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How Stress and Fatigue Affect RA

Learn how to reduce stress to battle RA pain, fatigue, and flares.
WebMD Feature

Stress and rheumatoid arthritis often go hand in painful hand. Many people trace the onset of their rheumatoid arthritis (RA) to a stressful event in their lives.

“I was going through a really stressful period in my life when I first developed RA, and I really believe that it aggravated it a lot,” says Keri Cawthorne, a fitness instructor and mother who was diagnosed with RA about a year ago. “I associate stress with my most painful flares. And when I’m really stressed, I don’t sleep, so my body’s not resting and not recovering. I know it affects me so much.”

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If you think stress is associated with your RA, you are probably right. Some studies have documented this association between stress and the onset of rheumatoid arthritis, as well as flares. Even minor stress has been shown to affect inflammation levels with RA.

How this happens is not entirely understood, says John Klippel, MD, president and CEO of the Arthritis Foundation. “The relationship between the brain, which is where stress starts, and the immune system is being intensely studied at the moment to better understand that. Some researchers believe that certain hormones that the brain releases in response to stress have the potential, in some people, to cause the immune system to become imbalanced.”

Having a chronic health condition like RA can bring its own stresses to the mix. RA can cause additional stress by presenting challenges like making your hands too stiff and painful to button your jacket to being too exhausted to meet a work deadline.

Klippel believes that not enough attention has been paid to managing stress in rheumatoid arthritis. He suggests that people with RA make an organized effort to track just how stress is worsening their condition. Note in a “stress diary” when you’re under stress and what the source is, whether it’s at work, in your family life, financially, or otherwise. Then you can see more clearly when and how stress affects your rheumatoid arthritis.

Here are some strategies to help better manage stress and help keep it from aggravating your RA:

  • Counseling. Seeing a psychologist or therapist can help you identify the most significant stressors in your life and develop strategies for managing them. Cognitive behavioral therapy is one technique that helps reduce stress. This technique helps people learn to identify and change stressful thought patterns.
  • Life changes. If your job is overwhelming you with demands or office politics, you might want to think about a career change. Are your family responsibilities stressing you out? Ask your partner or other family members to help you balance things, so you can keep your RA in check.
  • Stress reduction techniques. Simply eating well and getting enough rest, letting others help you, and simplifying your life can go a long way toward reducing stress.
  • Mind-body techniques. Yoga, tai chi, meditation, guided imagery, and biofeedback can help you train your mind to take over the body’s stress responses and may be beneficial.


Reviewed on April 13, 2012

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