Nociception in Pain Hyperacusis

Nociception in Pain Hyperacusis

“What are the mechanisms behind pain hyperacusis, and are there pain receptors associated with the ear? A straightforward answer appears to lie in the feedback and modulating system of nociception, which is integral to the mammalian pain response. Nociceptive pain is one of the four types of pain; acute, chronic, and neuropathic pain are others. The cochlear organ of Corti, particularly the outer hair cells, can be damaged by noxious noise, but this does not innervate nociceptors because this type of pain loop is not found in the inner ear.”​

Found this new paper today. Goes into the differences between pain hyperacusis and loudness hyperacusis, looks at the potential mechanisms that leads to pain hyperacusis, and examines future areas of study to better treat pain hyperacusis. I think this article is really solid in laying out the issues those of us with hyperacusis face—it made me feel really valid to read it. Of course, actual help is still a long ways off. But I hope this signals that the tide is changing slowly (and that I may be able to enjoy my life again in a few decades).

 

Yes I read this too. Very interesting, at least more articles are being made. It’s definitely from those Type 2 nerve fibers that trigger pain that never shut off for people when they are damaged.

I really think the next decade we have hope. I think these regen meds will help a lot with noxacusis. I can deal with pain all the time but when it gets bad and the tinnitus gets louder, it’s just debilitating.

Maybe even better treatments for it, I can live with a treatment that will let me leave the house every day and not be in pain.

 

Yeah exactly. I don't care if I'm fully cured. I just want to be able to go grocery shopping without fear for my health. No one should have to deal with this illness.

 

Yeah ikr. It’s crazy when it gets so bad sounds cut right through earmuffs and earplugs. I’m done going anywhere at this point. Gonna have to survive as long as we can until something comes out. It amazes me how there’s so little we can do. I mean many people see success with drugs but idk about you but my tinnitus is not worth risking, and all my crazy distortions, not trying to get worse there either lmao.

 

Good article but not very encouraging, especially the "Like tinnitus, hyperacusis is not always associated with clinical hearing loss, and to date, no one has been cured of pain hyperacusis." part.

There are many people who healed on this forum, although I am not sure if all of them had 100% pain hyperacusis.

https://www.tinnitustalk.com/posts/610106/

 

I have pain hyperacusis and have not healed. I think it has to be cochlear damage or synapse or nerve deterioration in the long run. There's no cure for this.

 

Very interesting article. Thank you!

If you want to read more on the olivocochlear system:

https://en.wikipedia.org/wiki/Olivocochlear_system

It's fascinating, although poorly understood.

As a long term sufferer of pain hyperacusis I can report many symptoms, including odd symptoms like:

- Very evident and loud typewriter tinnitus
- Not hearing anything for like a second but only a very loud high pitched tone, and then perceiving sounds like warping... and later on having more balanced hearing
- Eustachian tube thumps together with very loud tinnitus (briefly)

I think some of those symptoms have to do with the olivocochelar system that controls the cochlea.

 

Me too, I think the same that it's cochlear or nerve damage. For how long have you had it? Did it improve a bit or is the pain constant?

 

You or Juan get setbacks from squealing car breaks? I hear them through the walls in my house from the street. Even with earmuffs on. It’s absolutely insane. It seems every time I hear this noise my tolerance drops permanently. I have to wear earmuffs all day in my own house because of all the squealing breaks outside. I can tolerate my fan, it helps with the loudness hyperacusis, but if I don’t have earmuffs on during the day it will be nonstop pain.

Like the loudness of these squeals are like 10 dB maybe at most. It feels like it’s causing damage. I mean can it? I thought I understood hyperacusis but noxacusis is a different story.

 

Well, I can relate to that but I would make a precision. For me those sounds triggered a reaction that mimicked a setback but was not a true setback. This is, your body reacts, but ears calm down faster and there is no damage. That is my personal experience exactly with the kind of sounds and situation you report.

 

More than 10 years.

It did not improve. It changed and now I have tinnitus, which I did not have at the very beginning, and some hearing loss. I had terrible, horrible, very severe hyperacusis and it morphed into less hyperacusis but way worse speech recognition in noise etc...

Just listened to classical music at home, in silence, and had to cup my ears to perceive some details that were not hard to hear just one year ago. Every day this keeps getting worse.

 

To be honest I don't know what triggers the pain. Curiously car breaks do not bother me that much or other sounds that bother many people with hyperacusis. But in the same time I got very random pain so they might be related, might be delayed pain, dunno.

