Sunday, February 5, 2023

Does Stress Affect Rheumatoid Arthritis

Hormone Havoc Triggers Symptoms

How Does Stress Affect Arthritis?

The hypothalamus also activates a second part of the stress response system, using the hormonal signals of the HPA axis, especially corticotropin-releasing hormone , which causes the body to increase its level of what we call the stress hormone: cortisol.

Cortisol is the most famous hormone in our bodily response to stress, and with good reason. Cortisol turns on and turns off various reactions in our body. For instance, it tamps down the digestive and reproductive systems while boosting glucose in our blood.

Cortisol also alters the response of our immune system, emphasizing substances that repair tissue over other immune reactions.

Common Medications To Treat Arthritis Flares

OA patients might just need some OTC pain-relieving medication such as acetaminophen, ibuprofen, or naproxen. Dr. Bose also recommends topical gels and lotions like diclofenac gel or 2 Old Goats. If that doesnt work, Dr. Ashany says joint injections of steroids may be given. RA flares are more complicated. In inflammatory arthritis, steroids are often used to try to quickly bring a flare under control, Dr. Ashany says. If only one joint is involved a steroid can be given by injection, but otherwise it can be taken orally .

In inflammatory arthritis, if flares continue to occur, this indicates that the patients regimen of maintenance medication is not adequate, Dr. Ashany says. This may lead to addition of a medication, switching one drug for another or increasing the dose of medication that the patient is currently taking.

How Stress Affects Rheumatoid Arthritis

Rheumatoid arthritis is a condition that over 1.3 million Americans currently live with. If you are one of them, gaining a deeper understanding of the autoimmune disease is essential. The role that stress can play in affecting symptoms should be at the top of your agenda.

Knowledge is power and will support your bid to build a better lifestyle when living with rheumatoid arthritis. Heres what you need to know about stress and what it can do to your physical and mental wellbeing when living with a chronic health complaint.

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Symptoms Of Stress And Anxiety

Stress can wreak havoc on your mind and body. In small doses, the stress response can improve alertness and sharpen senses however, chronic stress can lead to serious problems such as cardiovascular disease, gastrointestinal problems, and autoimmune disease. Be sure to talk to your doctor if you experience any of the following symptoms on an ongoing basis.

Mental/Emotional Symptoms:

  • Frequent colds or infections

Assessment Tools For Pros

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Patient global assessment , due to its simplicity and feasibility, is the second most used single-item tool in RA that broadly reflects a patients experience of disease . The reliability, sensitivity to pain and global health, and construct validity for the numerical rating scale , verbal rating scale and VAS have been verified . Patient-Reported Outcomes Measurement Information System can assess the level of fatigue and quality of sleep . The Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire and BRAF Numerical Rating Scales are also used to measure the level of fatigue and coping . The severity of fatigue was measured using the Checklist Individual Strength -fatigue score in 230 RA patients in a cross-sectional study. The result showed 44% of patients have severe fatigue , and it has a bidirectional relationship with reduced physical activity. CIS score 32.1±12.6 of RA patients lies between the healthy control group and patients with chronic fatigue syndrome .

The Functional Assessment Chronic Illness Therapy-Fatigue scale and SF-36 were the measurements used most often in clinical trials to measure PROs and fatigue . PGA is a valid tool to measure PROs, NRS and VAS showing better concurrent reliability than VRS . HAQ-DI and BRAF-NRS are also considered reliable assessment tools for fatigue in RA .

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Ra’s Effect On The Brain

Learn about the possible links between rheumatoid arthritis and cognitive effects and how to manage them.

A lot of people with rheumatoid arthritis report having trouble with memory, attention, and mental focus. They forget names and appointments, struggle to find the right words and have trouble making and carrying out plans. Some say that the loss of mental clarity, commonly called brain fog, is almost as distressing as arthritis itself.

Limited Research

Its hard to say exactly how common fuzzy thinking is in RA because researchers have largely ignored it.

