Need a Break from Earplugs — Can't Use Earmuffs at Work: Between a Rock and a Hard Place

My right ear canal is sore, which I suspect is irritation from my earplugs. (I don't think it's an infection, but will probably see a doctor just in case.)

I don't want it to worsen so I'll need to give the plugs a break for a little bit. The problem is that I need the plugs because I have hyperacusis. While my hyperacusis is rather mild, I also have phonophobia which isn't doing me any favors.

I've been wearing earplugs more or less whenever I leave the house aside when I'm just checking the mail or something like that. And my rowdy family is consistently noisy, so I sometimes use them in doors as well. Lots of usage.

I can use muffs at home, and maybe (reluctantly) when going to the store and stuff. But what about work?

I work at a Walmart. There's obnoxious customers, shopping carts, loud refrigerators, and annoying music playing over the speakers. Ordinarily I wear my plugs from when I get on the bus to make it there, to when I'm arriving home. But as previously stated, this currently isn't really an option. And I can't wear earmuffs at work. It's just not happening.

So as things stand now, I can either

A: Not use earplugs in my noisy work place and risk a worsening.

Or

B: Continue to use them and cause my ears further harm.

Any advice? Really frustrated.

 

If it's just local irritation from the ear plugs, that should resolve in a week.

Can you take a week off work and then look for some that are less irritating (moldable vs foam for instance or vice versa)?

 

I can't take a week off, no. I'm already scheduled well in advance and I don't think management would take this too seriously.

I can't get foam plugs to fit properly, but I've never tried molded. Are they inconspicuous? That's why I've been using musician's Plugs. They're hard to notice.

 

I think they'd be less conspicuous if you found flesh colored ones but if someone were carefully looking (but why would they be), they could see you wearing them. Could you wear a winter hat over your ears so they can't see them?

 

Lol. I'm in Florida. Unless you mean a beanie, in which case maybe.

We're not allowed to use earbuds, so they may be looking for that. If they do so, I imagine they might take issue with me wearing plugs on the clock. (I have no issue helping or hearing customers, but you know how bosses are.)

 

I forgot you are in Florida. A beanie might work and tell them it cuts down on COVID-19 related haircut risks if they ask.

 

If your life depended on it, I mean seriously, would you not wear those earmuffs?

I'm pretty sure you already have the answer to that question.

When you live in pain and risk getting into more pain, then wearing muffs at a workplace should not even be a question.

Talk to your boss, explain the situation. If he won't understand, you make the choice: risking your health or risking one job.

 

Something people don't like to talk about here is how over protection can lead to worsening of symptoms. I don't know how often you are using hearing protection, but if you are over doing it I am sure your making your hyperacusis and phonophobia worse.

Maybe download an app on your phone and test the environment and if it is in safe levels and then take the earplugs out. If I am in a noisy place that seems loud I always check, and it if is too loud for comfort I pop my ear plugs in. If it isn't a loud environment, I don't use them.

The suggestion of wearing a beanie is a good idea because the covering over the ears would provide some dB reduction compared to nothing. This is of course if you need it and if it is too loud.

 

I agree. I go to the gym without. My tinnitus is no worse. It's annoying but no different when I was just cycling and off on a 7.5 week vacation when everything was closed.

 

Just about everyday.

I already do that, and it is very helpful. But my phonophobia (and probably my PTSD) makes me feel uncomfortable anyway.

As for overprotection worsening my hyperacusis and phonophobia: Maybe? It's hard to tell because I protect so often. But it doesn't really matter in my case: My phonophobia is more about what could be, as opposed to what is.

Do you have hyperacusis? How often would you say you protect?

 

I only protect when I am going to be in an environment for a while that is consistently in the high 70s - 80s dB. This is usually at restaurants and whatnot. I did have slight hyperacusis in the beginning when my tinnitus was made worse. I was following some of the advise on here and over protecting. Once I stopped over protecting, my hyperacusis slowly got better.

If you really think you have phonophobia or PTSD, you need to go see a mental health expert to get it addressed. Search in your area to see if there are any specialists for phonophobia. This is most likely not something you can handle on your own and you will need an experts help.

 

People always say this but is there evidence to back it up? I've never bought it. I've heard that you get temporarily more sensitive by 5-10 dB but that the temporary sensitivity is much preferred to the actual damage (hearing loss, worsenings) you can do to fragile hyperacusis ears by not protecting.

 

My therapist has diagnosed me with moderate PTSD, yes.

And, respectfully, I don't feel safe seeing someone specifically for my phonophobia (my therapist is aware of it.) Because I imagine it would involve exposure therapy, which could give me a setback.

 

How often have you had setbacks? How long do the recovery periods last on average? Is your tinnitus reactive?

 

My tinnitus takes on reactive elements during spikes.

My spikes, not counting my worsening, usually last a week or so.

 

Is there anyway you could find a quieter job? Easy to suggest, I know, especially in these times of the coronavirus.

At home at least I use ear muffs, never plugs. I really don't want impacted wax or ear infections.

 

Exactly, there is no actual evidence that protecting one's hearing will weaken it.

When you break an arm, you're not playing tennis until your arm is fixed.
Or if you do, you know that you will harm it more.

If ears are damaged, protecting them at all cost seems the most logical thing to do. We don't even know how much time it takes for ears to heal (that is if they even do, considering there are so many factors involved).

In my opinion, the only reason for not overprotecting at all cost would be for people whose tinnitus is awfully loud in low dB environment and who do not suffer hyperacusis.

