Does Anyone Else Have Pain Hyperacusis (Noxacusis) without Loudness Hyperacusis?

Hi everyone,

I have been suffering from what I can only suspect is pain hyperacusis (noxacusis) for a few months now. When I hear loud and specifically continuous noise, I have pain, which I would describe as a dull ache around my ear, and it goes to my jaw and neck if it gets bad enough. The pain is usually delayed and I am very susceptible to any digital noise.

I recently read the PDF of the Tinnitus Talk Podcast episode 8 with Bryan Pollard, and he said something along the lines that he has seen almost no cases of individuals with just pain hyperacusis and not some form of loudness hyperacusis to accompany it. I presently do not have any form of loudness intolerance or problems with my perception levels of sound, so I was wondering if anyone else only had only noxacusis or if I'm just a rare case or perhaps am suffering from something I have not considered.

Thanks,
Brody

 

I have pain hyperacusis and I've never really experienced loudness hyperacusis.

Obviously I'm pretty worried about loud sounds but they sound the same as they used to sound except they have reactive tinnitus attached now.

 

I would say my condition resembles yours. I don't experience sounds as "louder" per se, but many sounds that didn't bother me before now do. They feel uncomfortable to hear, and lead to physical discomfort. Like yours, my pain is usually delayed, aching, and radiating from the ear to the jaw, neck and head. I've experience stabbing pain from loud sounds too, although that has happened less and less as I've learn to protect from these.

 

I only had loudness hyperacusis to start with, then it developed into pain later. However, the loudness resolved and hasn’t come back. Been over a year.

 

I have noxacusis without loudness hyperacusis. Everything sounds the same level as before noxacusis. Also I can hear all the same frequencies.

I only get sudden light pain around my eardrums from the noise source. My only delayed pain is burning pain in the ear canal although I finally figured out that it's from too much noxious sound throughout the day.

My biggest mistake with noxacusis is when I had it super mild about 8 months ago. I kept going to loud places like restaurants like an idiot. I even went to Vegas. Sometimes I would plug, sometimes I wouldn't.

Long story short -- if I had just avoided noxious noise as much as I could when I had mild noxacusis, I'd probably be close to healed today. Instead I'm closer to moderate now and even my own voice hurts a little.

I'm now doing my best to avoid noxious noise. I even quit my job.

 

Yeh I have it in my right ear without anything sounding or feeling loud. Which is notably different to my left loudness hyperacusis I’ve had forever.

Like many above, this noxacusis ear is often delayed and a long dull ache. Kind of like ear fatigue.

Whereas the loudness hyperacusis ear, everything sounds loud at 75 dB and clips/distorts. It feels sudden and sharply loud, I’m not sure that it has always had pain but it does a bit these days. It also feels muffed quite easily if I don’t plug it. This ear has mild hearing loss. So these are seemingly predictable symptoms to go along with that.

Another interesting difference is I can’t use headphones on my noxacusis ear without pain but I could on my loudness hyperacusis ear if they’re not loud.

To me this signifies two types of pain and cause. One is very clearly hearing loss and the other I am not sure.

Recently the extended pain of noxacusis has started swapping ears for a week or so. Other than that they’ve always been distinctly different.

 

Reading a study just now.

Ear plugging can result in increased AMPA in the post-synaptic density (PSD) of bushy cells, making them cells more excitable. This increase is sustained after the ear canal is re-opened.

(Shore at al 2020)

 

Ah man I feel this, I tried to live normally when I had mild hyperacusis because I couldn't believe I'd have to give up a normal life. Now I have to live a hermit life + have a really low noise tolerance. It's just such a rare condition there's no playbook on how to stop it early in its tracks.

 

Interesting. Is this with regards to hyperacusis, or with tinnitus as well?

Could you share a link to the study? - I can't seem to find it.

 

@Stacken77, there ya go.

Ventral cochlear nucleus bushy cells encode hyperacusis in guinea pigs

 

I think it is hard to say that things sound "louder" (or not) than before hyperacusis, when there is aural fullness for an extended period.