We have relatively good literature on cognitive problems in lupus and fibromyalgia, where brain fog is well established, but nobody has really studied RA, explains Patti Katz, PhD, a professor of medicine at the University of California, San Francisco.

Katz and her colleagues looked at 15 studies on RA and cognition published between 1994 and 2016. Many were small less than 100 patients and not all were high quality. Yet most showed that people with rheumatoid arthritis performed more poorly on cognitive tests than their peers or controls. Memory, verbal communication, attention, concentration and problem-solving seemed to cause the most trouble.

Who Gets It and Why?

There are several theories why cognitive problems may be more common in RA and other inflammatory types of arthritis.

But Katz thinks it might not be that simple.

Some factors that may contribute to brain fog include:

What the CDC Says

Can Stress Relievers Alleviate Ra Symptoms

Researchers are also working to understand how modifying stress affects RA on a biological level.

In a review published online on Sep. 10, 2013, in the Journal of Evidence-Based Complementary & Alternative Medicine, author Manoj Sharma PhD, a professor at the University of Cincinnati found yoga to be a promising modality for arthritis. Of nine studies done between 2010 and June 2013, six showed positive changes in psychological and physiological outcomes related to arthritis, including pain. It relieves stress because your mind is not dwelling on things that are causing you anxiety and stress, Sharma explains, adding that this form of low-impact exercise also strengthens muscles and adds to the flexibility of joints.

Zautras research has also shown that mindfulness meditation, which focuses on acceptance and cognitive behavioral therapy, which works to combat negative thought patterns, can help people manage their RA pain. The mind is in the brain and the brain is in the body, so, if we change the way we think about something, it will have a physiological effect, Zautra says.

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Will I Be Able To Work How Do I Tell My Boss

I wont lie. Rheumatoid arthritis can lead to work disability, abseeteeism, and presenteeism at a high cost to you but also to your employer. Youve had the conversation with your family and friends but now its time to tell your boss.

First, youre not legally required to disclose your RA to your employer. However, as an employer myself, I would appreciate it if my employee would disclose this information. What if your job requires heavy lifting or standing around for a very long time? Maybe I can help you and re-arrange your work duties to better accommodate you? Maybe you need a better chair or a better mouse? Every situation is different. Not everyone with RA has horrible disease but on the flip side not everyones employer is accommodating.

Theres also the situation with doctors appointments. Most people with RA see their rheumatologist every 3 to 6 months for regular checkups. Some people may need medications that only come as infusions. These infusions are given in clinic and last between 1.5 hours to half a day. Thats more time off work.

By informing your employer, you are entitled to certain legal rights, as outlined in the Americans with Disabilities Act and the Family and Medical Leave Act. For more information, please click on the following link.

Ultimately, the choice to tell your boss or not is yours. You are in control.

Guide To Living With Rheumatoid Arthritis: Part 2

Stress and Rheumatoid Arthritis

If you missed Part 1 of Guide to living with rheumatoid arthritis please follow the link. In part 1 we covered the basics: what is rheumatoid arthritis, the cause, symptoms, diagnosis, and treatment. In part 2, Ill be covering how rheumatoid arthritis can affect your day-to-day living, habits that worsen RA, exercise, food, and stress reduction techniques. Without further adieu, here is Part 2 of the Guide to living with rheumatoid arthritis. I hope you enjoy!

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Stress Linked To Inflammatory Arthritis Among At

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Perceived stress is significantly associated with developing inflammatory arthritis among those who are at risk, according to findings published in Arthritis Care & Research.

Stress is a part of everyday life, but how we perceive and cope with stressors can have potential impacts on our health,Kristen J. Polinski, MSPH, of the Colorado School of Public Health, told Healio Rheumatology. In patients with rheumatoid arthritis, we understand that psychological stress can have negative effects on disease activity, but this relationship is not well established in preclinical populations. Our study adds to the emerging evidence suggesting that perceived distress may affect the future development of rheumatoid arthritis.

