limited time each day? It almost sounds like this is what you are doing–not exposing your ears to the hours of background sound you need each day.
It’s not wrong to push a bit harder for the 20 minutes or so that you are doing, but that should be IN ADDITION to the hours-long background sound you are slowly increasing.
You might want to read (or reread) about this in Chapter 9 of my book “Hypersensitive to Sound?”and particularly noting the principles enunciated beginning at the heading “Principles of Sound Therapy”.
Cordially,
Neil
Hi Neil, the sound therapy hasn’t improved anything. I can handle noise for hours on end if it does not exceed 59 db but Whenever I go beyond that into the low 60dbs, I experience pain. Sometimes it’s after a n hour or more and other times, it’s immediate but that is the threshold. I just can’t seem to get beyond that. The pain usually subsides after a couple of hours but since about 5 days ago, it has not gone away. There is also a big difference in the pain. Previously it was always the ear fullness feeling but now it seems to be a pain way down in the inner ear accompanied by a mild headache in the back side of my head. Is that odd that the pain is different all of a sudden? Why did i have this reaction this time when my exposure to noise has been the same as always? The noise dips into the low 60 dbs and I turn off noise soon after feeling pain. Thanks much, Paul
Hi Paul:
What kind of sound therapy are you using? What sounds are you listening to? Are you using it 24/7 or what?
Are you forming a “mental block” such that it kicks in the pain above 60 dB? I heard one man describe exactly this and he had to take himself in hand and overcome this. When he did it, his pain went away and he has progressed very well with his hyperacusis program.
Cordially,
Neil
Thanks for your quick reply Dr. Neil. I have used a variety of different sounds. I started using white and brown noise, nature sounds, running water, etc. and generally would have it on for 8-10 hours a day, 5 or 6 days a week. I was doing fine with these sounds getting it close to 70 dbs so I switched to instrumental music starting at 45 db and gradually bringing up the volume. Everything was fine until it reached 60 dbs. I guess my ears can’t handle the variety of frequencies inherent in music?
Hi Paul:
I’m not so sure your ears can’t handle the various frequencies. More likely it is that your ears can’t stand the sudden changes in volume. The spikes in the volume from various instruments is more than your ears can handle. That is why you use a constant sound at has a constant volume with no spikes in it.
So what you could do is try to find music that has a near constant volume with no spikes in it and see how that works for you.
Cordially,
Neil
Neil, that makes sense, unfortunately most music has spikes in volume. I feel like the condition is purely physical and it’s hard for me to believe that I may have a mental block when it reaches 60 db but certainly it’s possible. At this point I’m willing to try anything. What might you suggest I do to try and combat that? When you say the man who had a similar situation as me and “took himself in hand” to overcome it, what did he do exactly? Again, thank you so much for your insights. best, Paul
Hi Paul:
That’s the point. When you have hyperacusis, your ears cannot stand much change in volume, even at lower levels, and when you reach 60 dB and the spikes are up at 80 or more, your ears “rebel” and you are stuck. In order to push through that, you need a sound source that keeps the volume almost constant as you slowly increase the volume.
Basically, the man I was telling you about kept telling himself that the sounds were not really that loud and would not hurt his ears so he didn’t have to be afraid of such sounds–and over time, it worked for him.
So for best results you need to address both the sound therapy component and the psychological component.
Cordially,
Neil
Hello Dr Neil,
how did the surgery go? how is your recovery going? How are you feeling?
Hope everything is great in you life.
For the last three weeks my tinnitus went much worse. I don’t know why but I blame my duck for that(I didn’t have it before, I mean my parents didn’t have it) and also myneighbor’s dog barks very loudly(in front of my gate, near to my window. they didn’t have it before) They make noise all night long near my window. It sometimes interupts my sleep, my parents somehow don’t really care about my ear they don’t even consider my reactive tinnitus as something serious. I would like to ask you a few questions if you wouldn’t mind.
1) Can I do anything about it. I mean I can’t use ear protetors because when they make noise I am sleeping and only in the morning I can hear their sound.(or somtimes in the middle of the night)
2)If I don’t pay attention my tinnitus reacting at these sounds will my ear get used to it or will they make my tinnitus get worse and I will never recover?
3)If my reactive tinitus stays for 3 years, after that time can I say that it’s going to be forever reactive? or can it ose reactivity after 4 -5 years?
Thank you so much Dr Neil, hope you are healthy and safe. You are one of the most important people in my life.
Love,
Elena.
Hi Elena:
The second surgery fixed the problem and I’m recovering nicely. I’m feeling mostly myself again but still need to take it easy for the next few weeks.
Lack of sleep and worrying about your duck/dog sounds can certainly make your tinnitus worse.
1. I assume that when you are sleeping, the sounds don’t affect your reactive tinnitus. When you wake up and sounds are reacting, if you need to, wear your ear protectors to give your ears a bit of a rest until your reactive tinnitus calms down. Just try to wear them as little as possible.
2. It depends on how strong the reaction is. If it is just a very mild reaction, you could consider it just “pushing the envelope” and safely put up with it. However, if it is making your reactive tinnitus worse and worse, then you have to use your sound generators and wear ear protectors as needed to slowly improve again.
3. Don’t worry about how long it will take. That just makes you more anxious. Just keep on the program we set out previously and constantly work towards slowly getting better and better. That is your real goal. Keep your eye on the goal, not on all the setbacks that occur along the way.
Cordially,
Neil
Hello Dr Neil!
Backgound: Since 2015 I have tinnitus in my right ear after an acoustic trauma, I stupidly fired one shot with a rifle without ear protection during a holiday. I’m very careful with always protecting my hearing since then when exposed to loud sounds. I got habituated to my tinnitus after a couple of months. So tinnitus is not my issue
Problem today: February 8 this year I had one more acoustic trauma. A jet fighet plane flew very low (approx 200 m) above my head when I was in the forest in the countryside. Since then I have a feeling of tension/pressure in my right ear (same as tinnitus), the ear pops/crackles when swollowing/yawning. This condition is very stressful to me as music plays a big part in my life. I feel a need to pop my ear all the time to get rid of the tension – but it comes right back after popping my ear. I had a bit of hyperacusis pre to this trauma, but it has not been worse. I went to an ENT, and there is no visible issues with my ear or tympani. My audiogram shows no hearing loss. She could not explain my symptoms.
I’ve read your previous answers and a common answer is to get the stress/anxiety under control. I’m trying to work on that, but a big issue for me is that I don’t understand the symptoms or chances to get free from this. This is more physical than tinnitus and I don’t know how to get my mind off this. Also similar patient cases points to the direction that the symptoms will be permanent.
Thank you so much for taking the time to read and reply,
Cordinally,
Erik, 31 years old from Sweden
Hi Erik:
When you suffer acoustic shock (such as the plane thundering overhead unexpectedly) there are a number of symptoms that can show up. Loudness hyperacusis is one. Tinnitus is another. But one that you wouldn’t expect is that feeling of fullness in your ear that can sometimes be temporarily alleviated by yawning or swallowing. (Incidentally, your English is flawless except for the spelling of the word “swallowing” I’ve noticed that other Europeans make the same spelling mistake for some reason.)
I think that the main problem is that your trigeminal nerve (which controls the muscles that operate your Eustachian tubes) can become hyperactive and cause these problems as well a pain on the side of your face and around your ears.
So there is a physical component, but also a psychological component that is made worse by anxiety/stress. So you need to work on both components. Calm yourself down, but also calm down your trigeminal nerve and hopefully you will get things under control again. I don’t see any reason this should be a lifetime sentence.
Cordially,
Neil
Hi Neil,
I really appreciate you taking the time to answer. It made my day and I’m sure it goes for all others here. Well, Scandinavians are pretty much marinated in anglo-american culture. As we generally listen to or talk english more often than writing/reading, the spelling or formal language could be a bit off. Auto-correct also makes us lazy 🙂
I would say one of the biggest problems that fuel anxiety is that there is very little information about nerve/muscle damage in the ear, symtoms it might cause and prospects to heal . Other people often have a hard time understanding what is so agitating about it. Hence the feeling of being alone in the dark.
I’ve read many stories on Tinnitustalk.com, about acoustic shock and similar symptoms to mine. Some people have had it for years or even decades – which is a bit discouraging. A lot of success stories are not written of course.
I don’t quite understand why you wouldn’t expect ear fullness after acoustic shock? When googling “acoustic shock symptoms”, ear fullness often is mentioned. Sometimes my right ear flutters a bit, so some mild TTTS symptoms.
I didn’t get any immediate symptoms in my left ear, only the right. After my first trauma the left ear was affected some days, but it subsided. So I don’t think the sound was as loud this time.
I’ve had a periods pre to my 2nd trauma when I was anxious/stressed, but no added ear symptoms – but I actually had a low period when this was happening, maybe my buffer system was low, just speculating.
