Four Months After Firearm-Induced Acoustic Shock Tinnitus: Am I Having a Spike? Will It Get Better?

[Fazdoll]

Hello,

I am a single woman in my mid-50s with very little history of noise exposure. Life was great, but things changed last August 6. I took a lesson at an indoor firing range while wearing earmuff hearing protection, but I did not know I should double up with earplugs. During the lesson, someone about five aisles to my right fired a pistol that cracked loudly, about 15 times. I was wincing, and even the instructor commented, saying, "Yeah, it's killing me too."

When I finished and got to my car, I felt a "force field" outside my right ear blocking sounds. I could still hear somewhat out of the ear, and this sensation began to fade the next day. (I later realized this was likely temporary threshold shift.)

The real trouble started two days after the trauma. I began hearing a faint, low buzz inside my right ear, like a buzzing fluorescent light. The next day, both ears felt like they were filled with water, though the right ear was worse. Normal sounds did not hurt, but louder noises, like trucks, did. (I later understood this was mild hyperacusis at around 85 dB or more.) Initially, I thought it was related to my sinuses.

The tinnitus buzz in my right ear persisted. It seems to be low in volume because white noise or the sound of my refrigerator at 45 dB masks it. However, mild noise exposure, especially in the car, triggered a 500 Hz flute-like tone on top of it (reactive tinnitus), which would fade after sitting quietly for about an hour. The aural fullness was worse. Both ears felt like they would not "pop," and this sensation got worse when I was driving. Speech sounded muddled on my right side, and I had to turn my head to my good ear to hear clearly. Strangely, the fullness would ease while I was asleep, and sounds would be clearer when I woke up, only to fill up again as I moved around.

I could not see an ENT until 30 days later. Two weeks of prednisone followed. An audiogram showed a 40 dB loss at 500, 750, and 1000 Hz in my right ear, with no more than a 10 dB loss at other frequencies. My left ear was completely normal. By then, the hyperacusis had improved, though I was still a little sensitive. I experienced no vertigo or dizziness. An MRI with contrast came back completely normal. The audiologist was unsure if a hearing aid would help.

Using YouTube pure-tone videos, I noticed that I sometimes experience diplacusis at 750 and 1000 Hz, though not consistently. A second ENT confirmed acoustic trauma, even at low frequencies, and told me the symptoms would "fade." I remain skeptical of that reassurance.

After reading more about this, I started wearing a foam earplug about a month ago and downloaded a decibel meter app (NIOSH). Going about my day, I do not think I have been exposed to anything louder than 85 dB unprotected since the incident, so I hope I have not caused further damage.

Now, four months in, it feels like four years. (You all know what I mean.) A couple of weeks ago, I thought I was improving. Painful hyperacusis resolved within a month, with only some lingering sensitivity, especially in crowded spaces. Aural fullness became mild and intermittent, and driving no longer triggers it. The tinnitus buzz is tolerable, and I often only notice it in quiet rooms. Noise or vibration, or even speaking, still triggers the 500 Hz flute tone, but it has occasionally not triggered or faded more quickly. I started sleeping better and thought I was on track for gradual healing or habituation within 12 to 18 months.

However, in the past few days, I have developed a new tone. It is a high-pitched ~3500 Hz sound, coming from slightly behind and to the right. This seems to be the "traditional" tinnitus tone. Strangely, I believe I have heard this tone in the past, even before the trauma, but only for a few minutes at a time. Now it is there most of the time, at about a 4 out of 10 in volume, but it gets louder when I think about it. It is also keeping me awake.

Could this new 3500 Hz tone be a spike? Is it delayed onset tinnitus from the acoustic trauma? Could it be related to a stiff neck? I did vacuum the day before this started, while wearing earplugs. The vacuum is 90 dB unprotected.

Thank you for reading this far. The past four months have been hell. My mental state is improving, but I am in a constant state of low-level despair. I was feeling hopeful as things seemed to be improving, even the hearing loss, but now I do not know if I can handle a new high-pitched tone on top of everything else.

 

[billie48]

Welcome to the forum! It sounds like you are experiencing symptoms of acoustic trauma. In addition to tinnitus, this often includes other symptoms such as reactive tinnitus, hyperacusis, multiple tones, or aural fullness.

It typically takes 6 to 18 months for the ears to settle down, so it's important to be cautious and protect your ears from further loud noise exposure. Consider using musician's earplugs for added protection. During this period, patience and positivity are key.

You should see improvement over time, so keep hope alive. Take care, and God bless your recovery.

 

[noahelias]

Welcome to the forum! It sounds like you are experiencing symptoms of acoustic trauma. In addition to tinnitus, this often includes other symptoms such as reactive tinnitus, hyperacusis, multiple tones, or aural fullness.

