Like many other health conditions, it seems that arthritis can be triggered or made worse by stress. Living with knee arthritis can be stressful, which leads to a vicious cycle of emotional symptoms, such as anxiety and depression, and physical pain. In a survey of 232 people with RA, around 39 per cent said that their symptoms left them severely anxious and/or depressed, whilst a further 41 per cent said that they were moderately anxious and/or depressed. This chapter looks at what stress is and how it may be involved in OA, RA and other inflammatory forms of arthritis. Stress management and relaxation techniques are suggested to help prevent and relieve flare-ups and reduce tension and anxiety.

What is stress?

Stress is basically the way the mind and body respond to situations and pressures that leave us feeling inadequate or unable to cope. One person may cope well in a situation that another might find stressful; it’s all down to the individual’s perception of it and their ability to deal with it.

How does stress affect the body?

The brain reacts to stress by preparing the body to either stay put and face the perceived threat, or to escape from it. It does this by releasing hormones – chemical messengers – including adrenaline, noradrenaline and cortisol into the bloodstream. These speed up the heart rate and breathing patterns and can induce sweating. Glucose and fatty acid levels in the blood rise, to provide a burst of energy to deal with the threat. This is called the ‘fight or flight’ response.

Nowadays, the situations that induce the stress response are unlikely to necessitate either of these reactions. Those that continue for a long period of time, for example long-term unemployment, illness or an unhappy relationship, mean that stress hormone levels remain high, thereby increasing the risk of major health conditions such as coronary heart disease and stroke, as well as auto-immune disorders, such as RA. Other psychological and physical symptoms include irritability, poor concentration, anxiety, depression, headaches, skin problems, allergies, poor appetite or overeating, indigestion, IBS and palpitations, so it’s important to find ways to reduce and deal with stress.

How is stress involved in arthritis symptoms?

Research suggests that long-term exposure to stress hormones can affect the immune system and provoke inflammation in the body, which can trigger or exacerbate RA and other inflammatory forms of arthritis.

Also, when we are stressed we tend to tense our muscles – especially those in the neck, shoulders and arms, which can put a strain on the joints and both cause and worsen pain from all types of arthritis.