How Stress And Arthritis Affect Each Other
Stress affects your illness in two major ways, according to a meta-analysis of 10 studies on the relationship between stress and arthritis, published in the journal Arthritis Research and Therapy. Stressful events work on a physical level, increasing levels of the hormone cortisol in your body. This then triggers the immune system hyperactivity that is the hallmark of inflammatory types of arthritis while also reducing your immune systems ability to fight off harmful germs. Stress also affects you on a mental level, making you less resilient and able to deal with the symptoms of your disease. When our patients say that stress worsens their disease, they may be correct, the researchers concluded.
Fortunately, you can manage this vicious cycle of stress and its impact on managing arthritis. Here are some tips from Dr. Larsen and from fellow arthritis patients on how they cope with stress to minimize its impact on their arthritis.
Can Managing Stress Keep Ra Symptoms In Check
A link between stress and rheumatoid arthritis is commonly acknowledged. However, scientists continue to explore the connection between the nervous and immune systems and the effect on RA onset and progression. People with RA commonly report experiencing physical or emotional stress when first diagnosed with an autoimmune disorder like RA. However in a 2010 editorial in Arthritis Research & Therapy, Daniel Clauw, MD, a professor of anesthesiology at the University of Michigan , commented on a review of 16 studies on the stress-arthritis link. In his editorial, Dr. Clauw highlighted the verified link in animal models and the difficulty in proving a similar linear relationship in humans.
The reason its difficult is that it is hard to measure stress, and we know that not all types of stress are equally capable of affecting different individuals in the same way, explains Dr. Clauw.
But evidence of a connection remains an important focus among researchers. In the same editorial, Dr. Clauw referenced a study that found Vietnam combat veterans with post-traumatic stress disorder had an almost 17 percent higher risk for autoimmune diseases compared to those without PTSD. A 2009 study in Psychosomatic Medicine showed that people with two or more traumatic events in their childhood had a 100 percent higher risk for rheumatic diseases compared with people who didnt suffer childhood trauma.
How Is Rheumatoid Arthritis Treated
The goals of rheumatoid arthritis treatment are to:
- Control a patient’s signs and symptoms.
- Prevent joint damage.
- Maintain the patients quality of life and ability to function.
Joint damage generally occurs within the first two years of diagnosis, so it is important to diagnose and treat rheumatoid arthritis in the window of opportunity to prevent long-term consequences.
Treatments for rheumatoid arthritis include medications, rest, exercise, physical therapy/occupational therapy, and surgery to correct damage to the joint.
The type of treatment will depend on several factors, including the person’s age, overall health, medical history, and the severity of the arthritis.
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Treatment For Hair Loss
Although hair loss technically doesnt need to be treated, it can have a significant impact on your self-esteem and confidence which is reason enough to address it. Plus, hair loss could be indicative of other issues like mineral deficiencies or unknown illnesses.
Just on its own merits, we dont need to treat hair thinning, but I dont want to underestimate the significance of aesthetics, says Dr. Hamburger. Our patients suffer enough from damage to their joints, swollen joints, and sometimes weight loss or muscle wasting. Theyve got enough going on with their appearance and their self-image, they certainly dont need something as important as hair loss to deal with, too.
Talk to your doctor to find out whether one of the following will help treat your RA-related hair loss.
Whats One Thing I Can Do Right Now To Cut My Arthritis Risk That I Might Never Think Of
Make an appointment with your dentist. A study from the University of Leeds in England found that RA may be triggered by antibodies responding to gum disease. The association between gum disease and RA appears to be seen in chronic periodontitislong-standing generalized gum disease rather than acute inflammation, says study author Kulveer Mankia, MD, clinical research fellow in rheumatology. Make sure you also brush and floss daily.
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Make Relaxation A Part Of Your Life
Relaxation doesnt have to mean a long indulgent massage or vacation to a faraway place. You can find relaxation each and every day with a quiet guided meditation using an app on your phone, sitting on a park bench and watching the flowers, or by sitting quietly in a warm bath.
Oftentimes when youre stressed, youre so wired that you think you dont have time for these moments. But its exactly when you dont think you have time for them that theyre most important to your mental and physical health.
A little relaxation can put you back in perspective and take you out of the whirlwind that stress can cause.
Relaxation can help you notice where youre holding the stress: in a clenched jaw, shrugged shoulders, or tight back. By focusing on these areas, you can help them soften and slow the cycle of stress from affecting you physically.
At Maryland Orthopedic Specialists, were always available to help you find solutions to arthritis and other joint pain. our location in Bethesda or Germantown, Maryland or use this website to set up a consultation.