It typically takes 6 to 18 months for the ears to settle down, so it's important to be cautious and protect your ears from further loud noise exposure. Consider using musician's earplugs for added protection. During this period, patience and positivity are key.

You should see improvement over time, so keep hope alive. Take care, and God bless your recovery.

Hi Billie,

I got tinnitus in my right ear after a loud festival, I did not think of earplugs since I never go to these things. This is the first time experiencing tinnitus and it is driving my insane. The first 2 days were awful, it was a 10/10 but the days after it got less and on day 5-6-7 it went almost completely away 1.5/10. It was gone 1,5 week and now all of a sudden it's back bur I did not listen to any loud noise or music, I did not expect this at all. I hear it only in quite rooms but still with sleeping it drives me crazy. What are the chances this will heal and go away since it was gone and came back? It has been 3 total weeks now, where 1,5 week it was gone. I am stressed one festival made life changing changes and I will become depressed of it…. I am an 25 year old boy btw, and fully healthy normally…

 

[Fazdoll]

It typically takes 6 to 18 months for the ears to settle down, so it's important to be cautious and protect your ears from further loud noise exposure. Consider using musician's earplugs for added protection. During this period, patience and positivity are key.
You should see improvement over time, so keep hope alive. Take care, and God bless your recovery.

Thank you so much for giving me a little hope. At one point, I told my boss, who is also a good friend, that it might almost be easier to have breast cancer because at least there is a definitive recovery process for that. Are you sure about recovery? All I see online are stories of people who never recover, whose symptoms get worse, or who feel suicidal. If I knew with certainty that this would improve over time, I would be far less stressed. Even some level of habituation, however incomplete, might be enough to help me cope.

I am fairly sure my hearing is better than it was. Over the past few days, I have taken three types of online hearing tests multiple times. About 80 percent of the time, they show normal hearing. I realize those tests are not entirely accurate, but they should at least be precise enough to indicate improvement. Previously, my hearing tested at 45 dB, and now it seems to be closer to 20 dB. I suspect the aural fullness I was experiencing interfered with the earlier tests. I have another official hearing test scheduled in January, followed by an ENT appointment a week later. Maybe they will provide some answers.

Thankfully, the volume of my tinnitus seems relatively mild to moderate. The buzzing is about 1 to 3 out of 10, the flute tone is 3 to 4 out of 10, and the two new tones are 4 to 5 out of 10. These tones fluctuate with stress, masking, and even the sound of the heater.

Is there a specific decibel level I should protect against? For the past six weeks, I have been wearing a foam earplug when I go out, and that seems to provide enough protection. However, there have been a few occasions where I forgot to use it and was likely exposed to 75 to 80 dB. For example, the inside of a crowded Walmart is typically around 70 to 75 dB.

Should I consider TRT, which is Tinnitus Retraining Therapy, or other treatments? I tried online notch therapy, but it only seemed to trigger the reactive 500 Hz flute tone.

 

[Fazdoll]

Six-Month Update

I'm writing this down just to keep track. Six months have passed since the day my life was nearly ruined in 30 seconds. Has there been any improvement? Overall, the non-tinnitus symptoms have improved since the trauma, but the tinnitus itself has gotten worse.

Hyperacusis

I had some hyperacusis during the first six weeks, but I haven't really felt it since. I do occasionally experience mild discomfort or very slight pain in both ears, but it feels more like it's in the outer ear canal rather than deep inside. It seems to be more noticeable when I'm anxious rather than triggered by sound. It's random and short-lived.

Sensitivity

I don't react to single loud sounds, but I am sensitive to echoing voices around 65 dB. Possibly not as much as before. Using a foam plug in my right ear helps with this.

Hearing

A hearing test still shows a threshold of about 35 dB between 500 and 1000 Hz, while all other frequencies are at or below 10 dB. My speech recognition is fine.

Aural Fullness

For the first month, aural fullness was absolutely awful. It mostly subsided within four months, possibly due to prednisone. Now, I have a very low level of fullness most of the time, with occasional episodes of stronger fullness that last about 30 to 60 minutes, one or two times per day. It tends to worsen with stress.

Vibration

Sometimes when I speak, especially loudly or for a long time (like on the phone), I feel vibrations on my right side. A couple of times, I didn't hear as much vibration, so there might be some improvement.

Mental State

There has been some improvement, if you can call it that. I don't feel the overwhelming panic anymore. Instead, I live with a constant despair of acceptance. I can function as a person, just not very well. I can concentrate at work when I have to, but I have no ambition or drive for new hobbies, career advancement, or self-improvement.

