Overprotection and Avoiding Most Noise — Yay or Nay?

I have read some posts from people who may have experienced an improvement of their hyperacusis by protecting their hearing (wearing earplugs most of the time) and otherwise staying quiet. I also know of one person who tried this and became worse as a result.

I know that some “experts” advise against this because the auditory system will be more sensitive after removing the protection and that the auditory system is nourished by sound.

I have been using above the ear generators and listening to pink noise but I have not improved in six (6) months of this approach. I have experienced loudness hyperacusis for sixteen (16) months and have exposed myself to normal, everyday sounds. The tinnitus may have even worsened and the hyperacusis may also be more intense since I started sound therapy.

My audiologist wants me to keep using the sound generators and that he knows of at least one person who took two (2) years of this approach before their hyperacusis improved.

 

Most do, yes.

And in my own personal experience, if it's loudness hyperacusis (I can not speak for the ones with actual physical pain), I believe - in general terms - that overprotecting from everyday sounds will make you even more sensitive, fragile and eventually scared to sounds.

That being said, "one size doesn't fit all".

But resting ears from time to time is necessary imo. But that doesn't mean cover them up completely. You want some auditory input.

These processes do take a lot of time @Athens. It is a slow, non-linear process, and that makes it difficult to keep on track and believe in progress when you don't feel it or "see it".

You might not see any progress at all for the first year. We are all different.
But with time many do progress, and they get better overall. Progression can happen even after 2 years.

 

Wearing earplugs as a form of treatment for hyperacusis is not a good idea. Usually they will make the ears more sensitive to sound by lowering the loudness threshold of the auditory system. In addition to this, regularly using earplugs in this way can instil and reinforce negative thinking about intolerance to sound. It is the wrong approach to take.

As a previous sufferer of severe hyperacusis that has been completely cured for over 20 years, I wholeheartedly agree with your audiologist. Continue wearing the white noise generators. The white noise should be set slightly below the tinnitus and not mask it. Treatment for this condition can take up to 2 years. For best results regular counselling with your audiologist is required, as this helps to remove and dispel a lot of the negative thinking that is attached to tinnitus and hyperacusis. Without counselling treatment may not be successful.

Please go to my started threads and read my posts: TRT, Hyperacusis, As I See It, The Complexities of Tinnitus and Hyperacusis. These posts cover the treatment of hyperacusis in more detail.

Michael

 

Overprotection is completely and entirely a myth. And yes, I have loudness hyperacusis only to see it dramatically worsen because people told me not to overprotect. Logically, it runs counter to basic logic and is really attempting to paint an ear injury as an anxiety disorder.

The "proof" of this overprotection nonsense is a study that showed that if normal people wear protection for a few weeks, their sensitivity temporarily increases a bit, which should be obvious. But this isn't hyperacusis and is fully reversible.

I've had debilitating loudness hyperacusis and tinnitus for almost 3 years. I protect all of the time and wear hearing protection 24/7. Every bit of an improvement I have ever seen has been from resting my ears and every noise-related worsening I have ever seen was from telling myself not to overprotect.

It's an infuriating and possibly life-ruining advice to tell someone to not protect an injury. The people that do improve likely just needed time and got lucky. Pink noise doesn't do shit, and again, that's even for loudness hyperacusis. Obviously it doesn't do anything for pain hyperacusis.

 

I’m in the same boat. Trying to “push thru” resulted in severe setbacks for me. Resting my ears and protecting whenever I go out are the only things that have helped me in 2.5 years of moderate to severe hyperacusis.

I strongly believe that there are 3 separate conditions: loudness hyperacusis, loudness hyperacusis with pain, and burning hyperacusis. I have the latter 2 conditions. I don’t think exposure therapy works for burning hyperacusis i.e. noxacusis. I think it worsens it, at least that’s my experience.

Fortunately I just discovered that Ginger temporarily knocks out my pain hyperacusis burning, which is a revelation. It might allow me to treat my loudness hyperacusis with pink noise without sending my noxacusis into a frenzy.

 

In my own experience, continuous <insert color here> noise can be one of the most irritating sounds for the auditory system. If you believe that your tinnitus and hyperacusis have gotten worse from it, I would personally stop using it, especially since you've gone for 6 months without any improvement.

I don't think protecting 24/7 is a good approach either, as I believe that's the very thing that has put my life in complete misery, but I would recommend you to merely lower your exposure to the levels that you find comfortable. If your tolerances can improve, they will from that point. You could use high fidelity ear plugs in the daytime and just let in as much sound as your ears is okay with. We don't build tolerance to sound by being exposed to that which is uncomfortable.

Just my 2 cents,
Stacken

 

That is correct, I would agree. At least to some extent - judging by my own experience.