I don’t have any facial pain, so it couldn’t be trigeminal neuralgia then? But if the trigeminal muscle controls the muscles in the eustasian tube (tensor tympani, stapedius) it makes sense anyway that I have some strange symptoms. Here are som further questions if you don’t mind:
– Is there any medical treatment concerning my symptoms? I’ve read something about botox injections every 3rd month. Or even tympanoplasty (which sounds very drastic).
-Is there any studies about anxiety and my symptoms, like visible results after treating anxiety? What is your clinical experience?
Again, thanks a lot for this talk. It means a lot.
All the best,
Erik
Hi Erik:
One of the symptoms of acoustic shock is indeed a feeling of fullness in your ears. In fact, a feeling of fullness is common to many ear conditions such as sudden hearing loss, TTTS, loudness hyperacusis, etc.
I sure wouldn’t try Botox treatments. I hear from too many people who have sudden hearing loss from taking Botox injections. This just compounds the problems, not helps them.
By tympanoplasty, are you meaning putting “grommets” or “tubes” in your ears (through your eardrum)? Some people have this done, but that just opens a path for infections in your middle ear.
So often, the various medical solutions just cause other problems, so you have to weigh the supposed benefits against all the negatives that can surface later. You don’t want to put a bandaid on the symptom. You want to find and treat the basic problem so the symptoms go away.
Cordially,
Neil
PS. I found this interesting article before: https://www.frontiersin.org/articles/10.3389/fneur.2017.00420/full
“This study is the first to provide experimental support suggesting that middle ear muscles (MEM) can behave abnormally after ASI…The sensation of tension in the ear reported immediately after the acoustic shock may result from an abnormal contraction of the MEM signaled by the muscle spindles (9) and tympanum mechanoreceptors due to eardrum deformation (10). The traumatic acoustic episode may lead to anxiety and sensory hypersensitivity, which may in turn reduce the startle reflex threshold and/or potentiate the startle reflex (11), possibly through a descending serotoninergic innervation (12). This central feedback may facilitate tonic and phasic TTM contraction.”
The authors are also guessing that anxiety plays a part. Eardrum deformation sounds a bit scary though, could it be seen with otoscope, or only visible from the eustasian tube?
Hi Erik:
Yes, that article is interesting. Notice that it mentions the hyperactivation of the trigeminal nerve resulting in some of these problems–just as I had said in a previous reply. So it seems that calming down the trigeminal nerve is at the root of resolving acoustic shock injury.
Don’t be scared by the term “eardrum deformation” as they don’t exactly say what they mean by that. It could just mean that the eardrum was red because of engorged blood vessels (tympanum hyperemia) or stretched a bit out of shape from the original acoustic shock event. I think they were talking about seeing it through an otoscope.
Anxiety always seems to play a role in making ear conditions worse since many ear conditions are psychosomatic in nature. Thus, reducing anxiety/stress typically makes an enormous difference in how bad the symptoms are on any given day.
Cordially,
Neil
Hi Doc –
Firstly let me tell you that you’re doing gods work in helping people.
My story: about 2.5 weeks ago I went to a Kareoke event. Since the next am, my ears had a loud ring which last about 1.5 weeks. The ringing has faded dramatically. I know so as the only time i am ‘aware’ of it is when it’s dead quiet or I rest my head on a pillow. Its mostly turned to a Hiss or white noise but gets becomes ringing if there is medium levels of sound. It’s def in both ears. One ear comes and goes and other has a constant ring and some Morse code type beeps which are only evident when I plug my ears.
Interestingly the ear noise goes away completely when I am sleeping. I know so because whenever I wake up in the middle of the nights it’s gone completely. However when the first big sound hits in the am then things start up. I assume it’s reacting to sound.
Additionally I am def sensitive to things like dishes, water faucets, high freq sounds coming from computers or fridges. It’s not terrible but it’s there.
I’ve got an audio gram done and have a small notch at 4khz. Doc at NYU was super confident that with time things in my case should go away as degradation is still within upper limits or normal.
My question is around reactivity and hyperacusis. How do I got about the desensitization process. I have a baby who is super loud so I am using moderate ear plugs. I also live in NYC which is naturally loud.
Also how long does reactivity last. Its just so funny that if I had no sound I essentially do not have any ringing even when plugging ears.
Hi Frank:
Thanks for the kind words.
It sounds like you have some degree of reactive tinnitus. It should quieten down as time goes by. The noise notch at 4 kHz is to be expected if you expose your ears to loud sounds. And often loud sounds, especially unexpected or sudden loud sounds can result in loudness hyperacusis as well. When loudness hyperacusis marries tinnitus the result is reactive tinnitus.
To return to normal, with loudness hyperacusis you want to protect your ears from sounds that cause your hyperacusis to kick in. Definitely don’t want to let baby scream in your ears. So wearing ear protectors when needed is a good way to go–but be careful not to wear them when you don’t need to. The idea is that as time goes on, you push the sound envelope and gradually expose your ears to louder and louder sounds as they are able to bear it. If you push it too much and too fast you’ll suffer setbacks. The same goes if you accidentally expose your ears to loud sounds–but it is almost impossible to protect against such things without wearing ear protectors all the time–and that is a no no as that will make your hyperacusis worse too. So walk the fine line between not protecting your ears enough and overprotecting them and you’ll be fine.
How long the process takes varies from person to person depending on how sensitive their ear become, how much ambient sound is around them and how they emotionally/psychologically adapt to, and think about, their hyperacusis. I’d give it a minimum of 4 months and it could take 3 years. So much is up to you and how you view your tinnitus and hyperacusis.
Cordially,
Neil
NEIL BAUMAN, PH.D. hello sir. I ‘ve read several questions and answers but I would like to ask one question. On 02/12/2022 my son was firing a high-powered rifle and I was standing behind him when he fired the rifle before I put my hearing protection back on. The blast has caused some hearing loss in the left ear and now my ear is very sensitive to loud sounds. My wife wants me to buy a hearing aid but to me I think it would make my problem worse. I just want to ask you your thoughts.
Thank you, Dr. for your time.
Slim
Hi Slim:
I agree with you–you don’t want a hearing aid at this time. You first want to deal with the sensitivity to sound (loudness hyperacusis). Amplifying sounds at this time could make your hyperacusis worse and you definitely don’t want that. Dealing with your sound hypersensitivity could take several months or more. Once you have the hypersensitivity under control, then it is time to see an audiologist and discuss whether a hearing aid in your left ear would be appropriate. Just be aware that your left ear may always be somewhat sensitive to certain sounds–but you could expect to be at least 80% back to normal in time in this regard.
Cordially,
Neil
Dr,
I am a firefighter who had acoustic noise trauma 2mos ago from 2 events that were close together. The first was I was walking in front the fire engine and the driver setoff the air horn. I was 1 ft from the horn and it was inside the firehouse so the overhead door was closed which was also 1ft away on the otherside of me. I tested what the noise from the airhorn was with a niosh slm app and it was 136db. I had immediate pain, very loud tinnitus. My right ear which was facing the door was full. My doctor noticed fluid in my ears. One week later I had a supervisory alarm call for an activated fire alarm. This was in a resident group home that had a commercial fire alarm system which was very loud. I was in that for about 12-13minutes. My tinnitus has been far worse since plus i have hyperacusis now. An audiogram shows moderate snhl hearing loss. I have difficulty hearing conversations in public. Etc…
I am on light duty now. It is hard to hear radio transmissions on my portable radio, etc…. The radio tones for alarms being dispatched in the firehouse makes my ears reverberate. Kind of concerned that this will impact my ability to hear in a fire situation with loud background noises.
Hi Mark:
An air horn from 1 foot away in an enclosed space is definitely hard on the ears! That was above the threshold of pain which is around 120 dB.
I hope the guy that blasted you with the air horn has been admonished about the danger for doing this on people’s ears. Firemen need to know how this can cause permanent damage and cause hyperacusis that can prevent a person from doing their jobs in the future.
I know what fire alarms are like. I was a fireman for 10 years myself. And being “right there” for 10 plus minutes is definitely another trauma for your ears.
I’m not surprised you have tinnitus and hyperacusis now.
How long after the second incident did you have the audiogram? I’m wondering if there was time enough for the temporary threshold shift to resolve or not?
If you can’t hear/understand people talking, you need to get properly-fitted hearing aids to help you in those situations.
Your problem is to get your ears back to normal (or near normal) again–and that won’t happen as long as you keep exposing your ears to loud sounds. And by loud sounds, I don’t just mean the sirens and alarms, but louder everyday sounds that your ears now react to.
It takes time–a number of months and sometimes years–to get your ears back to normal. And each time you expose your ears to a loud sound, it causes a setback in your progress.
You might want to get reassigned to non-emergency duties such as public fire safety officer, or fire safety inspector or fire investigator where you don’t have to be around loud alarms, sirens, etc. and where hearing isn’t critical.
If you can’t hear your radio, wearing an earbud in one ear would be one solution. I never could understand my radio unless I held it up to my ear, but I could hear that someone was talking when it was on my belt. My radio was always at full volume so I had a hope of hearing it since I had a severe hearing loss.
