Hyperacusis - What Is it?

Everyone has heard a sound that could be said to “hurt” their ears.  It may not actually do damage, but it feels like it hurts because the experience is so uncomfortable.  The person with hyperacusis feels every sound.  Every sound hurts this person’s ears, and it can affect every part of his or her life.

Cochlear hyperacusis has to do with the way sound is processed.  It is what is usually thought of when the term is used.  There is also vestibular hyperacusis, which involves structures of the ears themselves and can lead to falling, vertigo and  loss of balance.  It can lead to mental confusion, loss of consciousness, and extreme fatigue.

People with hyperacusis can isolate themselves, become depressed or anxious.  They may even lose their jobs.  They will have trouble sleeping or doing the simplest chores, such as vacuuming or sweeping the floor.

Some believe that the causes of hyperacusis are physical.  They might be damage to the inner ear—especially to the cochlea, or to nerves going from ear to brain or to small muscles that protect the ear from blaring noises.  Sometimes, but rarely, there may be a brainstem disorder responsible for the condition. 

Others believe the mechanism responsible for hyperacusis is the complex processing of the information as it goes from the ear to the brain.  In other words, it starts in the ear as a normal sound, but is amplified through processes in the brain until it is perceived as an earsplitting noise.

Other known causes of hyperacusis are: William’s syndrome, Lyme disease, Bell’s palsy, and termporomandibular joint syndrome.  Sometimes it follows exposure to some sudden and extremely loud noise, such as dynamite exploding.  It can also be brought on by air bag deployment.

Hyperacusis is closely related to tinnitus.  In tinnitus, there is a ringing in the ears that never seems to go away.  Many who have tinnitus also have hyperacusis.  The opposite is true as well.  In fact, many of the treatments are the same for both.

There are many treatments for hyperacusis.  Some use medications.  Some are: Lorazepam or Klonazepam, antidepressants, antimigraine medications, anti-seizure medication, and Baclofen.  Others use natural remedies such as taking vitamins, minerals, or Chinese herb concoctions.  Exercise improves blood flow to the ears and vitamin B12 helps the body protect nerves of the inner ears.  Biofeedback, massage, exercise and acupuncture have all been used for hyperacusis with varying degrees of success.

Clinical hyperacusis treatments revolve around the use of sound-generating devices.  Tinnitus Retraining Therapy uses sound generators.  They emit a low level, low frequency sound.  Neuromonics Tinnitus Treatment, used not only for the buzzing of tinnitus but also for hyperacusis, consists of a small device which sends out a signal that contains music.  Both devices are used in decreasing increments to habituate the patient to normal sounds. 

Hyperacusis may or may not involve physical damage to one’s ears.  The pain, though, can be unbearable.  Understanding and treating it are more important now than ever.