For Kurt Wrigley, a 27-year-old living in the Midwest of the USA, three ear conditions have affected every part of his life: noxacusis, loudness hyperacusis, and reactive tinnitus. “Imagine every sound sounding way too loud and hurting you,” Kurt explained. “An ear ache on steroids when exposing to normal, everyday sounds. My right ear burns and throbs. My jaw cramps with needles that radiate. It’s the worst pain I’ve ever had in my life, and lingers for days or weeks. It’s like the world is coming through a speaker cranked and hitting red. And my ears ring louder and louder with every sound I hear. Sound avoidance is crucial for me.”

But when people get these conditions they come to realize just how integrated sound is in every task of life. “I can’t drive, talk in a normal voice without whispering, listen to digital audio or music, watch a movie or video with sound, go to a restaurant, spend a normal evening with friends, take a shower without ear protection like earplugs and earmuffs, cook without protection, go shopping, spend a day walking around town, go to a park, work in a public setting (I can only work remotely and without audio-based meetings). Basically, almost everything in life is compromised because sound is a part of everything.”

Because of these conditions Wrigley lost his former job as a corporate cyber security analyst since the company wouldn’t let him stay remote after its COVID-19 work-from-home restrictions were lifted, and a once-healthy marriage to his wife is now strained, and a good relationship with his eight-month-old son (it’s hard to be around him since children are inherently noisy). Kurt’s hobbies like golfing are ruined (it’s loud to whack a ball), leisurely but necessary activities like walking the family dog, cruising around and working on his car, going to the gym or exercising, and nights of entertainment attending stand-up comedy shows and movie theaters. The list goes on.

While noxacusis can manifest itself as instant pain to sound or even delayed after exposures, Kurt’s symptoms are delayed. His reactive tinnitus, which sufferers note is often conjoined with noxacusis and loudness hyperacusis, is aggravated by this cycle, too. Two phantom tones in his ears resemble the cacophony of a fire truck’s siren and electrical circuits firing. They get louder when exposing to daily sounds.

Even with ear protection many sounds are dangerous for Kurt, and that’s why he can’t just power through them and endure the pain. He’s mostly homebound to avoid sounds. But that could mean 40 or 50 more years of isolation since he’s so young. For many this severe, such an undertaking is not a choice but rather a necessity, because disobeying their limitations can quickly yield a permanent rise in their symptoms. People have learned that the hard way, when their symptoms worsened to the point where the faintest of decibels incurred further damage, and when hiding became a futile practice in a world bathed in noise, as they tried to hunker down in makeshift soundproofed rooms or tiny closets whose means to combat incoming sounds were no good. They couldn’t. The lower frequencies bled through. It was too late; they had missed the train for having some kind of dignified existence free of sound’s oppression. And because of that they folded shop. The suicide rate for severe noxacusis is somewhat high, especially. Prevention is key: don’t become worse, because whatever you lose may never be retrieved. That’s the scary truth for some.

While a multitude of factors are likely to blame for Kurt’s ear conditions, he’s confident their origins are linked to years of noise abuse. Although it’s worth noting that many people abuse their ears and still their hearing is healthy. It’s likely that genetic susceptibilities play a role in why some people get these rare conditions, as discussed by Dr. James A. Henry, author of The Hyperacusis and Misophonia Book, during Hyperacusis Central’s recent interview with him. “I did loud stuff with friends who already had mild tinnitus,” Kurt said, “and as far as sound abuse goes they’ve done far more than I ever did or ever will, like shooting guns without protection, being next to jets while they’re taking off, being involved in car accidents, taking ototoxic medications a lot, smoking and drinking alcohol, doing street drugs.”

So for Kurt a lifetime of bad behaviors coupled with a weaker auditory system genetically could have encouraged this nightmare to come about; for example, habits like cutting grass with no protection; neither earplugs nor earmuffs were used by Kurt when doing this. And occasionally he’d also use power tools or loud machines and did not wear protection. Other mistakes included going to bars, clubs, and loud restaurants, or going to concerts a few times. One, he noted, was very loud and exceeded his comfort zone for most concerts. And attending some sporting events for the Pistons and the Lions in Detroit surely didn’t help.

