Ringing Ears and Noise Sensitivity After a Crash: Questions Worth Asking Palm Beach County Patients
Ringing in the ears and a new intolerance for everyday noise are easy to miss on a neck-and-back intake. Both are linked to concussion in the research. What to ask, and when to look further.
Picture a hypothetical patient at a chiropractic office in Boynton Beach. She is 52 and was rear-ended on Glades Road in Boca Raton ten days ago. She came in for neck pain and stiffness, and that is what the intake form asks about.
Near the end of the visit she mentions, almost as an apology, that dinner with friends on Atlantic Avenue in Delray Beach was "unbearable." The restaurant noise felt like it was inside her head. At night she hears a high-pitched ring when the house goes quiet. She assumed it was stress.
Key takeaways
- The CDC lists being bothered by light or noise among common concussion symptoms.
- In a study of 341 adults with mild TBI, 45% reported noise sensitivity early and 28% still did at 12 months.
- Noise sensitivity is unlikely to reflect malingering and should be treated as a genuine symptom (Shepherd et al., 2019).
- New hearing loss, one-sided or pulsing tinnitus, or fluid from the ear deserve their own prompt evaluation.
Symptoms like these rarely make it onto the intake form unless someone asks. This article looks at what the research says and offers a few questions worth adding. It is educational and does not replace clinical judgment.
Two symptoms patients rarely volunteer
Noise sensitivity means ordinary sounds, such as a dishwasher, a crowded room or children playing, feel too loud or physically uncomfortable. Tinnitus is ringing, buzzing or humming that no one else can hear. The CDC lists being bothered by light or noise among common concussion symptoms.
Patients often do not connect either one to a car crash. Many expect a provider to care only about the neck or back, and some worry that the complaint sounds odd. In a qualitative study, people with noise sensitivity after a brain injury described avoiding stores, restaurants and family gatherings because of it (Landon et al., Neuropsychological Rehabilitation, 2012).
What the research shows
In a community study of 341 adults in New Zealand with mild TBI, 45% reported noise sensitivity soon after injury, and 28% still reported it at 12 months. Early noise sensitivity predicted more postconcussive symptoms later (Shepherd et al., Journal of Head Trauma Rehabilitation, 2021).
In a related study of 151 adults assessed within two weeks of a brain injury, 59% reported some degree of noise sensitivity, and anxiety was its strongest correlate. The authors concluded that noise sensitivity is unlikely to reflect malingering and should be treated as a genuine symptom (Shepherd et al., Brain Injury, 2019).
For tinnitus, a 2024 systematic review of non-blast TBI found that roughly one in three patients reported it, while noting that study quality was generally low (Le et al., Brain Injury, 2024).
Noise sensitivity after a mild TBI is a real symptom, not a complaint to talk a patient out of.
Questions worth adding to the intake
A few short questions can bring these symptoms out early:
- "Since the crash, do everyday sounds seem louder or harder to tolerate than before?"
- "Do you hear ringing, buzzing or humming in your ears, especially when it is quiet?"
- "Is it in one ear or both? Does it pulse with your heartbeat?"
- "Have you started avoiding restaurants, stores, church or family events because of noise?"
- "Have you noticed headaches, trouble concentrating, sleep changes or feeling on edge along with it?"
Dated answers in the chart make it easier to track whether symptoms are improving, holding steady or getting worse over the following weeks.
When the ears need their own workup
Noise sensitivity and tinnitus can travel with a concussion, but they can also point to problems in the ear itself. New hearing loss, tinnitus in one ear only, tinnitus that pulses with the heartbeat, or fluid or blood from the ear deserve prompt evaluation, and many providers refer to audiology or ENT. Bleeding or clear fluid from the ear after a crash calls for emergency care.
Where testing fits
When you decide concussion testing makes sense, Braintree's mobile team tests patients at your office in West Palm Beach, Boca Raton, Delray Beach, Boynton Beach, Jupiter, Palm Beach Gardens, Wellington, Lake Worth Beach and nearby communities. Scheduling is coordinated with your office. Results come back as physician-reviewed diagnostic reports to use alongside your own exam and history.
Learn more about concussion and TBI testing, see mobile testing in Palm Beach County, or check recent local crashes on the Palm Beach County Crash Map. Ready to refer? Send a referral.
Frequently asked questions
Can a car accident cause ringing in the ears?
It can. Tinnitus is reported after concussion and other head injuries. A 2024 systematic review of non-blast TBI found roughly one in three patients reported it.
Is noise sensitivity a sign of concussion?
It can be. The CDC lists being bothered by light or noise among common concussion symptoms.
How long does noise sensitivity last after a concussion?
It often improves, but not always. In one study, 45% of adults reported noise sensitivity soon after mild TBI and 28% still did at 12 months.
When should ringing in the ears after a crash be checked by a specialist?
New hearing loss, ringing in one ear only, ringing that pulses with the heartbeat, or fluid or blood from the ear deserve prompt evaluation.
Can Braintree test my patients at my office in Palm Beach County?
Yes. When you decide testing makes sense, Braintree's mobile team tests at your office and returns physician-reviewed diagnostic reports. Scheduling is coordinated with your office.
Sources
- Shepherd D et al. Sensitivity to noise following a mild traumatic brain injury: a longitudinal study. J Head Trauma Rehabil. 2021;36(5):E289-E301
- Shepherd D et al. Clinical correlates of noise sensitivity in patients with acute TBI. Brain Inj. 2019;33(8):1050-1058
- Landon J et al. Hearing every footstep: noise sensitivity in individuals following traumatic brain injury. Neuropsychol Rehabil. 2012;22(3):391-407
- Le M et al. Prevalence of tinnitus following non-blast related traumatic brain injury: a systematic review of literature. Brain Inj. 2024;38(11):859-868
- CDC: Symptoms of mild TBI and concussion (including danger signs)
- CDC: About mild TBI and concussion
- NIH, National Institute of Neurological Disorders and Stroke: Traumatic brain injury
- FLHSMV: Florida Traffic Crash Facts Annual Report 2024
- Florida Department of Health: Florida trauma centers (updated July 23, 2026)
- Health Care District of Palm Beach County: Trauma centers
Photo credits: West Palm Beach waterfront by FHolmstock, CC BY-SA 3.0, via Wikimedia Commons. FL 806 (Atlantic Avenue) in downtown Delray Beach by Adam Moss, CC BY-SA 2.0, via Wikimedia Commons.
This article is educational and is not medical or legal advice. If this is a medical emergency, call 911.
