Can Rheumatoid Arthritis Affect Your Hearing? Surprising Truth

Can rheumatoid arthritis affect your hearing? It’s not the first question most people think of when RA comes up in conversation, but believe me—after years of sitting across from patients, I’ve learned that rheumatoid arthritis can sneak up in some pretty surprising ways. As a Rheumatology nurse practitioner, I’ve had patients walk in worried about joint pain and stiffness, only to casually mention, “By the way, my ears feel weird lately. Could that be connected?” Well, yes. Yes, it absolutely could. Let’s dig into that lesser-known connection between RA and hearing issues—and why it matters more than you might think.

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Rheumatoid Arthritis Isn’t Just About Joints

When most folks hear “rheumatoid arthritis,” their minds immediately go to painful hands, swollen knees, and morning stiffness that just won’t quit. That’s totally valid—RA is a chronic autoimmune condition that primarily targets the synovial joints. But here’s the thing I always emphasize to my patients: RA is systemic. That means it doesn’t stay in its lane. It can and does affect many parts of the body—including the ears.

In fact, the ears are more involved in RA than most people realize. From my clinical experience, some patients even notice changes in their hearing before their joint symptoms become severe. That’s not super common, but it does happen—and it’s worth paying attention to.

So, how exactly can RA mess with your ears?

Let’s break it down a bit. There are a few mechanisms behind the connection between rheumatoid arthritis and hearing loss or ear-related symptoms:

Inflammation in the small joints of the middle ear: Just like RA can inflame the joints in your fingers, it can affect the tiny bones (ossicles) in the middle ear.
Autoimmune-related damage to the inner ear structures: The immune system’s misguided attacks can reach delicate auditory structures.
Ototoxic medications: Some drugs used to manage RA—like NSAIDs, corticosteroids, or even biologics—can sometimes cause hearing issues as side effects.
Vasculitis and blood supply disruption: RA-related inflammation in blood vessels (vasculitis) may impair circulation in the ear.

Now, that doesn’t mean everyone with RA is going to end up with hearing loss. But it does mean we need to stay alert, especially if any unusual ear symptoms come up. A little bit of proactive attention goes a long way in managing the less-talked-about aspects of this disease.

Can Rheumatoid Arthritis Affect Your Hearing? Signs to Watch Out For

In my practice, some of the hearing complaints I’ve heard from RA patients might sound familiar if you’re reading this and nodding along:

“Sometimes I hear a faint ringing, especially at night.”
“My hearing feels muffled, like I have water in my ears.”
“I feel off balance more often than I used to.”
“It’s harder to hear in crowded places or when there’s background noise.”

If you’ve ever mentioned any of these to your doc and felt brushed off, you’re not alone. But your symptoms are real, and they’re worth digging into. These could be signs of conductive hearing loss (related to the bones in the ear), sensorineural hearing loss (related to nerve damage), or a mix of both. And yes, they can be connected to RA.

Pro tip from someone who’s been in the room with hundreds of RA patients: Don’t wait to bring up hearing changes. Early intervention can make a big difference, and catching subtle hearing shifts early might even help guide your RA treatment plan more effectively.

Conductive vs. Sensorineural: What’s the Difference?

This is one of those things I like to explain in plain English during clinic visits because it helps people understand what’s going on in their bodies. Here’s a quick cheat sheet:

Conductive hearing loss: Happens when sound can’t get through the outer or middle ear. Think of it like your ear being “plugged.” RA can cause this if inflammation or bone changes affect the ear’s mechanical function.
Sensorineural hearing loss: Involves damage to the inner ear or auditory nerve. More permanent and harder to treat. RA-related vasculitis or autoimmune attacks may be responsible here.

Sometimes, RA patients develop a combination of both, which makes hearing issues harder to pin down. That’s where audiologists—and yes, sometimes even your rheumatology NP—come into play. I’ve coordinated plenty of care between ENT specialists and rheumatologists when hearing loss crops up. It’s all part of that whole-body approach we need for autoimmune disease.

Real Stories: When Hearing Changes Were the Clue

There was this one patient of mine—we’ll call her Maria—who came in mostly to discuss her joint pain flaring up again. She casually mentioned during her visit that her right ear had been ringing for months, and she figured it was just age. But something about the timing made me dig deeper. Turned out, she had moderate sensorineural hearing loss on that side, and her inflammation markers were through the roof. With a medication tweak and a referral to audiology, she saw real improvements.

That’s the kind of scenario I wish more people knew about. RA doesn’t follow a straight line, and sometimes the earliest whispers of trouble come through the ears—literally.

