Hyperacusis is characterised by discomfort when hearing certain sounds. Some may experience mild discomfort, while others will feel physical pain in response to sounds that seem too loud.
In some cases, people living with hyperacusis may also experience phonophobia, a fear of noise. As those living with the condition start to associate noise with pain, a genuine fear may develop.
Hyperacusis is often experienced by those also with tinnitus and may also be linked to anxiety and depression.

Some common symptoms of hyperacusis include:

• Finding ordinary sounds louder than normal
• Having the sensation fullness within the ear
• Experiencing discomfort and pain when exposed to loud noise
• Finding that your voice sounds loud or distorted when you speak
• Becoming fearful of loud noises

At present, there are no clinical tests that can accurately determine whether someone is experiencing hyperacusis or not.
Diagnosing hyperacusis relies primarily on the patient’s description of their symptoms and any discomfort that may be felt. Audiologists and doctors use the information that they gather from talking with their patient to determine whether hyperacusis is the likely cause of their symptoms. In order to differentiate between misophonia, in which only specific noises are experienced as painful, and hyperacusis, several questionnaires are also given to the patient.

Whether hyperacusis resolves depends largely on what is driving it. In many cases, particularly when it develops suddenly following a specific trigger - a loud concert, an ear infection, or a short-term illness - it can indeed be temporary. When the cause is identified and treated early, the auditory system often recovers, and sensitivity gradually returns to normal.

Recovery time is not linear and varies considerably from person to person. Some notice meaningful improvement within weeks of starting sound therapy; for others, the process takes several months of consistent work. The severity of sensitivity, the presence of other conditions such as tinnitus or anxiety, and how long hyperacusis has been present all influence the outlook.

For those with longstanding hyperacusis, full resolution may not always be a realistic goal - but that does not mean living with significant limitations is inevitable. With the right treatment and professional support, most people experience a meaningful reduction in symptoms and a gradual return to the activities and environments they had been avoiding.

Although the causes of hyperacusis are yet to be identified, ensuring that you care for your hearing may help to reduce your chances of developing the condition as well as others such as hearing loss and tinnitus.
Caring for your hearing isn’t overly complicated, with a few simple behaviours helping you to protect the delicate structures within the ear.

To protect your ears, look to:

• Listen to music at lower volumes and for shorter amounts of time
• Use hearing protection at work, when attending concerts and any time you may be exposed to loud noise for an extended period
• Understand the effect that exposure to loud noise can have on your hearing and look to minimise the amount of time you spend around excessively loud sounds (over 85 decibels)

Hyperacusis and tinnitus frequently co-occur, and living with both can be particularly challenging. The two conditions can reinforce each other - tinnitus increases awareness of sound, while hyperacusis makes that awareness feel threatening or painful. Integrated treatment that addresses both simultaneously, such as Tinnitus Retraining Therapy (TRT), tends to be more effective than treating each in isolation.