Hyperacusis/Noxacusis: Various Types of Pain and Their Associations

I was just wondering if people could describe the various types of pain they get and what type of noise exposures or whatever other factors they associate them with.

When I first got hyperacusis I got a lot of burning ear pain, mild stabbing sensations, jaw tightness and aching and at one point my forehead began to become sensitized and ache and tingle.

At this time I was still able to function without earplugs. I was definitely sensitive to a lot of environmental sounds.

A lot of these pains felt deep and nerve related.

Now after my worsening, I only get some mild burning sensation and discomfort feeling in the canals periodically so far as far as nerve like sensations. Everything else is just pain, but it’s very broad pain. Like every time it gets set off it’s through my whole outer ear and my whole face.

The pain ranges from low grade to strong moderate. It’s just I’m very many ways unlike my previous experience.

I’m wondering if certain pains anyone more so associated with inner ear issues vs middle ear muscle issues or any other type of input.

 

Yeah I have pain everywhere!

My left ear just aches all day and night, hurts like hell. I get stabbing and razor wire in that ear from high pitch noise and artificial audio. In my middle ear I get stabbing and a different aching feeling which just comes on from whatever, sometimes it’s noise. Anything too loud will trigger the razor wire electric feeling. It just kills me.

The right ear is tricky. It’s my fistula ear so it’s strange. From high pitch noise I get mild stabs, loud vibrations, and a feeling like menthol burning, and then sometimes the pain goes to my throat and face. That feels more middle ear related. Luckily, even though I have had some bad setbacks with that ear, it always seems to heal. The left ear just doesn’t. I want to just cut it out. My right ear has like deep pressure pain I get from bending over and straining, and I get dizzy from it. I also get beeping distortions. If I push too hard, I wake up the next day congested with much worse loudness hyperacusis. Those symptoms seem to be connected to the fistula from the deadlift injury. The other stuff is from the car accident.

Yeah this nerve pain stuff is all close by. It definitely can trigger face jaw neck pain. Those nerves suck.

 

I’m so sorry man. Honestly at a loss for words whenever you speak about your situation. We need some kind of relief so desperately. These regenerative drugs can’t come fast enough.

At this point with my level of tolerance there is no way I think I can even use Auricle if it comes to market to get some tinnitus relief. It would be easier to do constant hearing protection without having to listen to a handful of tinnitus tones. Especially this new low hum I have that’s driving me crazy.

So you think facial and throat pain is more middle ear related? I don’t get TTTS where it thumps super fast and super loud (only once very randomly in my right ear that I had a surgery on), but with earplugs in I can hear my ears thump, especially my left quite often. I wonder if this source of pain is any more likely to calm down than inner ear stuff. Or if it’s just an overprotection reaction to inner ear inflammation/sensitization and until that improves it will continue.

I forgot to mention in my first post, but I used to get the chisel in the ears sensation more regularly after my initial trauma. Like it just feels like someone is running one back and forth through your head. I did get it directly after my new irritation at the record store.

I think that was an indication of a flare up of the inner ear stuff. Not sure if this bottoming out of tolerance is more middle ear overprotectiveness since I’m not getting a lot of nerve pain or what. What do you think about the middle ear stuff?

You said you were doing sound therapy before and it helped loudness hyperacusis. Do you currently ever do any tests of your tolerances, or since your so bad currently you just do everything you can to avoid?

I’m thinking my hourly exposures I was trying may have ultimately just made things worse. It was only a few minutes each hour and I tried to mostly keep the sounds I was exposing myself to non-abrasive, but a week after I started trying things seem to have went down hill. I am tracking my days in a journal. I don’t know for sure though because the other night we had a horrible thunderstorm, and when I woke up due to the rumble outside, one of my plugs had partially come out of my ear. The day after that was my worst day so far. So I don’t know if it played a part.

 

Yeah, I think the middle ear stuff can be more controlled to neck and face pain. I read the Stapedius and Tensor Tympani can be connected to nerves all over. I mean if something causes me pain at this point, I completely avoid it. Pushing through, will result in worsening. I’m not in complete silence all day, the only way for my days to be quiet from road noise is for me to sit in my living room near the kitchen. The fridge is kinda loud. But I try to not wear earplugs as much as possible. Seems we have to gently push when our ears are ready. I have been struggling not being able to watch TV on any volume and discovered I can watch only on my living room TV from a very specific stereo.