To analyze the association between perceived stress and incident inflammatory arthritis, Polinski and colleagues conducted a prospective, longitudinal study of data from the ongoing Studies of the Etiologies of Rheumatoid Arthritis , a multisite cohort of 2,037 participants established in 2002. The cohort includes participants without inflammatory arthritis at baseline who were at risk for developing future rheumatoid arthritis, defined as first-degree relatives of RA probands or someone who screened positive for anticyclic citrullinated peptide autoantibody.

Disclosure: The researchers report grant funding from the NIH.

Mental Health And Rheumatoid Arthritis: Toward Understanding The Emotional Status Of People With Chronic Disease

Ewa Mojs

1Institute of Psychology, Adam Mickiewicz University in Poznan, Poland

2Department and Clinic of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poland

3Department of Stomatological Surgery and Periodontology, Poznan University of Medical Sciences, Poland

4Department of Clinical Psychology, Poznan University of Medical Sciences, Poland


1. Introduction

Chronic illness is indicated by the World Health Organization as the leading cause of premature death in the world. According to WHOs estimates, it is responsible for 63% of all fatalities . Chronic illness is defined by its slow progression and long duration, two traits which force patients to adapt to new, changed circumstances, and which affect most aspects of life, usually negatively, consequently significantly lowering health-related quality of life .

A basic problem that RA patients must cope with is pain. As the disorder advances, pain levels usually increase . The unpredictability of pain is one trait disrupting well-being patients cannot predict the end of an ongoing episode of pain nor the onset of another one. This negatively impacts the sufferers emotional state and greatly increases their negative affect.

2. Methods

2.1. Study Participants

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Yoga Improves The Bodys Response To Diseases

Since yoga helps to reduce stress, it can reduce the levels of cortisol in the body. Cortisol is a hormone closely associated with states of mental and emotional stress.

When we release stress, the secretion of cortisol is suppressed. Nowadays, its known that maintaining high levels of cortisol in the body can lead to alterations in the immune system. Its believed that cortisol may weaken the immune system giving way to the entry of pathogens.

When cortisol is controlled, the body is better suited to fight arthritis. Its not known to what extent this can delay the condition, however, its another thing patients can do.

Tackle Stress At Work

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Stretch. Aim to take a break every half-hour to stretch, walk around, and clear your head. When you can’t, stretch at your desk. Try to move all your joints. Arch your back. Shrug your shoulders. Stretch your arms above your head. Make claws with your hands. Flex your ankles and toes.

Breathe deeply. Take a few deep breaths with your eyes closed or open. Inhale through the nose, feeling your chest expand. Then exhale through your mouth. Repeat.

Relax your muscles. Slowly relax all the muscle groups in your body, starting with your feet and ending with your head. First, tense the muscles for about 8 seconds. Then relax them and feel the tension melt away.

Focus on a soothing image. Keep pictures on your desk or a slideshow of pictures on your computer that relax you. Try a favorite vacation spot, pictures of loved ones, or adorable kittens. Anything that makes you smile or feel calm helps.

Listen. Slip on a pair of headphones for a few minutes. Play a song that gives you happy, soothing thoughts. Or listen to relaxing natural sounds, like ocean waves or a waterfall.

Smell. Certain scents — like lavender, chamomile, and sandalwood — can ease stress for some people. Keep a bottle of scented hand lotion on your desk and use it when you need a little “aromatherapy.” Get products with real essential oils instead of artificial scents.

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Why Does Stress And Anxiety Cause Joint Pain

Life is full of stressful situations. You may feel stress over meeting a deadline, managing finances, or even something as simple as getting the kids out the door in the mornings .

According to the Anxiety and Depression Association of America, Seven out of ten adults in the United States say they experience stress or anxiety daily, and most say it interferes at least moderately with their lives.

