My Doctor Online The Permanente Medical Group
Are you having back pain with any of the following?
- Severe pain, weakness or tingling in your leg(s).
- Difficulty stopping urination or loss of control of bladder or bowels.
- Unexplained fever, nausea or vomiting.
- A history of cancer or unexplained weight loss.
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Overview
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Hyperacusis is a hearing-related condition that can make ordinary sounds — such as water running from a faucet, a shuffling of papers, or the clinking of silverware against a plate — painfully or uncomfortably loud. Machine noises and high-frequency sounds are often the hardest to tolerate. Sudden sounds, such as brakes squealing, an alarm going off, children screaming, or someone clapping, are also disturbing and painful. A person with hyperacusis cannot adjust to abrupt changes in sound volume.
Hyperacusis can occur in persons of all ages. It can range in degree from irritating to debilitating. In severe cases, people feel forced to isolate themselves, because sounds cause too much pain.
Hyperacusis differs from a condition known as recruitment, in which some hearing loss has occurred and loud sounds are experienced as intolerable. With hyperacusis, there is generally no hearing loss, and nearly all sounds are experienced as too loud.
Hyperacusis may appear suddenly, or it may develop gradually. It may affect only one ear at first. However, nearly always, the same symptoms will eventually be present in both ears. Hyperacusis often occurs together with tinnitus, a condition characterized by a continuous ringing or buzzing in the ears.
Additional References:
Symptoms and Diagnosis
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The main symptom of hyperacusis is a hypersensitivity to noises, even everyday sounds. Many people with hyperacusis describe it as a feeling of pressure in the ears, similar to what a person might normally feel in a descending airplane. This can be painful as well.
Another common symptom is phonophobia, or fear of noise. If hyperacusis is severe, it can make a person unable to work, perform errands, or enjoy relationships with other people. Hyperacusis may also cause:
- High stress and sleeplessness
- Extreme fatigue and confusion
- Nausea
- Loss of consciousness
Diagnosis
A diagnosis of hyperacusis can be made in conjunction with an audiological examination. The examination will include hearing tests and a loudness discomfort level test.
Causes
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The internal mechanisms that result in hyperacusis are not clear. Evidence suggests that the condition may be a result of damage to the fibers that connect the brain to the auditory nerve or an insufficient supply of the brain chemical that regulates how sense data are perceived.
The most common causes of hyperacusis are exposure to extreme noises, such as gunshots, or traumatic head injury. Other causes can include:
- An ear infection
- Adverse reaction to medication
- Meniere's disease, an inner ear disorder
- Lyme disease
- Temporomandibular joint (TMJ) syndrome, an inflammation of the joint connecting the jaw to the skull
- Bell's palsy, a disorder of the facial nerve
However, hyperacusis can also occur without an apparent cause. Children with hyperacusis may be at increased risk for autism.
Treatments
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Hyperacusis may cause restlessness and sleeplessness, especially at first. Therefore, anti-anxiety medication may be prescribed to help you reduce your stress level and get proper sleep.
If you have hyperacusis, even ordinary activities may seem painful. The use of earplugs can offer temporary relief but does not provide long-term management for the condition.
Sound therapy
Sound therapy is the standard treatment for hyperacusis. Sound therapy involves the use of a hearing aid-type device that generates soft, soothing sound known as pink noise. Being exposed to the pink noise, or a soft soundtrack, for several hours can gradually desensitize and retrain the brain.
While sound therapy normally takes 6 months to 2 years to achieve stable results, it has a very high success rate. More than 90% of persons with hyperacusis experience significant long-term relief as a result of sound therapy.
Counseling
People with hyperacusis often isolate themselves from social situations in order to avoid sound. They are also vulnerable to depression. Along with sound therapy, psychological counseling can help a person to cope with this condition and gradually reestablish social contact with others.
Behavioral desensitization for children
Children with hyperacusis are particularly vulnerable to anxiety and fear of being hurt by sounds. A sound therapy approach helps acclimate your child to sounds that they may have found uncomfortable. In addition to sound therapy, a program of behavioral desensitization can be helpful to overcome your child's fear of these same sounds.
Your Care with Me
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If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department.
During your office visit, we will discuss your symptoms and history and I will perform an audiologic evaluation. I will explain the findings of your tests and answer any questions or concerns you may have. We will discuss treatment options, and together we will create a treatment plan that is right for you.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with non-urgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.
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If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.
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Coordinating Your Care
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Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
If you call the Appointment and Advice line
- Our call centers are open every day of the year around the clock. If you need advice, we will transfer you to one of our skilled advice nurses (RNs). They can help you determine when you need to be seen and in what location.
- The advice nurse can often start your treatment by telephone depending on the situation and has access to your electronic medical record.
If you come to an office visit
- At the beginning of your visit, you will receive information about when you are due for your next test, screening or immunization. We can discuss and schedule any preventive tests that you need.
- At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
- To help you prepare for your visit, please see additional details under Office Visit.
If I refer you to another specialty colleague
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
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Convenient Resources for You
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As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
Manage your care securely
- View and compose secure e-mail messages.
- Manage your prescriptions.
- View your past visits and test results.
- View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
- Read about causes, symptoms, treatments, and procedures.
- Find interactive health tools, videos, and podcasts to help you manage your condition.
- View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
- Locate health education classes and support groups offered at every medical center.
- Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
- View your Preventive Services to see whether you are due for a routine screening or updated immunization.
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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.