It's important to find and surround yourself with noise that give you POSITIVE associations to sound again. Not a sound that feels and sounds aggravating.

As for this mentioned 6 months marks. 6 months is not long in this matter. You might not feel any progression after even a year. Maybe even longer. Only time will tell.

But again, use positive sound enrichment (anything you feel is okay), and start/continue on a very low, audible volume.

As @Stacken77 also mentioned; there will always be a fine balance with protecting your ears, resting your ears, and feeding your brain with sound input. Everyone is different. What might work for one, might not work for someone else.

 

This issue that I have is that my tinnitus is very reactive to normal, everyday sounds. The tinnitus seems to be worsening and the hyperacusis is more intense. There are certain people who are not able to tolerate the white or pink noise. I am not absolutely certain that the sound generators are making me worse but I am not going in the right direction. It is becoming more difficult for me to have a conversation on the phone.

 

Are you working full-time?

 

Thank you for the response. I have done the sound therapy for six (6) months but the hyperacusis has been present for sixteen (16) months. I had hoped that my brain would adjust after one (1) year but it seems perhaps even more intense and the tinnitus seems louder as a result. I agree that some people have improved several years later (even one person who improved four years later) but I am concerned about these symptoms consistently going in the wrong direction. I realize that it is not a linear process.

 

I understand what you are going through as I experienced the same thing. Although it reads on your profile cause of tinnitus unknown, your symptoms indicate noise induced tinnitus, which is one of the most common causes of the condition. One of the best treatments for it is wearing white noise generators and having regular counselling.

Introduce the white noise generators slowly to cause the least amount of irritation to your ears and auditory system. Set the volume of the white noise below the level of the tinnitus and wear them for just 1 or 2 hours, then remove them for the same duration. After the elapsed time put them on again setting the volume below the tinnitus and wear them for another 1 or 2 hours. If you notice any irritation reduce the wearing time again.

Continue doing this on day one, two and throughout the week. Continue this process for week two and so on, then gradually increase the wearing time. The goal is to achieve a total wearing time of 6 to 10 hours and many people achieve this. At night white noise generators shouldn't be worn while asleep. Instead use a sound machine by the bedside setting the volume slightly below the tinnitus.

Over time the white noise generators will desensitize the auditory system and treat the hyperacusis. At the same time the tinnitus is treated as the brain will habituate to the white noise generators and slowly push the tinnitus into the background so it becomes less noticeable. This treatment can take up to 18 months, sometimes longer. Ideally, regular counselling with an audiologist is advised. As previously mentioned, this helps to remove and demystifies the negative thinking that is often attached to tinnitus and hyperacusis. Contrary to some beliefs, hyperacusis can be completely cured using white noise generators or reduced considerably. The same can be achieved naturally without white noise generators or using self help as described in my post: Hyperacusis, As I See It.

Michael

 

I had an appointment with my audiologist yesterday. I have been disappointed by the counseling part of TRT.

 

An appointment with your audiologist does not necessarily mean you had a counselling session as part of TRT. I don't mean to sound pedantic. A Tinnitus Talk member told me a few years ago she had an appointment with her audiologist, who showed her some slides and talked about tinnitus and hyperacusis. She was curious and asked me if this is TRT counselling. It certainly is not.

Your audiologist maybe an excellent healthcare professional trained in audiology but unless he/she has tinnitus they cannot give high quality tinnitus counselling. One has to live with this condition to be able to understand how it can affect a person's mental and emotional wellbeing and thus be able to give high quality tinnitus counselling.

Please go to my started threads and read my post: What is TRT and when should it be started? There I explain in detail how an audiologist/hearing therapist administers counselling to a tinnitus patient as part of TRT.

Counselling cannot do all the work, the patient must make a conscious effort to reinforce positive thinking. My posts: Tinnitus and the Negative Mindset, Acquiring a Positive Mindset and others that I have advised you to read will help you to do this.

I wish you well.
Michael

 

That really begs the question of how loudness hyperacusis works. What about those who develop loudness hyperacusis after SSRI or Benzo cessation? Could that be considered an ear injury?

Like tinnitus, I believe loudness hyperacusis is mainly a brain problem, not at all related to anxiety but instead a real broken "gain calibration", that in quite a few cases has a peripheral cause, i.e. hearing damage. Some are more susceptible to setbacks, and some are lucky enough to regain pretty normal tolerances.

I may be completely wrong of course,
Stacken

 

Not sure, but the loudness hyperacusis I'm referring to is from lost peripheral hearing input. I know very little about purely central causes. Of course, the symptoms are central, but the fix for ear damage seems to require restored hearing input. In my experience, I often see my tolerances fluctuate (even for the better) living in dead silence so no argument could be made that sound rewired my brain, but rather that my brain decreased central gain when slightly better hearing signal was sent.

