Managing the symptoms is one of the cornerstones in the treatment of rheumatoid arthritis (RA). A flare-up in the symptoms is not only painful but it also damages the joints over time. One of the major factors that contribute to these flare-ups is stress. Stress and rheumatoid arthritis are directly linked to each other, and stress management is an important means to keep the symptoms and pain under control. However, stress is not necessarily due to external factors when it comes to RA. It can be caused either because of the arthritic condition or factors including challenges on the professional or personal front due to the condition.
“Stress plays an important role. It is seen that people who endure high levels of stress have higher chances of rheumatoid arthritis,” says Dr Harman Singh, consultant rheumatologist, at Fortis Hospital, Kalyan. “Among those who come for OPDs, almost 80% have stress as the common factor for aggravation of the symptoms.”
Dr Singh does not start the medications immediately when a person consults her for the first time with the symptoms of rheumatoid arthritis. Instead, while waiting for the blood reports, people are advised to control their stress levels. And once it goes down, there is a substantial improvement in the symptoms.
Rheumatoid arthritis and emotional health are directly linked to each other, says Ahmedabad-based senior consultant psychologist Dr Prashant Bhimani.
“An increase in ‘RA factor’ and symptoms have a direct correlation with the state of mind of the person,” adds Dr Bhimani. “If someone is feeling insecure, anxious, or angry, then the RA factor increases. And in a way, we can also call it a psychosomatic disorder.”
Stress and rheumatoid arthritis flare-ups
Stress causes a release of certain hormones which also increases the levels of pro-inflammatory chemicals in the body.
“When we are stressed, certain hormones or enzymes are released in our body and among these the most prominent one is cortisol,” says Dr Singh. “When cortisol levels in the body go up, the levels of pro-inflammatory chemicals like cytokines also rise. This increases inflammation, and hence swelling and other symptoms related to RA. The result is an increase in pain.”
The flare-ups caused by stress are usually short-term and can be managed through medications. But overtime, constant recurrence of the flare-ups can damage the joints permanently.
Coping with arthritis-related stress
“Those with RA should identify the trigger factors causing stress and work on it,” advises Dr Singh. “Exercise regularly as this increases the endorphin levels in the blood which makes one happy. This also ensures the joints remain mobile. And instead of refined foods, people should opt for natural foods.”
It is common for middle-aged individuals or those who are in their late 50s to experience stress, says Dr Bhimani. That’s the age when the onset of rheumatoid arthritis is observed among people.
“Mid-life crisis is one of the major causes of stress,” adds Dr Bhimani. “Women who are going through menopause, and people who are nearing retirement can experience stress and financial insecurity. Another major reason for the increase in stress is living a fast life which causes insecurity and comparison. High screen time, on the other hand, decreases the family time in the households leading to stress.”
He also insists on regular workouts being a great stressbuster. “Yoga and meditation with a balanced diet is also helpful. Learning self-relaxation techniques and spending time by oneself can reduce stress. Approach a psychologist if needed,” adds Dr Bhimani.
People with RA may not be able to be physically active or do certain activities because of the condition. It is important for them to consult a rheumatologist who can guide them through the activities that they can safely take part in.
Takeaways
- Stress and rheumatoid arthritis are directly linked. An increase in the stress level can lead to a flareup in the arthritic symptoms. If this occurs repeatedly over a period, it can damage the joints.
- Arthritis and emotional health are directly linked to each other. Hence, managing stress is important to identify and address the trigger factors, say experts.
- Due to stress, certain hormones are released including cortisol which increases the level of pro-inflammatory chemicals like cytokines in the body. This leads to an increase in swelling and pain.
