Does Stress Make Rheumatoid Arthritis Worse?

Table of Contents
View All
Table of Contents

Rheumatoid arthritis (RA) is a long-term health condition that affects about 1.5 million Americans, and about 2 or 3 times more women than men. It is classified as both an autoimmune disease and an inflammatory disease. Symptoms include stiffness and pain in the joints that can greatly impact daily life.

Stress can make RA worse because the physical response of the body—the fight, flight, or freeze response—can intensify the immune system's reaction, worsening RA symptoms. Learn more about RA and stress, how to manage stress, and more.

Stressed person holding the bridge of their nose with their eyes closed while sitting on a couch

Nattakorn Maneerat / Getty Images

Does Stress Make Rheumatoid Arthritis Worse?

Stress and rheumatoid arthritis are linked. When people experience stressful events, they can have a physical reaction called the flight, fight, or freeze response. This is when the body releases chemicals that can cause an immune or inflammatory response, especially if stress happens too often or lasts too long without relief. This immune or inflammatory response can lead to RA or increased symptoms of RA.

What Is an Inflammatory Response?

Inflammation is a healthy response the body uses to heal. It can include stiffness, redness, swelling, pain, heat, or a combination of these symptoms. Sometimes the body mistakenly attacks healthy cells, and inflammation causes damage to the body instead of healing. This is called inflammatory disease.

Immune System and Stress

Physical or emotional stress can activate the immune system. Sometimes the immune system becomes overactive or begins to attack healthy cells by mistake instead of attacking only unhealthy cells. This is called autoimmune disease.

How to Manage Stress

Stress can be a problem for people with RA. People with RA can cope with and manage their symptoms by preventing and managing stress in ways that are effective for them.


Exercise can be considered as a treatment for both rheumatoid arthritis and stress. People with RA can begin with low-intensity exercises to prevent injury and then increase as needed.

Eat a Healthy Diet

Like exercise, eating a healthy, well-balanced diet can help with both stress and RA. In fact, eating a plant-based diet with plenty of fruits and vegetables has been shown to relieve RA symptoms. Additionally, people who follow a plant-based diet tend to have lower stress levels and higher moods than those who eat meat.

Here are some nutrition tips for stress:

  • Eat plenty of fruits and vegetables.
  • Limit processed foods and sugars.
  • Eat nuts and seeds such as walnuts, flax seeds, and chia seeds.
  • Limit meat consumption.
  • Choose carbohydrates from vegetables and whole grains.
  • Stay away from alcohol and caffeine, especially close to bedtime.

Here are some nutrition tips for rheumatoid arthritis:

  • Eat plenty of fruits and vegetables.
  • Limit processed foods and sugars.
  • Include spices and herbs such as turmeric, ginger, and thyme.
  • Stay away from red meat and limit other animal products.
  • Don't eat too much salt and drink plenty of water.
  • Limit processed foods, sugar, and alcohol.

Join a Support Group

Support groups are led by qualified professionals and focus on supporting people with a shared problem. There are many benefits of support groups. Talking with other people going through the same or similar issues can help you feel connected, and it can reduce stress. In addition to providing support for the specific challenge, such as living and coping with RA, support groups provide emotional support.

Here are some support groups and similar options for rheumatoid arthritis:

Make Time for Relaxation

Similar to the flight, fight, or freeze stress response, there is a relaxation response that leads to positive physical and psychological changes. Learning how to relax (and relaxing regularly) can greatly reduce stress levels. There are techniques and exercises specifically for relaxation to reduce stress, but nearly anything a person finds relaxing can help.

Relaxation options may include:

Tips for Managing RA

There are measures that can be taken to help manage rheumatoid arthritis. Some of them are the same as those for managing stress, which means they provide double benefits. RA is a condition that can change over time and can ebb and flow in severity of symptoms, so it is important to review care plans regularly.

Some tips for managing RA include:

  • Getting regular physical activity, movement, or exercise
  • Eating a healthy, well-balanced diet
  • Getting support from professionals, friends, family, and others with RA
  • Following through with a care plan and taking medications as directed
  • Prioritizing health and self-care

When to Seek Medical Attention

It is important to talk with a healthcare professional:

  • When RA symptoms are noticed or when RA is suspected
  • If anything changes with symptoms, both improvement or decline
  • At regular intervals as recommended by your healthcare provider(s)
  • If there are any new concerns


Rheumatoid arthritis is a long-term condition that involves stiff, painful joints. Stress can make RA symptoms worse. There are steps that can be taken to reduce stress and improve RA symptoms, such as eating a healthy diet, exercising, and making time for relaxation.

A Word From Verywell

Rheumatoid arthritis can be challenging and life-altering. Facing high stress levels at the same time can be even more unpleasant, and it can make RA symptoms worse. If you or someone you know is experiencing RA or stiff, painful joints along with stress, you are not alone, and help is available. Reach out to a healthcare professional such as a primary care practitioner, rheumatologist, or mental health professional for support.

Frequently Asked Questions

  • What does an RA flare-up feel like?

    An RA flare-up (or flare, a time when symptoms worsen) can feel different for different people. It may include new symptoms or an increase in one or more symptoms. For example, someone experiencing an RA flare may feel exhausted and the joints in their hands may hurt much more than they typically do.

  • Does RA cause anxiety?

    It is not clear if RA causes anxiety, but people with RA are at an increased risk of anxiety and they experience anxiety at a higher rate than the general population. Additionally, symptoms of RA and living with a long-term health condition can be stressful.

  • Can emotional trauma cause rheumatoid arthritis?

    It is unclear if emotional trauma can cause rheumatoid arthritis. However, people who have experienced emotional trauma are at an increased risk of developing rheumatoid arthritis.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Arthritis Foundation. Arthritis by the numbers.

  2. Arthritis Foundation. How stress affects arthritis.

  3. Hospital for Special Surgery. Rheumatoid arthritis.

  4. American College of Rheumatology. Exercise and arthritis.

  5. Alwarith J, Kahleova H, Rembert E, et al. Nutrition interventions in rheumatoid arthritis: the potential use of plant-based diets. A review. Front Nutr. 2019;0. doi:10.3389/fnut.2019.00141

  6. Physicians Committee for Responsible Medicine. Food and mood: Eating plants to fight the blues.

  7. American Psychological Association. Manage stress: Strengthen your support network.

  8. Harvard Medical School. Six relaxation techniques to reduce stress.

  9. National Health Service. Living with rheumatoid arthritis.

By Ashley Olivine, Ph.D., MPH
Dr. Ashley Olivine is a health psychologist and public health professional with over a decade of experience serving clients in the clinical setting and private practice. She has also researched a wide variety psychology and public health topics such as the management of health risk factors, chronic illness, maternal and child wellbeing, and child development.