Overprotection Recovery with Pain Hyperacusis

Hey guys, hope you're all doing well

It's well known that overprotection increases sensitivity to noises. There was a study done with people who had normal hearing and after a while of overprotecting they had some increased noise sensitivity, but there was no mention for how long they had it after stopping overprotecting.

Needless to say, it's unlikely this study really apply to us without a normal hearing,

Sadly the rules of the game changes when we talk about severe pain hyperacusis, because it's simply not a choice to not use hearing protection, actually depending on the severity of your pain hyperacusis wearing both muffs and earplugs won't be enough for stopping setbacks and cycle of pain.

I want to ask those who used to overprotect for months/years, how was the process of tapering off hearing protection?
Did the increased noise sensitivity go away?
How long did it take to go away?

P.S.: I'm not mentioning phonophobia, earwax, impact of overprotection on tinnitus etc because my goal is to know the residual effects of overprotection on hyperacusis (especially pain hyperacusis).

 

I can only speak for myself -- after my big "incident" that led to my tinnitus/hyperacusis combo, even the smallest sound hurt for the first couple of weeks. I then overprotected, which didn't help.

The good news is, I found out what worked for me -- again, I can only stress that this worked for me, can't guarantee it for anyone else -- and I really learned the second time I had the worst setback possible and went back to square one. I've found that when I'm at my very worst, or have something happen to cause an "incident" that brings me back to square one, I need a few weeks to recover and take it easy around any type of noise. After that, however, things start to heal and I really need to start listening to music/reasonably loud noises to get my tolerance back. I'm to the point where things are generally tolerable at normal enough sounds, but if I don't listen to music for an hour every couple of days my tolerance does go back down.

I've had a bunch of audiologists help me out in this regard. Listening to music at low levels of volume isn't going to make my tinnitus worse long-term, or anyone's tinnitus worse long-term (most likely, of course). Of course, find what works for you, but I've found that I absolutely need to not overprotect and need to expose myself to sound or my sensitivity gets way worse again.

Forgive me if I rambled, and let me know if you want to know anything else about my experience.

 

I am not really protecting my ears at the moment and still have that burning sensation (sometimes mild discomfort).
I think Marks Strategy is the best way to go since any minor bits of improvement is lost if I get hit by any sound nowadays. I am thinking of wear earplugs all the time even during exercise for a few weeks. Any form of exercise seems to worsen my H. Though I may think of taking a week off from exercise.

 

@MarkLud
Hey Mark, sorry about the delaying to answer.
Thanks for your feedback about ur story and how you deal with it.

If I may ask some questions, is your hyperacusis loudness, pain or both?

Do you have long standing burning and pain symptoms after loud exposure or only your tolerance decreases?

Wish you the best.

 

I've reached a point where my hyperacusis seems to have improved quite a bit but I'm unsure whether to continue to 'play it safe' by using plugs when going out or not. What's peculiar is that I had about 3-4 days last week where I didn't didn't leave my house yet it didn't seem to make much difference in terms of my sensitivity and I didn't feel like it brought me much improvement. Yesterday though I went to visit some relatives so was a bit more productive and focused on just getting on with things and I've found that my ears feel less sensitive? Didn't expose myself to any excessively loud noise, was just socialising in a small group, cooking etc but I think just being surrounded by this kind of ambient environmental noise and getting on with my day as usual has helped de-sensitise my ears a bit.

I'm going to continue to use plugs but wean off them by using them on alternate days maybe... sitting at home holed up in my room with a laser focus on my ears isn't sustainable. I still need to get over my 'fear' of playing music/videos from my laptop lol... I'm haunted by that since it was watching Netflix that worsened my setback originally.

 

What earplugs do you use? Any muffs?

 

I don't use muffs. I just use the EarPeace musicians' plugs which come with different filters.

 

I don’t have an answer to the OP question but would just like to add my experience and perception of other people’s sensitivity that we all seem to differ a lot in how quickly we recover, if at all, and how careful we need to be to get better with a long term goal in mind. I personally think that if your pain is really real (because level of neuroticism also varies in all of us), there is more risk in underprotecting than overprotecting. It seems to me that for most people with severe hyperacusis the progress needs to be slow and steady. (I myself suffer from fibromyalgia so I’m predisposed to chronic pain.) It’s my impression that you’d quickly get used to sounds again but you could also quickly get a lot worse if you exposed yourself too much. After all, accidents happen all the time and you can only try and preempt them through caution. This is only my opinion, of course, as everyone will follow their own path. But I will no doubt play it safe for the rest of my life because I’ve seen just how badly the hyperacusis can deteriorate under the right circumstances. I took a lot of risks when I felt I could handle them, but after the rapid decline, I no longer feel able.

