Rheumatoid Arthritis and Stress

Is There a Connection Between RA and Stress?

Man at his desk in a warehouse environment, having extreme pain in the upper backQuestion: I'm 58, and I have a very demanding, high-stress job. I've also had rheumatoid arthritis (RA) for a few years. It seems like the more stressed I am, the worse my RA gets. Is there really a connection between stress levels and RA? If so, how can I reduce my stress?
— Cape Cod, MA

Answer: It's not just your mind playing tricks on you: There's a strong connection between stress and rheumatoid arthritis (RA), and it's a vicious cycle. You have chronic pain caused by rheumatoid arthritis, and you're physically and emotionally stressed, which can lead to an increased perception of pain in the joints involved with RA.

Feeling stressed and depressed when you have RA is normal, but these feelings may make it more difficult for you to successfully manage your RA. Routine tasks may be more difficult or take longer to complete. Learning stress-management skills is important to reduce stress, but you must understand your disease and know what to expect.

To help you understand the link between stress and RA, you need to know what happens to your body physically when you're stressed.

A typical stress response involves a rapid heart rate, quick breathing, and a spike in your blood pressure as a result of stress hormones flooding your body. It's normal for your body to respond this way on occasion (eg, slamming on your brakes to avoid hitting the car in front of you), but when you experience this stress response daily, it can definitely aggravate your RA.

With your demanding job, it sounds like your body is constantly battling the effects of stress. Ongoing stress weakens your body. It affects your immune system, which can promote inflammation, and your central nervous system, which can lead to even more stress.

Stress can also affect your perception of pain—the more tense you are, the more intense your pain may feel. Too much stress also means that you're more susceptible to other RA symptoms, such as fatigue and weakness.

While a completely, stress-free life isn't realistic, reducing stressful triggers and incorporating healthier behaviors can help you regain a sense of well-being. Fortunately, there are several things you can do manage your stress and control your rheumatoid arthritis symptoms.

You should start with your job. If you can, try to cut back at work—ask for help with assignments or talk to your boss about adjusting the number of hours you work per week. Try not to overdo things: Pace yourself and the activities you do to avoid becoming fatigued. Yes, work is important, but doing other things you enjoy—perhaps curling up with a good book—is just as essential.

Here are other ways to reduce stress and rheumatoid arthritis symptoms.

  • Breathe correctly: Most of us take short, shallow breaths, which can actually contribute to tension. Try to do deep belly breathing—your breath should be slow, smooth, and steady. This helps calm the nervous system.
  • Develop strong, personal relationships: Develop a network of friends and/or family members who understand and support you. Meet with them to laugh and to vent stress that may have built up. If your schedule allows, join a book club to get your mind off your stressors and to seek out new friendships.
  • Exercise: Making exercise a priority can boost your mood and increase levels of endorphins—your body's natural painkiller. Consistency is key here, so pencil in regular workouts. Moderate physical activity on a regular basis helps decrease fatigue, strengthen your muscles and joints, and improve your sense of well-being. Low-impact exercises, such as walking or riding your bicycle are generally good, safe options. Also, aerobic water exercise is good for your joints because it doesn't put a lot of stress on them, and it helps increase your stamina and strength.
  • Get a massage: Massage can literally help rub away your pain and tension. Schedule regular massages for maximum benefits.
  • Join a rheumatoid arthritis support group: Check out the Arthritis Foundation to find an Arthritis Foundation Self-Help Program in your community. Programs are also offered online.
  • Meditate: Taking a few minutes each day to meditate can help counteract the effects of stress and create a feeling of inner peace.
  • Sleep: Ideally, you should shoot for 8 hours of sleep each night, but go to bed and wake up at the same time every day. This helps your body regulate a healthy sleep-wake cycle.
  • Take a warm bath: The heat helps decrease secretion of stress hormones, signaling your body to relax.

Incorporating just a few of the stress management techniques mentioned above into your daily routine can help soothe your stress and ultimately ease your rheumatoid arthritis symptoms.