The Short Answer Educational content only. Persistent or worsening concussion symptoms warrant medical evaluation. Sudden severe symptoms (worsening headache, vision changes, vomiting, confusion, seizure) require emergency care. Coordinate symptom monitoring with treating providers. Sound sensitivity (hyperacusis) after concussion lasts 3-12 months in most patients, with significant individual variation (Patricios et al., 2023). Mild cases often resolve within 4-6 weeks. Moderate sensitivity extends 3-6 months. Severe hyperacusis extends 12-24 months in some patients. Approximately 30-50% of PCS patients experience sound sensitivity. The pattern typically improves gradually rather than resolving suddenly. Sensory retraining therapy, custom earplugs, and autonomic regulation work accelerate recovery. Recovery is typically gradual, not sudden. Sound sensitivity improves through progressive tolerance increase rather than overnight resolution. Track tolerance ceiling, not symptom presence. Severity at week 4-6 predicts duration. Patients with mild sensitivity at 4-6 weeks typically recover within 3 months. Severe sensitivity at this point often extends 12+ months. Most patients achieve substantial improvement. Complete resolution affects 70-80%. The remaining 20-30% achieve substantial improvement with residual mild sensitivity. Why Concussion Causes Sound Sensitivity Auditory processing dysfunction. Brain regions processing sound sustain microscopic injury during concussion. Normal sound processing requires healing. Autonomic involvement. Sound sensitivity reflects autonomic dysfunction beyond pure auditory processing. Stress response amplifies sound perception. Central sensitization. Heightened central nervous system sensitivity amplifies sound perception. Pattern resembles chronic pain sensitization. Vestibular contribution. Inner ear vestibular system involvement contributes to sound sensitivity through audio-vestibular interaction. Cervical contribution. Upper cervical strain affecting cranial nerves contributes to auditory symptoms. Typical Recovery Timeline Weeks 1-4: Peak sensitivity. Sound sensitivity often peaks during first month. Conversation-level noise feels overwhelming. Daily life function impaired. Weeks 4-12: Gradual improvement. Tolerance ceiling rises progressively. Quiet environments become manageable. Brief loud exposure remains difficult. Months 3-6: Substantial improvement. Most daily environments become manageable. Specific loud environments (concerts, restaurants, sports events) remain challenging. Months 6-12: Continued recovery. Most environments accessible with brief protection. Severe environments still warrant earplugs or avoidance. Months 12-24: Final recovery. Remaining sensitivity resolves or stabilizes. Long-term residual sensitivity affects 20-30% of patients. What Slows Recovery Constant earplug use. All-day earplug use produces auditory deprivation worsening hyperacusis. Use situationally. Complete sound avoidance. Avoiding all sound environments prevents gradual tolerance building. Strategic exposure helps. Untreated autonomic dysfunction. Stress and autonomic dysfunction amplify sound sensitivity. Address both. Sleep dysfunction. Poor sleep amplifies next-day sound sensitivity. Sleep optimization helps. Untreated cervical dysfunction. Neck strain contributing to sound sensitivity benefits from physical therapy. Mental health factors. Anxiety amplifies sound sensitivity. Address mental health concurrently. How to Accelerate Recovery Tinnitus retraining therapy. TRT addresses both tinnitus and hyperacusis through gradual sound exposure protocols. Pink noise therapy. Daily controlled pink noise exposure builds tolerance over weeks to months. Strategic earplug use. Custom plugs during high-exposure situations, plug-free during quiet environments. Graduated sound exposure. Progressive tolerance building through controlled exposure to increasing sound levels. Autonomic regulation work. Diaphragmatic breathing, vagal tone exercises, and stress reduction reduce sound sensitivity amplification. Vestibular therapy when indicated. Audio-vestibular component benefits from specialized vestibular therapy. Audiologist consultation. PCS-aware audiologist guides tolerance building and protection strategies. When Sound Sensitivity Warrants Evaluation Sensitivity worsening over weeks. Progressive worsening warrants audiologist evaluation. New tinnitus development. Ringing or buzzing onset warrants evaluation. Hearing loss alongside sensitivity. Combined hearing loss and sensitivity warrants audiology evaluation. No improvement over 3-6 months. Lack of improvement warrants specialized hyperacusis evaluation. Significant functional impairment. Inability to function in normal environments warrants specialized care. What to Expect Long-Term Most patients achieve substantial improvement. 70-80% reach near-complete resolution within 12-24 months. 20-30% retain residual sensitivity. Residual sensitivity ranges from mild to moderate. Most function with strategic protection. Strategic earplug use often continues. Many recovered patients maintain earplugs for high-exposure situations (concerts, sports, restaurants). Trigger awareness becomes habit. Recovered patients typically maintain awareness of personal sound trigger thresholds. Quality of life recovers. Most patients return to normal social and work function even with residual sensitivity. Supporting Mobility Routine These exercises support autonomic regulation reducing sound sensitivity amplification. JME 155 Diaphragmatic breathing supports vagal tone and parasympathetic regulation during symptom flares. 10 breaths every 60-90 minutes. JME 14 Chin tucks reduce upper cervical tension contributing to headache, dizziness, and visual symptoms during PCS. 10 repetitions with 5-second holds. JME 1 Cervical rotation supports cerebral blood flow and proprioceptive input affecting PCS symptom regulation. 10 repetitions each direction. JME 150 Thoracic rotation restores breathing depth shallow under autonomic dysfunction common in PCS. 8 repetitions per direction. Start your 3-day free trial for joint-specific mobility programs that support autonomic regulation during PCS recovery. Common Mistakes With Sound Sensitivity Constant earplug use. All-day protection worsens hyperacusis through auditory deprivation. Use situationally. Complete sound avoidance. Avoiding all environments prevents tolerance building. Strategic exposure helps. Pushing through severe exposure. Unprotected severe exposure produces flares extending recovery. Use earplugs strategically. Skipping audiologist evaluation. Persistent sensitivity warrants specialized evaluation for treatment options. Treating sensitivity in isolation. Address autonomic, cervical, and mental health factors concurrently for best outcomes. Does concussion sound sensitivity ever go away? Most patients achieve substantial improvement within 12-24 months. 70-80% reach near-complete resolution. 20-30% retain residual sensitivity requiring strategic management. Complete resolution remains possible even with extended initial duration. Why is my sound sensitivity worse some days? Sleep quality, stress level, and prior-day exposure shift daily sound sensitivity thresholds. Bad days typically follow poor sleep, high stress, or recent loud exposure. Pattern tracking reveals personal triggers. Predictable patterns enable preventive accommodation. Should I wear earplugs all day? No. All-day earplug use produces auditory deprivation worsening hyperacusis. Use earplugs during high-exposure situations (restaurants, concerts, sports events). Tolerate quieter environments without plugs to maintain tolerance building. Will hearing aids help my sound sensitivity? Hearing aids with sound balancing features address combined hearing loss and hyperacusis. Aids without hyperacusis-aware programming worsen sensitivity. PCS-aware audiologist programming matters more than aid brand for combined presentations. When should I see an audiologist for sound sensitivity? See an audiologist for sensitivity persisting beyond 4-6 weeks, sensitivity with hearing loss, new tinnitus development, or sensitivity affecting daily function. Earlier evaluation enables earlier intervention. PCS-aware audiologists provide specialized assessment. References Patricios, J. S., et al. (2023). Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022. British Journal of Sports Medicine, 57(11), 695-711. PubMed Silverberg, N. D., et al. (2020). Management of concussion and mild traumatic brain injury: a synthesis of practice guidelines. Archives of Physical Medicine and Rehabilitation, 101(2), 382-393. PubMed