I also wanted to say that to me it doesn’t always seem to be about exposure: sometimes my hyperacusis and tinnitus soar without any external stimuli. Some days I don’t suffer that much from a trip in my car when on other days I will suffer a lot. I’ve decided that it’s not ALL about sound, but also about hormones, neurotransmitters (e.g. dopamine levels), blood pressure, and perhaps other factors that I don’t quite understand including psychological processes that may have nothing whatsoever to do with the hyperacusis and tinnitus (at least superficially). Or something you ate. And then as you say, it’s not always the loudness factor, but a question of frequency. This has been quite a problem to me as I can’t hear certain sounds all that well through my ear plugs and muffs, and think I’m safe, yet the high frequency actually caused a set back. I think we’re all struggling to interpret the data and may get a bit neurotic about protection because some things just don’t quite add up/make sense. But perhaps better be neurotic than sorry? I appreciate that some people get caught up in cycles of fear, but not everyone is prone to phonophobia. Jmo.

 

To be honest, I completely agree and think that hyperacusis benefits a lot more from overprotecting than underprotecting, particularly the pain hyperacusis variant where it's typical to experience delayed, prolonged burning. I don't see how it's feasible in that case to just continually expose yourself to triggering noise as you will just end up with a horrible pain flare later on. I think there can also be a bit of confirmation bias at play, where once people start improving they naturally start protecting less which prompts them to say that it helped them improve?

I also don't want to invalidate anyone's experiences though and if there's one thing we know about hyperacusis is that there's no one-size-fits-all road to recovery. But in general I see hyperacusis as a 'noise injury' - (a term which I have seen used in some of the literature) and you have to view it like you would an injury to any other part of the body. If you broke your leg you wouldn't just immediately go out and walk on it.

 

I don't understand how anyone is able to wear ear protection besides when absolutely required. I use plugs and muffs when using my snowblower, but the roaring drives me absolutely insane.

Doesn't the noise drive you batshit crazy?

 

This. Same thoughts. With any hearing pro on my tinnitus completely takes over everything and is just absolutely terrible and migraine inducing. I do my best to keep my exposure low but sometimes there is noise outside of my control and that’s when the hearing protection goes on.

 

Yes I agree with you and the reason I responded earlier was precisely because I felt I could relate to the way you perceive of your condition. The main difference is probably that I deteriorated from a point where I was (probably) like you, but because of a lot of invasive medical interventions things de escalated and I reached rock bottom, and am having a really hard time climbing back up. As a chronic pain sufferer, I’m used to experiencing pain that goes on and on for years, but in some cases, it does eventually get better. The body is a funny thing. So I’m not completely without hope but I’m super realistic and will probably always be wearing custom made ear plugs in public (once I can have decent ones made because the previous attempt was a failure - turns out I have weird ears).

I completely get that people think their interventions have helped when in fact the condition just started to improve by itself. I can also see how you do naturally let go of some of the protection when you start to feel better. I certainly do, it’s just baby steps and I just can’t risk my progress at this stage. I just want to add to the discussion as a word of caution because people have gone quite mad and depressed from overexposing their ears as per authorities’ recommendation.

Just to clarify that I think *some* people believe their interventions worked when in fact they were simply constitutionally strong enough to deal with it and healed over time. For others maybe it was a combination of interventions and time. Others, yet again, are mentally more prone to anxiety and fear and believe themselves to be worse than they really are. And so on. Everything’s possible.

 

Well you do because you have to. It’s not really all that difficult when the suffering is really great and there simply is no other option. It’s horrible but for some of us it’s necessary (don’t get me wrong, I really do hate it).

 

It’s an awful situation when you would rather sit and listen to roaring tinnitus than risk causing yourself hyperacusis pain because every little sound can potentially do that to you. I’m now vary of things such as the wind, rain, radiators coming on... not to forget things dropping on the floor by mistake. I do take protection off when I eat usually because the chewing is louder with plugs in, and also when I feel safe. But it really is very seldom. Even in bed I can’t risk outdoors sounds and the sound of my own snoring.

I was NOT like this prior to the medical events that lowered my tolerance to basically zero. I was very outgoing and didn’t have set backs if I used ear plugs while attending events etc. I talked to people and loud talk didn’t bother me at all as long as I wore a plug to soften or filter the sound. But now, no matter how much protection I wear, the sounds seem to cut right through. The decline was quite sudden so it’s not because of over protection - that to me is myth and in any case there ARE sounds in my daily life, it’s never completely quiet.

