“What did you say?” “Would you repeat that please?” If you find yourself asking those questions more frequently, you are not alone – and your hearing loss could have an arthritis-related reason, either due to the disease itself, or to the drugs used to treat it.

Clinical trials have found higher rates of sensorineural hearing loss – a type of hearing loss usually caused by poor function of the hair cells in the cochlea – in patients with rheumatoid arthritis (RA). For example, one study published in 2006 detected hearing impairment, which was overwhelmingly sensorineural, in 42.7 percent of patients with RA. By contrast, only 15.9 percent of the control group showed that type of hearing loss. Other, smaller studies have found similar results. Some evidence also links psoriatic arthritis (PsA) and juvenile idiopathic arthritis (JIA) with hearing loss (research on hearing loss in patients with Sjögren's syndrome have been inconclusive).

A 2006 Mayo Clinic study bucked the trend, finding no significant link between hearing and RA. However, it concluded that patients with RA were more likely to perceive that they had hearing problems.

The drugs used to treat the aches and pains of arthritis could also be to blame. A 2012 study published in The American Journal of Epidemiology found that women who took ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) two or more days per week were more likely to report hearing loss than those who rarely took the painkillers. And the more often women took either medication, the higher their risk for hearing loss. Women who used ibuprofen two to three days a week had a 13 percent increased risk, while women who took the medication six or seven days a week had a 24 percent increased risk. This link between analgesics and hearing loss was generally stronger among women younger than age 50.

The researchers speculate that the drugs could reduce blood flow to the cochlea or deplete factors that protect it from damage. Earlier studies have linked regular use of aspirin to hearing loss as well.

Delaying Treatment May Lead to Cognitive Decline

The sooner hearing loss is treated, the better. According to two studies, untreated hearing loss may be associated with accelerated cognitive decline and brain atrophy. One study, out of The Johns Hopkins Center on Aging and Health, found that not only was cognitive decline faster among those with hearing loss, but patients with hearing loss were at higher risk for developing cognitive decline in the first place. The second study out of the Perelman School of Medicine at the University of Pennsylvania, found that older adults with hearing impairment had lower density of gray matter in the auditory areas of the brain.

The lead author of the second report said that as hearing ability declines, interventions like hearing aids may not only improve hearing but also help preserve the brain.

What You Can Do

It’s not easy facing up to a hearing problem. It might feel embarrassing or too personal to talk about, especially in a work environment. But treating and being open about hearing loss early on benefits you and everyone involved. Taking action is ultimately easier than straining hard to hear people, missing out on conversation, or risking that other people will think you are ignoring them.

If you notice a change in your hearing, tell your health care provider; he or she may adjust your medications or refer you to a specialist, such as an audiologist who can fit and dispense hearing aids.

You also can creatively adapt to hearing impairment by following these simple steps:

  1. Be upfront.Once people know you are hard-of-hearing, most will be eager to help. Ask them to speak clearly but not to shout.
  2. Hear what you’re missing.Test out the best hearing aids you can afford, in a free trial. They are an investment in quality of life.
  3. Speak louder.Other people tend to reflexively speak up, too. 
  4. Position yourself.Sit near the middle of the table where you can better hear everyone. At a party, move away from noisy areas like an entrance or kitchen.
  5. Be positive.No one hears perfectly. Don’t be too hard on yourself! You probably compensate by relying on other skills. You might be an attentive listener, or adept at reading visual cues. These can become real gifts. 

For more advice on how to deal with hearing loss, visit hear-it.org.