Cordially,
Neil
Thank you for your response. My audiogram was completed about 3 weeks after the second event. I tested the air horn with a niosh phone app and it showed it was 136db.
The issue is on the fire ground wearing an earpiece isn’t an option. Another weird thing that happened was we did a drill a week after the second incident to my hearing and every inhalation breath while wearing my SCBA my right ear which is the ear that was blocked would completely “close off” until I exhaled.
I wore an scba a week after that to see if it would do it again. It didnt completely shut closed but my right ear would feel full again. The Dr. Said it was Eustachian tubes and asked if i had allergies. I would think it was tied to the acoustic trauma I experienced but don’t know how.
When my right ear would be blocked shut when I exhaled it would clear and i could hear until my next inhalation.
Hi Mark:
Since your audiogram was taken three weeks before, any temporary threshold shift should be over. Thus what you are left with is almost certainly permanent hearing loss.
Your Eustachian tubes are tied to your hearing and the feeling of fullness and the loud noise incident because the same nerve–the fifth cranial (trigeminal) nerve that innervates your Eustachian tubes also controls the tensor tympani muscle that pulls the hammer bone away from your eardrum when you are exposed to loud sounds.
When you startle reflex gets messed up, like yours did with the air horn blast, you can have weird effects on your Eustachian tubes. I think that is what is happening in your case now. The trick is to calm down your trigeminal nerve so this doesn’t keep happening.
Cordially,
Neil
I just wondered if you could give me some help.
I was careless and forgot about hearing protection hammering out nails from a fence weeks ago. I didn’t think that vibration could be so loud but later my right ear was ringing a bit. It went away quite soon, and I didn’t feel much apart from dullness. Over the next few days, I felt mild ringing/fluttering and thinking it was just ear wax cleaned it out. The left ear (furthest from the noise) seemed ok. About two weeks later I noticed an increase in sound sensitivity that just seemed weird. I can now only feel the ringing when I yawn, burp or when the wind blows over the ear. My own voice sounds tinny and echoes in the ear. Outside medallic noises are really loud like trollies being pulled over cobbled roads or metal bins closing yards away for instance. In the supermarket It is like every amplified sound coming from every direction and voices sound garbled and tinny and it causes maximum anxiety. I have become so stressed and anxious I couldn’t sleep so I spoke to a GP and he said that the symptoms would probably go away over time and to just wait it out and gave me some anti-depressants to help sleep (didn’t work). The thing is I was shopping a week ago and everything was almost normal and at home it is only sometimes, when I seem to get stressed, sounds like plates, cupboard doors, tins being opened and doors closing seem unusually loud. The doctor put it down as intermittent tinnitus and hyperacusis, but I just wondered if the stress factor has anything to do with it. Surely with hyperacusis it is a one-way street and not just some of the time. I have read many posts here and you say that the hypersensitive hearing can often go within months.
Hi Douglas:
Pounding nails, especially in thick boards like fence boards for horse corrals can be very loud. I found I couldn’t stand that sharp sound myself. I was pounding 6″ nails with a 2.5 pound baby sledge hammer. I had to wear ear muffs to protect my ears, but even shorter nails can cause ear problems. So I understand what you are saying.
You now have loudness hyperacusis. You’d think it would occur right away like the tinnitus does, but loudness hyperacusis often takes a couple of weeks or so to develop. You get increasingly sensitive to certain loud and sharp sounds.
Typically, the sounds that bother you the most are higher frequency sounds so plates and cutlery clinking sound very sharp and excessively loud. That is why you react to certain louder sounds and not others that are lower in frequency.
So, if you are not around sharp, higher frequency sounds, you may not notice your hyperacusis.
Loudness hyperacusis is a psychosomatic condition so your emotional/psychological status plays a LARGE part in how you experience it. As you have found, when you are stressed or anxious, your hyperacusis gets worse. Thus, you need to calm down in those situations and learn how to manage your stress correctly.
When you do this and don’t focus on your hyperacusis, you will typically find it will become less and less and finally disappear in time. However, if you expose your ears to sudden loud sounds while this is happening you may experience a setback that will take that much longer to go away, and it will go away if you continue on the program.
Cordially,
Neil
Hi Dr Bauman,
I have been experiencing sensitivity to most sounds and ear pain, which I believe is from ototoxic medication. I started taking metoprolol for ten days, then had a medical procedure that required an IV of Ancef (cefzolin) and then symptoms began the next day, which include: sensitivity to sound/ear pain, headaches, vertigo (when closing eyes), nausea, fullness in ears, ear fluttering sounds.
I don’t think I have any hearing loss, but need to keep everything at a low volume, otherwise it’s pretty uncomfortable.
I’ve had two episodes of inner ear issues from previous rounds of oral neomycin (500mg), that went away–and I’ll never take that again. But, I’ve never had ear pain like this and it seems to be getting a bit worse.
I’m wondering the likelihood of this improving, as it is likely from medication, and interested in your thoughts. Seeing an ENT soon, but he hasn’t been too helpful in the past.
Thank you very much.
Steve
Hi Steve:
If you need to take a beta blocker, I’d suggest that Labetalol has a much lower risk than Metoprolol.
Cefazolin has a lower risk than Metoprolol for sure, but it can also cause hearing loss, tinnitus, vertigo ear fullness and ear pain just like Metoprolol can. In addition, Metoprolol can cause hyperacusis (ear sensitivity).
Taking them both one after the other could increase the risk of them acting synergistically and causing the resulting side effects to be worse.
I hope your symptoms subside as the drugs get out of your system (I hope you’re not taking them anymore), but there are no guarantees.
Since you now have sound sensitivity, you want to take special care not to expose your ears to loud sounds until the sound sensitivity goes or it can just get worse.
I also doubt your ENT will have anything constructive to do/say as they typically are not experts in tinnitus and hyperacusis.
Cordially,
Neil
Hi Dr Bauman,
I went to a club almost 8 weeks ago and have developed tinnitus. I also had a temporary threshold shift but this was gone by the next morning. The ear fulness feeling went away after about 2 weeks and my sensitivity to sounds has also improved a lot. The exposure time in the club was almost 2 and a half hours and the noise was probably around 100db (with no ear protection as I didnt realize it can cause damage, never heard of tinnitus before). I dont think I ever experienced tinnitus before, not even briefly.
I am 23 years old and dont have any other health issues. The tinnitus declined quite a lot in the first 2-3 weeks but now it feels it is the same. On the 7th day after the acoustic trauma I took a course of steroids (40mg per day for a week) but have not noticed a lot of changes due to this. I can usually only hear it in a complete silence now and I have been avoiding loud places since and also wore earplugs. I was wondering what you think my chances are for a complete recovery given that 2 months have passed already? Do you think there is anything I can do to improve my chances of full recovery or is there any medication you think might be appropriate to try?
I forgot to mention that my audiogram was normal when tested 1 week after the club
Kind regards,
Paulina
Hi Paulina:
As you now know, when you expose your ears to loud sounds, the result can be hearing loss, hyperacusis and tinnitus.
You are lucky that your hearing returned, your hyperacusis is fast disappearing and your tinnitus is at a very low level.
Note that a “normal” audiogram doesn’t mean you don’t have any hearing loss, just that no hearing loss by frequency is greater than 25 dB. True normal (“perfect”) hearing would be at 0 dB in every frequency. Thus you could lose 25 dB of hearing and still be considered to have normal hearing.
Since your tinnitus is at such a low level that you don’t normally hear it except in complete silence, it isn’t affecting your life and thus the best treatment is to just ignore it and NEVER try to hear it to see if it is still there. This just tells your limbic system that this sound is important and it will turn up your internal volume so you can hear it better–exactly what you don’t want to happen.
So just go about your life and focus on the loves of your life, not on your tinnitus and in time it may totally disappear, or remain at this very low level where it won’t bother you.
There are no drugs approved by the FDA for treating tinnitus–and close to 1,000 different drugs that can make tinnitus worse, so I’d stay away from any drugs as the chances of them making your tinnitus worse far outweigh the chances of them helping it.
Cordially,
Neil
Dear Dr. Neil,
I am a 51 year old self-employed professional singer (mainly musical theatre) living in Germany.
On December 31st 2020 I was exposed to a fire cracker. Since then I am experiencing tinnitus in both ears. I was still able to function in my profession as a singer but have struggled emotionally.
In March 2022 I was exposed to a very unexpected additional sound that created a high pitch noise in a small room (similar to a gunshot). Ever since then I have been becoming very sensitive to sound in both ears. My left ear is worse and it almost feels that the sound can reach my inner ear “unfiltered” and unprotected. I started wearing ear plugs in both ears to protect me from unpleasant sound. I was scared that another accident would destroy my hearing completely and/or increase my tinnitus even more.
Wearing ear plugs also have enabled me continuing working as a professional singer, my only source of income. Since March 2022 until today I probably had 30 performances in total, so I am not performing every night.
Over the last 7 months my ears have become more and more sensitive and also my tinnitus got more intense. It reacts to noises in my environment, even to moderate and soft noises such as fans or the refrigerator. Also, sometimes my ear drum would pound.
