Acoustic Trauma from Loud Concert... and Hello!

I’ve been frequenting this forum mostly every day over the past few months, so I figured I might as well participate.

I'm 25 years old... turning 26 in a month.

I suffered an acoustic trauma on May 22, 2022, attending a concert at a small independent venue. I knew the show was louder than usual (and I had been drinking a little), but I did not expect to leave with my life being altered for the foreseeable future.

Upon leaving, I noticed that my left ear had this feeling of fullness. There was the usual concert tinnitus and that was about it - no noticeable hearing loss, dizziness, or anything else. I figured that it could have been some impacted earwax or something else benign and that I’d give it a few days to settle.

Over the next week or so, the fullness feeling and the tinnitus in my left ear had become more and more noticeable. I searched out for any ENTs in the NYC area on Zocdoc and booked the next available appointment possible.

I made it to the ENT exactly 2 weeks from the date of the concert. Again - no noticeable hearing loss, but at this point extreme fullness, eardrum inflammation, “ETD”, more noticeable tinnitus, and a sensitivity to sound. The doctor put me on a 6-day course of Methylprednisolone, gave me a Nasonex script, and told me to use a saline flush a few times a day.

Over the next 2 months, my ear felt completely full. I couldn’t move my Eustachian tube at all and could barely get any air to push through even using the Valsalva technique. Now upon entering month 3 my fullness does feel that it is starting to get better and I am beginning to be able to push some air through. My sound sensitivity is also getting better - however, I am beginning to notice that I’m not hearing low frequencies as well in my affected ear. The uptick in tinnitus has overall stayed the same, but I am habituating well so far.

I just followed up with the ENT and she put me on another 6-day course of Methylprednisolone. I am currently on day 4 and feel as though this may be making the sound sensitivity a bit worse again. I plan on finishing the course so as to not experience withdrawal symptoms.

Overall, I just want to say that ear injuries are tough! I am an aspiring musician who had been playing gigs and doing production work for pay, and this injury has been the most mentally tough thing I think I’ve had to go through. I say am though because there’s no way I’m going to let this end my journey in music - this is just a bump in the road!

Still, I have no idea what the road to recovery for an injury like this looks like. I have found all different types of stories on this forum - everything from successes over 6-18 months to horror over years. This unknown creates a lot of anxiety for me, but I am trying to remain optimistic and do all of the things to put myself in a position for success.

Anyway… I want to say hello! I know how valuable it is for someone going through an injury like this to see that they are not alone, so I plan on updating this thread periodically with my progress and responding to messages on this account. Further, if you are reading this and have any advice to share I would love to hear it.

TL;DR:

• Acoustic trauma from loud concert on May 22, 2022.
• Aural fullness, tinnitus, hyperacusis onset.
• Aural fullness and hyperacusis slowly improved after 3 months, but still lingering.
• Mentally, a really tough injury to go through - looking for advice and will update this with progress.
• Staying strong is very hard. I value everyone who has contributed to this forum over the years. It has helped me more than you could know.

 

Hello back and sorry your night of fun and music ended like this for you. It's understandable that the combination of your symptoms have you on edge, because it really is a nightmare to deal with.

I'm suffering from tinnitus and hyperacusis myself and, as far as my hyperacusis goes, the only thing that helped was staying away from pretty much all kinds of noises for an extended period of time. I didn't want to believe it in the beginning and kept trying to talk to people on the phone, listen to music, watch TV, ... but eventually I was in so much pain that the little distraction wasn't worth it.

I love music and not being able to listen to it was more than a little depressing. It must be so much harder for somebody who is having a career in music and I get why you feel you won't give up this part of your life. There are a couple of people here who are professional musicians, too, and I've gathered from some of their comments that custom earplugs seem to make a difference.

Keep doing what you love but start listening to your body, if you're not doing so already. Hyperacusis and tinnitus are nasty conditions on their own and even in their milder form, so please don't push yourself / your ears to the point where the both of them take over your life even more than they already have. Allow your ears lots of rest and take these little early warning signs seriously.

I'm sorry I haven't got better advise to give.

All the best,
Leila

 

Do not try to "get any air to push through". Your hearing is blocked trying to heal. You do not want the fullness to go away so fast. Do not use the Valsalva technique either.

Hearing heals and changes very slowly.

Those nasal sprays will not do any good either.

It was a bit late for the Methylprednisolone but the first course 2 weeks after the original injury might help. My personal experience with setbacks is, if it's bad it will take like 3-4 weeks to go away.

