Rheumatoid arthritis can be caused by and result in stress, as well as other conditions such as gastrointestinal problems (IBD).
Rheumatoid arthritis (RA) is a chronic inflammatory joint condition and an autoimmune disease that can be caused by stress, according to research.
- Stress triggers rheumatoid arthritis by setting off the immune system’s inflammatory response in which cytokines are released.
- Cytokines are chemicals that play an important role in inflammation and can increase the severity of rheumatoid arthritis in some patients.
- The greater the exposure to stress, the greater the inflammation, which triggers a rheumatoid arthritis flare.
RA has no definite cure; however, treatment can make its symptoms (pain and swelling) disappear for a while. This symptom-free period is referred to as “remission.” Remission is followed by the reappearance of symptoms, which is a period known as a flare-up.
Studies show that inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) can coexist in some people. Both rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) are autoimmune conditions.
Can rheumatoid arthritis affect your mental health?
Rheumatoid arthritis contributes to stress and affects mental health, especially when its symptoms occur for a longer time.
- Constant joint pain and poor sleep create a vicious cycle. Each symptom worsens the others and adds to the stress the patient already feels.
- When a patient feels tired due to stress, they don’t feel like exercising. A lack of exercise triggers pain, which makes it harder to sleep.
- The patient gets anxious about their future disability, getting pregnant, or handling the financial burden of treatment.
- These things only add up to more stress.
Around one out of five patients with rheumatoid arthritis has depression due to the illness. Depression, in turn, further aggravates RA and leads to a greater number of painful joints, reduced functioning (higher number of days in bed), and increased visits to the doctor’s clinic.
All these further affect the patient’s mental health and cause more stress and depression.
Rheumatoid Arthritis Risks and Complications
What are rheumatoid arthritis risks and complications?
Since rheumatoid arthritis is a systemic disease, its inflammation can affect organs and areas of the body other than the joints.
- Arthritis-related inflammation of the glands of the eyes and mouth can cause dryness in these areas and is referred to as Sjögren's syndrome.
- Inflammation of the white parts of the eyes (the sclerae) is referred to as scleritis and can be very dangerous to the eye.
- Rheumatoid inflammation of the lung lining (pleuritis) causes chest pain with deep breathing, shortness of breath, or coughing.
- Inflammation of the tissue (pericardium) surrounding the heart, called pericarditis, can cause chest pain that typically changes in intensity when lying down or leaning forward.
- Rheumatoid arthritis is associated with an increased risk for heart attack.
- Rheumatoid disease can reduce the number of red blood cells (anemia) and white blood cells.
- Decreased white cells can be associated with an enlarged spleen (referred to as Felty's syndrome) and can increase the risk of infections.
- The risk of lymph gland cancer (lymphoma) is higher in patients with rheumatoid arthritis, especially in those with sustained active joint inflammation.
- Firm lumps or firm bumps under the skin (subcutaneous nodules called rheumatoid nodules) can occur around the elbows and fingers where there is frequent pressure.
- Nerves can become pinched in the wrists to cause carpal tunnel syndrome.
- A rare, serious complication, usually with longstanding rheumatoid disease, is blood vessel inflammation (vasculitis).
How does a patient calm down their rheumatoid arthritis?
Stress can cause rheumatoid arthritis and rheumatoid arthritis itself can also cause stress.
Treatments that don’t work or their side effects might affect the patient’s mind. Joint pain and swelling can make routine activities difficult for the patient. All the things that come with rheumatoid arthritis can make the patient stressed, which can further trigger joint inflammation.
The patient can calm down their RA by following a few steps:
- Take pain medications: Analgesics help a lot to relieve joint pain. Take them as scheduled as prescribed by the doctor. Make sure to drink enough water during the day.
- Use a warm or cold compress: Warm packs reduce stiffness and ice packs work on the inflamed joint.
- Go for massage therapy: Getting a massage can ease pain and relieve stress and anxiety.
- Try relaxation techniques: These include deep breathing, meditation, Tai chi, and yoga.
- Seek cognitive behavioral therapy (CBT): Psychotherapists use CBT to help the patient change the way they think about situations that may be contributing to anxiety. Lower stress levels may also reduce flares.