I would have the following questions, if you would be so kind to help me:
1. Thanks to your books I was able to learn more about my situation which helps me a lot.
As I understand I most likely have hyperacusis and reactive tinnitus, maybe even an acustic sound disorder with TTTS (occurs only to certain frequencies such as created by a low rumbling generators or a high pitched sound from a water faucet).
Would you agree?
2. As I understand hyperacusis has to be addressed first. I am taking out my ear plugs as much as I can. I tried to listen to pink and brown noise. Since I seem to have reactive tinnitus it will act up after a certain amount of time, for example I would wake up in the middle of the night and have to switch off the sound. Is there any other sound I could listen to that would help improve my hyperacusis?
What do I do? Just pushing through it?
3. Since my ears feel “unprotected”, as described above, I am not sure if my startle reflex works properly. As you wrote in your book a threshold test should not be performed in my condition. How can I make sure the startle reflex is still working properly and therefore protecting my ears from louder sounds? Especially now that my ears are used to the extra protection from the ear plugs.
4. You mention in your books that it takes longer time to improve the hyperacusis and I shouldn´t be exposed to 80 db plus. Since I am a self-employed professional singer I have been wearing ear plugs during my performances (soft ear plugs) which helps me to create a sound level of the orchestra probably around 80 db. I am not sure though about how my ears would anticipate my own singing voice wearing ear plugs and if it will even get amplified internally. For example, if I wear ear plugs while eating the chewing sound does get amplified.
If I canceled my performances that would mean I would have no income which would create additional anxiety. But worsening my condition would too.
Could I sing wearing ear plugs? That would be 2 concerts of a duration of approx. 1 hour a month.
Thank you so much for your help and input and for all your work!
Sincerely,
Marc
Hi Marc:
If you wear the ear protectors too much when you shouldn’t need them just because you are scared a loud sound might occur, you are making things worse. First, your brain is then starved for sound and consequently turns its internal volume up thus making your ears even more sensitive to sound. Second, your fear is also making your condition worse.
If you know (or there is a strong likelihood) that there will be a loud sound, you are wise to put on ear protectors, BUT as soon as the sound or strong likelihood of a loud sound has passed, take the ear protectors off so you don’t make things worse.
Your ears are becoming more and more sensitive due to two things as I see it. First, you are wearing your ear protectors too much, and second, your anxiety levels over your ear problems are rising and making things worse.
Hyperacusis does not destroy your hearing at all. It just seems like it would, but it doesn’t. So you don’t have to worry in that respect. It’s your perception that the sounds are excessively loud, not that they are really loud as you KNOW that fans and fridges aren’t that loud in practice.
Now to answer your questions.
1. You appear to have reactive tinnitus which is a marriage of tinnitus and loudness hyperacusis. I’m not so sure you have TTTS. I’d have to know more about your experiences to figure that out.
2. If your reactive tinnitus “winds up” and gets worse after you have been listening to a certain sound for some time, your ears need a break at that point. You might want to turn the sound off or wear ear protectors or move away from the sound and let your ears “unwind” for a while. Then you can expose them to that sound again.
Some people like pink or brown noise, I don’t. You may find that water sounds of some sort–rainfall, waves on the beach, waterfalls, babbling brook–whatever sounds good to you. And there is nothing to say that you can’t change the background sound from time to time if one sound begins to bother you.
If the sound is bothering your hyperacusis, then likely you have it too loud–so turn it down to just below where it begins to bother you.
3. Your startle reflex is working–just too well! You need it to settle down. So calming yourself down is a good step. Learn to relax. Don’t overuse your ear protectors. Over time you should be using them less and less as your dynamic range increases again until you don’t need them at all except when in loud venues when everyone should be wearing ear protectors.
4. I don’t see a problem with your wearing ear protectors while singing if you need to as you’d only be wearing them for about an hour. So that shouldn’t mess up your program of slowly increasing the background sounds to fix your hyperacusis. It’s when you wear them for too long at a time that your brain fools around with the volume control.
I assume you wear musician’s ear protectors which balance the sounds between frequencies so it all sounds normal. Regular ear protectors cut the bass, but not the treble and it is typically the treble sounds that cause your hyperacusis to kick in the most.
Don’t fear sounds. Just be aware of them and as needed wear ear protectors–but take them off as much as you can as your ears can stand it. Remember, you are always pushing the envelope–just don’t push too hard or too fast.
Cordially,
Neil
Dear Dr. Neil,
Thank you so much for your fast response and your advice. It all makes sense.
I own custom made musician´s ear plugs but they only bring down the loudness level about 15 to 20 db by keeping the balanced frequencies. My ears are too sensitive, especially in the higher frequencies, to use them on stage. Therefore I use foam ear plugs. It seems like they are cutting out the high frequencies. I can sing with them and became very sophisticated finding several positions of placing them in my ears, depending on the loudness level on stage. I am relieved that you don´t consider it as a problem of worsening my hearing, when I perform in “controlled” areas as I described to still be able to have income and also not to get depressed.
As I understand you, once the hyperacusis gets better my reactive tinnitus will as well improve, so it doesn´t react that intensely anymore to surrounding noises and that it will turn into a “non-reactive” tinnitus just like it was before my hyperacusis got more severe.
I will treat my hyperacusis first and I am aware of the needed patience that will come along with it. Also, I will remove my ear plugs the best I can, step by step.
I have 2 more questions, if I may:
1. I am very scared though of high pitched noices. They almost make me have a (milder) panic attack once I notice them.
Would you recommend that at the same time treating my hyperacusis I also get some psychological help, for example Cognitive Behavioral Therapy (CBT)? It seems like I should also address my false perception of sounds as well since I always get such a strong reaction.
2. Concerning my reactive tinnitus – as the name says, it is reacting to certain noise. In my case it is mostly quiet, sometimes very quiet noise that is being created by fans or fridges (even if they are very far away). During the day surroundings with moderate noise my tinnitus doesn´t seem to react to these and is not winding up as intensely, like it is at night time while sleeping being exposed to these more quiet noises. The tinnitus then winds up and wakes me up at least 2 or 3 times being screaming loud and most of the time I create dreams to the sound (or maybe the tinnitus gets even created by dreaming a weird drem?). After some relaxation exercises, getting up or massaging my head next to my ears, the tinnitus then slowly gets back to baseline.
Why is my tinnitus acting up mostly to quiet sounds and especially at nighttime and what situations could I create at nighttime to avoid or reduce these situations?
Thank you for your help, I really appreciate it a lot!
Best regards,
Marc
Hi Marc:
Obviously you need ear protectors that provide more than 15 dB or so of protection. I was just reading an article called “Best Earplugs for Live Music in 2022”. The link is https://www.hearingtracker.com/earplugs?utm_source=hearingtracker.com&utm_medium=newsletter .
#5 on the list (Minuendo Lossless Earplug) caught my eye as it has continuously-variable attenuation between 7 and 25 dB so you could adjust them on the fly to whatever level you need at any given time. They are a bit expensive at $159.00 US$. You might want to investigate them.
With these you can have some protection but it doesn’t have to be “all” or nothing–but adjustable to your current situation. Remember, you want to get enough protection to keep your hyperacusis from kicking in, but at the same time you want to push the window a bit. I think these could be an ideal solution for people in your situation.
Now to answer your questions.
1. When you have hyperacusis, typically your dynamic range in the high frequencies is much less than in the low frequencies. Thus, your hyperacusis is more intense in the high frequencies. This is the way it normally is so that is where you need the most protection. As I mentioned before, foam ear protectors typically reduce low-frequency sounds, not the high-frequency sound you now need reduced–thus, they are not as useful as they could be.
CBT tailored to help those with loudness hyperacusis is not a bad idea at all. The trick is finding someone that is experienced in using CBT to help people with loudness hyperacusis.
2. Everyone is different and you reactive tinnitus reacts to continuous lower-level background sounds–the “winding up” kind of hyperacusis. To me the solution is to have some background sounds around you all night that don’t “wind up”. Again, I suggest trying various kinds of “water sounds” and see if that works for you.
Cordially,
Neil
Hello Dr Neil, I have a question in early november 2022, i was exposed to loud noise from a power tool for couple of seconds. from nov to dec 2022 i have been feeling my ears aching,throbbing,,pressure,tension headache ,noise sensitivity ,.it gets worse when i listen to loud music or washing dishes or exposed to loud noise, it makes crackling popping sound and feel like inside ear shakes to loud noise…………as of right know if feel better than i did in november and december because i took precaution from exposing myself to loud noise, i told my dr about this but they think it is related to earwax or don’t know what im talking about…..do you know if hyperacusis gets better with time like a bruise and if so does it slowly go away or is it chronic, also sometimes my ear makes popping sound or trembles when doing dishes or hearing clank noises.
Hi Jonah:
Your ears were exposed to a loud, sudden sound that caused acoustic trauma which has lingered and you now have acoustic shock syndrome. All the symptoms you have mentioned are consistent with this syndrome.