After the fullness subsides and clears (takes weeks in a bad case, up to 3 months sometimes after a very bad setback), the previous baseline, in terms of quality of hearing, volume etc. may be forgotten. So one cannot compare with the original state of one's hearing because, let's say that a person has spent 3 full months with blocked hearing due to the fullness.

In turn, recruitment is easy to point out: grab the remote control, start increasing the volume on your Hi-Fi equipment step by step. Suddenly there is one step when the leap of sound does not seem progressive, it is like it got so much louder... and sometimes feels like the sound accelerated too.

Pain hyperacusis also has to do with the sudden increase in volume, on top of the volume itself. Hyperacusic ears do not cope well with sudden increases in volume (i.e. fork on a plate, and a more extreme example: firecracker.)

 

I have pain hyperacusis without loudness hyperacusis. Mostly just one ear now, although briefly had it in both ears. I have tinnitus in the bad ear too, a high pitch tone that I can mask sometimes without causing pain but that decibel range isn't very wide.

 

Hi all on this thread.

Like you, I never seemed to develop loudness hyperacusis. After starting with tinnitus from noise exposure, this developed to ear clicking/popping to certain sounds (e.g., light switch/chopping veggies) which comes and goes. Also aural fullness which again comes and goes. This has now worsened to a mild and dull trigeminal neuralgia in my left side (bad ear is also left) to loud sounds. At this moment in time, my left cheek feels very delicate (the only way to describe this).

My reason for posting here is after a noise exposure setback in April which I felt I was recovering from, I was out in the garden last Saturday and there was a constant-ish noise of 55 to 60 dB (thanks NIOSH SLM Decibel app) for about an hour. I had my foam earplugs in. Later in the day, I heard a moderately loud crack sound in my bad ear and then two days later a considerable drop in my sound threshold. Has anyone had any experience of this? I am also feeling dizzy now and again.

I have been diagnosed with MS which can cause hyperacusis and trigeminal neuralgia but it’s too much of a coincidence re: the sound and then this.

Any advice would be greatly appreciated.

 

A crack? I think @Brian Newman said something in a post about hearing a crack coming from his middle ear.

 

I’ve experienced things like that before but no after effect.

From my limited knowledge, anything that can crack would result in pain; middle ear bones, round window. Otherwise it’d likely be opening of sticky ETD, dried fluid, neck, jaw or something non serious.

We tend to pay more attention to these common occurrences when fixated on our ears.

 

Hi @Benjaminbb, thank you for replying and I agree completely with you on your fixation comment.

It’s just because my sound threshold has dropped and am getting dizzy every now and again, trying to find a cause (which there might not be one). I’m just putting it down to the crack as that’s the only unusual thing I noticed a few days prior to the day my threshold dropped.

Hopefully auditory, mental and physical rest will help.

 

The symptoms are different in each ear.

On the right, I hear sounds louder (all high-frequency sounds), and in terms of pain, it's a contraction, numbness in the auditory canal, eardrum, up to the jaw. This sensation tends to stay.

On the left, however, I can't hear any louder. I have a vibration of the eardrum with often a pain in the head.

The pain hyperacusis is different in each ear, so it's really difficult for me to know whether it's due to tonic tensor tympani syndrome or something else.

 

Same for me.

 

Interesting. I have a similar variation between ears; the louder ear is sharp and the other ear has a hum and dull pain.

When you say vibration, do you mean vibrating hum or clicking?

Do you have any hearing loss? I’ve been getting a few “EQ peaks” at certain frequencies like 1 kHz - I have no measurable hearing loss there and am hoping it’s more to do with hyperacusis.

 

Hello @Benjaminbb, sorry for the late reply.

In fact, in the left ear, it's more a vibration of the eardrum, a bit like testing a microphone by tapping it. A sound makes it vibrate. I don't know if you know what I mean. It vibrates, a bit like a clap, and it gives you a pain in the head. At low frequencies, it vibrates and buzzes.

Importantly, these vibrations only occur when there's a sound input.

I have slight hearing loss. My last audiogram was in February 2022. I'll have to have another one because my chronic tinnitus has increased, especially the somatosensory tinnitus (which I modulate with my jaw, head and neck).