My Pain Hyperacusis 100% Resolved from Tamsulosin (Flomax)

Yeah I agree people should be more specific on what their pain is like as I think it’s possible different types have different pathologies. For instance, I do not know if people who get acute stabbing when a loud noise hits them have the same pathology as someone who has burning pain in their face from sound.

 

I hope people in this thread will respond because there is smooth muscle around the tympanic membrane and since alpha 1 blockers relax smooth muscle it would make sense that it would help this sort of pain. Intuitively, this might make a difference in TTTS type pain especially.

 

My stabby pain often feels like a very “hard” muscle contraction if that makes sense. Like a deeper more painful version of the thumps that I get.

It’s not like a needle prickling at all.

 

If my theory is correct (and it is just a theory, I'm not suggesting anyone be a Guinea Pig), I think you would benefit more from something like the Flomax referenced in this thread.

I also think (again if my theory is correct) that people who get some relief of pain from benzos might also get benefit from a smooth muscle relaxer (alpha 1 antagonist like Flomax). I don't know its other effects, though. I haven't looked into it enough.

I started getting more mild thumps on both sides and moderate face pain as of two days ago. It definitely seems to be more TTTS in how it feels than true intracochlear noxacusis. If it gets worse, I might be the Guinea Pig (I have access to a similar drug, Prazosin).

 

What type of facial pain? Is it stabbing or burning?

 

Electrical-burny feeling. Definitely not stabbing.

And my jaw muscles feel tight which they never do (I even had TMJ fully ruled out as a co-factor by two specialists and a CT when my hearing issues began).

 

I’m so sorry you have to deal with this, I have the same thing. It really sucks. And they told me I didn’t have TMD and yet my jaw pops, so not sure what to believe. It’s honestly weird because I never had any jaw issues before noxacusis. And now my jaw does a lot of weird stuff even tho I got this from acoustic trauma. It’s very weird.

The only thing that helps me is gabaergic drugs like Phenibut. So if this keeps up I recommend that for occasional use.

 

I have been doing a metric shit ton of reading about this and it seems that TTTS (which seems distinct from intracochlear noxacusis) can cause spasms in surrounding muscles in your jaw. These spasms can cause trigeminal irritation.

GABA drugs are also muscle relaxers. I just took a Klonopin (I never take this normally unless I'm having a severe vertigo attack and I haven't had those in more than a year). More diagnostically than anything. Will see if it helps.

For this type of pain, relaxing what essentially is a reactionary muscle spasm should help. I'm wondering if that's why the Fosamax helped OP.

TMJ can also cause this inversely (especially if it leads to ETD) but in my case I actually had TMJ ruled out before any of this started.

 

I have stabbing pain when exposed to loud noise. Very much like a needle being driven deep into the ear. I also get what feels like a sunburn deep in the ear after bad exposures. This sunburn sensation hasn’t happened in a long time as I’ve been protecting my ears and using pink noise to desensitize. However the stabbing pain is still around and sometimes my ears are more sensitive to it, i.e. less loudness is required to trigger the stabbing pain.

Electric guitar being overdriven is the number one irritant. Horns are bad. Sirens. Dishes clanking. Tinny laptop speakers and phone speakers. Children yelling or screaming. Dogs barking. Lower frequency stuff doesn’t bother me much even at loud volumes. Bass for example.

I’ve suffered from this since I was about 18 but it got really bad in 2019 after an extremely loud rock concert. I was completely dysfunctional for about a year, had drastically improved around June of 2020 (85% recovery), and sadly had another setback that is just now starting to improve again. Right now I’m probably at 65% of what a normal person could tolerate. I can listen to music at low volumes but no headphones, I’ll never wear them again as that’s what caused my setback. I also wear musician’s earplugs whenever I leave the house and listen to pink noise at least an hour a day right when I wake up.

 

Is it kind of like what you'd imagine an acid burn to feel like, or like when you get a bad sunburn and the pain kinda radiates and stings?

 

Did the sunburn sensation ever radiate to your face or skull area (top/back of head)?

 

My pain appeared very very shortly after I started having spasms. Before the spasms I had 0 trigeminal type irritation, so I agree with what you mention above. It would make sense that something is driving the facial nerve irritation to where it's not shock like pain as with compressions in classic TN but just the nerve constantly being aggravated.

