New Onset of Pain Hyperacusis from Headphones/Dental Procedures/Bad Posture?

Hello everyone,

I've been following Tinnitus Talk for a few years now. My tinnitus journey began in April 2021 after my first COVID-19 vaccine. The tinnitus has been difficult to deal with, but I've mostly gotten used to it. I have occasional setbacks, but it usually goes back to baseline.

About a month ago, I noticed a burning sensation in my ears while at work. I wear headphones at work for about 6-8 hours a day with music, podcasts, or movies as background noise while working. After I noticed the burning sensation, I wondered if it was from the headphones, so I took them off. Things calmed down, and I assumed the burning was just from allergies, as it's that time of the year. Then, about a week later, I started experiencing stabbing pains in my ears. At first, I didn't notice it was happening during noise, so again, I thought it was just from allergies and continued wearing my headphones.

Then, one day when I took the headphones off, I noticed the pain was gone. I started testing noises and found that certain noises were triggering this pain, such as dishes clanking together, cabinet doors shutting, doors around the house shutting, and sometimes even my cat meowing. One day, my husband was talking to me, and my ears seemed to crack, making his voice louder than usual. This also happened with my kids talking to me. Additionally, from April 22nd to last week, I've had four root canals done, which involved a lot of dental shots in my mouth as I don't numb easily.

Considering these factors, including always wearing headphones at work, the dental procedures, and some issues with my neck from sitting in front of a computer all day for work, I'm not sure what is causing this.

I've lived with just the tinnitus all these years without any kind of hyperacusis until now. This doesn't make any sense to me. Since the tinnitus has persisted all these years, I'm now terrified that this pain hyperacusis is going to stay with me as well.

We are supposed to be leaving for a week-long beach vacation to Corpus Christi on the 25th, and now I'm terrified of going, even though I love the ocean. I'm scared of the almost 13-hour drive there, although we are stopping halfway there in Fort Worth for the night and finishing the drive the next day. Should I not go on vacation?

Is there a chance this will get better or go away? I have read so much about "let your ears have exposure to help get through this" and then "constantly protect your ears" that I don't know which one to do. I'm just looking for some ideas from anyone who has been through the same.

 

Hi @Alishia.

The COVID-19 vaccine could have caused or contributed to your tinnitus. It's a good idea to try to determine which one it is. From the information in your post, I get the impression you had tinnitus before having the COVID-19 vaccine, although it may have been at a low, manageable level. If you have been a regular user of headphones, then up until now, I feel confident in saying your tinnitus was originally noise-induced.

Noise-induced tinnitus is one of the most common causes of tinnitus, and typically, it is caused by listening to audio through any headphones at too high a volume without realizing it. This includes headsets, earbuds, AirPods, noise-canceling, and bone-conduction headphones. In addition, using them for long durations without giving the ears sufficient time to rest can cause tinnitus. Exposure to loud music at clubs, concerts, and other entertainment venues, even when wearing noise-reducing earplugs, can cause tinnitus too. Working in a noisy environment can also cause noise-induced tinnitus.

The pain you describe in your ears from the sound of dishes clanking together, the closing of doors, and experiencing pain in your ears when your husband and kids are talking to you are all typical signs of pain hyperacusis. This condition often (but not always) accompanies noise-induced tinnitus. The underlying root cause of the hyperacusis stems from noise-induced tinnitus, which I believe was brought on by listening to audio through headphones for too long a duration and probably at sound levels that were too loud without you realizing it.

My advice is not absolute because we are all different. However, it is based on personal experience of living with noise-induced tinnitus and once having severe pain hyperacusis, which is now cured. I have corresponded with and counseled people with tinnitus and hyperacusis for many years. The feedback I received from people that I have helped has been favorable.

I advise you to stop listening to audio through all types of headphones, even at low volume. Depending on how severe your pain hyperacusis is, it could improve by itself with time and with some self-help. The solution is not to overuse hearing protection as you risk lowering the loudness threshold of your auditory system, which can make your ears more sensitive to sound and increase the hyperacusis. Neither is it a good idea to shut yourself away at home and not go out. Some people believe one should avoid all sounds and stay home in a quiet environment to give the ears time to heal. Most audiologists and hearing therapists advise hyperacusis patients this is a bad idea, and I agree.

Some people have extremely severe and very painful hyperacusis, which I believe needs professional medical advice and treatment; I am not talking about this kind of people.