Why Hearing Changes Deserve a Spot in Your RA Checklist

Here’s the thing I’ve learned over and over again in clinic: the squeaky wheel gets the grease. That means if you don’t speak up about a new symptom—like ringing in your ears or sudden sensitivity to sound—it might not get addressed. And when it comes to RA, that delay could mean more inflammation, more damage, and a missed opportunity to intervene early.

Honestly, I wish hearing evaluations were part of every routine RA assessment, especially in long-term patients. Can rheumatoid arthritis affect your hearing? Absolutely, and yet it still flies under the radar more often than not. That’s one of the reasons I always ask my patients open-ended questions like, “Anything else that’s been bugging you lately, even if it seems unrelated?” You’d be amazed what comes up when you make space for it.

We know that RA is already a full-time job. There’s medication schedules, lab work, joint care, and often fatigue that hits like a brick wall. But ignoring those subtle signals your body sends—like slight hearing loss—can let a manageable issue snowball into something that limits your quality of life even more.

When to Talk to Your Provider About Ear Symptoms

There’s no official rulebook, but based on experience, here’s when I’d say it’s time to loop in your rheumatologist, primary care doc, or ENT:

You notice new or worsening tinnitus (ringing, buzzing, etc.)
Sounds seem muffled or distant, especially on one side
You struggle to follow conversations in noisy places
You’re feeling more off-balance or dizzy than usual
You have a sense of fullness in your ears that doesn’t go away

None of these mean you’re doomed to hearing loss, but they are worth checking out—especially if you have RA or another autoimmune condition. Catching things early makes a difference.

The Role of Medications in RA-Related Hearing Loss

Now, let’s talk meds. I’ll be honest—this part gets tricky. Some of the same medications that help slow RA progression and calm inflammation can also have ototoxic effects (meaning they could harm your ears). I’m not saying this to scare you, but because informed patients are empowered patients.

Here are a few categories that pop up most often:

NSAIDs: Ibuprofen and naproxen, when used long-term, have been linked to hearing changes in some people. It’s rare, but I’ve seen it.
Salicylates: High doses of aspirin (especially older treatment regimens) may cause temporary hearing loss or ringing.
Biologic DMARDs: These are game-changers in RA treatment, but like all powerful meds, they come with potential side effects. Some patients report hearing-related issues—though the data is still evolving.
Corticosteroids: These are a double-edged sword. While they can actually help *reverse* some types of hearing loss due to inflammation, long-term systemic use carries its own risks.

Pro tip: If you’re noticing ear symptoms and you recently started a new med—or increased a dose—mention it. Adjustments can often be made, and sometimes switching to a different class of medication does the trick.

What I Tell My Patients About Drug-Related Ear Risks

Look, medications are powerful tools, and I’m not quick to pull people off of something that’s keeping their RA in check. But I always encourage my patients to keep a running list of new or unusual symptoms, even if they seem small. That way, we’re not guessing if a change pops up. Instead, we’re making informed decisions based on trends we can actually track.

Also, don’t forget to tell your pharmacist about your RA history when picking up any over-the-counter meds. Some seemingly harmless drugs could interact with your current regimen in sneaky ways that could affect your ears.

Let’s Talk About Testing and Audiology Referrals

Sometimes people get nervous when I suggest a hearing test. But let me tell you—it’s quick, painless, and incredibly informative. A simple baseline audiogram can tell us a lot about what’s going on in those inner ear structures. And if something’s off? We’ve got options.

I had a patient not too long ago—a retired teacher—who was struggling to follow conversations in her book club. We ran a hearing test, and it showed mild sensorineural loss. With the right adjustments to her RA treatment and a tiny hearing aid she swore no one could even see, she was back to leading the group in no time.

Here’s what I typically recommend if RA patients notice ear symptoms:

Request a referral to an audiologist or ENT (Ear, Nose, and Throat specialist)
Ask for a baseline audiogram if you’ve had RA for more than 5 years
Follow up yearly if symptoms persist or worsen
Discuss medication adjustments if a potential link is found

Early Detection = Better Outcomes

I can’t stress this enough. The earlier we catch changes—whether in your joints, your vision, or yes, your hearing—the more options we have to manage them. That’s not just medical theory. That’s something I’ve seen play out over and over in real life, with real people.

So if you’ve been pushing that weird ringing sound or ear pressure to the back burner, consider this your gentle nudge to bump it up the list. RA is complex, but your care doesn’t have to be.

And hey, you don’t need to become an expert in audiology overnight. That’s what your care team is for. Your job? Be honest about your symptoms, advocate for yourself, and don’t assume that your ears are off-limits when it comes to RA-related damage. They’re part of the story too.

