Hyperacusis/Noxacusis: Various Types of Pain and Their Associations

Do various sounds no longer seem too loud to you? I thought that noxacusis might be loudness hyperacusis but with an additional component of feeling pain when hearing noises as too loud.

 

Pretty much nothing sounds too loud to me anymore. When I first had my acoustic trauma the hum of the refrigerator sounded on par with voices. I still have some of the typical symptoms of loudness hyperacusis like cutlery and shrill sounds could make my ears tighten up, but even those had mostly gone away, and it was not like I was perceiving them as too loud. Also, my noxacusis worsening has not made my hyperacusis return.

 

I don't think I have any loudness hyperacusis. Nothing sounds louder to me. My hyperacusis has always just been pain, mostly an aching soreness feeling, and a really uncomfortable feeling of pressure. Like my ears are about to bust.

 

There are some people who believe that reactive tinnitus and hyperacusis are the same thing.

 

Did you start out with loudness hyperacusis that developed into pain hyperacusis?

 

Do sounds cause the pain or do you also feel it in a quiet room?

 

I believe I had both in the beginning to some degree. I think the noxacusis became more entrenched while the hyperacusis abated.

I improved over all in pretty much every way, but artificial audio from stereo’s, television, iPads etc always remained a problem for me and my levels of tolerance for those things didn’t improve as much as my tolerance for just everyday one off noises.

Music is what has made my noxacusis severe. If I make it back from this level I definitely won’t be listening to music and probably won’t be watching television until there is some type of treatment, if ever.

 

Does stacking plates and bowls and silverware hitting a bowl or opening a paper or plastic bag bother you from a loudness standpoint? It is this type of crisp sound that bothers me. It does not cause me pain but is too loud and gives me kind of a startle reaction.

 

Both. It varies. The pain can pop up randomly even in silence.

 

Not any more.

 

All the things you mentioned bothered me too at one point (from a loudness standpoint). The ears get startled and the discomfort comes on immediately, Its in the moment and the eardrum has a spasm like feeling. But no lingering pain. If I kept getting hit with noise, my ears will start to feel fatigued. I need a good night sleep to reset the ear fatigue. This has been happening less and less though as time goes on (ear fatigue).

 

The stories I heard are all so different it’s impossible to tell which one is right.

Something works for everybody, that’s a fact.

Some recover, some not so much, but it all depends. Some crazy amounts of improvement, some a little.

It seems loudness hyperacusis has much better chance of recovery.

 

Do you feel pain when you hear those sounds?

 

Have you ever tried any sound therapy?

 

I’m new with reactive tinnitus so I’m still trying to figure it out. Mine is instantly reactive to most sounds which I believe is manifesting as a super high frequency electrical sound. The original sound I hear doesn’t cause pain, but the sound my ears produce in response DOES hurt. It’s always intermittent and brief unlike my other tinnitus (except a new Morse code sound), so I wonder if it’s truly tinnitus or simply my ears crying out in pain. It hates white noise the most which makes me think I messed it up by overusing a box fan at night.

Earplugs help in the short term, but not completely. Still no idea how I should handle things long term. I kinda just want to take an ice cream scooper and take out my entire auditory system.

 

I think that the passage of time seems to be the one consistent factor in improvement. I have had hyperacusis for eighteen (18) months and tinnitus for about sixteen (16) months. The improvement does not necessarily proceed in a linear fashion. There are a lot of treatments that may be available soon depending on various trials this year.

 

Thank you for your thoughts. I know that improvement does not necessarily proceed in a linear fashion. Some people have even referenced that hearing loss over time has resulted in offsetting their hyperacusis and lessened the uncomfortable nature of normal, everyday sounds. Their tinnitus may have increased, however.

I have a friend with Meniere’s Disease with almost total deafness and loud tinnitus in one ear. She is on a trip overseas right now. She has been dealing with it for at least ten years. She told me that she used to have sound sensitivity in that ear but perhaps the progressive hearing loss resulted in less hyperacusis. She has apparently been able to emotionally deal with this condition over time. I have had my symptoms for less than two years and there is no way that I could take a trip overseas right now.

 

I wasn’t feeling pain from those sounds before my setback. But at the same time I was careful not to just stack plates haphazardly and be loud with it. I didn’t have to wear hearing protection though to avoid the pain.

Now with my setback unprotected I’m in pain within minutes in a quiet room. My pain is pretty much delayed though and that’s the problem.