Hearing protection can be helpful, but it must be used judiciously and prudently; otherwise, you risk worsening hyperacusis and tinnitus. Ideally, you should be examined at ENT and referred to an audiologist specializing in tinnitus and hyperacusis management.

Please click the link below and read my thread: I Have Noise-Induced Tinnitus, What Should I Do? Please go to my started threads, print, and read all the posts mentioned in the list, particularly Hyperacusis, As I See It.

I advise you to start using low-level sound enrichment during the day and especially at night using a sound machine. You can use a desktop sound machine to play nature sounds while at work. The sounds should be kept low and not drawing attention to themselves. More information is in my list of threads, which I strongly advise you to print and not just read on your phone or computer monitor. This way, you will absorb and retrain the information better.

Only you can decide to go to Corpus Christi on the 25th. I don't know how severe your hyperacusis is at the moment. You may be able to wear noise-reducing earplugs for some of the time and be fine. However, as I have said, they should not be used too often. When I had severe painful hyperacusis, I was unable to go to specific venues, including a wedding and the reception. This was 28 years ago. The decision is yours, and I wish you the best of luck with what you decide.

Please see your ENT doctor to ensure your auditory system works correctly. If all is well, I suggest you see an audiologist, as explained above.

I wish you well,
Michael

I Have Noise-Induced Tinnitus — What Should I Do? | Tinnitus Talk Support Forum

 

Hi @Alishia!

I'm dealing with my first major setback myself, and trying to navigate this condition is tough. While we can't know for certain what caused your problem, 6-8 hours of daily headphone use is more than enough to induce hyperacusis in a susceptible individual. Dental work is also a considerable noise dose. Operating under the assumption that noise is the cause is probably the best thing you can do to maximize your recovery. Failing to do so carries the risk of worsening. Severe cases are often blamed for spreading doom and gloom, but after corresponding with a few of them personally, they have every reason not to sugarcoat. Hyperacusis & tinnitus can get brutal with enough carelessness and bad luck. This will probably scare you. Use that anxiety to take appropriate action; things will most likely improve with time.

As you have noted yourself, there is a lot of conflicting advice out there, and it can be frustrating to make sense of all the noise. A scientific vacuum is filled with heavily polarized anecdotes claiming to know what works. This is both understandable and problematic. Hyperacusis has a broad spectrum of severity, and people differ a lot symptomatologically. Some can push through discomfort and pain and do just fine. They attribute their success to their strategy and try to push that on everyone else. Some will claim that medication x, y, or z made them worse and try to tell you that all drugs are ototoxic. A few unlucky ones will keep getting worse no matter what they do until they eventually stabilize in some form of LDL-0 noxious hell.

We know for certain that you have no way of knowing which category you are in. You could be a “dropped plate from disaster” (credit to Joyce Cohen) if you are very unlucky. This reveals another divide in the community: the question of overprotection. The idea is that “overprotecting” could lead to “lowering the auditory threshold of your auditory system,” as @Michael Leigh put it. The intellectually honest answer is that we don't know. No matter what anyone tells you, there is insufficient data to support this claim. Clinicians often give this advice without nuance. What constitutes overprotection is not defined and is usually mentioned in the context of “everyday sounds.” But then you must ask yourself: what are everyday sounds, exactly? A dropped plate could objectively reach damaging sound pressure levels. It might not happen every day, but someday it probably will. “Overprotecting” against that has to be weighed against the risk of not doing so. I'm not pretending to know the long-term effects of walking around in Peltors all day. But dissecting these clichés leaves you with an equation of noise-risk/noise-exposure/protecting/not protecting that you will have to solve for yourself. This boils down to one simple piece of advice - be careful. Take advice, but be skeptical. Give your ears some rest.

 

My advice not to overprotect one's ears using hearing protection is based on corresponding with and counseling people with noise-induced tinnitus, with or without hyperacusis—many audiologists and hearing therapists who work with tinnitus patients back this up.

It is similar to people who often wear sunglasses when there's really no need. Their eyes get used to reduced light, and when not wearing them, they tend to squint. It is up to the individual what they decide to do.

If I were in @Alishia's position, I would follow the advice that I have given. It is based on personal experience, and many people that I have corresponded with have noise-induced tinnitus and hyperacusis. Some have told me their tinnitus and hyperacusis became worse due to overusing hearing protection and staying at home with the belief this would help heal their ears. Unfortunately, this practice led to some being referred to an audiologist for additional problems that I mention in my thread: The Complexities of Tinnitus and Hyperacusis.

