What Causes a Tinnitus Spike and Can It Be Cured?

What Causes a Tinnitus Spike and Can It Be Cured?

Spikes are a regular topic of discussion in tinnitus groups. Some people regard them as a minor inconvenience due to the fact they have learnt to accept it over time. Others not so fortunate find the sudden increase in tinnitus much more than a mere nuisance, especially when it lingers on for days or even weeks in some cases, that can render a person unable to carry on with their daily affairs in the way they would like. The longer this continues the more frustrating and problematic it can become. Two questions often asked about this peculiar anomaly: what causes a spike and more importantly can it be cured?

There is no definitive answer I can give to these questions but I have opinions on what I believe causes a spike and possible treatments that a person might find helpful, in making their life easier and possibly stop them from occurring. Tinnitus is a complex condition that comes in many forms and intensities that no two people experience it the same. Because of this my focus will primarily be on spikes that affect people with noise induced tinnitus with or without hyperacusis, as this is one of the most common causes of condition. Most of the posts that I have read concerning spikes and the people that I have corresponded with have this type of tinnitus.

This is not to say people with tinnitus that wasn't noise induced aren't affected by spikes and don't find them distressing, on the contrary they do. However, I have noticed the spike is usually associated with other things and not usually caused by sound. For instance the consumption of certain foods or beverages, even changes in atmospheric pressure can affect the way their tinnitus behaves. Again this is not a generalization for we are all different but more often than not the increase in tinnitus for these people, will after a while subside and return to baseline level and won't last for days or weeks at a time or increasingly get worse because of oversensitivity to sound.

Stress is an integral part of our lives and we are unable to separate ourselves from it. Neither directly or indirectly for the simple reason few of us live completely isolated, our lives are interwoven by associating with other people at least to some degree. Therefore, whatever affects their life intern will affect ours. Whether this is a partner, relative or friend. Stress needs to be managed otherwise it can make the perception of tinnitus worse or cause spikes. Stress makes tinnitus worse and tinnitus makes stress worse. It can become a vicious cycle which I have covered in other posts available on my started threads.

When a person develops tinnitus caused by noise trauma, it's not unusual to experience some oversensitivity to sound, or in more severe cases hyperacusis which can be painful. Some people habituate to the tinnitus naturally over time and find their oversensitivity to sound reduces to more acceptable levels or goes away completely, without the need to see an audiologist specialising in tinnitus and oversensitivity to sound. Whilst a person is able to habituate to this type of tinnitus, if oversensitivity to sound is left untreated then spikes can become a long term problem. Not only having to endure the sudden increase in tinnitus from its baseline but the psychological effects it can have on a person's mental and emotional well-being. Over time this yo-yo effect can wear a person down considerably.

Some people take to wearing hearing protection thinking it's best to avoid sounds that will spike the tinnitus. This may provide relief in some instances but it's not an ideal long term solution and in the process, one risks lowering the loudness threshold of the auditory system, which will make it more sensitive to sound. I am aware there are conditions such as noxacusis, where a person has very acute oversensitivity to sound. If you have been diagnosed with this or hyperacusis then try and get some professional help with an audiologist that specialises in this field. One can also try self help which I have covered in my thread: Hyperacusis, As I See It.

My ENT doctor and Hearing Therapist diagnosed me with severe hyperacusis. It was so bad when in conversation with anyone, I politely asked them to lower their voice as my ears were in pain. The hyperacusis was completely cured in two years wearing white noise generators as part of TRT and having regular counselling. It has remained this way and I haven't had a spike in over twenty years.

Michael

 

2 questions:

1. What if the white noise or sounds irritate our ears? Do we keep doing sound therapy?

2. How does one habituate if their tinnitus is up and down all day every minute every hour?

I do agree about not overprotecting. My ears were becoming sensitive when I was doing it all the time and it eased up now.

