Hyperacusis & Tinnitus: Are they Related?

What is Hyperacusis? This condition involves the inability to bear daily sounds. People suffering from hyperacusis usually find normal sounds to be very loud, painful, and uncomfortable. The most common cause of hyperacusis is impairment of the inner ear due to exposure to loud noises and aging.

Experts link this condition with tinnitus, which involves a ringing, buzzing, or whistling sound in the ear without any external source. Most people face this condition in both of their ears. However, hyperacusis can occur in just one ear, as well. Other conditions that make people intolerant to sound are phonophobia and loudness recruitment.

Hyperacusis and Tinnitus are they related?

Symptoms of Hyperacusis

Symptoms of hyperacusis can be sudden or gradual. These symptoms include:

  • You will find your voice to be distorted or loud
  • You will find low sounds to be very comfortable, but ordinary sounds will irritate you
  • You will feel pain and discomfort Around loud and sudden sounds
  • Sounds with low intensity, such as that of a refrigerator, will seem very loud and annoying

Causes of Hyperacusis

Here are some causes of this condition:

  • Head injury
  • Certain medications
  • A slap on the ear
  • Hearing problem because of aging
  • Noise exposure such as working in a loud environment
  • Ear surgery
  • Exposure to an explosion or sudden sound
  • Medical procedures such as getting your ear canal cleaned can temporarily increase the intensity of sounds you hear
  • Facial nerve paralysis can affect the mechanism in your middle ear which is responsible for protecting your ears from loud noise

Other Causes of Hyperacusis

Below you will find some other causes of hyperacusis:

  • Fibromyalgia
  • Endocrine disorders
  • Autoimmune disorders
  • Neck and head injury or trauma
  • Withdrawal symptoms or medication side effects
  • Lyme disease
  • Migraine headache
  • Metabolic disorder
  • Meniere’s disease
  • Acoustic trauma and noise exposure
  • Neurological conditions
  • PTSD
  • Perilymph fistula
  • Ototoxins
  • TMJ disorder
  • TBI
  • Williams syndrome
  • Sensorineural hearing loss
  • Superior canal dehiscence
  • Facial nerve or viral infections in the inside of the ear

If you cannot tolerate sounds in a single ear, an ENT doctor will investigate for a tumor (acoustic neuroma) on the vestibular (balance) nerve. If they detect a tumor in time, experts can remove it in time. Even if the specialist finds a tumor, they need not necessarily remove the tumor.

Treatment of Hyperacusis

At this time, no medical or surgical approaches specific to hyperacusis exist. However, medical specialists can suggest various treatments to reduce a patient’s anxiety and fear. These therapies can also help with sensitivity to sound. Here are those therapies:

  • Retraining Therapy
  • Sound therapy
  • Cognitive-behavioral therapy
  • Lifestyle changes
  • Counseling and education


In tinnitus, you will perceive noises despite them having no external source. Such sounds include hissing, ringing, and buzzing. This condition can occur in both or a single ear. Tinnitus can be centered inside or from outside the head. There are two types of Tinnitus. Objective tinnitus is when the noise is from inside the body. This type is rare, but an examiner can hear the sound. In Subjective Tinnitus, an ENT doctor cannot hear the sound. This type of tinnitus is very common.

Hyperacusis and Tinnitus is there a relation?

Symptoms of Tinnitus

The symptoms of hyperacusis and tinnitus may differ in severity and description among individuals. Both hyperacusis and tinnitus may be symptoms of different diseases or disorders and may be linked with various conditions.

Symptoms of tinnitus may be:

  • Low or high pitched noise
  • Intermittent, pulsing, or constant
  • Non-bothersome or bothersome
  • Chronic or acute
  • Centered inside or localized from outside of the head
  • Present in both or a single ear

Causes of Tinnitus

Risk factors and causes of objective tinnitus are:

  • benign intracranial hypertension
  • atherosclerotic carotid arteries
  • arteriovenous malformation
  • arterial bruit
  • anemia
  • Blood flow changes in the vessels near your ear because of:
  • thyrotoxicosis
  • strenuous exercise
  • pregnancy
  • glomus tumors
  • neck or head injury or trauma
  • middle ear muscle spasms
  • Eustachian tube dysfunction
  • Vestibulocochlear nerve’s microvascular compression (VIII);
  • Palatomyoclonus

Risk factors and causes of subjective tinnitus are:

  • Barotrauma
  • Hormonal changes
  • Ménière’s disease
  • Acoustic trauma
  • Endocrine disorder
  • Cerumen blockage
  • Sinus/ear infection
  • Migraine headache
  • Presbycusis
  • Vitamin and mineral deficiencies
  • Temporomandibular joint (TMJ) disorder
  • Otitis media
  • Metabolic disorder
  • Medication side effects
  • Hearing loss
  • Tumors such as meningioma and vestibular schwannoma
  • Traumatic brain injury (TBI)
  • Otosclerosis
  • Whiplash
  • Viral infections of the inner ear
  • Multiple sclerosis

Treatment of Tinnitus

Before treating your Tinnitus, ENT doctor will go through diagnosis to identify the reason for this condition. The treatment will depend on the symptoms. Here are some types of treatments that will help you in treating Tinnitus:

Treating an underlying health condition

  • Earwax removal
  • Treating a blood vessel condition
  • Changing your medication

Noise suppression

  • White noise machines
  • Hearing aids
  • Masking devices
  • Tinnitus retraining


  • Tricyclic antidepressants, such as amitriptyline and nortriptyline
  • Alprazolam (Xanax)


A specialist will recognize the condition you are suffering from and suggest a suitable treatment method. Contact us at 646-213-2321 or visit our website to learn more.

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Tinnitus Cognitive Center

Stephen Geller Katz, LCSW-R
Tinnitus Cognitive Center ™

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