Arthritis refers to more than 100 different conditions that cause joint pain. The most common types are osteoarthritis, caused by wear and tear on joints, and rheumatoid arthritis (RA). RA, which affects about 1.5 million Americans, is one of the most serious forms of arthritis because it’s an autoimmune disease. Not only can it spark joint damaging inflammation, but active RA puts your immune system in overdrive and may attack healthy cells in your eyes, lungs, heart, bones, nerves, and blood vessels, too. Researchers have also found it raises the risk of hearing problems.
Over the past decade, some studies have suggested people with rheumatoid arthritis had an increased risk for hearing loss. Recently, a team of researchers from the department of Rheumatology at Odense University Hospital in Denmark conducted a comprehensive review of all the studies that looked at rheumatoid arthritis and hearing impairment. They concluded the answer was clear: RA is significantly linked to hearing loss in many rheumatoid arthritis patients, and the loss is across all frequencies of sound. The researchers noted people with RA can potentially lower their risk of permanent hearing loss with lifestyle changes and regular hearing tests.
Sensorineural hearing loss, which occurs when there’s damage to the inner ear (the cochlea) or to the nerve pathways that extend from the inner ear to the brain, is the most common type of hearing damage in rheumatoid arthritis patients, according to the study. In fact, the research team found that 25 to 72 percent of people with RA are likely to have some sensorineural hearing loss. Older patients, those who have had RA for many years, patients with active disease, and those who develop rheumatoid nodules (tiny lumps that grow in some RA patients near inflamed joints) appear most likely to have hearing loss, the research showed.
Exactly how RA impacts hearing isn’t known, although there are several possibilities. Rheumatologist Amir Emamifar, MD, who headed the study, and his colleagues think likely reasons for the hearing loss include damage to tiny joints in the ear that normally carry vibrations, auditory nerve damage, possible RA-related destruction of the hair cells in the inner ear (resulting in a permanent loss of sensitivity to some sounds), and medications that may contribute to hearing loss.
If you have rheumatoid arthritis, talk to your doctor about the possibility of changing any drug treatments that may be ototoxic (damaging to hearing). Emamifar and his research team noted that because hearing impairment may be present in RA patients even if they haven’t noticed it yet, getting regular hearing tests is advisable so any hearing loss can be identified and treated at an early stage. And if hearing loss that’s not reversible is found, using various types of hearing aids and implantable devices can help. When people with RA have symptoms of serous otitis (better known as fluid in the middle ear), which may cause hearing loss, imaging tests can see if RA nodules are responsible.
Some research suggests antioxidants, including vitamin E and N-acetyl cysteine, may help preserve hearing by protecting your inner ear, according to the researchers. They also advise patients and their families to avoid smoking. Cigarette smoke, including second-hand smoke, can damage the inner ear and cause hearing deterioration. Reducing or stopping the consumption of alcohol may help slow or prevent hearing loss, too.
It’s also important to have regular check-ups with your doctor if you have RA or have symptoms of the disease. Advancements in RA have resulted in better diagnosing, treatment, and the ability to help many patients get their disease under control and even into remission.
For more information on rheumatoid arthritis, visit the American College of Rheumatology web site. The Arthritis Foundation also offers tips on living with arthritis and information on treatment and more.
June 08, 2016
Janet O’Dell, RN