Sleep

This has improved. I've accepted the noise enough to fall asleep with it in the background, even with new tones. White noise and music never really worked for me, but talk-heavy podcasts distract me and help me fall asleep. Benadryl and melatonin don't seem to make a difference.

Tinnitus

I'm estimating volume based on a 1-to-10 scale. Some people have tinnitus so loud that white noise would have to be damagingly loud to mask it—maybe that's a 10. I'm nowhere near that. My buzz tone can be masked at 40 dB, which I gauge as a 2/10. Other tones are too high-pitched to mask. I'd say my case falls on the mild side of moderate.

• Original buzz tone (fluorescent light sound, in-ear): Still there. Low volume, about 2/10. It spikes with activities like driving but calms down within an hour. No real change. Somatic.
  
  
• 500 Hz reactive flute tone (in-ear): Around 3/10. When triggered, it fades in 20 minutes instead of 45. A few times, it didn't trigger at all. This might be improving, but it's still inconsistent. Can be somatic.
  
  
• High electronic ringing (full head): Can range from 2/10 to 6/10, worsens with stress or when I think about it. Initially thought it was 3500 Hz, but now it seems closer to 7500 Hz, possibly with harmonics. Not sure if the tone actually changed or if I misidentified the frequency before. Right now, this tone dominates everything else.
  
  
• Morse-code tone (~1100 Hz, in-ear): Soft volume, around 1-3/10. It settles to a softer level during the day but can spike at night.
  
  
• New tone (past two weeks): Around 1500 Hz in my unaffected ear. Yikes. It's extremely soft—I had to plug my ears to notice it—but now that I know it's there, I hear it more. Ugh. Now I'm just driving myself crazy.

Oto-Neurologist Visit

I saw an oto-neurologist last month. He has had tinnitus for over 20 years, with no known cause, and doesn't really care about it anymore (fully habituated). He said:

1. New tones can be caused by anxiety, but he can't say for sure.
   
   
2. Low-frequency hearing loss due to acoustic trauma is unusual but possible. The theory is that it results from inflammation rather than direct damage to the cilia.
   
   
3. Even though I lost some hearing, I can still understand speech and get by without a hearing aid. I might try one for other symptoms, but that's my decision.
   
   
4. He was adamant that I needed much more time and told me to come back in a year for another audiogram. He kept repeating that, for most people, this fades—not necessarily completely, but it fades. Yeah, right.

Bottom Line

After six months, the tinnitus itself is no better, but I'm getting better at dealing with it. Still not good though.

 

[mzrach03]

Six-Month Update

I'm writing this down just to keep track. Six months have passed since the day my life was nearly ruined in 30 seconds. Has there been any improvement? Overall, the non-tinnitus symptoms have improved since the trauma, but the tinnitus itself has gotten worse.

Hyperacusis

I had some hyperacusis during the first six weeks, but I haven't really felt it since. I do occasionally experience mild discomfort or very slight pain in both ears, but it feels more like it's in the outer ear canal rather than deep inside. It seems to be more noticeable when I'm anxious rather than triggered by sound. It's random and short-lived.

Sensitivity

I don't react to single loud sounds, but I am sensitive to echoing voices around 65 dB. Possibly not as much as before. Using a foam plug in my right ear helps with this.

Hearing

A hearing test still shows a threshold of about 35 dB between 500 and 1000 Hz, while all other frequencies are at or below 10 dB. My speech recognition is fine.

Aural Fullness

For the first month, aural fullness was absolutely awful. It mostly subsided within four months, possibly due to prednisone. Now, I have a very low level of fullness most of the time, with occasional episodes of stronger fullness that last about 30 to 60 minutes, one or two times per day. It tends to worsen with stress.

Vibration

Sometimes when I speak, especially loudly or for a long time (like on the phone), I feel vibrations on my right side. A couple of times, I didn't hear as much vibration, so there might be some improvement.

Mental State

There has been some improvement, if you can call it that. I don't feel the overwhelming panic anymore. Instead, I live with a constant despair of acceptance. I can function as a person, just not very well. I can concentrate at work when I have to, but I have no ambition or drive for new hobbies, career advancement, or self-improvement.

Sleep

This has improved. I've accepted the noise enough to fall asleep with it in the background, even with new tones. White noise and music never really worked for me, but talk-heavy podcasts distract me and help me fall asleep. Benadryl and melatonin don't seem to make a difference.

Tinnitus

I'm estimating volume based on a 1-to-10 scale. Some people have tinnitus so loud that white noise would have to be damagingly loud to mask it—maybe that's a 10. I'm nowhere near that. My buzz tone can be masked at 40 dB, which I gauge as a 2/10. Other tones are too high-pitched to mask. I'd say my case falls on the mild side of moderate.

