Rheumatoid Arthritis and Its Effect on Hearing: What You Need to Know

When we talk about rheumatoid arthritis (RA), most people think about aching joints, morning stiffness, and maybe even those telltale swollen fingers. But here’s something that often gets overlooked—rheumatoid arthritis and its effect on hearing abilities. Yes, you read that right. RA doesn’t just attack your joints; it can mess with your ears too. And trust me, as someone who has spent years treating RA patients, I’ve heard plenty of people say, “Wait, my hearing loss could be related to my arthritis?” Yep. And it’s time we dig into why that happens.

How Rheumatoid Arthritis Can Impact Your Hearing

RA is an autoimmune condition, meaning your immune system mistakenly attacks healthy tissues. While joints take the brunt of it, inflammation can spread far beyond your knees and fingers. That includes the delicate structures inside your ears.

There are a few ways RA can mess with your hearing:

• Inflammation of the middle ear – The same swelling that makes your joints ache can also affect the tiny bones in your ear, leading to conductive hearing loss.
• Damage to the auditory nerve – RA-related inflammation can harm the nerves responsible for hearing, potentially causing sensorineural hearing loss.
• Ototoxic medications – Many RA patients rely on medications like NSAIDs, steroids, or methotrexate, but some of these drugs have been linked to hearing issues.

And it’s not just theory—research backs this up. Studies have found that people with RA are more likely to experience hearing loss compared to those without the condition. But here’s the kicker: many people don’t even realize it’s happening until the damage is already done.

Early Signs of RA-Related Hearing Loss

One of the biggest challenges with RA-related hearing loss is that it sneaks up on you. It’s not like waking up one day and suddenly everything sounds muffled. It’s more subtle than that.

Here are some early signs to watch for:

• Needing to turn up the TV or ask people to repeat themselves more often
• Ringing or buzzing sounds (hello, tinnitus!)
• Difficulty hearing high-pitched sounds, like birds chirping or children’s voices
• Feeling like certain sounds are distorted or unclear

If any of these sound familiar, it’s worth bringing up with your doctor. I can’t tell you how many times patients tell me they just assumed their hearing issues were from “getting older” when RA was the real culprit.

Why Aren’t More People Talking About This?

RA’s impact on hearing is one of those things that flies under the radar. Most rheumatologists are focused on joint health, while audiologists aren’t always looking at autoimmune diseases as a potential cause of hearing issues. That means a lot of people slip through the cracks.

Plus, let’s be honest—when you’re already dealing with joint pain, fatigue, and other RA symptoms, worrying about your hearing might not be at the top of your list. But here’s the thing: ignoring it won’t make it go away. In fact, the sooner you address it, the better your chances of slowing down any further damage.

How RA Medications Can Affect Hearing

Here’s something that often catches people off guard: the very medications meant to help manage rheumatoid arthritis could be affecting your hearing. It’s frustrating, right? You’re taking meds to keep inflammation in check, only to find out they might be causing another issue.

Let’s break it down:

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) – These are lifesavers for managing pain and inflammation, but long-term use has been linked to hearing problems, including tinnitus.
• Corticosteroids – While steroids can reduce inflammation (which in theory should help protect your ears), abrupt withdrawal or high doses over time might cause temporary or permanent hearing changes.
• Methotrexate – This common RA medication can have neurological side effects, and some studies suggest it could play a role in hearing loss.
• Biologic therapies – TNF inhibitors and other biologics work wonders for controlling RA symptoms, but because they alter immune system function, they could make your ears more vulnerable to infections or damage.

What’s the takeaway here? If you’ve noticed changes in your hearing, don’t just chalk it up to aging. Have a conversation with your doctor about whether your RA meds might be playing a role. There may be alternative treatment options or adjustments that could help.

The Connection Between RA, Tinnitus, and Ear Fullness

Ever had that annoying sensation where your ears feel clogged, like you’ve just gotten off an airplane? Or maybe you’re dealing with a constant ringing or buzzing that just won’t quit? If so, you’re not alone. Many people with RA experience tinnitus and ear fullness, and the link isn’t just a coincidence.

Here’s why it happens:

1. Inflammation and fluid buildup – RA-related inflammation can affect the Eustachian tubes, making it harder for your ears to regulate pressure. That can leave you with that frustrating “blocked ear” feeling.
2. Blood flow changes – RA affects blood vessels, which can impact circulation in the inner ear and contribute to tinnitus.
3. Nerve damage – As we touched on earlier, RA can damage the auditory nerve, leading to hearing disturbances, including phantom noises like ringing or buzzing.