Stress has become such a part of daily life that many people dont realize its a problem until symptoms become unbearable, and sometimes, irreversible.

The Stress And Chronic Inflammation Link

Anyone with RA knows that stress plays a role in ramping up inflammation. We see it in patients all the time. Somebody loses a job or they have a fire in their house and suddenly they have a big flare, says Daniel Muller, MD, a rheumatologist at UCHealth in Ft. Collins, Colorado, and a coauthor of Integrative Rheumatology.

But how exactly does this happen? Experts dont have all the answers, but science has provided some clues.

A study published in Proceedings of the National Academy of Sciences looked at mice and blood samples from low-income people. Researchers found that stress alters some genes in the bone marrow, which in turn produces immune cells in our blood that are more pro-inflammatory. You can see how pro-inflammatory cells would be valuable in a stressful moment in which the body needs to fight the bruises or potential infection resulting from battle with an enemy. But this dynamic leads to chronic inflammation if the stress never lets up.

Another study, published in February 2021 in Scientific Reports, documented how chronic stress in early life alters the expression of genes. By examining the blood of 2,000 Europeans who came from disadvantaged childhoods, they found that changes in the identity and function of certain genes could explain the connection between this early stress and later levels of inflammation in adulthood.

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Mental Health Disorders And Ra

Depression negatively affects RA patients ability to function in the presence of their physical symptoms, such as pain and fatigue . Long-term exposure to raised cytokines such as IL-1, tumour necrosis factor – and IL-6 in RA can cause maladaptive responses to sickness behaviour, causing fatigue, pain, fever, anhedonia and depression . Depression presents with low mood, low self-esteem, fatigue, lethargy, insomnia, psycho-motor dysfunction and repetitive negative thoughts . MDD presents with more aggressive symptoms of depression together with feelings of low self-worth, difficulty concentrating, anhedonia and suicidal ideation, making it potentially fatal if left untreated .

Chronic Stress And Long

Stress and Arthritis [How Stress Can Affect Your Arthritis]

Aches and pains are common symptoms of stress, however, ongoing pain or stiffness may be a sign of a more serious problem.

A 2018 study published by PubMed revealed Stress-related disorders were significantly associated with risk of subsequent autoimmune disease.

Autoimmune diseases cause your immune system to produce antibodies which attack and damage the bodys healthy tissue instead of fighting infection. In certain conditions, such as rheumatoid arthritis and lupus, the antibodies attach to connective tissue within the joints leading to pain, stiffness, swelling, andwithout treatmentpotentially permanent joint damage.

Autoimmune diseases are often incurable however, early intervention and treatment can help prevent further damage and joint deterioration.

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Inflammation And Stress: Theyre Closely Connected

Research shows that stress may play a role in the cascading process that leads to inflammation and causes RA pain. Inflammation in RA is partly caused by molecules called cytokines. While cytokines can be released for a variety of reasons, stress also releases them. If youre stressed and are producing more cytokines, you will most likely develop more inflammation, which may result in more pain.

Whether we consider rheumatoid arthritis, osteoarthritis, systemic lupus, or any other rheumatic disease, the presence of emotional stress may well exacerbate the condition, says Richard Roseff, MD, a rheumatologist at Danbury Hospital and a private practitioner in Danbury and Ridgefield, Connecticut.

What Is Autoimmune Disease

These are fascinating and mysterious conditions in which the bodys immune system “misfires” and attacks its own tissues. There are scores of autoimmune diseases out there. Some of the most well-known are , psoriasis, multiple sclerosis, and type 1 diabetes.

In some cases, a condition is labeled “autoimmune” based on conventional wisdom or expert consensus rather than hard science. And Ive seen the term “autoimmune” used loosely to apply to any condition of unknown cause in which inflammation is present or the immune system appears to be active. But an infection could do the same thing. So perhaps some of these conditions now considered to be autoimmune will turn out to be chronic infections by an organism weve not yet identified.

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