Only comedy shows with voices just on a volume I can barely hear them. I found some days it even eases some of the inner ear pain. Don’t know how. I guess that’s the spot I need to gently push. I mean on any other audio from anything I get that inner ear gnawing and the pain gets worse in until I get a setback and have an episode. I think finding the sweet spot our ears can handle is important because my pain from other artificial audio is still bad but not catastrophic.

Sound therapy for this noxacusis crap is Russian roulette, you need to pay very close attention to how your ears handle it. I think there will be more research in the future but it makes you think, if every one of us has that sweet spot that our ears like, can it help. Maybe, some people think only complete silence works, others think sound therapy works. I think it could definitely be both. All my life I have been working out and studying the body. Every single thing can be improved. I tore my peck off the bone from benching. What did i do? Take years off chest, let it heal and slowly built it back up. This is a nerve, not a muscle, but I think it could be the same idea. This ear shit is tricky because for any other injuries it’s like ok, don’t do what makes it worse, but if every single noise makes it worse than what can you do?

I can tell you I won’t be living at this level forever, if I don’t off myself and drugs don’t work I’ll find something. Be cause some people like ourselves just stay inside and never leave again. Fuck that bro. I am perfectly happy living a quiet life but I need to leave the house with earplugs in and be ok. I think you agree. I definitely will not go to loud places ever again. But improving from ground 0 is a must. Our lives are not designed to be lived like this, they just are not. Humans need to be social, exercise, make money, to be able to be okay. I mean in order to get better from this you literally need money, or a silent job, live alone, have family and friends near by to help get your stuff.

 

I’m glad you’ve found something you can do with the Comedy audio for now. Another poster said at one point that when they listened to music their hyperacusis started to feel better.

It’s weird because in the past sometimes, rarely, I would have that too. Like the muscles tensed up initially, but then eased off and it actually felt somewhat good. I still avoided pushing it at that time because I figured it was ultimately something that would still lead to a setback and sometimes it still did lead to some pain.

Before, once I started to get better, going to physical therapy and getting neck massage helped me a lot. I wish I could do that now just for the massage. I can’t really afford to pay someone to come in regularly to my house and I don’t know if I could tolerate it anyway. I’m often having to whisper to my kids right now. So speaking to anyone is difficult. My kids’ teachers look at me like I’m crazy with earmuffs on all the time. I hate being looked at like I’m mentally ill when I’m suffering from some rare nightmare that they thankfully don’t have to experience.

My youngest son got up angry this morning and came over to me and said sternly several times “you didn’t give us as much time to sleep”. He wasn’t yelling but he got close to my face. I had to ease him back and remind him how sensitive my ears are right now. And sure enough I got deep aching pain in both ears that’s been on and off for 2.5 hours now from it.

Yesterday my daughter ran downstairs in the basement room and got her keyboard and brought it to the main living area as soon as we got home from school. She just starts bashing away at it while I’m trying to put up book bags and things before I could escape to the top floor.

Only my oldest son gets it. He is very considerate and respectful of my condition. My 6-year-old twins I have to constantly say please don’t do whatever you’re doing and they just don’t seem to care. It breaks my heart and of course worries me that it will keep me from improving. They’ve always been this way even when I was in much better condition before.

Sorry for going off on a tangent. I hear you on needing to get out. I mean I felt like I was avoiding loud places for the most part. I did take my kids to the water park this summer, but I wore earplugs and stayed away from the louder rides. I just rode the lazy river and helped them on some kids’ rides. I took them to a small Greek festival in town, but I completely avoided the music stage. We just went to the food areas and to see the art.

I really didn’t think going in a record store with music at like 70ish dB was gonna ruin my year of improvement. God how I regret it and all subsequent tiny things that then chipped away to the point I’m at now. I’m just in shock honestly. From your story it seems similar with the gradual decline. It’s just ridiculous.

Like you said you need money, isolation, family etc to heal from this and I don’t have any of that currently. I feel like I’m facing such an uphill battle. And I don’t want to basically have to abandon my kids to recover. But I’m not worth much to them right now in this state. I can’t hear them through the earplugs so we barely talk. I just take them to school and back, feed them and do their basic needs like make sure they bath. I’m basically like a nanny or home health aide, not a father now.