Two things of note are that you now have loudness hyperacusis. That is why louder sounds and particularly higher-pitched sounds such as dishes and cutlery clinking now sound much too loud. Second, the shaking feeling–would you call it fluttering–is called tonic tensor tympani syndrome. Both of these conditions are mainstays of acoustic shock syndrome.
Your doctor is totally ignorant about ears, that’s for sure. You do know what you are talking about, and it is NOT earwax.
Now to answer your questions. Yes, loudness hyperacusis can get better over time–from what you said, it is already getting better. But it takes time. You also have to do the right things.
First, you need to protect your ears from louder sounds while they heal. This can take several months to 2 years or more depending on the severity. At the same time, you need to build up your tolerance to sounds again. You do this by SLOWLY exposing your ears to louder sounds as they can stand it. Don’t force it. Slowly does it.
Second, realize that loudness hyperacusis and TTTS are both psychosomatic conditions–the both have a physical component and a psychological component. Of the two, I consider the psychological component the most important. Thus, how you react or respond to these conditions makes all the difference as to whether you get better in time, or get worse.
You need to understand that exposing your ears to normal sounds does not damage them–much as it may feel like it must be doing. Therefore, you don’t have to be anxious and worried about your ears. You want to remain calm and keep your anxiety under control. This is probably the most important advice I can give you. It makes all the difference.
In the coming weeks, if you do that, you’ll notice your ears are “acting up” less and less as they return to normal.
You don’t want to expose your ears to louder sounds than they can stand without “acting up”. So listen to music at a low level. If you have to be around truly loud sounds, wear ear protectors. If you don’t, you can undo all the good progress you are making (called setbacks). If/when this happens, don’t get all anxious again, remain calm and continue on your program of slowly getting better. It will just take longer, but you will get there if you persevere.
Cordially,
Neil
Thanks for taking the time to reply, i also have a few questions. Does tempor tympanic that makes popping , flutter sound in ear go away with time or is it permanent…. also with hyperacusis is it like injury in the ear that gets better with time or is it chronic and also does taking magnesium supplements help with my recovery
Hi Jonah:
Neither condition has to be permanent. They should both go away with time if you are not anxious and worry about them.
Taking magnesium supplements (and zinc too) is a good idea. I’d recommend magnesium threonate and zinc picolinate. That is what I take.
Cordially,
Neil
thanks Dr, i have a few more questions sometimes i hear little hisss left ear will that go away with time, also i read online forums like reddit of people having this for more than 5 years is this because they never took time time to recover or take it seriously…also sometimes loud noise make my ear feel full,dull,migraine will that slowly go away with time and will i be able to listen to music
Hi Jonah:
A hissing sound is a common tinnitus sound. I have the high-pitched hissing sound kind of tinnitus myself. And I’ve had it for more than 70 years now that I can remember.
So tinnitus can persist. It is not that I didn’t recover from it, but that my tinnitus accompanies my hearing loss and since I was born with a severe loss, I’ve had tinnitus as far back as I can remember.
Thus, tinnitus that accompanies hearing loss can last as long as the hearing loss. But it doesn’t have to be a problem if you habituate to your tinnitus. My tinnitus is not a problem, it is just there, but hours go by every day when I am not aware I even have tinnitus even though it is still there.
If tinnitus is caused by certain drugs, when you stop taking the drug, the tinnitus goes away in a few days. For other drugs, their tinnitus is permanent–but you can still habituate to it so it no longer bothers you.
It takes time for your ears to recover, so during that time it is common for your ears to feel full, etc. This will gradually go away. However, if you listen to louder sounds that your ears can currently stand, those feelings will come back. So listen to music all you want, just keep the level down to where it doesn’t bother your ears.
Cordially,
Neil
hi Dr, thank you for your response, does wearing ear plugs count as ear protector,also i’m 24 years old does H/TTTS cure within time and recovery,
Hi Jonah:
Yes, wearing ear plugs is one form of ear protection. But if you can, it’s better to just turn down the sound level. You wear ear protectors when you don’t have access to the sound level.
Loudness hyperacusis and TTTS respond to time and doing the right things–and the main one is to control your anxiety over these conditions.
Cordially,
Neil
Hi Dr Neil so what your saying is my H is caused by anxiety not loud noise exposure
Hi Jonah:
No, it is caused initially by the noise exposure, but then anxiety crops up and often becomes the main factor preventing the best recovery possible. You still have to treat your ears for the hyperacusis–basically by protecting them from louder sounds and giving them a rest from louder sounds for a few weeks to months as they recover.
Cordially,
Neil
hi Dr. i forgot to mention i work dental assistant when exposed to loud high pitch power tool at work that was too loud does it cause temporary damage ear muscles or nerves. if so does it heal overtime or is it permanent with H/T/TTTS , also i don’t have hearing loss.
Hi Jonah:
Loud, high-pitched dental tools if they cause loudness hyperacusis and/or TTTS don’t cause physical damage so much as they hyperactivate certain nerves and thus you experience these two conditions. Your nerves can calm down over time, but you have to give them time (months typically) to do this. So, in the meantime, you have to protect them from such sounds while they “heal”. This means that if you work in a dental office, you’ll probably have to wear ear protectors anytime such tools are being used.
Cordially,
Neil
Hi Dr, after my ears take time to recover,Will my hearing tolerance go back to the way it was,also is it good to listen to pink noise
I forget to mention It was a dental drill that was causing the ear ache
Hi Jonah:
Your sound tolerance should return to normal or near normal.
When you have loudness hyperacusis, listening to a constant background sound like pink noise is one good way to help increase your tolerance to sound. Over time you slowly increase the volume as your ears are able to stand it until your dynamic range is back to normal or near normal.
Cordially,
Neil
Hi Dr, after being exposed loud noise in nov 2022 probably around 90 or 100 db from dental power tool for like 1 minute or less do you think its possible for my sound tolerance to go back to the way it was. in dec 2022 i had setback from listening to loud music i felt pain,throb,tension and now since jan 2023 i feel better than i did in nov and dec 2022 , i feel little bit noise sensitivity/ttts from dishes,people talking out loud,police siren,
Hi Jonah:
Yes, you should be able to get your sound tolerance back to about 90% of normal. It may never get to 100%, but at 90% it will be very tolerable so it won’t bother you.
Setbacks are a fact of life. The trick is to try to minimize them by wearing ear protectors in places where you know there are sounds that are too loud for you ears at whatever stage of recovery they are currently in.
When you experience a setback, just continue on with your hyperacusis program, but from where you are now after the setback.
I think you are progressing just fine. Just don’t give up and you’ll achieve your goal.
Cordially,
Neil
Thanks for the response Dr Neil, i have a couple more questions
1) did the noise exposure from dental drill cause permanent nerve or muscle damage to the ear, if so does it slowly improve and heal with time?
2) will tensor tympani syndrome,ear fullness,migraine,tension and ear nerve pain slowly go away with resting ears from loud sounds?
3)can i listen to mp3 music earbuds without restriction within couple months from now ?
4) will very mild tinnitus with hiss and static noise slowly improve or go away with time?
5)what exactly does magnesium threonate and zinc picolinate do for the ears,does it help ear nerves that are hyperactive? is there any other supplements/vitamins that will help?
6)is it okay to get impacted earwax removed, and will exercise help with my H/TTTS
7)does constantly wearing ear plugs at work and taking precautionary measures to avoid and rest ears from loud noise help with my healing process for H/TTTS
8) is it true that people who had noise induced tinnitus , recovered within months or a year?
9)what will be the amount of db level i can handle for sound?
Hi Jonah:
1. I doubt the noise caused any damage to your muscles. It probably hyperactivated certain nerves causing certain symptoms. If you calm down these nerves so they are not hyperactivated and hypervigilant, things should improve with time.
2. Reducing loud sounds is part of the solution, but so is #1 above–calming the appropriate nerves.
3. You need to keep the volume down to a reasonable level. Reasonable to my way of thinking is that you listen to music at the same volume you hear people talking. The more you deviate from that, the more you risk having such episodes flare up again and probably get worse.
4. Your tinnitus may or may not go away, but it can certainly fade into the background where it isn’t a problem. You need to treat it as not a threat to your well being–and since you ignore such sounds, ignore your tinnitus and focus on other things. That way you will habituate to it and hours may go by without your even being aware you have tinnitus.
5. Your ears need both magnesium and zinc to operate properly. I don’t know the exact mechanism of how they work. As for vitamins, Vitamin D3 is important for ears and the rest of your body. Most people are grossly low in their Vitamin D3 levels–down around 20 t 30 ng/ml. You should be up between 60 and 80 ng/ml.
6. Impacted ear wax can result in temporary hearing loss and the resultant tinnitus it causes. So yes, you need to have it removed. But it has to be removed very carefully and not yanked out which causes your eardrum to move violently and thus cause acoustic shock similar to hearing a sudden loud sound. The wax should first be softened so it is easy to remove.
