Can Rheumatoid Arthritis Be Caused by Stress?

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.

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.

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.

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.

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:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Frequent and prolonged use of NSAIDs can cause gastritis and peptic ulcer disease.
• Steroids: High doses of steroids for prolonged periods may result in gastric ulcer, gastrointestinal (GI) perforation (GI bleeding), and pancreatitis. The risk increases if you are also taking NSAIDs.
• Disease-modifying antirheumatic drugs (DMARDs): Methotrexate can cause diarrhea, nausea, vomiting, and abdominal pain.
• Immunotherapy (biologics): Many drugs used for immunotherapy to treat RA can produce side effects, such as nausea, diarrhea, or abdominal cramps. Serious complications include GI perforations and bowel obstruction.

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.

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.