 

Sound therapy is usually good for tinnitus and hyperacusis @Wrfortiscue, but not if it's causing irritation to your ears.

How long have you been using the white noise? Is this through the hearing aids that you are now wearing? If you have just started using white noise via the hearing aids, then I suggest to introduce it slowly. My posts on TRT and using white noise generators explains how to do this. Briefly, keep the white noise very low and only uses it for 1 or 2 hours, then turn it off for the same duration. After 1 or 2 hours use it again and continue with throughout the day for a week or two. The idea is get your ears and auditory system used to the white noise without causing irritation. This takes time. If 1 to 2 hours is too much for you, then try 30 minutes at a time.

This can be challenging but it is still possible to habituate. Again it takes time and do things very slowly when using sound enrichment through hearing aids/white noise generators. The tinnitus usually settles down in time but again, this takes time so stay with using low level sound enrichment. As you are now wearing hearings aids for your hearing loss, in time the tinnitus should reduce but it does take time.

It is important not to overuse hearing protection. Habituating to tinnitus and treating hyperacusis is not easy for some people. However, it is still possible to get some relief but it will take time so do things very slowly. If you are feeling stressed by this which is quite understandable, talk to your doctor who may advise medication and counselling with an audiologist that specialises in tinnitus and hyperacusis management.

Hope this helps.
Take care.

Michael

 

@Michael Leigh, are you still wearing the white noise generators or was that just a 2 year thing to beat hyperacusis?

 

Hi @SectorClear.

I still wear white noise generators but this is more to do with the fact that I like hearing sound enrichment at low level. When the tinnitus is silent, mild or moderate, I don't have to use them as I am fully habituated but still do. My tinnitus is still variable and this is explained in my post: My Experience with Tinnitus, so no two days are the same. However, I have habituated to this.

When the tinnitus is severe the white noise generators are used to help me cope with the severity of the noise. They are not used to mask the tinnitus because that is impossible, the volume is kept low to provide some distraction. At this level it is sometimes necessary to take Clonazepam (but not always) to calm the tinnitus down to silent, mild or moderate. This can take 2 to 12 hours.

I no longer experience any symptoms of hyperacusis and haven't for over 20 years.

In the near future I hope to be writing a piece on how habituate to variable tinnitus, as I have been asked this question. This is a specific form of tinnitus that is related to people that have habituated to noise induced tinnitus, then suffered a second noise trauma and it has changed to variable. This can reach severe levels and not easy to deal with.

Take care and I wish you well.
Michael

My Experience with Tinnitus | Tinnitus Talk Support Forum

 

Thank you @Michael Leigh, I really appreciate your response and all your other informative posts! Good luck as well.

 

Thank you for your kind comments @SectorClear.

All the best.
Michael

 

@Michael Leigh, hello, what do you mean when you say overprotection makes the auditory system more sensitive? Does this mean you will perceive sound as louder than it is and it will be uncomfortable, or does it mean that your auditory system will become weakened and more susceptible to being harmed further?

 

I think both...

Sometimes you don’t have a choice though.

 

Oof. Yeah. I've been getting so much conflicting information from these tinnitus forums that I don't know what to do anymore. I have been wearing earplugs pretty much every time I leave the house because I thought I was supposed to protect my ears as much as possible in the first few months following the onset. I have noticed that my sound sensitivity is heightened, but I thought it was just my anxiety (I have severe phonophobia). But then again, my mom has tinnitus as well and she has sound sensitivity, but she doesn't wear earplugs anywhere and lives life normally.

 

A question on sound therapy; can it be administered to one ear only? If the sensitivity to sound lies in the central auditory system, shouldn't it be possible to treat it through one ear?

The reason why I'm asking is because my left ear seems much more broken and fragile than my right. It has suffered two loud noise incidents and has a greater hearing loss. The tinnitus in that ear has increased threefold from moderate noise, it's now so intrusive that I can't afford to have it worsen further. My right ear hasn't progressed nearly in the same way, as it has only worsened very gradually over the last months.