• Original buzz tone (fluorescent light sound, in-ear): Still there. Low volume, about 2/10. It spikes with activities like driving but calms down within an hour. No real change. Somatic.
  
  
• 500 Hz reactive flute tone (in-ear): Around 3/10. When triggered, it fades in 20 minutes instead of 45. A few times, it didn't trigger at all. This might be improving, but it's still inconsistent. Can be somatic.
  
  
• High electronic ringing (full head): Can range from 2/10 to 6/10, worsens with stress or when I think about it. Initially thought it was 3500 Hz, but now it seems closer to 7500 Hz, possibly with harmonics. Not sure if the tone actually changed or if I misidentified the frequency before. Right now, this tone dominates everything else.
  
  
• Morse-code tone (~1100 Hz, in-ear): Soft volume, around 1-3/10. It settles to a softer level during the day but can spike at night.
  
  
• New tone (past two weeks): Around 1500 Hz in my unaffected ear. Yikes. It's extremely soft—I had to plug my ears to notice it—but now that I know it's there, I hear it more. Ugh. Now I'm just driving myself crazy.

Oto-Neurologist Visit

I saw an oto-neurologist last month. He has had tinnitus for over 20 years, with no known cause, and doesn't really care about it anymore (fully habituated). He said:

1. New tones can be caused by anxiety, but he can't say for sure.
   
   
2. Low-frequency hearing loss due to acoustic trauma is unusual but possible. The theory is that it results from inflammation rather than direct damage to the cilia.
   
   
3. Even though I lost some hearing, I can still understand speech and get by without a hearing aid. I might try one for other symptoms, but that's my decision.
   
   
4. He was adamant that I needed much more time and told me to come back in a year for another audiogram. He kept repeating that, for most people, this fades—not necessarily completely, but it fades. Yeah, right.

Bottom Line

After six months, the tinnitus itself is no better, but I'm getting better at dealing with it. Still not good though.

Thank you for sharing your story. I suffered acoustic trauma from an MRI that reached 130 dB, even with my earplugs in. I've noticed all the same symptoms you have.

However, my hyperacusis seems to be even more severe—restaurants with clattering dishes are unbearable for me. Two months in, I'm still praying for recovery.

God will never give us more than we can handle. Thank you again for sharing.

 

[Fazdoll]

Nine-Month Update

I'm writing this down to keep track. Nine months have passed since the day my life was nearly changed in just 30 seconds. Has there been any improvement since the six-month mark? Overall, the non-tinnitus symptoms have improved a little more. I believe the tinnitus has also improved slightly, but it's hard to notice clearly, and I don't know if that means further improvement will follow.

Recommendations

• checkhearing.org – Great for quick hearing tests.
• Earplugs – For regular use, I recommend soft foam plugs. They stay in better and are more comfortable. I found some that are flesh-colored (Caucasian tone), making them harder to see.
• How to insert: Twist the earplug to a point. When inserting, twist and push gently, as if screwing into a wall. You should feel the tip reach deep in the ear canal. Hold it in place for 30 seconds. If inserted properly, it will come out with a rippled shape that matches the ear canal before springing back. I wish I had known this at the firing range.
• Decibel meter – Use the NIOSH dB Meter app on your phone to get a clear sense of how loud different environments are. It also helps you track how loud masking sounds need to be to cover tinnitus tones.
• Supplements – I take one-quarter of a small B-12 tablet and 700 mg of Lion's Mane. To be honest, I don't think they make any difference.

Hyperacusis and/or Ear Pain

I haven't had any real hyperacusis for the past two months. A couple of weeks ago, I did feel a bit of random ear pain, but it wasn't triggered by noise. Strangely, the only time I noticed it was when I thought, "Oh, I haven't felt that in a while." Then it disappeared again.

Hearing

A professional test in January showed about a 35 dB threshold between 500 and 1000 Hz in my right ear. All other frequencies were at or below 10 dB. My speech recognition was fine, with only a 5 dB difference between my good and bad ear.

This week, I took a home hearing test online. These are often unreliable, but I used my unaffected ear as a baseline. It showed a threshold of about 25 dB between 500 and 1000 Hz, which is no different from before. This hearing loss is likely permanent.

Sensitivity

This sensitivity feels different from inner ear pain. It's as if sounds are louder or as if there's a kind of force field around my right ear. I don't react to single, short, loud sounds like sink splashes or doors slamming—unless they are especially loud. But if there's a prolonged sound, like echoing speech or background noise above 60 dB for more than 10 seconds, I feel the sensitivity.