So the only reason anyone would ask this question is because you don’t understand how bad it can get (and that hyperacusis pain is worse than just having tinnitus if the person asking doesn’t suffer from hyperacusis). And you can’t understand it until it happens to you.

 

Oh, trust me, I have pain. Pain so severe I can't even wear muffs because it makes the top of my head feel like there's acid on it and ear plugs can make my ears burn. I haven't left my house in 6 months and on some days I struggle to communicate using soft voices.

Despite this, I still can't wear hearing pro 24/7, the tinnitus is just THAT bad, I literally want nothing more than death. Some days it's bad enough to wear I'd trade it in for the pain if it was going between the two. This isn't a critique on overprotection or saying that hearing protection all day is wrong. I am simply wondering HOW people are able to tolerate it 24/7 as even with severe 24/7 pain I have to give my ears a break from ear plugs. I just don't think it's good to make this into the Suffering Olympics, at severe levels both conditions are suicidally bad. Having them both at the same time is a special kind of hell.

 

I’m sorry to hear that and of course I wasn’t implying anything specific about your pain levels - it’s just my observation that people often complain about something without realising just how much worse it could be. I think your testimony only proves just how variable this condition is, and really my main objective is to try and illuminate the experience the best I can so that when it comes to the treatments, the one-size fits all model that’s currently prevalent could be overturned. As a chronic illness sufferer I have suffered from simplistic medical models all my life.

Ok, so how then can I tolerate protection almost 24/7, hm well, I’m just different. Bear in mind that I have been suffering from overall body pains all my life. Perhaps I’m more tolerant. Or perhaps the discomfort is different. However it really is often quite difficult at night when the hyperacusis and tinnitus are both soaring and I’m trying to watch something on Netflix and focus on a story without sounds. Especially if the tumbler dryer is going so I can’t risk taking plugs out. I admit I often resort to paracetamol, it takes the edge off a little bit. I don’t currently talk to people if I can avoid it. I’m giving it a year or two, probably the latter.

 

@Moss, my apologies if my comment came off ignorant, I could have phrased it better. My thought process was more so of "how" can people tolerate it as opposed to "why". I understand that it's not really optional with severe hyperacusis and you have to do what you have to do. I just don't tolerate my tinnitus well at all and with pain and tinnitus being trapped in with earplugs it's just too much to handle.

 

@Orions Pain, we’re not always in the best frame of mind to express our thoughts in the most optimal way and I probably sounded a bit dismissive for which I apologise. I’m reminded never to make any assumptions whatsoever about another person’s experience of pain and discomfort.

To try and answer the ‘how’, well I don’t know other than that I have a more optimistic outlook on life than I used to because of also having had good things happen in my life and finding a greater sense of both inner and outer peace. I don’t take the good stuff for granted so that helps. I no longer try and look for a way out but rather accept the situation as one possible condition of life.

 

I’m pretty fresh in this. I have had my tinnitus for 2 1/4 months, pain hyperacusis started about 2 weeks into the tinnitus.

After about a month of only using hearing protection when I noticed distortion, I started having my symptoms get severely worse to the point where the pain was unstoppable - anywhere from a 6-10 on pain scale, and even quiet sounds distorted.

Once that point was had I started wearing earplugs all day long from the moment I woke up to the moment I returned to bed. This greatly tapered the pain although it was still there. I was aware that I could be increasing sensitivity but I didn’t care since the pain was far too severe for me to not protect.

About a week and a half ago I started getting random vertigo attacks that seemed to be triggered by sounds experienced on the rare occasions I didn’t have earplugs in or from over exertion after long periods of rest. I believe I may have Ménière’s or something similar but I’m also not sure.

Very recently however I’ve noticed some major improvements. I haven’t had a vertigo attack in days and 2 days ago I even went through the whole day without earplugs in! Certain noises were still hell like airplanes flying overhead (I live and work next to an airport).

 

Maybe not Meniere's but it does sound like some conditions closely related to it like endolymphatic hydrops or Tullio's. Or maybe even a perilymph fistula since you were exposed to a blast. Fortunately, these are pretty treatable conditions so long as you find someone that knows what they're looking for which is almost possible.

Have you ever considered the Silverstein Institute? Someone with a type of "hyperacusis" similar to yours was recently cured with round window reinforcement but the caveat is that with a reinforced round window, drugs like FX-322 will not reach the cochlea, although the surgery is reversible.

Seriously though... congrats you're getting better!