The original injury, the first one that triggers hearing problems, and very loud sounds, like an MRI test, can take 3 - 6 months to start fading and getting back to the new normal...

 

A quick update:

It’s now just over six months since my acoustic injury. I can certainly say that everything has improved greatly, but I’m nowhere near symptom-free.

The worst symptom by far is the aural fullness, though I do notice slow but continuous improvement. I am still somewhat sensitive to sound, but at this point I hesitate to call it hyperacusis. My eardrums react forcefully with things like clanking dishes, but louder sustained noise doesn’t bother me. I think both the fullness and sound sensitivity are more consequences of TTTS, or more generally some sort of eardrum overuse/shock injury. I very infrequently get eardrum spasms, but if I do it’s usually at night or while I am asleep.

The tinnitus onset is still the same from the incident, and I notice it more after being exposed to loud noise. However, this is the least of my worries and I am habituating well.

Six months have provided much clarity over what is happening with my body. I’m about 95% certain that what I’m experiencing is a direct result of acoustic shock. I’ll post a study that is passed around this forum a bit for those who haven’t seen it:

An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock

Here’s what I feel has been working for me as I manage this injury:

• Limiting loud noise exposure. For the first few months, I used an earplug at my cafe job and on the train. My ear has improved a lot, so now I only try to use it at the music studio or when I’m knowingly exposing myself to loud noise.
• Managing anxiety. Meditation, getting proper sleep, working on my mental health, and making healthier choices like drinking less alcohol and eating a better diet have put me in a much better position to maintain progression through recovery from this injury.
• Supplements. I’ve noticed that my body feels much better using Magnesium biglycinate supplements. I saw someone online call it nature’s Valium, and they’re not completely wrong. It soothes my otalgia and helps me sleep. I have also started taking a prenatal vitamin for all my Vitamin B’s and fish oil for my Omega-3’s.
• Self-neck massage. Massaging the same side of my neck as my injured ear does bring me some relief. I also often use a heating pad or take a hot shower and find it helps.

For the first few weeks to months following this noise event, I truly didn’t know what to expect. After six months, I have learned that this is an injury with a slow and long recovery, and the only things that can truly make this better are time and rest.

I joined this forum because I wanted to share my experience as well as learn from the experiences of others. I made this post because I know the feeling of absolute panic during the first few weeks after experiencing this type of injury.

My message here is this: I am improving, and I fully expect to continue improving. It’s taking a while and the improvement has not been linear. Take this one step at a time, and believe that it is going to be okay.

 

Hi!

 

Hi @CJCP - I love the realistic optimism of this post. I'm also coming up on 6 months post acoustic trauma, so resonate with so much of what you wrote.

I appreciate your desire to post so that those who are in a panicked state can see that things can get better, even though the improvements can be slow and nonlinear.

I'm hoping that you continue to see a reduction in your symptoms and an increase in your ability to live life fully!

 

Hi all! I hope this post finds you well.

It has been a year since my acoustic shock incident. I want to report on my current feelings towards this experience and the lessons I have learned throughout this ordeal.

I stated that the two most important things in managing this injury were limiting noise exposure and managing anxiety. One of these is fairly easy to accomplish - however, I’ve learned that the other one might be one of the toughest tasks I’ve ever had to take on in my life.

I had taken notice of how much mindfulness and relaxation exercises were helping me to feel slightly better, though this relief only lasted for a short time. Having already limited my noise exposure to comfortable levels, I concluded that I simply needed to focus more of my energy on the mental health aspect of this entire situation.

And BOY HOWDY has my life improved tremendously from this revelation forward!

I started by searching for a therapist through my insurance provider’s website. I found a few and reached out to them by email. I eventually found one that was interested in my situation and wanted to help me. She noted some parallels between my situation and those diagnosed with PTSD and suspected previous traumas throughout life could have been contributing to these chronic ear sensations I was experiencing.

I wasn’t totally sold on this idea, but I had looked into the new research being done on chronic pain and thought this wasn’t too crazy either. Further, I didn’t see any harm in attempting to resolve previous emotional traumas. It was worth a shot.

My therapy consisted of unpacking my life experiences and analyzing the close relationships I’ve had with people growing up. To my surprise, I found that I had an incredible amount of impactful and long-standing emotional experiences that I had yet to process. This emotional processing work was combined with traditional CBT methods, sort of like those used in TRT.

The results? Every single week after working to process my emotional experiences, my ear was feeling better and better. I can absolutely say that my recovery accelerated. I was regaining confidence that I would be able to continue a career pursuing music.

I also finally had to face the reality of the physical toll my unchecked anxiety disorder was beginning to play on my life.