“I guess a lot of things attributed to this and worsened me. I wasn’t careful enough, especially after the initial signs that something was wrong cropped up. I still did band practice at a friend’s house. Went to a club, too, the same night. And continued to use a deck sander, although I wore earplugs for that. One time I was with a friend who blasted music so loudly that it shook the car. Another time I blasted music myself while driving. I went to an IMAX movie — Top Gun: Maverick — and noticed it was loud. And one night a joke from my wife inadvertently worsened me. She cupped my ears to surprise me and when she pulled away the pressure change caused significant pain inside the ear my noxacusis is present in.”

So when Kurt got mild versions of these conditions he initially continued to go out and attempt to live a normal life, and a list of endless sound exposures added damage to the “open wounds” that were his ears, more or less. For some things he used protection yet it wasn’t good enough. He wants people who have these conditions to understand the potential risks they’re facing so they don’t end up like him, worsening, becoming homebound, and losing everything. It’s case by case, of course, but he feels that sharing his story could save a life. We agree.

Kurt’s Timeline

The warning signs started in December of 2021 with temporary pain sensations in his ears while hammering inside the closed-in space of a wheel bearing on his Malibu. An acoustic trauma had happened and permanent tinnitus in quiet rooms emerged. “I later got loudness hyperacusis in August of 2022 when a cellphone blasted my right ear at close range. At this stage everyday noise was loud but not painful; it just felt super jarring. Not long after the cell blast, I noticed that everything was different. My uncle dropped by and we watched some YouTube videos. While listening I was like, ‘Hey, can you turn that down? It’s really loud.’ As things progressed my right ear began to get delayed pain with sound exposures, and my tinnitus went haywire.”

At this point for Kurt both ears were affected with tinnitus, his left one a mild stable tone and his right an ever-worsening catastrophic tone whose deterioration couldn’t be linked to anything other than the fact that total sound avoidance is impossible in life, even with ear protection because it doesn’t block all frequencies and loudness thresholds, and therefore forced exposures equate to inevitable repercussions in a situation such as this. Over time the electrical components of his ringing became more and more pronounced, and the usual tone — which sounded like eeeeee — started to shift in timbre to mimic a noise like a broken electrical cell misfiring up and down (eeeEEeEEeeeEeeEEE).

It’s torture for Kurt to wear hearing protection because his tinnitus is so loud; all he hears is ringing. And it’s loud enough that if he didn’t have any sound intolerance, masking attempts using other sounds to drown it out still wouldn’t work. He’d still hear it everywhere. “On average it sounds like it’s 70 decibels. When I’m wearing ear protection it feels like 100. It’s so loud that I can’t hear anything — no talking; nothing. The screech is overpowering.”

But Kurt explained the worst of his story came on December 15th, 2022, when he went to a dentist for a cleaning and a filling. Against his better judgment he did it, and that was the thing that caused him noxacusis. He felt a shock sensation while the dental hygienist was working on his teeth with an ultrasonic scaler, and symptoms of ear pain arose.

His attempts to calm the damage were quick and decisive. “Right off the bat I talked to someone who had severe noxacusis. We met online. I thought it was so unlikely to get noxacusis that I didn’t take the advice he gave me. I thought that he was just unlucky — just beyond it, you know? I thought, Meh, the highest-rated earplugs should work fine. It’s not like I’m going to concerts or working on my car again. I’m doing normal things. And the data on hand had made it clear that exposures to everyday sounds were safe, like online information and ENT advice. But, to be cautious, I did wear earplugs everywhere: to drive; to work; for walks outside as well; stuff like that. But the data was wrong — tragically wrong. Those everyday sounds were still too much, even with earplugs. So I worsened more and more. And later, on Christmas Day, I learned that the hard way. I didn’t wear the plugs for our family gathering. After a while my right ear was burning and turning red. I took a picture. I could physically see the redness. This badly set me back, and only time will tell if it’s permanent.”