I say again. Some have very severe and painful hyperacusis; the advice that I have given is not for this kind of person. They need very specialist care because their auditory system is hypersensitive to sound.

Please see your ENT @Alishia. If all is well, get a referral to an audiologist specializing in tinnitus and hyperacusis management. Please type headphones in the search box at the top of the page and read the posts.

Take care, and I wish you well,
Michael

 

Please don't listen to @Michael Leigh. If you are experiencing pain from sound, you should definitely protect yourself. Try to have as much silence as you can. Hopefully, you will improve in time. Then, if you are feeling better, try slowly reintroducing sounds.

 

There are two types of hyperacusis: loudness hyperacusis and pain hyperacusis (noxacusis).

When it comes to the exposure vs. protection argument, exposure seems only beneficial for certain cases of loudness hyperacusis, particularly those with "central gain" loudness hyperacusis.

Exposure is not beneficial for individuals with pain hyperacusis (noxacusis). As you rightly mentioned in your post, it's important to protect your ears and avoid any sound that triggers the pain.

A 13-hour drive might be risky. If the car's noise causes pain in your ears, you shouldn't go.

Pain hyperacusis can improve and possibly go away completely as long you protect yourself. Don't assume that hyperacusis will stay just because tinnitus has stuck with you for years. Hyperacusis has a much better chance of improvement than tinnitus.

 

With respect @Utdmad89, you have had tinnitus for a short while, and it may not have been caused by exposure to loud noises, as mentioned on your profile. Therefore, you know nothing about this condition, whereas I do.

The wrong approach is to protect one's ears as much as possible when it is noise-induced. Of course, one should be careful when exposed to loud noise. As many audiologists and hearing therapists advise tinnitus patients with noise-induced tinnitus with or without hyperacusis, I am saying to use low-level sound enrichment. This helps to desensitize an oversensitive auditory system and allows the brain to habituate to the tinnitus. It is quiet rooms and surroundings that can cause more harm than good, as mentioned in my thread: The Complexities of Tinnitus and Hyperacusis.

Many people I have corresponded with who follow your approach of protecting their ears or overusing hearing protection have developed phonophobia and misophonia. I am not going to get into a slanging match with you, as you so like to do with other members of Tinnitus Talk.

I am right, and you are wrong.

Michael

 

Well, many people who have followed your advice have worsened. They have literally told you this on Tinnitus Talk. So it's not just my advice.

→ What I Have Learned from My Hyperacusis Patients

I, and many others, think you're wrong.

You have also got into plenty of slanging matches yourself with members here.

I have also defended you here in other threads, but that was before the type of advice you preach worsened me.

 

If the people who followed my advice had followed it correctly, their tinnitus and hyperacusis would not have worsened. These people are the ones that I have placed on ignore. They are always looking for someone to blame for the difficulties they have with their tinnitus and hyperacusis.

Many of them have additional problems, and they visit Tinnitus Talk to vent their frustrations at people like myself who are only trying to help. Often, they look for unrealistic expectations, a complete cure for whatever ails them.

Read any of my posts and threads. There is absolutely nothing I have written and advised people to try that will make their tinnitus or hyperacusis worse if they follow the advice correctly. In addition, I always say that my advice is not absolute and that a person should see their ENT and be under the care of an audiologist specializing in tinnitus and hyperacusis. TRT and the wearing of white noise generators are not dangerous when they are carried out correctly. This means one should be under the care of an audiologist specializing in this treatment.

I give advice. I am not a doctor and have never claimed to be. Many people beyond the realms of Tinnitus Talk have followed my advice, and I have received positive feedback. Although few people will believe what I am about to say, an ENT doctor with tinnitus contacted me and commended me for what I do. I am only trying to do what I once received many years ago when I was a newbie suffering from severe tinnitus and hyperacusis.

I am not looking to conflict with anyone. Treat me with respect, and I will respect you. But I will not engage with anyone who uses foul or abusive language or is disrespectful toward me.

Michael

 

So now you're blaming the victims and nicely dodged the link of an actual expert who literally deals with hyperacusis as a living and has said that for people with pain hyperacusis, there isn't any such thing as under-protecting.

I haven't been abusive or disrespectful towards you. As I said, I have previously defended you. But I did find your previous post to be condescending.

 

I told you I would not engage with you in a slanging match. However, if you have something interesting to say in the future, I will consider corresponding with you.

Good day, and I wish you well.

Michael