Managing Hearing Health as Part of RA Self-Care

Let’s talk about something I bring up with my patients a lot—self-care doesn’t stop at joint protection. It extends to your hearing, balance, and overall sensory health too. One of the most empowering things you can do as someone living with rheumatoid arthritis is to become your own health advocate. That includes listening—really listening—to what your body’s trying to tell you, even if it’s whispering from your inner ear.

I’ve had folks tell me they feel almost “vain” for wanting to check on something like mild hearing loss when their joints are flaring. But here’s the truth: you deserve full-body care. Every symptom counts. If your ears are giving you grief, whether it’s a constant high-pitched hum or a vague feeling of pressure, it’s not insignificant. That symptom could be a clue your RA isn’t as controlled as it should be—or that your medication regimen needs tweaking.

Integrating Hearing Awareness Into RA Management

If you’re living with RA, you’re probably already juggling a long list of to-dos: labs, follow-ups, meds, exercise, diet changes, rest… it’s a lot. I get it. So how do we make hearing health part of the routine without adding more overwhelm?

Track changes: Keep a short journal or use a notes app to track symptoms like ringing, fullness, dizziness, or trouble hearing speech.
Bring it up at appointments: Don’t wait until you’re asked. Even if it feels unrelated, mention any new ear-related issues to your provider.
Ask for a referral: If your rheumatologist doesn’t manage ENT issues directly, ask for a referral to audiology or an ENT specialist. It’s your right.
Consider baseline testing: Especially if you’ve had RA for years or are on long-term medications with known ototoxicity, getting a baseline hearing test is a smart move.

And most importantly—don’t gaslight yourself. I’ve seen too many patients doubt their own symptoms because they didn’t think RA “should” affect their ears. RA can, and often does, go beyond the joints. You’re not imagining things. You’re being intuitive, and that’s powerful.

What Treatments Are Available for RA-Linked Hearing Loss?

So let’s say you’ve followed the signs, had your hearing checked, and there is a confirmed change. What now? The good news is, you’ve got options—and some are surprisingly effective, especially when the issue is caught early.

Here are a few treatment approaches I’ve seen help RA patients with hearing complications:

Medication adjustment: If a certain RA drug is contributing to hearing issues, your provider might swap it out or lower the dose.
Hearing aids: Today’s devices are light-years ahead of what they used to be. They’re discreet, smart, and customizable.
Steroid therapy: In cases where inflammation is acute and directly impacting the ear, short-term corticosteroids might help restore function.
Physical therapy for balance: If balance is a problem, vestibular therapy can strengthen the connection between body and brain.
Assistive listening devices: Beyond hearing aids, there are tools to help you hear better in noisy environments—something many RA patients appreciate.

One of my patients, a guy in his early 60s, had been dismissing his hearing changes as “just aging.” Turns out, once we adjusted his methotrexate and added a short course of steroids, his ear pressure and balance issues improved drastically. It wasn’t age—it was inflammation.

Be Proactive, Not Reactive

The biggest takeaway? Don’t wait until you’ve lost a significant amount of hearing to act. With autoimmune conditions, the earlier you step in, the more you can preserve—and even regain. There’s a strong case for integrating hearing protection and monitoring into your RA lifestyle, especially for patients on long-term treatment regimens.

If you work in noisy environments, attend loud events, or even use headphones often, think about investing in simple hearing protection tools. It’s a small step that can pay off big in the long run.

More Than Joints: RA Affects the Whole You

By now, I hope it’s clear that asking, “Can rheumatoid arthritis affect your hearing?” isn’t just a throwaway question—it’s a meaningful health concern that deserves real attention.

RA is not a disease that stays in one lane. It’s sneaky, systemic, and deeply individual. No two patients present the same, and that includes how (or if) their hearing is affected. But with proactive care, honest conversations, and a willingness to explore beyond the obvious symptoms, we can catch these things early—and do something about them.

Whether it’s me sitting across from a patient in clinic, or you sitting on your couch noticing something “off” with your ears, the goal is the same: listen to what your body is saying, and take the next best step.

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Disclaimer

This article is for informational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Always consult your healthcare provider with any questions you may have regarding a medical condition. The content reflects personal clinical experience and research but should not be used as a substitute for personalized care from a licensed medical provider.

Tarra Nugroho

Tarra Nugroho is a dedicated Nurse Practitioner with a strong foundation in family and preventive care. She brings both compassion and clinical expertise to her practice, focusing on patient-centered care and health education. As a contributor to Healthusias.com, Tarra translates medical knowledge into clear, empowering articles on topics like women’s health, chronic disease management, and lifestyle medicine. Her mission is simple: help people feel seen, heard, and informed—both in the clinic and through the content she creates. When she’s not caring for patients, Tarra enjoys weekend hikes, plant-based cooking, and curling up with a good health podcast.