Wish you well,
Stacken

 

Hi @Beep Boop Bop.

If a person overuses hearing protection there is a risk of lowering the loudness threshold of the auditory system, which will make the ears more sensitive to sound. I say risk because we are all different but more often than not, overuse of hearing protection makes the ears and auditory system more sensitive to sound.

It is similar to some people that wear sun or heavily tinted glasses purely for fashion when there really isn't the need for it. If there is no medical reason for them having to wear dark glasses and the glare of the sun isn't particularly bright, restricting light into eyes in this way, overtime will make them more sensitive to natural daylight and potentially cause squinting, when not wearing their dark or tinted glasses.

I agree with @Wrfortiscue's comments. The overuse of hearing protection goes far beyond the physical problems of making the ears more sensitive to sound. There is also the phychological problems that I hope to cover in a future post. Please read: Hyperacusis, As I See It, in the link below where overuse of hearing protection is mentioned.

All the best,
Michael

Hyperacusis, As I See It | Tinnitus Talk Support Forum

 

According to an audiologist I know, she said the brain has one auditory centre and therefore, only one ear needs to be treated with sound therapy. She advises her patients to wear one white noise generator not two. She specialises in tinnitus and hyperacusis and said, all her patients that have hyperacusis have responded well when following her treatment plan. The only ones that don't do well are those that don't follow it. She works for the NHS and not private.

Hope this helps.
Michael

 

Thank you for your reply! You are absolutely right that over protection causes psychological damage. I had a pre-existing anxiety disorder and OCD, so when I got tinnitus I went through the roof trying to control the situation in an attempt to prevent the tinnitus noise from getting worse. Now I'm in a very dark place. I just can't get past the fear of random loud noises catching me off guard. I'm always on edge and don't enjoy life anymore. Are ~1-second long loud noises enough to worsen tinnitus? Am I worrying over nothing? Do you have any tips for overcoming phonophobia?

 

I am sorry to hear that you are going through such a difficult time at the moment @Beep Boop Bop. You are still in the early stages of tinnitus and it can be a lot to deal with so don't be too hard on yourself. Talk to your doctor who may prescribe something to help with your anxiety. Please do not dismiss taking medication if it is suggested, as it can help lower your stress and anxiety which will have a positive impact on the tinnitus by reducing your perception of it.

If you can get a referral to see an audiologist that specialises in tinnitus counselling I believe this will be good for you. Go to my started threads and print the posts mentioned below and refer to them often. This will also help reduce stress and anxiety, as they are a form of counselling and instil positive thinking over time.

It is much better to print the articles rather than reading on a screen, where there is a tendency to skim through the information without absorbing it fully because there is a lot to read. By taking your time you will understand how tinnitus can affect a person's mental and emotional wellbeing and your brain will learn to no longer fear the noise. Believe me it it works and is very similar to what tinnitus counsellor would tell you in therapy. Tinnitus counselling cannot do all the work, a person has to put what they have been advised into action. The way to do this slowly incorporating and focusing on the positive things in your life. Be patient and give yourself time.

New to Tinnitus, What to Do? Tinnitus, A Personal View, The Habituation Process, How to Habituate to Tinnitus, The Complexities of Tinnitus and Hyperacusis, Tinnitus and Mental Health, Hyperacusis, as I See It, Tinnitus and the Negative Mindset, Acquiring a Positive Mindset, From Darkness into Light, Tinnitus and Negative Counselling, Is Positivity Important? What Is TRT and When Should It Be Started?

Take care and I wish you well.

Michael

 

Here on the forums it's like that. Everything harms tinnitus; from loud noise, to an anti-depressant, to breathing. Each case is different. I was very protective of my ears, and even then the tinnitus kept getting louder. So I stopped protecting my ears so much, I keep running away from sounds above 90 dB and my tinnitus didn't get any worse.