 

Man, I’m sorry, I literally cannot imagine having kids. Having to take care off others, god I would be done for. That setback of yours seems awful. Like I can’t imagine. I always get worse so it’s like whatever but getting better than that ahhh man. This condition is truly from Satan.

 

It’s a very strange setback/worsening. Because it’s so unlike my previous experience. So it does seem like it really isn’t an acoustic shock in the usual sense like my first experience.

I mean before I had all kinds of ETD issues crop up and constant popping, clicking pressure regulation issues. I had patulous Eustachian tube for awhile where I had to put my head between my legs all the time to relieve some of the sensation. I had fullness really bad and the fuller my right ear was the louder my tinnitus screamed. I had the various kinds of nerve pain in my ears, jaw and face. I had just general muscle pain too, but not like I have now. But of course my sound tolerance wasn’t anywhere near this bad. I definitely went through a long period of spiking to practically everything. But as far as pain from noise, I don’t know, I wasn’t anywhere near where I felt I had to protect all day long. Like I could get agitation from a machine outside or something and have to hide and put on earmuffs, but I could always drive with no pain from my vehicle so I was able to do what I needed to do.

My pain was also more consistent then. Like you say just all day sometimes, but better others. I went through a lot of different issues that would clear up. Now as long as I’m protecting 24/7 I can keep it pretty minimal in the house. But I am afraid if I exposed even in low level areas like 30ish dB and just dealt with the pain it would only get worse. Much like you it seems people’s pain level is usually way worse when their tolerance bottoms out like this. I’m curious if that means I should be more optimistic my condition will improve with time.

If it’s not an all out acoustic trauma, does the 9 month synapse dying thing apply?

 

Hmmm, yeah, that is interesting. It’s very different when your LDLs drop to 0. Like being comfy in my house was nice. When it gets to the point noise outside your house, that a normal person would not hear, hurts you, it’s like what is this. And synapses, I don’t know if they die from noise that isn’t an acoustic trauma or acoustic shock. They definitely die for a long time for months after. Years later I think the Type 2 nerves are just overactive and just never turn off, causing chronic inflammation and pain. Because remember, the Type 2s don’t get damaged, they turn on from outer hair cell damage, and synapse damage.

 

I guess I probably shouldn’t be optimistic then since I’ve now sensitized them to this level

 

I hope not. It seems for many people they calm down over time. Even the worst cases get a little better. Only a few people in the world I’ve heard of who are 5+ years in and who still need complete silence. Seems for most they calm down. Just crazy to think all this is coming from a nerve that’s not even damaged.

 

When you reference people calming down and getting better, are you referencing hyperacusis in general (all types) or pain hyperacusis specifically?

 

I think this is not accurate. Or needs to be explained better. People do not "heal" from pain hyperacusis, meaning getting back to normal, this is, recovering crystal clear hearing again while being able to tolerate loud noise.

On the contrary, what happens is that "ears change" and may develop other hearing conditions as a trade off for less extreme or less severe hyperacusis.

These other hearing conditions range from hearing loss to tinnitus, distortion, etc or a combination of those.

 

Typo. I meant their ears calm down, or improve. I have read stories of people getting better after 5 years. Pretty crazy.

 

Wait, when did I say heal? And that makes sense, tbh you’re one of the few cases I’ve read who slowly got worse hearing, trading off for hyperacusis. I haven’t read about too many like this. And it’s a nerve, you don’t need anything trading off. It can just stop firing pain signals for most people and get less reactive to noise.

 

I knew that you meant their ears/auditory system. I have also read of many people improving after three to four years. I have saved these postings for inspiration.

I went to a friend’s house last night. She tends to be a somewhat loud talker and perhaps the acoustics were not good in the room but it was a very difficult experience.

 

Are you now able to go to a restaurant or similar establishment? I recall you referencing that you experienced more hearing loss which resulted in you being able to better tolerate normal, everyday noise.

 

Yes, these stories are important to keep us going. I can rarely have convos with people without earplugs in. With earplugs in I can talk for a short time, then the pain kicks in. On bad weeks I can’t talk at all. This sucks.

 

After so many years, I do not really know. I only talk out of personal experience. Every case is different though.

 

Yes, I can manage in a restaurant if it is not too noisy. Now the problem is the "cocktail party effect", this is, understanding speech in noise.

Restaurants tend to be a lot noisier these days, and the decoration and materials restaurant owners use make sound bounce, let alone the ubiquitous music...