Exercise is good for your body in general. I don’t think it directly helps hyperacusis, but may help calm down/regulate your trigeminal nerve which causes TTTS.
7. Constantly wearing ear protectors make Hyperacusis and TTTS worse. You need to expose your ears to normal sounds. You are just supposed to wear ear protectors when the sound level is above 80 dB or so and take them off as soon as the sound level goes down.
While your ears are healing, you may need to wear them for lower sound levels, but the aim is to slowly push the envelope so your ears do not react to normal sounds.
8. There are no guarantees that noise-induced tinnitus will ever go away–especially if it is due to noise-induced hearing loss. However, you can habituate to such tinnitus so it no longer is an issue.
9. That will change over time as your ears “heal”. While you have hyperacusis, the level is just below where your hyperacusis kicks in. The accepted level of sound where you never will cause hearing loss over your lifetime is 70 dB average each day.
Cordially,
Neil
Thank you so much for your advice Dr Neil, i have a couple questions
1)does hyperactive nerves cause ttts, if so will it be a chronic issue
2)while i’m not experiencing any hearing loss or muffled hearing is there any way to make ear hair cell stronger, or make cochlea strong with supplements
3)when i work in front desk area at the dentist office i don’t feel bothered by phone ringing or hear water running but when assist Dr do wear ear plugs to protect high pitch noise , especially dental drill?
3)does exercise help circulation in the ears?
4)sometimes when i bend over or do any physical exertion my ears feel clog, is it because of impacted earwax or ttts?
5)if finish recovery from H and TTTS , will i be able to listen to use earbuds not necessarily at 100% volume but somewhere around 80 or 90% ?
6) will i still notice some sound sensinity and ttts i noticed that i don’t feel bothered by police sirens that much is this because my ear nerves are less hyperactivated.
7) will collagen powder supplements do anything for ear nerve or health?
8) is H and TTTS like a pulled muscle or pinched nerve?
9)do ear nerves take a slow time to recover?
10) if i finish recovery from H and TTTS, will i always have to be on guard on everyday noises like police siren,dishes clanking,people talking out loud, keep in mind that i rarely go to clubs or loud events
11) is trigeminal nerve pain temporary ?
Hi Jonah:
1. If nothing calms them down, hyperactive nerves can cause chronic conditions.
2. There is nothing specific to make hair cells “stronger”. A healthy anti-inflammatory diet is the way to for good overall health, including your ears.
3 (a). If certain sounds cause you certain ear conditions such as hyperacusis, then wearing ear protectors is a good idea to prevent it getting worse, provided you take them off as soon as the offending sounds cease.
3 (b). Exercise increases circulation throughout your body including your ears.
4. Neither. I’d say it has more to do with increased pressure in your head when you bend over or exert yourself.
5. You should be able to listen to earbuds at a comfortable level. Listening to loud sounds is a sure way to cause a re-occurrence of hyperacusis. A good level to listen to music is the same level you hear people talking.
6. Not necessarily if your ears return to normal. Not being bothered as much by police sirens could be because your nerves are calming down, or more likely because you are calming down and are not so anxious. The two work hand in hand.
7. I doubt it.
8. I’m not sure what you mean by that, but I’d say no.
9. Recovering from hyperacusis can take up to 3 years, but it can be much faster. TTTS is more related to your level of anxiety so when you get your anxiety under control you are likely well on your way to recovery.
10. You don’t want to expose your ears to truly loud sounds which includes nearby sirens, but dishes clinking and people talking fairly loudly shouldn’t be a problem.
11. It can be, or it can be long term. It depends why the nerve is causing pain.
Cordially,
Neil
Thank you for your response. Dr Neil
1) a) is it possible for H and ttts to completely go away and never happen again?
b) i had setback in Dec 2022, as of jan 2023 i have taken safety measures to avoid loud sounds and experience mild H and ttts symptoms i feel even better in early jan 2023
2)is H and ttts some type of nerve injury and takes a long time to recover?
3)) is trigeminal nerve pain caused by acoustic trauma i had in nov 2022?
Hi Jonah:
1. Yes it is possible, but is it probable? Yes–if you eliminate the things that caused it in the first place. However, doing that sometimes depends on the luck of the draw. Unexpected, sudden, loud sounds can come out of the blue–you’re crossing a street and a truck with an air horn suddenly blasts his horn. You’re in the wrong place at the wrong time and these conditions can pop up again. This is just life.
As I said above, setbacks can happen, but you just have to take them in your stride, accept it, and continue on with the program and they too will resolve in time.
2. It’s typically not a nerve injury as such, but rather over-stimulation or hyperactivation of certain nerves AND how your brain processes these extraneous signals.
3. Trigeminal nerve pain can be from several causes. One is a pinched nerve in your neck resulting in pain. A second, is some experience hyper-activating it. This could be a sudden startling sound that results in TTTS for example. And never forget the role that your emotions play in such episodes. So you can’t talk about TTTS and hyperacusis without dealing with the psychological factors such as anxiety towards this condition.
Cordially,
Neil
Thank you for your response. Dr Neil i have some questions
1) a) i’m not experiencing any problems with hearing people talk or muffled hearing but i feel my left ear full, does it go away
b) does mild tinnitus cause ear fullness
c) sometimes i feel little bit relief from fullness in ear when i yawn or have a hiccup
2) does water and ear wax drops cause the ear to feel full
3) can loud noise i had in nov 2022 cause eustachian tube dysfunction
4) if i can hear noises at 10 db does on my left ear is that good
5) can loud noise damage trigeminal nerve
6) a) i’m starting to notice less noise sensitivity and feel better now , will my H still improve in the following months
b) did taking magnesium since dec 2022 made a difference for my H
7) does h cause ear fullness
Hi Jonah:
1. Tinnitus doesn’t cause anything. It is a symptom, not a cause.
2. It could, but that is easy to fix. For most people that complain of ear fullness, the cause is either gunk in the middle ear/Eustachian tubes or the Eustachian tube not working properly.
3. Sudden unexpected loud sounds can cause your trigeminal nerve to become hyperactive and since it controls your Eustachian tubes, they may not work properly until the nerve calms down again.
4. If you can hear sounds at 10 dB, you have very good hearing (or you could have hyperacusis).
5. No.
6a. Hopefully, if you don’t expose your ears to excessively loud sounds.
6b. I don’t know. Only you can tell that.
7. Not directly–but what caused hyperacusis could also cause ear fullness.
Cordially,
Neil
Thank you for your response. Dr Neil
1)is ear fullness caused by ttts
2)is ear fullness from h temporary or chronic?
I have tinnitus and severe hyperacusis . My nervous system is so over sensitized that touching a phone or tablet screen make my ears hurt worse (( WEIRD)) !!!!
Hi R7:
Does this only happen when these devices are turned on. If you turn them off, what happens? If it only occurs when you have them turned on, I think your have electromagnetic hypersensitivity due to the presence of microwaves.
This is becoming more and more prevalent as people use more and more wireless devices.
Cordially,
Neil
Thank you for your response Dr.Neil
It happens after any loud sound . it’s among the symptoms of hyperacusis. Even when I touch any mirror with my fingertips, I feel pain in my ears . Imagine that even when I scratch or rub my hands, I feel pain in my ears too . it drives me nuts . I don’t think it has anything to do with wireless devices . Any advice please
Hi R7:
You didn’t explain clearly enough and just mentioned electrical equipment that produced microwaves. That is why I thought it might be electromagnetic sensitivity. However, if it is just the act of touching things–anything–that causes the pain in your ears, then what is happening is that your somatosensory nerves that send touch/feel/pain signals to your brain are probably hypersensative for some reason and all these extra signals get sent to the base of your brain where neurons and supposed to route them to the appropriate sensory parts of your brain. But due to overwork or whatever, it routes some of these signals to the auditory parts of your brain and you then perceive them as pain or tinnitus or loud sounds.
Most people have this when the somatosensory nerves in their face and neck act up. But there is nothing to say it couldn’t be your hands.
Cordially,
Neil
Hi Dr.Neil
I apologize for not being clear enough .
Thanks for your reply .
it’s very helpful .
Hi Doctor Neil, I was exposed to a loud burglar alarm and had to turn off the keypad to stop it. It’s supposed to be 85 decibels (that assumes a certain feet?) so at close range it could be higher. Hearing test shows normal hearing and the doctor thinks I will make a full recovery in a couple of months or so. I have a few questions:
1. Will it be complete recovery or you think there is still hidden hearing loss e.g in a noisy environment as the hearing test does not pick up all the hearing loss? If loss, was it hair cell/nerves of inner ears that were damaged? Do they grow back with time?
2. Will full recovery be months? If there are further unexpected loud noise, it can go up and down for years? Does the incident make me more susceptible to future episodes than someone without an injury before, as the effect may be cumulative? I read about easy flareups by others after an initial injury.
3. Initially there was ear pain and a feeling of blocked hearing which has resolved. A month and a half later there is still sensitivity to loud noise esp car horns, beeps, loud car engines, sirens. Do you think the sound sensitivity will still get better in a few months/how long will it take? Do those sounds actually hurt me more than someone with normal hearing, or it is just a perception? Should I not wear earplugs to protect from those noises?