 

Hi Zugzug,

I'm not completely familiar with your situation/coping regimen so have no idea whether you've considered using hearing aids or not, but did you happen to see this post from @Philip83? Might be of some interest.

 

Yeah, I agree. I personally think most loudness hyperacusis is in the brain, some is from the middle ear, the stapedius or tensor tympani, and there could be some from the cochlea, synapse damage. I feel that it is the majority whose brains are causing it from hearing loss, and that’s why it gets better and sound therapy works. People with middle ear hyperacusis is half, and cochlear-based hyperacusis sufferers could be the ones who don’t improve from anything. So many things can cause it. It’s crazy.

 

It’s like the kid who got pain hyperacusis from dishes dropping. Like how did that cause any damage to the point he has to wear earmuffs and live in silence? I felt like it was a brain mechanism to protect from that moment of PTSD. Forgot his name but he’s on YouTube.

 

To be fair, I think dropping dishes can easily peak way over 100 dB, which probably could cause, if not hair cell damage, maybe nerve damage in some people.

But, I get your point, I've myself experienced worsening in symptoms from sound in the 60 dB range; if those sounds did cause structural damage then it must have been absolutely minuscule. I think it's very likely that there's a centralized issue at play in a lot of cases, and not necessarily true structural damage.

Stacken

 

Tom Maholchic. But he played a lot in the garage with his band. The dishes were just the final straw for him, like for many of us.

 

Damn that makes sense.

 

This is purely anecdotal based on my own experience with hyperacusis (with physical discomfort), but white/pink noise made mine worse while ear protection as needed definitely helped.

One thing I'll add is that, for some of us, the type of noise is as important as volume. In my case my hyperacusis was caused (or at least triggered) by playing electric guitar through an amp with gain/distortion, and even now after I have recovered considerably my setbacks are always caused by listening to music with gain/distortion. Listening to a jackhammer in the street or my young kids shrieking at outrageous volumes doesn't bother me, but even 30 mins of electric guitar can set me back for days. So I try my best to wear earplugs whenever I play guitar or listen to music, and it seems to be working for me. The static-like sound of white/pink noise probably bothered me because it's in the same frequency range as (or at least sounds similar to) distorted guitar.

 

If you have pain hyperacusis, there is no point in going around without hearing protection. You will be in pain all the time, your hearing will deteriorate and hyperacusis will not go away... so not using hearing protection is a really bad idea.

 

Yeah the dishes broke the camel’s back for him. I had a similar experience. My ears were weak from shooting guns without earplugs 5 years ago. Blew a hole in my cochlea a year ago which made both ears sensitive as hell. Got in a car accident and the airbag deployment caused bad damage. Then the final straw was a brake squeal from my Hellcat Brembos. It was just enough at the right pitch to break the camel’s back. I felt the nerves being ripped to bits from it and ever since I’ve been as bad as Tom the guy you saw on YouTube. Yeah, trust me dude, it can be that bad. Tom seems like he’s over exaggerating in the video but believe me, he’s not.

I remember when my tinnitus and hyperacusis were mild and barely affected my life. I watched the video and was like Tom has to be bullshitting, it can’t be that bad. I only understand what I had experience with. I never knew you could get ear pain from your phone playing music on volume 1. I mean I was like these people are all just being babies. Nah bro, trust me. Shit can happen. And my pain was moderate from March to June of 2021. It was stabbing and aching but lasted maybe a few hours after a bad sound. I still kept trying to live and push though shit being the dude I am, thinking I can’t just give up, I can’t just give up my entire career, job, friends, the gym, everything for this. But that was before the pain got so bad I would just throw up and pass out.

I’m telling you man, if you have it like me and @Taw and tom, the pain is like nothing you have never experienced. I’ve torn my peck, broken bones, torn ligaments, fractured bones, had teeth pulled out with no numbing, had bulging discs in my back. The closest was when I was a kid and had like 30 warts each hand and they used liquid nitrogen to freeze them off, for one or two it was quick and not bad, but nonstop liquid nitrogen for 15 minutes was just horrible pain, and I had to go every few weeks. I used to skateboard and that sport hurts like hell and. I’m no stranger to pain bro, I’m not a cry baby. But i can tell you, the ear pain got so severe I told myself I will never leave my house again if it meant the pain will stop. I literally have thought about death every night holding my gun wanting to end it all because of the pain. This kind of pain is nasty because of where it is, ear pain like this is a bad sensation. If you felt this pain anywhere else on your body, it would not be as bad. Like a 4 on my normal ear pain days is like a 8 or a 9 on normal parts of the body.