Like when I went to the record store that caused the initial setback, if I would have experienced any immediate pain I would have left. I stayed 15 minutes and as I was driving home is when my jaw began to ache, tingle and feel tight.

The only things that cause me immediate pain most of the time right now are artificial audio like television, iPads, phones. The other day at the apartment complex that butts up against my neighborhood a crew of workers were using a wood chipper and it ripped through my ears immediately. So like to say it just depends on the noise.

 

I don't have any sources but if I remember correctly, some people on Tinnitus Talk said so. In my own experience it is so as well, although it is difficult to empirically trace a direct link between the two. Health experts typically claim that if you experience tinnitus symptoms after a loud event such as a concert, it indicates that your hearing has been damaged on some level. Ergo, I 'd figure if you experience a worsening of your tinnitus symptoms after exposure to sound, even though that sound might be quieter than dB thresholds commonly marked as 'dangerous', it is an indication that that sound has been too loud for your ears, in one way or another. Not an expert by any means, but this is just my 2cts.

In my opinion, things only start to improve over time if you take measures the prevent aggravating your hearing. Just continuing your life as usual and hoping it will go away will probably not work.

 

I respect your opinion, and how you have experienced it. We are all different.

My experience differ completely though, and I have never heard of this correlation between reactive tinnitus and hyperacusis with pain - in terms of this reactiveness being a precursor to hyperacusis with pain.

Imo, and also in my own experience, reactiveness in tinnitus is a subset of hyperacusis.

 

Yes I did during the early stages. It was a very slow gradual exposure by listening to certain sounds in my home. I was using my bathroom faucet as sound therapy for starters. I structured out my plan by starting at 10 minutes listening to it run while I’m in the vicinity of the faucet (near my bedroom area). I increased the duration by 1 minute every 2 days or so until I reached up to 30 minutes. By the 30 minute mark, I was beginning to tolerate it well.

Nowadays. I don’t do much structured sound therapy as my sensitivity has been stabilizing. I take in as much sounds as I can when I’m in the house. Whether it’s watching news on the TV, showering, listening to outside city ambience late at night when my windows are open. I sometimes find myself listening to relaxing music from Mozart for about an hour every few days. Recently, I’ve been listening to nature sounds like birds chirping, etc.

 

I have been wearing above the ear sound generators and listening to pink noise at between 3 dB and 7 dB. Some people find the therapy too aggravating. When I wear them, it seems like it makes it easier to tolerate various sounds, but I wonder whether the sound itself could be causing an aggravation.

I think that a whisper is 20 dB but is 3 dB to 6 dB much louder simply because the noise is so close to your eardrum and auditory system?

 

How long did you have hyperacusis before you started seeing improvement?

 

So I had it since April 2021, I finally saw some improvement in October and from then on it has slowly improved.

 

Maybe precursor isn't the right word, but in my own experiences, if my tinnitus reacts after exposure to certain sounds, I know I'm pushing my limits and a setback might be triggered if I'm not careful. I don't necessary claim that everyone with reactive tinnitus will eventually develop pain hyperacusis, but I do believe that by not avoiding reactive tinnitus spikes by guarding oneself against certain sounds, one cultivates the conditions by which pain hyperacusis might come about at a later stage in life.

 

The last sentence makes it sound like an inevitability. Hyperacusis is very rare and pain hyperacusis rarer still.

 

I'd say his is a matter of subjectivity and own experiences.

Don't forget it is possible to build tolerance to sound, even with reactive tinnitus/hyperacusis (even though your personal experience may be different).

Tolerance probably won't get back to where it was though, and if it would, we would and should protect ears when necessary.

Personally I did not avoid sounds that I reacted to due to the fact that I reacted to anything at one point, and to quit living was not an option to me. My ears reacted, and it did set me back, or annoy me temporarily, but over time I did slowly build tolerance, and overcame also a lot of fear. Fear of worsening.

I did use musician earplugs around a lot of certain sounds for some time, but over time less and less. I am talking about everyday, normal sounds like frying food, listen to TV and music on low/normal volume, and such...

What might or might not happen in the future is impossible to tell. But I choose to have a positive view on the future.

 

You are great to communicate with because you have really done your homework.

 

I have learned something new this week. I always thought that pain hyperacusis/noxacusis was loudness hyperacusis plus a pain component but apparently not.

 

I have learned something new this week. I always thought that pain hyperacusis/noxacusis was loudness hyperacusis plus a pain component but apparently not.