4. How long should extra protection be continued for? What to do in case of future unexpected sounds eg sirens, alarms (even sticking fingers into ears will only give slight relief). I don’t think you suggest wearing earplugs all the time is a good idea for the long term, but if the earplugs are not already in, then if an unexpected sound comes, there is lost time when earplugs are suddenly needed.
5. Suppose I make a “full recovery”, can I wear earplugs and go to loud restaurants/concerts in a few months, or how to know when will be ok to do so? Or better just avoid them? How about dental cleaning/suctions/drills as earplugs will not protect those sounds as they are not external in the same sense. I heard people get flareups during loud flights as well.
6. Do NAC/
magnesium/zinc/prenidsone help in the initial stage/ now, or are there side effects?
7. If this does not get better in the future (give it a few months? a year?), have you referred people to personal injury attorneys who handle these cases? If the hearing test shows normal hearing, how to document the hidden hearing loss? Is it considered a hearing loss if sounds seem louder? Thank you very much for your help.
Hi M:
You left out a critical piece of information–how long were you exposed to the fire alarm? If it was at 85 dB, theoretically it should not damage your ears unless you were listening to it for around 4 hours or so. However, if it went off unexpectedly and really startled you, you may have experienced acoustic shock.
So let’s answer your questions.
1. There may be some hidden hearing loss. Only time will tell whether this proves to be the case or not. If it did cause any sensorineural hearing loss, then the affected hair cells typically die and thus you have a permanent loss. If the underlying support cells in the spiral ganglia had their synapses broken, they may repair themselves and hearing will come back. However, if they can’t repair any broken synapses, then eventually the corresponding hair cells will die. This can take up to 3 months or so to occur.
2. I assume you are asking about recovery from sound sensitivity. Depending on your emotional/psychological state, this could take a few weeks to a few months or longer. It’s not cut and dried. I tend to think you will be more sensitive to louder sounds in the future especially if you don’t have full recovery but 80 to 90% recovery. If you have 100% recovery, then there may not be any noticeable difference in the future. But you can get setbacks during the recovery period that will prolong the recovery process.
3. Sound sensitivity makes it seem like louder sounds are hurting/damaging your ears, but unless the sounds are so loud that they damage other people’s ears too, it is just your perception that these sounds are now so loud that they are damaging your ears, but they really aren’t damaging anything. While you ears are healing (you still have sound sensitivity), you should wear ear protectors when you are around louder sounds that “hurt”. If they don’t bother you, let your ears be exposed to them. You don’t want to overprotect your ears, but at the same time you don’t want to under-protect them and cause setbacks. So you walk a fine line between the two, but you want to continue to slowly push the envelope towards louder sounds not bothering your ears.
4. For just as long as you need it. When you encounter an unexpected loud sound, use your fingers, but don’t stick them in your ears as that doesn’t give a good seal. I find it much better to use your index fingers to push the tragus (the flap of skin and cartilage at the front of your ear canal) over the ear canal opening. This gives a good seal and will protect your ears as much as ear protectors would in my opinion. You can’t anticipate such sudden sounds, so you may suffer setbacks. That’s just life. If you wear ear protectors most times to protect against such unexpected sounds, you just make your hyperacusis worse. However, if you know you are going to a place where there is a high probability of such sudden sounds, it’s not wrong to wear ear protectors at that time. Just be sure to take them off when you move away so your ears are exposed to normal sounds again.
5. Personally, I think it is just asking for trouble if you go to super-loud venues such as concerts, etc without wearing ear protectors. Even then, you may still experience problems. Once the sound is above 90 dB, everyone should be wearing ear protection. Dental drills can be too loud while you are recovering, and there’s not much you can do about it. You can try ear protectors for the high speed drill and they should help, but the low speed drill sounds are more transported to your inner ears via bone conduction and wearing ear protectors would just make things sound even louder.
6 To be effective NAC has to be taken within a day or so. Prednisone may help if given soon enough. Magnesium and zinc are needed for your ears to work properly, so can help in recovery, but I don’t think they do much to stop damage that is already occurring like NAC and Prednisone can.
7. It’s hard to win a case for sound sensitivity, etc. And court cases that drag on can make your ears worse as you are constantly focusing on your ears and the damage they have sustained. This doesn’t let you focus on other things and thereby habituate to your tinnitus, hyperacusis, etc. Personally, I wouldn’t do it as I don’t think the benefits outweigh the negatives that can result.
Cordially,
Neil
Hi Doctor Neil,
Last year I was exposed to to a lot of noise through work and hobbies. I was working with chrildren and playing (On the stereo and as a musician) and noticed that my tinnitus – that had been habituated for 15 years – was getting worse. I was recording with my band at the time and one the other members ended up turning the speaker up near my bad ear. I had I bad tinnitus spike and noticed that is started reacting to music and also started hurting.
I actually read comments hear and tried to incorporate them in finding a midleground between what I felt I was experiencing and what my doctors were saying.
I was told that I keep working and that I did not need to protect my ears. But I started to protect them at work as it quite hard to geuess when a 5-6 years old will be loud in a school setting. I experienced pain time from time but it felt like it was eneough to protect them. But there seemed to be gradual worsening and my tinnitus baseline seemed to rise. I accepted this as the doctors did not see it as problem – but I was directed to hearing center where I should be starting noise terapi from the 7th.
What worries me is that after three months of mild(?) hyperacusis – where I only protected my ears at work and when being inside with people my threshhold for noise seemed to collapse in december. My ears seem to react to everything. My tinnitus winds up from PC-fans, the ventilation in my appartment, talking to people at normal voise causes pain – often after a few days – and even just walking makes my T. go wonky.
If I read correctly I should not be stimulating my tinnitus but I have no clue how not to as everything makes it react. The last few months I been protecting way more than I imagine is healthy. But I have no idea how not to if I need to make t. and h. settle down.
I am quite aware that the psychological aspect is key when dealing with f.ex. tinnitus. Putting the fear away helped a lot when I first got it. But right know I am scared that the ways to heal are out of my reach. Is there anything I can do?
I apoligize for clunky english. I am not a native speaker.
Best regards
The panicky one
Hi Claus:
Your ears can only stand so much exposure to excessively loud sounds before they no longer can cope as before. So when the speaker near your head was suddenly turned up, your ear received an acoustic shock which resulted in louder tinnitus, loudness hyperacusis and pain (and no doubt some degree of hearing loss–which may be hidden–cochlear synaptopathy for example.
That advice from your doctor was just plain wrong. You DO need to protect your ears from louder sounds while your ears are healing–and this can take several months. The trick is not to over-protect your ears. The proof that your doctor was wrong is that things are getting worse and worse for you.
It is good to begin sound therapy, assuming that the person actually knows how to treat a person with hyperacusis as well as tinnitus. In my experience, too many set the sound therapy levels to “fix” the tinnitus and when you have hyperacusis, this just makes things worse. You have to set the sound therapy levels to what your ears can stand without hyperacusis kicking in (whether it helps your tinnitus or not). Eventually, as your hyperacusis improves, the sound therapy levels will reach a point where it will help your tinnitus as well.
It seems that you exposed your ears to excessively loud sounds in December to cause things to get worse, and/or you let your anxiety levels rise and focused on your ear problems–which causes things to get worse.
As you know, reactive tinnitus is basically a marriage of tinnitus and loudness hyperacusis. Both of these conditions are psychosomatic in nature. Therefore your emotional/psychological state plays an enormous role in whether you continue to get worse, or you start to get better and continue improving.
The first thing you need to realize is that these sounds are not damaging your ears. You are hearing normal, everyday sounds, but you are perceiving them as excessively loud–so loud they hurt. And this causes you a lot of anxiety. So you need to calm down because you are NOT damaging your ears with everyday sounds.
What you want to do to start with is have soft background sounds on 24/7. Soft is defined as sounds so low that they do not make your tinnitus react. To start with, these will be very faint sounds. Slowly, over several months, you will increase these sounds as your ears can stand it.
Always wear ear protectors when you are around loud sounds. To start with, you may have to wear ear protectors around moderate sounds too. You may find that you can stand these sounds for a few minutes, then your hyperacusis kicks in. At this point, but in your ear protectors and give your ears a rest. Over time, you can “push the envelope” and go for longer and longer times before you need to put in your ear protectors.
You may also benefit from CBT (cognitive behavioral therapy), especially if it is adapted to people that have loudness hyperacusis.
Your English is almost flawless. Nothing to apologize for.
Cordially,
Neil
Hi Neil,
Before venturing forward with more questions I would first like to thank you for your words and time. It easy to feel like I am continuously making harmful decisions without knowing it. I am extremely thankful that you are willing to lend a guiding hand.