Then yes, giving your brain the possibility to mix the tinnitus in the sound environment makes sense, as long as they stay under a noise level that doesn't spike or make the tinnitus react.

 

In the Richard Tyler podcast he talks about how over protection makes symptoms worse.

There are countless posts on here about people saying that when they were over protecting their symptoms got worse.

 

Have you always worn plugs at work from day one or did you have an incident that made you decide to do it?

I’m not getting at anything in particular. Just curious really.

It’s definitely hard to decide on these things. I live in an apartment complex and I certainly don’t want to protect every time I go outside. I’ve had several instances where I wasn’t wearing protection outside that have caused issues though.

1. Throwing trash away in the trash compactor. Someone left a bag of trash laying by the compactor. Me trying to be a good neighbor and not leave trash laying out... throw their bag in which happens to have glass bottles all in it so makes a huge sound in the enclosed compactor that goes right into my right ear. Gained a new tone that day. This tone has now become one of my two main tones.

2. Was installing one of my kids car seats in the car the other day. No landscapers at my complex so I thought I was fine. My complex and the neighboring complex have large grassy hump dividing them. Suddenly a commercial zero turn mower pops over the hump very close to me. Very loud of course. I was in the car applying pressure to the seat to do a forward facing seatbelt install and had my hands pushing the seat and pulling the seatbelt as tight as possible so not easy to quickly cover my ears. Got a spike that day that lasted several days and some mild pain.

3. Went to the storage unit to get some free weights out. As I’m approaching, I see a guy pulled up to a garage unit beside the door to the storage units. He has a motor in the back of his truck. So I look into the garage as I’m approaching to do a check and see if it looks like he is about to use any loud power tools. I don’t see anything and assume it’s all good. I go in the storage unit, get my weights and come out. Immediately, some other guy who I hadn’t seen is standing there with him and starts using a pneumatic torque wrench. I have two weights in my hand so again can’t cover my ears. So I just start running to get away. I don’t think I really had an issue with this one in the end. Although, the next two days I had a little more sound sensitivity, but no spike or pain.

 

I used to work unprotected, and then I started protecting after getting a temporary tinnitus spike from traffic on my day off. I will admit that my protecting at work is probably more an emotional/fear thing.

 

And there are countless posts about people saying their situation got unbelievably worse because they thought they were safe when they were not.

To be honest, I believe there is no rule but each individual's rule.

Protection helps? Stay protected.
Protection doesn't help? Then don't.

There's no such thing as a rule when it comes to a symptom that is not even understood properly by science.

I was giving my input and my beliefs, but there are just beliefs.

 

Do you have a timestamp for this part of the discussion?

 

Reversible Induction of Phantom Auditory Sensations through Simulated Unilateral Hearing Loss

This article discusses tinnitus being brought about by unilateral plugging in some individuals who did not previously have tinnitus. So if you already have tinnitus it would seem constant protection could cause an increase in tinnitus.

With the central gain theory of hyperacusis I believe the reasoning behind it making symptoms worse is it would cause your brain to turn up central gain even more to compensate. I could be wrong. Maybe someone else has a link in regard to that.

However, I believe @FGG discussed somewhere in one of the research threads a possible inflammatory cause for hyperacusis. If that were the case I’d think protection would aid in reducing the inflammation.

 

Was it the constant protection that caused the tinnitus or the fact that it was a physical obstruction?

 

“It has been long known that complete auditory deprivation can induce tinnitus-like phantom sounds in healthy, normal-hearing volunteers. After several minutes of complete silence in an anechoic chamber or sound-proof booth, participants reported auditory sensations, and the descriptions of the sounds were very similar to those given by tinnitus patients. After leaving the anechoic chamber, the phantom sounds disappeared.”

If the anechoic chamber can cause auditory sensations that fit the description of tinnitus after minutes (and it’s not an obstructing of the canal) then it seems possible their model of plugging simulating hearing loss can make sense. Are you thinking that using muffs vs plugs would bring a different result because it’s not an obstruction?

 

Just to clarify, I wasn't saying loudness hyperacusis is *always* inflammatory but I just noted that it often resolves even when tinnitus doesn't and resolves in the acute stage when inflammation would be highest.

 

Reduced input causes tinnitus, you could probably simulate that with constant plugging as they did in that study.

 

Unfortunately I don't, although I remember discussing it with him.

 

In my case, overprotection due to phonophobia wrecked my tolerance to sound. For months, I wore Peltor X5A earmuffs every time I was outside the house, which was not often, and, when I was at home, I avoided even harmless sounds like running water (I went 3 months without a bath/shower), and I lowered the volume on the TV to where I could barely hear it. As a result, I became incredibly sensitive to everything, and I often had anxiety attacks whenever I heard something that I perceived as too loud, even if it wasn't. Overprotection didn't weaken my hearing. On the contrary, it strengthened it, making everything sound louder than it actually was, and making me more susceptible to tinnitus spikes.

Immediately after an acoustic trauma, protecting your ears is very important, but for how long? Many of us are too shell-shocked to try living without hearing protection, so it goes on and on, becoming a vicious cycle. I stopped using hearing protection cold turkey 6 months ago, and my sound tolerance is back to normal. I have my good/bad tinnitus days, but I no longer have the stress of trying to control every sound I hear.

I truly believe that it's impossible to habituate to tinnitus while overprotecting your ears, and that, once you're past the point of healing an initial acoustic trauma, it starts to become harmful.

 

Molded plugs are invisible to most people. I wear a set of Clear Westone TRUs all the time. Even my wife can’t tell I’m wearing them most of the time.