Oftentimes sufferers have said that sound avoidance has helped their noxacusis improve. And that after they improve it’s safe to cautiously venture out and use common-sense practices with hearing protection when going around risky noise. However, Wrigley is somewhat bitter — and for good reason — because information on the Internet, just as he mentioned above, contradicted that advice which sufferers would later report to him once he got these conditions. “All the stuff online said not to hide from normal sounds to encourage healing. It said the opposite: to expose to them. So I did and all this damage happened.” And now the window for recovery is fading perhaps, Kurt fears, which sometimes happens when too much damage occurs, according to sufferers. With so much regret he wishes he could go back in time and isolate first and foremost. (Prevention is key: don’t become worse, because whatever you lose may never be retrieved.)

During the course of his journey Kurt visited several ENTs who also gave him advice that was similar to the Net’s: counterproductive for his situation, a trend observed with many patient stories on Hyperacusis Central. However, this makes sense because the rarity of these conditions means that many clinicians get little training on how to handle them (as noted in the survey by our Scientific Advisor Kelly Jahn and her colleagues, where only five hours or less of hyperacusis training is common), so clinicians may not understand these conditions thoroughly, or sometimes they haven’t heard of “hyperacusis” or “noxacusis” if they weren’t trained.

“I underwent multiple hearing tests but everything looked fine. Everything looked normal. These were standard audiograms, not extended, so they didn’t cover all the frequencies of sound — just the common ones we hear.” The truth, however, is that these conditions are not detectable through common diagnostic procedures done by clinicians. The ENTs gave Kurt a clean bill of hearing health. The first doctor he saw had also had tinnitus for years, which started from loud noise and going to concerts. He did say that maybe earplugs could help to manage things. At that time, however, Kurt was already using them. “I wish doctors understood these conditions better so they could be like, ‘Hey, this is what’s going on. You have to be careful and here’s how. Give yourself a chance to heal. If you don’t it could cost you everything.’

“The ENTs also prescribed me some medications to try: low-dose prednisone for five days; methylprednisolone for seven; nortriptyline for seven; and later nortriptyline again for three months. I decided to try it again after talking to other noxacusis sufferers who had used it with no adverse reactions, and possibly, had gotten improvements in their symptoms from taking it, too. So for 2 months straight, I took the lowest possible dose at 10 milligrams. And then the doctor upped it to 30 pills at 25 milligrams. I took that over a three month period every couple days, so it ended up balancing out to a lower dosage, as if I had taken 10 milligrams every three months instead of 25 milligrams. And that’s when I started feeling the side effects, like blurry vision and dry mouth, so I slowly tapered off.”

The first two drugs mentioned above are steroids, and a study found that sometimes they help hearing loss or trauma if taken right after the loss or trauma happens (Leung, Flaherty, Zhang, Hara, Barber, & Burgess). The final med, nortriptyline, can sometimes help people’s tinnitus, according to a study (Sullivan, Katon, Russo, Dobie, & Sakai). For Kurt, though, they didn’t help at all, and the nortriptyline might have been spiking his tinnitus or playing a role in its decline since now it’s more severe than ever. Kurt isn’t sure if it was the drug or the culmination of sound exposures that worsened it. Maybe both.

He also had his sinuses checked to rule out pressure issues, and everything looked fine. Nevertheless, the doctor prescribed a nasal spray to try, but Kurt decided to pass on taking it, as the risks of medications are always intimidating for tinnitus and noxacusis/hyperacusis sufferers, who commonly report temporary or chronic reactions after taking them. On his own accord, he took N-acetyl cysteine (NAC) and turmeric, too, but neither helped nor hurt, he said. NAC can sometimes help with ear trauma, according to a study (Chang, Lui, Hung, & Kang). And turmeric is a natural anti-inflammatory.

At Michigan Ear Institute, Kurt was eventually formally diagnosed with tinnitus and hyperacusis. “The neurologist evaluated my history and ear structure, but nothing odd was ever found. Another ENT later checked my hearing again, and everything — yet again — looked normal. But the doctor wrote a note to tell my workplace that working from home would be necessary due to my conditions. However that request was later rejected by the company.” Again, that was why his aforementioned position as a cyber security analyst came to an end, although he later found a new work-from-home job in the same field.