For me the best option is still sitting outside. We have good weather in Spain... better said, warm weather, so it is possible to eat outside, and less noisy. Most restaurants do not have music outside (thank God!) but there is often traffic around and other noises... so I choose carefully and pick restaurants that are close to the beach or near pedestrian areas.

 

Yeah, Spain has really great restaurants and a lot of pedestrian areas to walk. I am glad that you can have dinner at the restaurants, if I remember well, you were a pretty severe case yourself (with burning pain), but improved quite a lot.

 

Yes. My body traded off some hearing for new spaces of freedom (less severe hyperacusis), limited spaces but anyway it's great as compared to how things were at the beginning (pain lasting weeks after a single sound, horrible headaches, tension, anxiety through the roof obviously etc etc).

Just wanted to add: no matter how bad hyperacusis is, listen to some sound of music at low volume, sounds you like.

Listening to music is important. It has also a benefit in case you lose hearing like me: you will remember the accurate pitch of sounds in every song if you have listened to it before a few times.

So your brain will fill the gaps in a song even if your hearing deteriorates.

 

Did you have a hearing test when you first developed hyperacusis? I am wondering if you had any hearing loss at that time. My hearing loss is only minor and consistent with age and I have had 100% word recognition scores. I have had three separate tests. It makes me wonder if I have sustained major damage to my auditory system given that my tests have not really reflected significant abnormalities. Perhaps there is a strong psychological component here.

 

When you reference improvement and calming down, are you referencing hyperacusis generally or pain hyperacusis specifically?

 

Both. I have read many stories of people improving with time. I don’t know how other people’s hyperacusis works but being around low level noise definitely helps my loudness hyperacusis. Slowly introducing sound works. Your ears adapt. Just be in environments you can control noise. They are two different mechanisms, as I have found out the hard way. Everybody is different, but for me, the more noise I’m around the better my hyperacusis gets. That’s why you see all these people giving shit advice to noxacusis people because they think it’s the same. If I didn’t have noxacusis, my hyperacusis would be almost gone. It’s all so different for everybody.

 

I agree with Brian, except for dishes/electronics/paper/etc, I barely notice my loudness hyperacusis, as long as I stay under 80-90 dB.

But the pain is a totally different story, sometimes I think I have mild loudness hyperacusis and chronical pain for other reasons.

Although I doubt it, because I was having mild ear pain from headphones way before my acoustic trauma.

 

My hyperacusis does not really have a pain component but the tinnitus seems reactive. I wish that I could see some progress with the sound therapy and exposing myself to normal, everyday sounds.but it may just be that my age (almost 57) means that I will have a longer period of time before I see improvement.

I have read several postings of people who took 2 to 4 years to see improvement. Walking on squeaking floors, turning a door handle, a fork hitting the side of a plate, opening the door to the washing machine are all uncomfortable and seem, in the aggregate, to cumulatively worsen my condition. All of these sounds have a certain crispness to them (unlike putting a book down on the bed which does not bother me at all). Even turning the page of a book can occasionally be uncomfortable because of the crisp nature of the sound.

Do the stories that you have read that reference improvement generally involve people with significant improvement or just minor improvement?

 

I am not going to tell you to protect when unnecessary or tell you how much to protect. That is up to you.

I will say that even when I wasn’t protecting, I would wear my earmuffs for a little while here and there to let my ears rest. Often I felt that gave them a reset from accumulated aggravation. It’s always something you can try out. The less aggravated, the more likely to heal in my opinion.

My loudness hyperacusis is pretty much gone for all intents and purposes. My noxacusis is what I have issue with.

 

Someone can correct me if I'm wrong, but it appears to me that reactive tinnitus is a precursor to actual pain hyperacusis. So I'd be very careful if exposure to sound is causing tinnitus spikes. The suffering caused by pain hyperacusis far outweighs the discomfort of wearing hearing protection.

You can thank you lucky stars you've made it this far in life without hearing disorders.

In my opinion, the best option is to just cut your losses, don't rush the healing process, and try to wear adequate hearing protection from now on, besides making the obvious adjustments to your lifestyle.

 

Where do you have this information from? I do not think it is correct, but correct me if I'm wrong...

 

I wonder if genuine healing is possible if there has been significant damage to the auditory system. I thought that the brain might adjust and stop feeling the need to turn up the volume.