This has not improved. When I'm in meetings in echoing rooms or driving, a soft foam plug in my right ear prevents the sensation. Since this kind of sensitivity is a symptom of hearing loss, it may be permanent.

Aural Fullness

There has been more improvement here. At the six-month mark, I had a low level of fullness most of the time, with 90 to 120 minutes per day of more noticeable fullness. Now, there are long periods without any fullness, and the total is more like 30 minutes a day, spread across 5 to 10 minute episodes. I still feel it in both ears, but more in the affected right ear. It seems to react more to mental stress than to sound. I can trigger it by thinking about it, but I can also forget about it easily when I'm distracted.

Vibration

I believe the vibration has lessened. I only feel it in echoing rooms or after speaking for 20 to 30 minutes. Even then, it doesn't always happen. Since vibration is also a symptom of hearing loss, this may be a permanent change.

Mental State

There has been improvement here as well. I'm functioning better than I was at the six-month mark and feel a bit like my old self. I can ignore the sounds, but it still feels like I'm constantly trying to hold them back. The moment I let my guard down, stop thinking about it, or remove masking noise, one or more symptoms return.

Some ambition and hobbies have returned, but I need to be in a masked environment. Gardening outside is fine. Reading in a quiet room is still difficult. I'm not yet in a state to think about career advancement or deeper self-improvement.

Sleep

This has improved slightly. I'm more tolerant of the constant air or wind-like tone and can usually fall asleep with it. Only once or twice a week do the noises wake me up. When that happens, I feel anxious and struggle to fall back asleep. I tend to get depressed in those moments.

It helps to go to my laptop, read the news, or watch YouTube for an hour. That calms me down, and I can then return to bed.

Tinnitus Tones and Volume

There may be some improvement. I say "possible" because my original tinnitus was mild, worsened around month five, and may now be returning to that earlier mild state.

I estimate volume on a 1 to 10 scale. Some people have tinnitus so loud that masking it would require harmful noise levels—maybe that's a 10. I'm nowhere near that. If a tone can be masked at 40 dB, I call that a 2 out of 10. Some tones are too high-pitched to mask, so those are just estimates.

• Original buzz tone (in-ear): Volume 1 to 3. This was my first post-trauma tone. It can sound like rushing wind but spikes into a buzzing tone, like a dying fluorescent light, after noise exposure. No real change. Possibly somatic.
  
  
• 500 Hz reactive flute tone (in-ear): Volume 0 to 3. This one has changed a little. It is triggered by prolonged background noise or speaking but not always. It used to appear in the shower but rarely does now, likely because showers last less than 10 minutes. Walking outside used to trigger it quickly, but now it takes 30 to 60 minutes. Once triggered, it fades in 20 minutes rather than 45. It sometimes blends with the buzz tone. Early on, it would wake me up at night—no longer the case.
  
  
• High electronic ringing (full head): This started as harmonic tones and now resembles a high-pitched hiss, like a tea kettle. The volume has definitely dropped, from 2 to 6 down to about 0.5 to 3. It responds to stress. The frequency has changed too—from 3500 Hz to 7500 in January, then to 10,000, and now closer to 12,000 or even 13,000 Hz. It is unclear if the tone changed or if I misjudged earlier. On good days, it doesn't dominate. On loud days, it becomes sharper and lower, which makes it more noticeable.
  
  
• Morse code tone (~2300 Hz, in-ear): Volume 0.5 to 3. I previously logged this as 1100 Hz, which must have been wrong. This tone disappears sometimes, especially in very quiet environments or when I'm lying still at night. But if I think about it or turn my head, it returns. This is currently the most annoying tone.
  
  
• Faint tone on the left side of my head: Volume 0 to 2. Around 4000 Hz in my unaffected ear. It scared me three months ago, but now I only hear it at night or in extreme quiet. It hasn't worsened.
  
  
• Spikes: Between months five and eight, I experienced spikes where a new tone would last 30 to 60 seconds, or an existing tone would change. Sometimes I woke up to a spike. These are now much less frequent.
  
  
• Good days vs. bad days: Between months six and nine, I had about two good days for every bad one. Now it's more like four or five good days to one or two bad ones. Also, the bad days are not as intense as they were three months ago.

Bottom Line

After nine months, my mental state has improved. The original rushing or buzz tone is no better than it was at the start. However, the additional tones seem to be improving. There may be subtle overall improvement, or I may just be taking a long time to return to baseline.

I'm grateful that my tinnitus appears to be low volume compared to what I've read from others. Still, it's persistent and annoying, and I continue to wake up each day with a sense of despair.