From my experience, many RA patients don’t realize these symptoms are connected to their condition. Instead, they try everything from ear drops to decongestants, only to find little relief. If this sounds familiar, it’s worth getting checked by both a rheumatologist and an audiologist.

What Can You Do to Protect Your Hearing?

Alright, so now that we know RA can impact hearing in multiple ways, the big question is: What can you actually do about it? The good news? There are plenty of proactive steps you can take.

1. Get Regular Hearing Checkups

You wouldn’t skip your rheumatologist appointments, right? Well, the same mindset should apply to hearing health. Schedule regular hearing tests, especially if you’ve been living with RA for a while.

2. Keep Inflammation Under Control

Managing your RA effectively can help reduce the inflammation that contributes to hearing problems. That means sticking to your treatment plan, eating an anti-inflammatory diet, and staying active.

3. Be Mindful of Medications

If you suspect your RA meds are affecting your hearing, don’t just stop taking them—talk to your doctor first. There might be alternatives that are easier on your ears.

4. Protect Your Ears from Noise

If you already have some hearing sensitivity, loud environments can make things worse. Use ear protection in noisy places and keep the volume reasonable when using headphones.

5. Address Stress and Fatigue

RA already drains your energy, and stress can make tinnitus and ear issues even worse. Finding ways to manage stress—whether it’s through meditation, light exercise, or just prioritizing rest—can make a difference.

At the end of the day, knowledge is power. The more you understand how RA affects not just your joints but also your hearing, the better equipped you’ll be to take care of your whole body.

Managing RA-Related Hearing Issues: What Specialists Can Help?

If you’re dealing with both rheumatoid arthritis and its effect on hearing abilities, it’s important to know that you’re not alone—and more importantly, you don’t have to figure it all out by yourself. The right specialists can help you manage symptoms and prevent further damage.

Here’s who you might want on your team:

• Rheumatologist – Your go-to expert for all things RA. If you suspect your hearing issues might be connected, they can help assess whether inflammation, medications, or another factor is at play.
• Audiologist – These hearing specialists can perform tests to pinpoint hearing loss, tinnitus, or other ear-related problems.
• Otolaryngologist (ENT) – If there’s fluid buildup, chronic ear infections, or structural issues with the inner ear, an ENT doctor can evaluate and recommend treatments.
• Neurologist – In rare cases, RA can cause nerve-related hearing issues. A neurologist might be needed if symptoms like dizziness, numbness, or neurological complications are present.

From my own experience working with RA patients, the best results come from a team approach. No single specialist has all the answers, but when you combine their expertise, you get a much clearer picture of what’s happening.

Real Stories: How RA Patients Are Coping with Hearing Loss

RA-related hearing issues might not be mainstream news, but trust me—plenty of people are dealing with it. Over the years, I’ve heard some eye-opening stories from patients who never expected their arthritis to affect their ears.

Take Lisa, for example. She’s had RA for over a decade and started noticing that conversations in crowded places felt impossible. She assumed it was just background noise until her audiologist confirmed mild hearing loss. Turns out, the culprit was long-term NSAID use. After switching medications and using hearing aids for clarity, she feels like she’s “gotten back” part of her social life.

Then there’s Mark, who developed tinnitus that made it hard to sleep. His rheumatologist adjusted his methotrexate dosage, and his ENT recommended white noise therapy. It didn’t cure the ringing, but it made it far more manageable.

Stories like these highlight one key lesson: ignoring the problem won’t make it go away. The sooner you seek help, the better your chances of keeping your hearing as sharp as possible.

Final Thoughts: Don’t Ignore the Signs

Rheumatoid arthritis is already a complex condition, and adding hearing loss into the mix can feel overwhelming. But here’s the good news: by staying proactive, getting the right care, and making small lifestyle adjustments, you can protect your hearing and overall well-being.

If you take away one thing from this article, let it be this—don’t brush off hearing issues as “just aging” or “a minor annoyance.” If something feels off, get it checked out. Your ears, just like your joints, deserve attention.

References

• Arthritis Foundation
• National Library of Medicine
• American Speech-Language-Hearing Association

Disclaimer

The information in this article is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider for personalized recommendations.