Still, these results certainly have not been linear. As the improvements began to feel more profound, so did the setbacks. I began to realize that setbacks were simply anxiety manifesting itself in physical sensations at specific parts of my body - which used to mainly include my stomach and chest, but now included my left ear.

I decided that gaining more control over my anxiety was needed if I wanted to overcome this thing. I asked my doctor to prescribe me a low dose of Zoloft, which I now have been taking for 3 months. I know many others have their opinions and experiences with this stuff, but I feel this may have been the best thing I’ve ever done.

I currently have so much more control over my anxiety. Still, being on an SSRI is not a realistic, long-term solution to dealing with anxiety. I’m using this newfound (and temporary) mental clarity to double down the focus on my mental health journey.

This week, I started the process of EMDR - something my therapist feels I am a perfect candidate for. I will update this forum post in a few months on my experiences with it.

Nonetheless, the sensations in my ear have become less and less intrusive. The more I embrace the sensations, the less of an impact they have. The more I embrace louder sounds, the happier I am in life.

The tinnitus uptick I experienced after my acoustic shock has pretty much completely faded. Even if I look for it I can’t find it. Perhaps this is because I really didn’t care about the tinnitus after the event and focused on the pain itself.

I went to a club last week and saw a friend do a DJ set without earplugs. Nothing happened. I am so extremely proud of myself for doing that. It goes against most of the advice on this very forum, but it was something I needed to do for my recovery.

This is a mental battle. This is about regaining and relinquishing control. This is about feeling comfortable within your environment and within your skin.

I’m not completely through this yet, but I certainly see the light at the end of this tunnel. I am extremely optimistic, and I have mostly taken my life back. Onward.

 

Glad to hear you're doing better. I'm suffering from a similar acoustic trauma. You no longer experience any ringing at all?

 

When I describe that the ringing has faded, it means that I do not experience any emotional reaction to the tinnitus I experience. I believe this is what is called habituation.

The sensory difference from my acoustic event is obviously still there. I’ve worked very hard on this emotional acceptance piece, and am still working on it.

However, at this point my body literally feels like it’s forgetting that ringing exists at all. It’s such a strange feeling you fully can’t comprehend until you reach that point, and it still amazes me how effective it is.

It saddens me to think about how I looked down on habituation as a concept. It is wildly freeing once you truly experience it. I’m working to do that with my hyperacusis as well - and it is working.

In my view, experiencing hyperacusis and tinnitus means that at some level your body is fearful of further damaging more of your sensory structures through sound. Your body in turn becomes more sensitive. Living with this fear is unhealthy and prevents recovery.

The strange thing I’ve come to learn is that I really have no direct control over this fear. This fear comes from parts of the brain I cannot access consciously. I think this is why the emotional processing work has had so much of an impact on this process. I also think this is why relaxation techniques helped so much in the beginning of my experience as well.

I don’t want to present myself as some miracle case on this forum. My only goal is to provide a level-headed report on my experiences so that others (like yourself) can take solace in the fact that things get WAY better - especially when you take the right approach. There are things you can start working on right now to improve your situation.

And if you do this work, before you know it you will take a look back at yourself from a month ago. You will notice how much you’ve improved. That feeling of improvement is so exciting to me, and it keeps me chugging along. I think that’s why I ended that post with the word onward.

Wishing you the best.

 

I'm glad you're habituating. I dislike when people describe that the ringing is gone and that isn't actually the case though. It's important to keep the distinction so we eventually know why it actually resolves for some people and doesn’t for others, especially for people with very intrusive tinnitus.

 

I understand where you're coming from, and I truly empathize with that. However, I would still say that the ringing is out of my perception about 95% of the time now - which was not the case even 3 months ago. And when I do notice the ringing, it is not nearly as intense as it used to be. I think it is fair to describe that as fading.

Experiencing a permanent threshold shift means just that. Still, this in no way means that your brain cannot adapt to sensory perception differently.

My assertion is that this is more of a mental battle than a physical one. In my experience, engaging with the mental battle head-on has been the only thing that has brought me true, long-lasting relief.

 

@CJCP, thank you for continuing to follow up throughout your journey. It's great to see positive stories to help us remain optimistic when it can sometimes be difficult. It makes me smile to see that you are recovering well.

I feel like my story is quite similar to yours, and I'm following in the same footsteps, just a few months behind your journey. I'm just over 7-months into my hyperacusis/tinnitus journey.

