Uncover your sources of stress to keep it from worsening your RA pain.

Key Takeaways

Stress may play a role in the inflammation that causes RA pain.

Finding the source of your stress can improve your mental health and your symptoms.

Try yoga, mindfulness, and exercise to reduce stress and RA pain.

Stress is an inevitable part of our daily lives, and it can come from small, day-in, day-out annoyances, like being stuck in traffic or waiting in long lines.

Regardless of the cause, if you’re like many with rheumatoid arthritis (RA), you'll notice that when your stress level rises, so does your pain.

RA and Stress: Pinpointing the Problem

“Whether it’s rheumatoid arthritis, osteoarthritis, or lupus, any condition plus stress makes the condition worse,” says Richard Roseff, MD, a rheumatologist in private practice in Danbury and Ridgefield, Connecticut. “We know that there can be rheumatoid arthritis flares from a clear reason, like an injury, but stress can be a factor in the worsening of RA.”

Research shows that stress may play a role in the actual inflammation that causes 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 you’re stressed and are releasing more cytokines, you will most likely develop more inflammation, which may result in more pain.

RELATED: 7 Bad Habits to Drop with Rheumatoid Arthritis

Identify the root of your stress to adequately address the problem. “Stress can have a lot of different causes,” Dr. Roseff says. “Some stress is self-limiting, like the death of a loved one — time alone will help. But there are other stresses that are chronic, so we try to get to the bottom of it.”

Once you find out the true reason for the stress, you need to deal with it. Of course, not all stress can be eliminated easily — like a job with constant deadlines. In that case, the goal is to manage it.

Set up an appointment with a counselor or a psychiatrist to review possible stressors and solutions. “Stress can have an underlying component of depression, and for that we can prescribe antidepressants," says Roseff. "Several have pain-relieving qualities as well."

9 Ways to Relieve RA-Related Stress 

Sometimes the stress and pain connection can work in reverse, and your worsening RA symptoms are causing the extra stress. “Stress or secondary depression can go along with an illness that isn’t being adequately treated,” Roseff says. “But with new treatments we can stop the progression of the disease and control symptoms — treatments that weren’t available as recently as 10 to 12 years ago. There are few people with uncontrolled disease.”

Talk to your doctor if you feel that your symptoms aren't responding to your current RA treatment plan because there might be other options to try. Here are more ways you can relieve stress and mitigate rheumatoid arthritis symptoms:

Practice yoga or mindfulness meditation. Yoga “can be very good in terms of stretching, spirituality, and relaxation,” Roseff says. “Patients who go this route do well.” And practicing mindfulness meditation, which teaches how to focus on the present moment, reduces stress and fatigue in people with RA, according to a November 2014 study in the journal Annals of Rheumatic Diseases.

Consider tai chi. The Arthritis Foundation recommends tai chi, and offers videos on its website with sample moves you can do. They include shoulder exercises, spine stretches, and neck stretches.

Exercise. “Exercise benefits you emotionally and physically. It strengthens the joints and structures surrounding the joints," says Roseff. "It helps you sleep better and provides stress relief."

Try swimming. One of the best ways to exercise if you have RA is to get in the pool, says Stephen Soloway, MD, president and founder of Arthritis & Rheumatology Associates of South Jersey, in Vineland, New Jersey. “Start with lessons, if you need them, so you know the proper way to kick," he suggests. "Get some equipment like a kick board so you can stretch your fingers wide on the surface. Try to swim once a day every three days to start. Consistency is the key, no matter what exercise you choose.”

Maintain a balanced diet. The processed sugars and sodium in packaged foods aren’t good for anyone, says Dr. Soloway. Choosing a balanced diet with foods that include a combination of natural carbohydrates, lean proteins, and omega-3-rich fats like salmon and avocado will help your overall well-being.

Go to physical therapy. “Working with a good, caring physical therapist can have a marked improvement on symptoms,” Roseff says.

Quit smoking. For anyone who thinks of lighting up as a stress-reliever, your smoking could very well have the opposite effect. “If you smoke, you are more likely to develop [RA],” Roseff says. “For those who already have RA, smoking [can make] it worse." Research presented at a 2014 meeting of the American College of Rheumatology found that RA patients who participated in smoking cessation programs also reduced their pain.

Limit alcohol. The occasional recreational drink is fine, Soloway says, but people with RA should pay attention to potential drug interactions, as well as the sodium and carbohydrates in alcohol.

Find a doctor with whom you feel comfortable. Stress levels increase when you’re unable to communicate your concerns and symptoms to your physician, so be sure you’re happy with your relationship with your doctor, Soloway says. “When a patient doesn’t have open conversations with their doctor, they may not convey their questions and problems, and then they may not get the treatment they need.”

—Additional reporting by Liza N. Burby