Pain hyperacusis, also known as noxacusis, causes physical pain in response to everyday sounds that do not bother most people. How sound causes excruciating pain that can last for weeks or months in otherwise healthy individuals is not well understood, resulting in a lack of effective treatments. To address this gap, we identified the most salient physical and psychosocial consequences of debilitating sound-induced pain and reviewed the interventions that sufferers have sought for pain relief to gain insights into the underlying mechanisms of the condition. Adults (n = 32) with pain hyperacusis attended a virtual focus group to describe their sound-induced pain. They completed three surveys to identify common symptoms and themes that defined their condition and to describe their use of pharmaceutical and non-pharmaceutical therapies for pain relief. All participants endorsed negative effects of pain hyperacusis on psychosocial and physical function. Most reported sound-induced burning (80.77%), stabbing (76.92%), throbbing (73.08%), and pinching (53.85%) that occurs either in the ear or elsewhere in the body (i.e., referred pain). Participants reported using numerous pharmaceutical and non-pharmaceutical interventions to alleviate their pain with varying degrees of pain relief. Benzodiazepines and nerve blockers emerged as the most effective analgesic options while non-pharmaceutical therapies were largely ineffective. Symptoms of pain hyperacusis and therapeutic approaches are largely consistent with peripheral mechanistic theories of pain hyperacusis (e.g., trigeminal nerve involvement). An interdisciplinary approach to clinical studies and the development of animal models is needed to identify, validate, and treat the pathological mechanisms of pain hyperacusis.

This work was supported by the National Institutes of Health National Institute on Deafness and Other Communication Disorders (NIH NIDCD) K01 DC019647 (PI: Jahn). KNJ reports additional support from the Department of Defense Congressionally Directed Medical Research Program and the American Speech-Language-Hearing Foundation. STK reports support from the American Speech-Language-Hearing Association and the Susan and Jim Jerger Research in Audiology Fellowship. MSY reports support from the NIH National Institute of Diabetes and Digestive and Kidney Diseases (NIH NIDDK) R01 DK134893 (PI: Yousuf). KNJ is a member of the Scientific Advisory Board for Hyperacusis Research Ltd. and serves as the scientific advisor for Hyperacusis Central. The authors declare no other conflicts of interests.

This work was funded by the National Institutes of Health National Institute on Deafness and Other Communication Disorders (NIH NIDCD) K01 DC019647 (PI: Jahn).

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