 

One thing that seems to be helping me somewhat already is injectable magnesium. I take the oral tablets regularly and it didn't help this. I am on my last intramuscular bottle and can't get more at the moment so I will probably switch to liquid oral magnesium chloride.

It tastes absolutely disgusting (if I don't put it in lime juice and chase it with sucking on an actual lime it makes me gag) but seems to be better absorbed for me (I can feel it unlike tablets where I can't, even chelated etc).

Magnesium is great for muscle relaxing in general but it's very hard to absorb.

 

Thank you for the tip, I didn't even know Magnesium comes in liquid form like that. I might try that out. Just oral Magnesium chloride?

 

These effervescent Magnesium tablets are also nice and taste good.

I wonder if they're equally good to the Magnesium chloride @FGG mentions?

https://www.amazon.com/Magnesium-ef...=magnesium+effervescent&qid=1613694572&sr=8-3

 

Yes. There are two types the oral kind and the topical kind. The topical kind doesn't help me (though some people swear by the topical used with DMSO but I'm a bit wary of DMSO personally because it can be ototoxic in large amounts).

The Trace Minerals one (used to use it for PMS symptoms) seems especially potent but apparently has small amounts of Arsenic in it so I need to look for a new brand myself.

 

Those don't work for me (I tried most every different type as not to have to take gross tasting ones) but maybe they would for someone else.

I could actually feel my muscles loosen after a few days on the liquid magnesium chloride. Normally only injectable does that for me.

 

I've been reading more about the jaw lately and I think I may have accidentally stumbled upon a potential relationship between Flomax (an adrenergic antagonist) and ear disorders (such as hyperacusis):

The association between tinnitus, the neck and TMJ

"Contraction of the smooth muscle cells in the spiral modiolar artery is hypothesized to be tightly regulated to meet the demand of cochlear tissues (Wangemann, 2002b). Contraction of the smooth muscle cells of the vascular wall reduces its luman diameter with the effect of decreasing blood flow, while relaxation of the smooth muscle cells increases blood flow. Smooth muscle cell contractility is signaled both with central neural and local metabolic signals. Sympathetic (peptidergic and adrenergic) nerve fibers have been found in the spiral modiolar artery of the gerbil and guinea pig (Brechtelsbauer et al., 1990; Carlisle et al., 1990; Rauchegger et al., 1981). Norepinephrine-induced vasoconstriction in the spiral modiolar artery is mediated by α1A-adrenergic receptors (Gruber et al., 1998). Stimulation applied in the sympathetic ganglia, stellate ganglion, or superior cervical chain in the guinea pig has been shown to alter CoBF (cochlear blood flow) in situ (Laurikainen et al., 1994; McLaren et al., 1993; Ren et al., 1993). In addition, distribution of vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), substance P (SP), and calcitonin gene-related peptide (CGRP) are also found in the spiral modiolar artery (Carlisle et al., 1990; Qiu et al., 2001). These findings support a hypothesis that CoBF is controlled by neuronal signals at the level of the artery (Gruber et al., 1998; Herzog et al., 2002; Sadanaga et al., 1997; Scherer et al., 2005; Wangemann, 2002b; Wangemann et al., 1998; Wonneberger et al., 2000). – Shi, 2011​

 

It’s a little too much for me to digest quickly but I think in general I agree with this.

My tinnitus wasn’t noise induced yet I still had a bunch of other ear issues including hyperacusis which I have felt are related to TMJ issue and/or ANS dysfunction (hence norepinephrine). I believe that Wim Hof breathing exercises may have upset the ANS balance and as such the release of norepinephrine, which seems like it would correlate with your post. I think this is why VNS might be helpful for some people.

 

Many studies I've read mention that tension/pain in the ear can be caused by the Tensor Tympani muscle contracting and pulling on the eardrum. That this is actually tension of the eardrum that can be causing the pain.

This study says that smooth muscles of the eardrum (tympanic membrane) play a major role in its tension:

Smooth muscle in the annulus fibrosus of the tympanic membrane: physiological effects on sound transmission in the gerbil

Since it all started with a Q-tip to the eardrum, maybe it has nothing to do with TTTS or nerves and is all about damage to those smooth muscles of the eardrum itself.