Why everyday sounds can feel painfully loud

If a coffee grinder or slamming door makes you wince in actual pain, you might have hyperacusis. Here's what's happening in your brain.

Inside the auditory brainstem, neurons that translate sound into loudness use a gain dial. In hyperacusis, that dial gets stuck at maximum.

Researchers link the shift to damaged outer hair cells in the cochlea, which normally compress loud input before it reaches the brain. When compression fails, sounds at 70 decibels can fire neurons the same way 100 decibels would, which the brain reads as threat and pain.

Up to 40 percent of people with chronic tinnitus also report this loudness recruitment pattern.

Source: Auerbach, Rodrigues, and Salvi, "Central gain control in tinnitus and hyperacusis," Frontiers in Neurology, 2014.

For educational purposes only. Not medical advice.

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