It is bad dude, it’s hard to understand when you don’t have it because I didn’t get it until I got it. Try to imagine you get a screwdriver jabbed all the way in your ear and the wound never heals. You feel the pain all the time and every noise including your own voice. Sometimes it feels like rubbing alcohol is being dumped into the wound. God it’s seriously one of the worst conditions on the planet man. And having tinnitus with it, hahaha, makes it worse. Because any pain meds you take just make the tinnitus worse. My tinnitus is pretty bad and I don’t even care anymore. But yeah I think in these cases it’s like a nerve or synapse hanging on by a thread and one right noise just completely disconnects it. I don’t think hair cells can be damaged that easily, I mean maybe but it’s not likely.

 

Wise words @Brian Newman. I wish someone also told me this when my hyperacusis was mild. And indeed this pain is on a different level compared to other pain types. I have chronic gastritis which hurts like hell and nothing relieves the pain. I also had a spine surgery and did not take any medication after it, because I can endure the pain.

At least that's what I thought before getting severe pain hyperacusis. The pain from hyperacusis is in another league.

 

Your story is so heartbreaking man. I hope with all the effort you are putting into getting compassionate use access to the meds in the Research News section that something works for you to ease the pain.

What type of exposures were you “pushing through the pain” still? I know you had the worsening from the deadlift first. So was this stage of pushing through things before the delivery van wreck?

 

What was it that caused your case to go from mild to severe? Were you pushing through pain at any point like @Brian Newman mentions?

 

Yep, I used the subway (95 dB there), and I thought before (I remember the exact words): I should push a bit more to get back to normal, how bad the pain could be? I was sooooo wrong...

 

Thanks man, I appreciate it. I hope I can find relief from something. I can live in silence but if I’m always in pain too, it’s just rough. And yeah the deadlift caused loudness hyperacusis but not actual pain yet. So pushing through stuff didn’t make me worse really, just working out would make my ears more sensitive and make the distortions in the fistula ear worse. I didn’t get pain till weeks after the car accident, my car’s squealing break set the pain in. Yeah it was severe pain, it hurt like hell but it went away after a bit and I only got pain from those high pitch noises, slowly, as I think my issues are synapse damage, I read synapses can keep dying over a period of 9 months.

For months I was ok in the house, no issues. I went everywhere with earplugs in just in case. No pain from artificial audio. Everything started to get bad when I yelled months later and felt the classic snap in that bad ear. Then everything started to just hurt. Even then the pain was short in duration and I was not suffering like I am now. I did my best to avoid loud noise and wear earplugs everywhere because I knew what could happen. I just kept worsening from then on. Before I was careful, and like most people with noxacusis, I would heal, build up tolerance, but after the sound therapy I tried months later my ears just stopped healing and I’ve been stuck with an open wound in my bad ear most of the time.

As I started getting discomfort from artificial audio, I refused to stop because I literally had nothing else to do. I kept getting more and more discomfort, then starting getting pain but continued to push through it. That didn’t help. I remember my last night going to a restaurant with my buddies and I was wearing foam earplugs, everything was fine, the music, the talking, but then my friend’s dad starting telling funny jokes and we were all drinking. My other friend has a high pitch squeal laugh. I kept feeling pain from it but I kept telling myself there’s literally no way I can get damage through foam earplugs.

From that night onward I kept getting worse. And my ears just stopped healing. I noticed if I feel moderate pain, it’s ok, but once it starts to escalate quick to severe pain, I gotta stop quick. If I don’t, it’s permanent worsening. I remember 3 months after the car accident I only had mild pain in that ear and was fine driving for hours with earplugs in. It just kept getting worse. It’s crazy man, like I’ve had ear shit a long time and I’m not an idiot, I just didn’t think noises literally under 50 dB could make this worse. I mean it’s definitely not killing hair cells or synapses, it’s probably just over sensitizing the Type 2 nerve. Only explanation for all of this.

 

Lol how bad can the pain be, dude I get so upset when people say there’s many things more painful. I could peel the flesh off my bones and sit there and laugh man. I mean pain anywhere else in the body is not as bad. Maybe some spinal injuries or trigeminal neuralgia. That seems closest to what we have, doctors say trigeminal neuralgia is the most painful condition on the planet. I think this is definitely equal, probably worse. People are in so much pain, but most are like yay, I went to a club or a restaurant or a bar or at work. People don’t understand leaving the house and living makes pain much better. All of them were diagnosed by doctors who want to help and know about it. We go and most say, eh, sucks man, I don’t know what to do. We all know being in pain sucks but having no medical help, no sympathy, and having to sit home and stare at the fucking wall all day while listening to blaring tinnitus is a new level of torture nobody will ever understand.

I mean they just won’t. It’s impossible even for people with loudness hyperacusis and tinnitus, it’s just not possible. Like I said, I felt bad for Tom on the YouTube video but I was like this dude gotta be exaggerating. Sheesh man.