Learning tools and getting treatment to manage your arthritis pain can help reduce your stress levels, too.
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Accept Responsibility For What You Can Control
One of the predominant things arthritis steals from you is your sense of control of your life and your body. This can lead to a lot of fear and helplessness, which in turn can make your arthritis worse. Stop this anxiety by recognizing what you can control and taking responsibility for that, Dr. Larsen says. For instance, you may not be able to control your pain, but you can take charge of taking your medications exactly as prescribed and doing your physical therapy exercises, both of which may help lessen your pain.
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Get The Best Of Stress
Just because you have RA doesnt mean you have to feel stressed all the time. Theres plenty you can do to control the stress in your life and reduce its impact on your well-being. Here are five ways
1. Exercise. It can help with depression, , and sleep. Physical activity can even increase levels of chemicals in your body that improve your mood.
2. Breathe deeply. To promote relaxation, practice deep breathing, in through the nose and out through your mouth. Feel your belly rise and fall as you breathe.
3. Talk it out. Telling someone about negative emotions youre experiencing can help relieve stress. If you dont feel comfortable talking about these things, write them down in a journal.
4. Embrace the outdoors. Spending time in nature can boost your mood and quell stress. Take a hike or scenic drive. Enjoy a picnic. Plant a garden.
5. Get organized. At the end of each workday, create a to-do list for the following day. This can help you leave work behind so you can enjoy the rest of your day.
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 rheumatoid arthritis, 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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The Effect Of Stress On Arthritis
Stress. There is no avoiding it completely. It is a part of everyday life. Just when you think it is gone, it is back again. It is the way the mind and body react to tension and pressure. Too much stress can increase pain, can make a person prone to illnesses, and can make it more difficult for people with arthritis to cope with the added burdens imposed by their disease.
Stress Management And Treatment
Stress is a physical and psychological reaction to stimuli. Everyone experiences some stress at times. The burst of hormones produced when youre confronted with a threat triggers the fight-or-flight response. A little stress is part of a normal, healthy life. But too much stress or an inability to handle stress can be harmful.
One way to reduce the stress in your life is to avoid situations you know will create stress. This can be as dramatic as leaving a stressful job or ending a bad relationship. Everyday stress management can also mean doing things like turning off the news if its distressing, or taking an alternate route to work if the traffic on your usual route causes you stress.
To manage your stress, youll need to start by identifying the things that cause you stress and thinking about how they can be avoided or managed. For many people, making certain lifestyle changes can help. Good stress-relief tips include:
- Get at least seven to eight hours of quality sleep a night. If you have trouble falling asleep or staying asleep, tell your doctor or see a sleep specialist.
- Exercise every day, if possible. Physical activity may help ease stress and improve your mood.
- Compromise when necessary. Sometimes you need to give a little to reduce the stress in a situation.
- Relax. Take a class or talk with a therapist to learn relaxation techniques such as guided imagery, meditation, yoga, or breathing exercises.
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Are Your Joints Thirsty
Dr. F. Batmanghelidj who studied many chronic and acute signals of dehydration in a stress filled environment in Iran has proposed that dehydration is one of the major causes of rheumatoid arthritis.
However, at present there is no clinical evidence whether or not dehydration is one of the causes of rheumatoid arthritis or affects its progress.
His proposal suggests that even mild dehydration can trigger joint pain in some humans. Furthermore, chronic dehydration would lead to damage to the cartilage, inflammation and angiogenesis, which is consistent with being one of the causes of rheumatoid arthritis.
I include it here as food for thought. Because of the theorys simplicity, it probably will not receive funding to be adequately tested in a clinical setting.
However, you may want to monitor your water intake in case that his theory of dehydration may be one of your causes of rheumatoid arthritis.
How Stress Affects The Immune System
Showing a correlation between stress and the inflammatory chemicals associated with RA has been complicated. We know that stress affects the sympathetic nerve system and cortisol levels, explains Theodore R. Fields MD, an attending physician in rheumatology at New Yorks Hospital for Special Surgery. But in terms of being able to show how thats related to specific inflammatory chemicals of RA, we need more data.
Its believed that stress reduces the immune systems ability to function properly. Researchers are trying to better understand the role of proinflammatory cytokines like interleukin-6 released during times of stress. Alex Zautra, a professor in the Department of Psychology at Arizona State University, co-authored a commentary published in the October 2013 issue of Nature Reviews Rheumatology about a July 2013 Dutch study on the effect of stress on joints. In the study, researchers measured levels of cortisol and inflammatory markers like IL-6, IL-8, interferon and tumor necrosis factor.