But i almost never got instant pain from breaks. My worst enemies are dishes and music.

 

Damn lucky man . Every time I get exposed to a car break, I get more sensitive to that noise. Not even kidding. And I can hear the noise better and better as time goes on. Yeah dishes and music are easy to avoid. I use paper plates and don’t go anywhere so there’s no music. These car breaks haunt me lol. It’s a nightmare. I hear them through Peltors half a mile away.

 

So what for you was a true setback? Would you get setback wearing earplugs or earmuffs? I don’t leave the house without something in and I still get worse. Almost like it doesn’t matter. And if I barely hear volume through the TV with muffs on, boom pain, other nights not much. I think something else is going on. I have had some doctors suspect a PLF or CSF leak too. I heard this one girl her ears amplified high pitch noise and hurt her horrible because of the PLF, it’s making me wonder. I think my PLF is making high pitch noises louder and it’s mixing with the damage from the car accident.

 

I've seen some success stories of people with pain hyperacusis on here, though my understanding is that most of those people start with mild hyperacusis, take some time to rest their ears, and are then able to resume their daily lives, but the threat of re-injury always remains. So, to that extent they're not truly healed as their ears are still more delicate than an average person's and remain much more susceptible to acoustic trauma. What I've seen happen on this forum and on the hyperacusis subreddit is that someone with pain hyperacusis will recover for a few years but then forget how fragile their ears and re-injure themselves and end up way worse than they were before. It's a tricky thing to manage, and to that extent I agree with the characterization that no one has ever been cured.

 

For me a true setback is walking on a quiet street, in an urban area, earplugs and earmuffs on, just to turn the corner and bump into a guy that just started using a jack hammer.

Or, again, be walking on a quiet street, just past the open door of a small business, and it turns out someone is doing construction work inside. They were resting but as you passed they suddenly start drilling the wall or cutting tiles.

This kind of stuff happens oddly no matter how much care you use, because you cannot anticipate noise or have any visual contact with close potential danger, and produces a true setback that messes everything up even more, creates an imbalance and can produce new symptoms or alter the existing symptoms.

 

Sorry to hear this, I am in constant severe pain (9.5/10) for 2 weeks and I cannot imagine how is it to have pain for 10 years. I admire your courage, I don't think I would want to live anymore if it won't improve in 1-2 years.

 

Not sure if I consider myself lucky because the pain is so random, I cannot understand what triggers it and what not.

What bothers me today can be tolerable the next week and vice versa. Now I cannot tolerate my voice.

 

Things change over time. One gains perspective, sees things different.

A good approach is trying to concentrate on things one can do and enjoy, and not on things one cannot do.

 

I think it has to improve. Mine improved after two years. Pain is almost gone. Please be patient and don't let these dark thoughts consume you.

 

I can do this when the pain is tolerable and not constant, but when it's 24/7 it's quite hard.

@Vassili, thanks for the nice words, I started to improve a bit after 8 months but after setback it's worse. This is great news that you improved, can I read your story somewhere? What did you do to improve?

Congrats!

 

How are things in Latvia?

I read about a lockdown over there; is that true?

 

Latvia is breaking records. They do have a lockdown at the moment.

It's not that much better here in Estonia. Government is constantly talking about the possibilities.

 

I also had my first small improvement after 8 or 10 months and I've experienced lots of setbacks with pain and tinnitus severity. So it's all part of the game.

I don't have a success story because I still have quiet tinnitus. My main thread is called On My Way to Recovery from Tinnitus and Hyperacusis in the introduction section. You can read my story there.

I did nothing special to improve. Just protected my ears. Time was my healer. I hope for a full recovery in 3-5 years. Time will tell.

 

Why are COVID-19 cases going up?

 

Lots of people don't get vaccinated.

 

Man, if you had sharpening burning pain in your ears and if lasted days/weeks, you are truly a success story. I also had mild tinnitus my entire life and after the acoustic trauma, the tinnitus became moderate.

But the tinnitus is a piece of cake compared to my hyperacusis, I can live with this tinnitus my entire life.

Enjoy your success, you deserve it and don't risk anything.

 

Did not mean it like that, sorry. But yeah my voice bothers me too sometimes and triggers the pain. Ahhhh sigh.

 

It actually lasted much longer in my case. I think for 1.5 years for sure.

Thank you for kind words. Take care.

 

Btw I forgot to ask (or maybe I did), can you travel by plane, train, car?

Flying again is my biggest dream, but having a setback from the subway I don't think I will fly very soon.