- Regular exercises and a healthy diet: These two things in combination can help reduce the severity of rheumatoid arthritis. Exercise also has many direct benefits for arthritis, including strengthening joint-supporting muscles and helping with weight loss. Both cardio and flexibility training helps rheumatoid arthritis.
- Keep weight in check: Obesity affects RA. Hence, modify lifestyle to control weight gain and, subsequently, rheumatoid arthritis.
- Enjoy simple pleasures: Patients should do what they enjoy. Watch a funny movie, paint, go for long walks, work in the garden, light a fragrant candle and soak in a bubble bath.
- Join a support group: If patients find it hard to handle stress and rheumatoid arthritis, they should join a support group.
- Listen to soothing music, sing or dance: When patients cannot turn off negative thoughts, turn on some feel-good, foot-tapping, upbeat music and sing along and dance.
- Trust the doctor: The patient needs to have faith in their doctor. If the patient has doubts about some treatments, they should discuss it with their doctor, but should not stop treatment.
- Complementary and alternative therapy: Natural treatments can be useful for some individuals when used in combination with traditional treatment options. For example, Ayurvedic treatments offer a holistic approach to treating rheumatoid arthritis. However, the patient needs to talk with their doctor before they try any of them.
- Ask for medicines: If the above activities fail to help, medications such as antidepressants and anti-anxiety meds can help relieve anxiety. These medicines should only be used in the short term and under medical supervision.
The term arthritis refers to stiffness in the joints.
Does rheumatoid arthritis cause IBD?
Both rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) are autoimmune conditions.
According to multiple studies, many immune-mediated diseases have overlapping pathologies. Hence, some people affected with RA may develop other autoimmune conditions, such as IBD.
However, people are more likely to have other issues with their digestive system that may not necessarily be caused by IBD.
How can rheumatoid arthritis affect your digestive tract?
Role of inflammation
Studies show that inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) can coexist in some people.
- IBD represents two conditions: Crohn’s disease and ulcerative colitis. These are characterized by chronic inflammation of the digestive tract. It is the “chronic” inflammation that is common to both conditions.
- The same inflammation that targets your joints in RA may also affect your digestive system and lead to IBD.
Rheumatoid vasculitis is a condition that causes inflammation of the blood vessels. It can also affect the gastrointestinal (GI) tract and result in symptoms, such as abdominal pain, nausea, vomiting and diarrhea, and weight loss. Controlling RA by targeting the inflammation alleviates these symptoms as well.
Role of genes and environment
Common genetic (genes, such as HLA-DRB1 and TYK2) and environmental factors may play a role in the development of both RA and IBD.
Side effects of RA medications on your digestive system
It is common to experience gastrointestinal symptoms as side effects of medications for rheumatoid arthritis (RA).
The common RA medications and gastrointestinal side effects include:
You should discuss all the possible risks and benefits of taking any of these medications with your doctor as part of your shared decision-making process.
How can you alleviate gastrointestinal problems in rheumatoid arthritis?
If you want to alleviate your gastrointestinal (GI) symptoms, it is important to follow your doctor’s instructions for keeping your arthritis under control.
Also, let your doctor know if you experience any new GI symptoms after starting the medications. They may change your medication or put you on drugs, such as proton-pump inhibitors, that work to reduce your nausea. They may also recommend certain dietary modifications to minimize your GI complaints.
What Is Rheumatoid Arthritis (RA)? Symptoms, Treatment, Diagnosis
Medically Reviewed on 8/4/2022
Medscape Medical Reference
Frontiers in Neuroscience
The interplay between stress, inflammation, and emotional attention: relevance for depression
Arthritis Research & Therapy
Attalla MG, Singh SB, Khalid R, Umair M, Epenge E. Relationship between Ulcerative Colitis and Rheumatoid Arthritis: A Review. Cureus. 2019;11(9):e5695. https://pubmed.ncbi.nlm.nih.gov/31720163/
WebMD. RA and Inflammatory Bowel Disease: What's the Link? https://www.webmd.com/rheumatoid-arthritis/ra-and-ibd