They found that daily stressors predicted increased fatigue for patients the next month, and worrying predicted increased patient reports of pain, swollen joints and disease activity the following month. But inflammatory markers and cortisol levels did not appear to change because of stress.
Different biopsychosocial pathways of disease progression need to be charted, Zautra and his co-author wrote.
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Corticosteroid Use And Stress
Many arthritis patients are prescribed a corticosteroid, such as prednisone, as part of their treatment plan. Without some precautionary measures, stress can be dangerous to someone taking corticosteroids. Corticosteroids are closely related to cortisol, which is a hormone produced by the adrenal glands. Cortisol helps regulate salt and water balance and carbohydrate, fat, and protein metabolism. When the body experiences stress the pituitary gland releases a hormone which signals the adrenal glands to produce more cortisol. The extra cortisol allows the body to cope with the stress. When the stress is over, adrenal hormone production reverts to normal.
Prolonged use of corticosteroids results in diminished production of cortisol by the body. With insufficient cortisol production, the body could be left inadequately protected against stress and open to additional problems such as fever or low blood pressure. Physicians often prescribe an increased dose of corticosteroid to compensate for this when there is a known or expected stressful event.
Will Dietary Changes Help My Rheumatoid Arthritis
Diet may play a role in some patients, but most patients should maintain a well-balanced diet rather than avoid specific foods. Keep a diary to determine whether certain foods are associated with your disease flares and then see if removing them from your diet is helpful.
Some studies do suggest that eating fish two or more times per week may be associated with fewer disease-related symptoms, and there is increasing evidence that achieving and maintaining a healthy weight is helpful for managing RA.
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What Are The Symptoms Of Rheumatoid Arthritis
The symptoms of rheumatoid arthritis include the following:
- Stiffness, especially in the morning or after sitting for long periods
Rheumatoid arthritis affects each person differently. In most people, joint symptoms may develop gradually over several years. In other people, rheumatoid arthritis may proceed rapidly. A few people may have rheumatoid arthritis for a limited period of time and then go into remission .
Cartilage normally acts as a shock absorber between the joints. Uncontrolled inflammation causes the destruction and wearing down of the cartilage, which leads to joint deformities. Eventually, the bone itself erodes, potentially leading to fusion of the joint . This process is aided by specific cells and substances of the immune system, which are produced in the joints but also circulate and cause symptoms throughout the body.
Hormone Havoc Triggers Symptoms
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.
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Figure Out What Stresses You Most
Even though some events seem inherently stressful including dealing with a year-plus-long pandemic stress is influenced as much or more by an individuals reaction to a situation as to the event itself.
Some people are more naturally resilient to stress, but anyone can learn to build their resilience, such as by teaching themselves to reframe situations in a more positive light. Scientists are also coming to see that many things play a role in our stress response, including gender for example, women are more apt to seek social support in stressful times .
It helps if you can determine the factors that bring on most of your stress. Stress can result from many different situations. Some stress is relatively self-limiting, but other stresses are more chronic, and we do make attempts, as clinicians, to figure out where these stresses may be coming from, Dr. Roseff says.
In some cases, to determine this you might benefit from an outsiders perspective, especially a psychotherapist or other mental health professional, says Daniel Muller, MD, a rheumatologist at UCHealth in Ft. Collins, Colorado, and a coauthor of Integrative Rheumatology.
Find A Workout You Love
Have you heard the phrase motion is lotion for your joints? Exercise is one of the best things someone with arthritis can do for their body and their mind. We get how hard it can be to walk across the parking lot to the gym when youre in pain, much less sweat through an hour-long class. When I workout regularly I just feel better physically and Im less stressed, Amanda says. The trick is to find an exercise you actually love and can get excited about, not one that stresses you out more. For Amanda, she loves BodyPump classes as they incorporate weight lifting and some light cardio without feeling too intimidating, she says. For others, structured classes at the gym might be too much. Or just
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Habits That Make Rheumatoid Arthritis Symptoms Worse
For the millions of people living with the effects of rheumatoid arthritis, an autoimmune disease that can cause chronic pain and joint deterioration, effectively managing symptoms is an important part of maintaining a healthy quality of life. As with any medical condition, rheumatoid arthritis can affect everyone differently. Working with a Beverly Hills rheumatologist to find an individualized arthritis treatment plan that is most appropriate for each patients circumstances is the best method to find what is the most effective, be it medication, physical therapy, lifestyle modifications, or a combination of treatments.
In addition to professional medical care, there are a number of practical steps that every rheumatoid arthritis sufferer can take to help keep pain at bay and to stay healthy and active even after a diagnosis.