I've improved significantly in the last couple of months; at the same time, it's when I've become much more relaxed and gotten a better handle on anxiety. Although I'm still far from "normal," I've been able to return to work again and can go in cars, malls, and quiet to moderate-noise restaurants. My tolerance is around ~85 dB.

What has been causing me some anxiety lately is the uncertainty. Even though my tolerance has increased and noise below those levels does not irritate my ears, there is still a low constant discomfort/pain, especially in my right ear and around the ear, that hasn't gone away yet, along with the aural fullness. It has improved a lot, but it's hard not to spiral down a dark hole mentally, wondering if the pain will ever fully go away so I can "relax" fully. My tinnitus is still noticeable but not as bad as the initial onset. I can usually ignore it most of the day; the only time it regularly causes me a bit of stress is when trying to sleep. I can usually start to ignore it, but there are usually a few minutes when I first lay down where I have to calm myself down and become at peace with it. I think the stress still gives me poor sleep regularly with some tossing and turning throughout the night.

Question: Do you still have regular pain/discomfort or aural fullness, or has that resolved? Are there any specific noises or situations that cause you issues?

Thanks again for the optimistic posts.

 

Hi @Playdohh, I remember reading your “trifecta” post months ago. Happy to hear that you’ve improved a bit as well.

Everything you said here resonates with me. Weening off earplug usage in public and fully returning to everyday activities was an arduous process. You hit the nail on the head in observing what role your anxiety level plays into this experience.

I absolutely relate to that uncertainty piece, and I believe it plays greatly into that constant low-level discomfort. Your experience of spiraling down a dark hole that focuses on and exacerbates that discomfort is all too familiar.

The good news here is since I started focusing on the mental health piece, all of this just got lighter. That’s the best way I can describe it.

I still experience pain, discomfort, and fullness - but it is very different from a few months ago. It’s not as intense. My attention to it doesn’t last as long. There are still times I can spiral down that hole, but these episodes are happening way less often now.

On the flip side of this, I’m also starting to experience moments where I am not bothered by discomfort at all! I would describe this as feeling “safe”.

One of the most impactful lessons I’ve taken from therapy is learning how to foster perceived safety. When we experience hyperacusis, we are experiencing perceived danger - a danger that is not really there (e.g., everyday sound damaging your ears). A basic thought exercise to help with this is to simply imagine yourself in an environment you feel completely comfortable in, and to allow yourself to feel the sensations you’d feel when you are actually in that space.

For me, this is my music studio - a place where I have control over the levels of every piece of equipment making noise. The feeling of regaining control is instrumental in this process. Once I started really feeling that sense of control, it was imperative for me to begin allowing myself to relinquish that control.

It’s really important to understand these sensations are the body’s natural way of trying to protect you in the face of a perceived threat. In my experience, the more I allow myself to feel safety and comfort, the less weight these sensations have.

So the pain, discomfort, and fullness are all going away. I am feeling so much better and I know that I will continue to feel better as time moves on.

You seem to me that you are on the right path - here’s to your recovery!

 

My experience is quite different. Yes, there would be feeling of a danger if the noise was objectively loud - for any person - like a car alarm, siren, leaf blower, etc.

But I deal with discomfort of loudness for many sounds like motorbikes, diesel trucks, small airplanes, or A/C compressor running, etc. I know these noises are nowhere dangerous (especially at a distance), yet I find it uncomfortable. First, because I know it should not be that loud (distinctly remembering how things sounded before hyperacusis). Second, because I find them distracting, they bring my attention and I don't want to pay attention to them.

Second category is misophonia-like, certain people loudly talking, unruly kids, cars left idling needlessly. These sounds feel louder, too, but they are simply annoying. I just do not want to hear them, not at that volume.

So nothing about danger or anxiety, or lack of safety. I just hate these sounds being that loud now. I am unable to filter them out, that's all.

I dealt with unpleasant sounds in the past, of course, before hyperacusis - I self-diagnosed myself with misophonia. I never really developed a way of dealing with unwanted sounds other than elimination (avoiding/running away from them/making them stop) or covering them up (with an acceptable sound, sometimes with headphones - at work). Sometimes if the sound wasn't too obnoxious I was able to tune it out by concentrating on something absorbing like work, but I always found that difficult and preferred avoidance/masking - controlling my environment.

I also recognize that my ability to ignore/tune things out was related to my emotional state, and perhaps still is, just the limits are severely impacted due to the loudness change. If I was irritated it was difficult, and right impossible if I was angry.

With the increased loudness, and impaired ability to concentrate (due to tinnitus), I am f**ked. I suppose I should be telling myself "these sounds are not that bad, deal with them". The effing brain seems to disagree.