Rheumatoid arthritis (RA) increases the risk of tinnitus in two ways: it causes hearing loss either directly or indirectly.
According to an article by rheumatologist Judith Frank in Arthritis Health, inflammation from rheumatoid arthritis can damage the tiny joints in the ear and it can also lead to the development of a rheumatoid nodule inside the ear.
Still, rheumatologist Nilanjana Bose notes at WebMD that in order for your hearing to be affected, you must have advanced RA, have had it for a long time, and you don't keep up with inflammation control treatments. In other words, hearing issues are most typically experienced by older people who have had rheumatoid arthritis for some time.
Another reason why RA increases the risk of tinnitus is that many of the drugs that help with rheumatoid arthritis can actually bring on tinnitus. These include aspirin and other non-steroidal anti-inflammatory drugs; however, you likely won't experience chronic tinnitus if you limit any NSAIDs to short periods of time or if you take aspirin in low-dose amounts.
According to a MedicalNewsToday article, reviewed by Nancy Carteron, M.D., "damage to the ear from arthritis medication may happen when a person uses these drugs at high dosages for a prolonged period, as they reduce blood supply to the inner ear. The same inflammation and immune response that attack the joints may also damage the inner ear in some people with arthritis."
But to put it into perspective, look at what the team at San Francisco Audiology write: "About one percent of the general population experiences RA, and around 75 percent of these people have sensorineural hearing loss (hearing loss caused by nerve damage)."
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