Stress can interfere with your health in many ways. It’s a risk factor for heart disease and can lead to headaches and problems with your sleep. Stress can be especially harmful if you have rheumatoid arthritis (RA). RA is an autoimmune disease, a condition in which the body’s immune system attacks healthy tissue.

For people with RA, the attack on healthy tissue causes damage to the lining of your joints, especially the joints in your hands and fingers. Symptoms of RA aren’t always present. Instead, they tend to flare up at certain times. Stress is a common trigger for painful RA flare-ups.

The connection between stress and RA has been identified in numerous studies. An analysis of 16 studies, published in Arthritis Research & Therapy, found that:

  • Stress tends to make RA symptoms worse.
  • People with post-traumatic stress disorder (PTSD) have a higher risk of developing RA and other autoimmune diseases.
  • People who have experienced childhood trauma were more likely to have rheumatic diseases.

The researchers noted that several of the studies were small, and some relied on self-reported information from the study participants. These issues raise some questions about the reliability of the studies. However, the researchers concluded that there still appears to be a strong connection between stress and the risk of developing RA.

Research analyzed in another study in Arthritis Research & Therapy found that:

  • Stressful events often precede the onset of RA.
  • Higher stress is associated with a less positive outlook of RA.
  • Individuals with RA may be more sensitive to certain sources of stress, called stressors.

Managing stress can play an important role in managing RA. The next time you talk with your doctor, share some of the things in your life that cause you stress. Your doctor may have some advice about how to manage your anxiety and stress.

Your doctor may also be able to refer you to a therapist who has been successful helping people living with chronic conditions, like RA, to manage stress.

Be open with your doctor about your symptoms and the stressors in your life. Be specific when describing your symptoms:

  • What brings them on?
  • How long do they last?
  • What helps relieve your symptoms?
  • Where do you feel pain?

You should also talk with your doctor about managing other flare-up triggers, such as overexertion, poor sleep, or an infection, such as the flu.

Learn more: What other symptoms does RA cause? »

If you’re able to manage your RA with medications and lifestyle choices, you may only need to see your doctor for regular checkups. If your symptoms change or if flare-ups are becoming more frequent or more severe, see your doctor soon. Don’t wait months for your next appointment.

Keep your doctor informed about your health. If you’ve started taking a new medication and suspect it’s interfering with your sleep, for example, tell your doctor. Your doctor may be able to recommend changes to your routine or healthcare plan that can have positive impacts on your health and the management of your RA.

Tips for managing stress

  1. Try to avoid situations you know create stress.
  2. Get seven to eight hours of sleep a night.
  3. Add regular exercise to your routine.
  4. Set aside time for activities you enjoy and find relaxing.
  5. Don’t bottle up your feelings. Be open about things that are bothering you or causing you stress.
  6. Work with a therapist if you are unable to manage stress on your own.

Stress is a physical and psychological reaction to stimuli. Everyone experiences some stress at times. The burst of hormones produced when you’re confronted with a threat triggers the “fight-or-flight” response. A little stress is part of a normal, healthy life. But too much stress or an inability to handle stress can be harmful.

One way to reduce the stress in your life is to avoid situations you know will create stress. This can be as dramatic as leaving a stressful job or ending a bad relationship. Everyday stress management can also mean doing things like turning off the news if it’s distressing, or taking an alternate route to work if the traffic on your usual route causes you stress.

To manage your stress, you’ll need to start by identifying the things that cause you stress and thinking about how they can be avoided or managed. For many people, making certain lifestyle changes can help. Good stress-relief tips include:

  • Get at least seven to eight hours of quality sleep a night. If you have trouble falling asleep or staying asleep, tell your doctor or see a sleep specialist.
  • Exercise every day, if possible. Physical activity may help ease stress and improve your mood.
  • Share your feelings. If you need help with a project at work or have something that’s bothering you, tell someone. Resentment can build up if you keep things inside.
  • Compromise when necessary. Sometimes you need to give a little to reduce the stress in a situation.
  • Relax. Take a class or talk with a therapist to learn relaxation techniques such as guided imagery, meditation, yoga, or breathing exercises.

You may also find relief by working with a therapist or mental health counselor on strategies to reduce stress in your everyday life. Cognitive behavior therapy (CBT) is a widely used approach to help with stress, anxiety, depression, and other conditions. CBT focuses on changing the way you think about a situation so that your feelings about the situation and your behavior will change. It’s often a short-term approach to specific problems.

RA is a chronic condition. That means managing your symptoms is something you’ll need to do long term. Your symptoms may temporarily improve, only to flare up again in the future.

One way to help improve the health of your joints, and your physical and mental health, is to incorporate low-impact aerobics and muscle-building exercises into your regular routine. Stronger muscles take some of the pressure off your joints. Tai chi, a type of martial arts that emphasizes slow, deliberate moves and focused breathing, is associated with reduced RA symptoms and stress reduction.

Other tips to manage RA include:

  • Heat and cold treatments: Heat may help relieve some pain and relax your muscles. Cold helps numb the pain. Ask your doctor about this regimen.
  • Swimming or water aerobics: Being in the water takes some pressure off your joints and can help you relax.
  • Medications: Follow your doctor’s recommendations on painkillers and disease-modifying antirheumatic drugs (DMARDs), which help slow the progression of RA and reduce damage to your joints. DMARDs include methotrexate (Trexall), leflunomide (Arava), and hydrochloroquine (Plaquenil).
  • Relax: If you haven’t gotten enough sleep or you’re feeling overworked, rest and relax. This may help reduce stress and prevent a flare-up.

If you are newly diagnosed with RA, your long-term outlook is better if you start treatment early. You may be able to minimize joint damage if you are proactive about your treatment.

You’ll also do better if you work closely with a rheumatologist. This is a doctor who specializes in RA and other conditions that affect the joints, muscles, and ligaments.

If you’ve been living with RA for a long time and you suspect stress is making your symptoms worse, getting help may offer some relief. Don’t assume it’s too late to get a handle on your condition.