To review, throughout his struggles Kurt’s protection methods had proved to be useless. Plugging up and muffing up to coexist with noise was inadequate. The loudness of the world quickly showed him just how common sound is, and avoidance of it when trying to have a relationship with life is impossible if you have these conditions at severe levels. That’s why they’re so cruel. They make the land like Chernobyl: ruined, sound your “radiation.” Sacred things are dead. For instance, Kurt experienced a bad setback in May of 2023 when he visited a hospital for four days to witness the birth of his newborn son. “Unfortunately the people and machines were just too much: the bothersome beeping of tones for the EEG and vital signs that monitored my wife, and the sensor machine for my son, and the cardiopulmonary monitor. I was wearing protection during the whole visit, both earplugs and earmuffs. Nevertheless, severe jaw, ear, and face pain resulted. While there, I used CBD oil for a couple days to remedy the pain, but it wasn’t good enough. By day three the pain was too severe, resulting in a prolonged setback.

“You know, to me it’s just shocking that some ear conditions could rob you of everything important and everything period, because life is just saturated in sound. I built a life toward success with a strong foundation but now that doesn’t matter. These conditions make the foundation sand and you end up sinking. I can barely see my son. It worsens my conditions to do so but f*ck, you know, I love him to pieces and what do you do with that? Not be a dad? It’s beyond cruel. These conditions need more funding and research to develop reliable treatments. As it stands now there’s nothing, and all I can say for the ones affected, including myself, is God help us.”

Update, June 2025

The good news is that Kurt’s noxacusis and loudness hyperacusis improved by avoiding sound exposures (the time-and-silence approach, which sometimes helps and sometimes doesn’t, according to sufferers), but the bad news is that his tinnitus became worse. He’s still homebound because his ear ringing permanently climbs with everyday sound exposures. It’s deafening and crippling to his quality of life. The strain of these conditions played a role in his divorce from his wife. He cautiously sees his son every other week, although it’s not the same. Fatherhood is compromised, and notions of attending future school events and being a central part of his child’s life and milestones are nonexistent at this time. Kurt also lost his career. His symptoms became too severe to work because every job wanted him to participate in meetings, phone calls, or other acoustic-related activities. He’s pursuing disability benefits.

*AI wasn’t used to write or edit this story.

*The patient’s name was changed for privacy.

References

[1]. Jahn KN, Cohen J, Llodra O. What patients say and what audiologists say. Hyperacusis Research. Mar 2025. https://hyperacusisresearch.org/pain-hyperacusis-what-patients-say-and-what-audiologists-say/?fbclid=IwY2xjawJVFFlleHRuA2FlbQIxMQABHS3aWv8pblG-pkyKPuzejV7ZwLhqRos5oRDFI2gblJIprtzwe0Y0XlBoNQ_aem_wAL5oZxapWpTJL6P9ifwfA.

[2]. Leung, MA, Flaherty, A, Zhang, JA, Hara, J, Barber, W, Burgess, L. “Sudden Sensorineural Hearing Loss: Primary Care Update.” Hawaii J Med Public Health. 2016 June, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928516/.

[3]. Sullivan, M, Katon W, Russo J, Dobie R, Sakai C. “A randomized trial of nortriptyline for severe chronic tinnitus. Effects on depression, disability, and tinnitus symptoms.” Arch Intern Med. 1993, https://pubmed.ncbi.nlm.nih.gov/8215728/.

[4]. Chang, Po-Hsiung, Lui, Chia-Wei, Hung, Shih-Han, & Kang, Yi-No. “Effect of N-acetyl-cysteine in prevention of noise-induced hearing loss: a systematic review and meta-analysis of randomized controlled trials.” Arch Med Sci. 2022, https://www.archivesofmedicalscience.com/Effect-of-N-acetyl-cysteine-in-prevention-of-noise-induced-hearing-loss-a-systematic,109126,0,2.html.