Regarding the liveliness of tinnitus is there a threshold? It seems to react to all sounds. Even with earplugs or heavier hearing protection. F.ex. if I do do dishes, shop for food etc. Do I need to ‘double protect’ in these instances? I have several different sounds in my ears at this point – and music – is it okay if some of them ‘say hello’ during the day. Because I have no idea how I could keep my tinnitus stable at this point. What really scares me is the fear that my threshold – or the hyperacusis’ threshold – becomes so low that sound therapy will not be possible. If this can happen, I do not know. I find it a bit hard to navigate in this condition.
Right now, talking to people – also when wearing earplugs or other – triggers my tinnitus. Should I stop talking to people until it settles down? I have been isolating for two months at this point where some the only verbal contact, I have is with doctors (Chrons) and work. This is not nurturing a calmer state of mind but if it is necessary I will continue to do so. I had an overreach of sound three weeks ago – meetings regarding sickleave, neighbors playing music etc. – and all the small stressers chipped away at my ears as they did not get the necessary breaks. They seemed stable after a very quiet Christmas and my tinnitus was stable for a few weeks. And I could talk to people for an hour or two with earplugs. If had two to three days between this conversations and outings. Now they returned to the same point as in December.
And I know this is very specific but, in my apartment, there is a ventilation-system connected to every room. As my ears get more sensitive this also triggers my tinnitus. Should protect all the time until I start the sound therapy?
I actually thought that I ended up with pain hyperacusis as I do not experience sound as louder. Or it sounds correctly but of course the tinnitus reacts promptly. It always great to write with people with more knowledge than one self. I will definitely try CBT!
Thank you for your kind words! And thanks for doing this. It is an immense help.
Best regards
Claus
Hi Claus:
You tinnitus may seem to react to all sounds, but I believe there is a level, maybe very soft, where your tinnitus won’t react. That is where you begin your sound therapy.
But you may have to keep telling yourself that this sound is so soft that it can’t possibly hurt your ears in any way. You need to believe this, and curb your anxiety. You need to keep telling yourself that this sound is not a problem, and therefore you do not need to be anxious about it, that nothing bad will happen as you listen to it.
At this point, it wouldn’t be a bad idea to deliberately practice some relaxation exercises and take your mind off your ears. Practice breathing exercises too. Focus on your breathing–counting as you breathe in, hold your breath for a count, then breathe out for the count. To begin with you may only be able to count to 3 breathing in, holding your breath to the count of 3 and breathing out to the count of three. As you focus on your breathing, you will be ignoring your ears and when you stop the breathing exercises, you’ll see that the soft sound did not damage your ears.
The more you focus on things other than your ears, the sooner you’ll start on the path to recovery.
When doing dishes the sharp sounds of the dishes clinking can be hard to stand. So if you want to wear ear protectors or even double ear protectors at the start, that is fine. As time goes on, you’ll realize that you don’t need double protection and later on not even single protection. The idea is to protect your ears from hearing these short, sudden, loud, higher-frequency sounds.
You’ll probably find that you can much more easily stand low-frequency sounds so you may want to start with them and slowly increase the amount of mid-frequency sounds and then the high-frequency sounds as your ears are able to bear it.
Remember, your aim is to slowly push the envelope so your ears adapt without hyperacusis kicking in, to louder sounds. So you want to expose your ears to any sounds at a volume that they can stand without making your hyperacusis becoming annoying.
Do as many activities as you can–talking to people, etc. The more you do things, the less time you worry about your ears. Just don’t overdo it. Maybe your ears can only stand say 10 minutes of conversation now. But slowly you can push the time more and more until you can talk to people for say a hour without problems. You’ll know when your ears have had enough, and then you can either go to a quiet place or put on your ear protectors to give your ears a rest. When they are ready, go back to what you were doing before.
Since your ventilation system is bothering your ears, what I’d do is as I said above, leave your ear protectors off for a time, then when it gets too annoying, put them in again and give your ears a rest.
The more you focus on the loves of your life, the more you will “forget” about your ears and this will definitely help you recover. So protect your ears as needed and continuously work to reducing the time you need ear protectors. And slowly increase the level of background sounds that you can stand.
Cordially,
Neil
Hi, Dr. Neil.
A few years ago, I went through a very bad car accident, and since then I have been having this ringing in my ears, not constantly but very now and then. I also realized that my left ear its quite more sensitive than before, for example I cannot use earphones on that ear, no one can speak on that ear or just the scissors cutting my hair on that side it’s just horrible.
This sensitivity feels weird, I wouldn’t call it pain, more like a ticklish kind of thing, kind of uncomfortable. This thing starts right on my left ear and then it starts spreading to my waist and sometimes I just got to put pressure on my waist cause it’s a lot.
I know that it might be some tinnitus or that’s what I think, but the waist hurting because of it it’s kind of confusing.
Sorry If I’m having bad grammar, not a native speaker.
Best regards.
Hi Angelica:
If your head got banged around, or you got whiplash, that could have been the cause of the tinnitus.
When you say your left ear is sensitive, most people mean that it hears sounds as louder than normal and often more shrill. In other words, they have loudness hyperacusis in addition to tinnitus. However, you indicate you have more of a feeling sensation. Is this correct?
To me this sounds more like certain nerves were hyperstimulated by the accident and have never calmed down and that is why the sensations can spread down to your waist.
What I’d do in your case is go to an upper cervical chiropractor if you ca find one, or otherwise a conventional chiropractor and see if any of your vertebrae are out of proper alignment. That may be all it takes You can find upper cervical chiropractors via the website at http://www.upcspine.com/ and click on “practitioners”, then your part of the world.
Cordially,
Neil
Hello, Dr. Neil. How are you? I hope everything is great in your life.
I want to start by saying that I am very grateful for your help. My hyperacusy is gone. I started listening to music like I did in the past. ( at 75–80 decibels.) I wouldn’t be here without your help. You are an amazing person, and I am very lucky to be able to ask you so many questions.
I have just one question for today. I am going to the party on July 1st, and I am afraid that I can’t use earplugs. I don’t know why, but I can’t put them correctly in my ear canal. I wanted to ask you, if I go to the party without wearing earplugs, do you think that my hyperacusys will come back?
The party will be like 90-100 decibels. I forgot to say.
Hi Elena:
Good to hear from you. I’ve been wondering how you were doing? So glad to hear you now have your hyperacusis under control.
Your ears may be back to normal now, but I think they are not as “robust” as before. Thus, I think that sound levels you could experience before without problems may be a problem for you now. Thus, I wouldn’t push the envelope and expose your ears to sounds that are now too loud for them to handle. (You don’t want to get hyperacusis all over again!)
So I’d strongly suggest you wear ear protectors of some kind to prevent this from happening. If the ear protectors you currently have don’t seal properly, you still have time to get different ones and learn how to insert them properly.
Have fun, but if your ears start to act up, it’s time to leave.
Cordially,
Neil
Hello, Dr. Neil.
Thank you so much for your kind words. I wouldn’t be here without you.
I bought new ear protection today. (Foam ones), and I checked, and they are great. They can provide at least 20-25 decibels of protection. I was just wondering, if I wear these earplugs so I get only 80 decibels from the speakers instead of 100-110, can 80-85 decibels damage my hearing in three-four hours?
Thank you so much, one more time. I hope everything is going great in your life.
Love, Elena.
Hi Elena:
If you stay below 85 dB, I doubt you’d damage your ears even after 3 or 4 hours. It’s the peaks that could cause damage–and cause your hyperacusis to flare up. So listen to what you ears are telling you and if they start complaining, then cut the time at the party short. You don’t want to go through the hyperacusis episode again I’m sure.
Have fun.
Cordially,
Neil
Dear Neil!
I am a 37 year old drummer from sweden, that always wear hearing protection when i drum.
But I still developed tinnitus and hyperacusis roughly 5 months ago.
Both conditions have improved since then, I have protected my ears and havet played drums since.
Ive had some setbacks along the way, and I am curious as to wether these setbacks are always caused by too loud noise, and if they are indicative of further injury to my ears?
I havent really exposed myself to very loud sounds, but this is sometimes hard to avoid.
My daughter is 1,5 years old and screams at around 90 db(a) at times, should I always wear hearing protection around her?
I am very greatful for this page and for your dedication to the community.
Thanks a million!
/Tomas from sweden
Hi Tomas:
What happened 5 months ago that caused your tinnitus and hyperacusis? Was it noise or medications or stress or what?
Setbacks can be caused by the same things that cause the initial conditions. Noise is a common cause of setbacks, but excess stress or anxiety can also cause setbacks.
Since your tinnitus and hyperacusis are improving while you are not playing your drums, that makes me think that the ear protection you are wearing while drumming isn’t adequate in the first place.
There are always loud sounds that occur suddenly that you can’t always avoid and these can cause setbacks. That’s just life. Your daughter is a case in point. What I’d suggest is when you are around her and she is likely to scream, wear your ear protectors. When it is unlikely she’ll scream don’t wear them. And in those times if she suddenly screams, quickly put your fingers in your ears to minimize the risks of setbacks. The best way is to press the tragus into your ear canals. That gives the best seal to outside sounds.
Cordially,
Neil