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How Stress and Fatigue Affect RA

By Camille Noe Pagán
WebMD Feature
Reviewed by David Zelman, MD

If you have rheumatoid arthritis, it’s important to learn ways to manage stress.

“Chronic or intense stress seems to cause certain chemical reactions in the body that may increase inflammation,” says Patricia Katz, MD. She's a rheumatologist and professor of medicine at the University of California, San Francisco.

A review of 16 studies on stress and RA found that stress often comes just before -- and may even trigger -- RA flares. When affected joints become especially swollen and painful, that's considered a flare.

Stress makes pain feel more intense, too, and can turn tiredness into exhaustion. What’s more, “some of the ways people cope with stress -- like overeating, smoking, not exercising, or avoiding friends and family -- can make RA symptoms seem and/or actually become more severe,” says Harry D. Fischer, MD. He's chief of the Division of Rheumatology at Mount Sinai Beth Israel in New York.

Stress can even feed on itself: A long-term disease like RA is a source of worry, and that stress can make the disease worse, leading to a cycle of painful symptoms and emotional turmoil. 

Fortunately, you can learn ways to calm the tension -- and these same steps will boost your energy levels and improve your overall health.

Get moving. Physical activity gives you a win-win solution. “It decreases inflammation and builds joint-protecting muscle, which eases RA symptoms,” Katz says. “At the same time, it increases calming brain chemicals and helps shift your perspective, too. You don’t have to go to the gym or take up running. If you can take a 10- to 20-minute walk, you’ll feel better.”

Make shut-eye a top priority. A recent British study found that more than 40% of people with RA had sleep troubles, which boosted their stress. If you don’t get enough (or good-quality) sleep, tell your doctor as soon as possible, Katz says. “It’s often a sign your RA pain isn’t well-controlled, and you need to adjust your treatment plan.”

Aim for 8 hours of sleep a night, but skip the nightcap -- alcohol can cause you to wake up repeatedly (even if you don’t remember it the next day). Regular exercise can improve the quality and length of your sleep, too.  If you’re tired but wired, take a nap. One study revealed that a half-hour nap lowered levels of a stress hormone.

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