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Stress and RA: How to Stay in Control

WebMD Feature

Hilary Wilson of Duluth, Ga., now 60, was officially diagnosed with rheumatoid arthritis or RA in 1987, but she is pretty sure she had the inflammatory arthritis long before that.

RA is a chronic disease, marked by inflammation of the lining of the joints. It can lead to chronic joint pain, loss of functioning and disability.

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But some people with RA manage to thrive despite their condition – and that describes Wilson. Ever since the diagnosis, Wilson has followed a healthy lifestyle designed to keep stress -- and her symptoms --under control. She follows the same plan, whether her life is hectic or more relaxed.

"I take steps to help my arthritis, regardless of the stress level," she tells WebMD. That means taking yoga three days or more a week, walking between 8 and 12 miles weekly, and keeping her weight down (she has some clothes from high school she still fits into).

It also means keeping her sense of humor. "I can't flex my head back," she says, as the RA has affected her cervical spine and therefore her neck functioning. It's not uncommon for people to ask her what's up with that, but she easily explains and laughs it off. A sense of humor, she discovered, helps minimize stress, too.

Wilson, who works as an independent management consultant and is on the board of the Arthritis Foundation in Georgia, says she has never noticed a link between the amount of stress she is experiencing on the job and a worsening of symptoms. And her healthy lifestyle, focused on managing stress, could well be the reason.

Stress and RA: The Link

The cause of RA remains unknown. But most experts agree that genetic and environmental factors play a role, including the body's response to stressors such as physical or emotional trauma. That does not mean, however, that stress alone can cause RA.

"In general, it's felt that stress does not cause RA," says Scott Zashin, MD, a clinical professor of medicine at the University of Texas Southwestern Medical School and attending physician at Presbyterian Hospital, Dallas.

However, he says, a stressful event, such as the loss of a loved one or marital stress, may trigger the RA to develop at that time. "That doesn't mean it wouldn't have developed at another time," he tells WebMD.

Patience H. White, MD, vice president for public health for the Arthritis Foundation agrees. While stress alone will not cause RA, it's one of many factors that may play into getting the disease and the severity of symptoms.

The picture can become complicated from patient to patient. "Many patients with RA have secondary fibromyalgia," Zashin says. Fibromyalgia is a body-wide pain condition, with tender points at the joints, muscles, and tendons and other tissues.

How does stress affect inflammation? According to White, the research is mixed on that.

But whatever that relationship, stress can wreak havoc, she says. "When you are stressed, you don't sleep well," she says. You can get achy. "People with RA have morning stiffness. If they haven't slept well, it feels worse. Once you get tired, you have no resistance to stress."

Some facts are indisputable: stress can make pain, and your whole body, feel worse. Chronically high levels of stress aren't good for anyone.

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