the Link Between Anxiety and Rheumatoid Arthritis Risk

The likelihood of anxiety-induced rheumatoid arthritis?

Hello Doctor, I previously asked you questions related to rheumatoid issues.
I have health anxiety and had blood tests for rheumatoid-related checks last November.
At that time, the doctor said the results were normal and advised me not to worry, attributing my finger pain to anxiety.
In July of this year, due to finger pain and significant stress, I feared it might be early symptoms of rheumatoid arthritis and consulted another doctor.
After examining my hands, the doctor told me my symptoms were not consistent with rheumatoid arthritis and reassured me not to worry, suggesting that another blood test was unnecessary.
After relaxing and not focusing on my fingers, the pain gradually subsided.

Last week, I experienced itching on my fingers due to an allergic reaction to a scrub, which reminded me of my fear of rheumatoid arthritis.
I felt a vague pain in my finger joints (though not in a specific location).
On August 25, I visited a doctor again, who performed an X-ray and confirmed everything was normal.
Subsequently, my finger pain also diminished.

However, today I accidentally came across a book about autoimmune diseases that mentioned stress can trigger rheumatoid arthritis, stating that individuals under long-term stress are 176 times more likely to develop rheumatoid arthritis than the general population.
This frightened me because I am someone who easily feels anxious and have been under stress frequently over the past six months.
I am worried that this prolonged period of anxiety might have triggered rheumatoid arthritis.
While thinking about this, I noticed that pressing my pinky finger causes pain.

I would like to ask the doctor:
1.
Do I need to visit the hospital for another examination? (I just had one a week ago.)
2.
Does the doctor think I have a possibility of developing rheumatoid arthritis?
3.
Is stress really that likely to trigger rheumatoid arthritis, or are there other factors that can induce it?
4.
Are there any methods to prevent it?
I kindly request your response, thank you, Doctor!

Yu, 20~29 year old female. Ask Date: 2023/09/02

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
First of all, I'm not sure where you saw that "people who are under long-term stress have a 176 times higher chance of developing rheumatoid arthritis compared to normal individuals." In my knowledge and the relevant literature, such a figure is not mentioned.
Therefore, my answers are as follows:
1.
Do I need to visit the doctor again? (But I just had an examination a week ago) --> No, you do not need to.
2.
Does the doctor think I have a possibility of rheumatoid arthritis? --> Very low.
3.
Is stress such an easy trigger for rheumatoid arthritis? Or what else could trigger it? --> Very low.
Stress is not a risk factor for rheumatoid arthritis.
4.
Are there any methods to prevent it? --> Please maintain a regular routine, avoid staying up late, and engage in regular exercise.
This will help stabilize your immune system and reduce your stress and anxiety, which in turn will lower the chances of developing rheumatoid arthritis in the future.
Best regards from the Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare.

Reply Date: 2023/09/02

More Info

Thank you for your detailed inquiry regarding the relationship between anxiety and rheumatoid arthritis (RA). Your concerns are valid, especially considering your history of anxiety and the physical symptoms you've experienced. Let’s address your questions one by one, while also providing some context about the connection between anxiety and autoimmune diseases like RA.

1. Do you need to see a doctor again? Given that you recently had an evaluation and the results were normal, it may not be necessary to see a doctor immediately unless your symptoms significantly worsen or new symptoms arise. It’s common for anxiety to manifest as physical symptoms, including joint pain, which can be exacerbated by stress. If your symptoms persist or you feel overwhelmed by anxiety, it might be beneficial to consult with a healthcare provider who can help manage both your physical and mental health.

2. Is there a possibility of having rheumatoid arthritis? Based on your previous evaluations and the normal results, the likelihood of developing RA at this moment seems low. RA typically presents with specific symptoms such as prolonged joint stiffness, swelling, and pain in multiple joints, often accompanied by blood markers like rheumatoid factor or anti-CCP antibodies. Since your tests were normal and your symptoms have been attributed to anxiety, it is reasonable to consider that your symptoms may not be indicative of RA.

3. Can stress easily trigger rheumatoid arthritis? While stress is known to impact overall health and can exacerbate existing conditions, the direct link between stress and the onset of RA is still a subject of research. Some studies suggest that chronic stress may influence the immune system and potentially contribute to autoimmune conditions, but it is not the sole factor. Genetic predisposition, environmental factors, and other triggers also play significant roles in the development of RA. Therefore, while your anxiety may contribute to your symptoms, it is not a definitive cause of RA.

4. Are there preventive measures? To help manage anxiety and potentially reduce the risk of autoimmune flare-ups, consider the following strategies:
- Stress Management Techniques: Engage in mindfulness practices, meditation, or yoga to help reduce anxiety levels. These techniques can promote relaxation and improve your overall mental health.

- Regular Exercise: Physical activity can help alleviate anxiety and improve joint health. Low-impact exercises, such as walking, swimming, or cycling, can be beneficial.

- Healthy Diet: A balanced diet rich in anti-inflammatory foods (like fruits, vegetables, whole grains, and omega-3 fatty acids) may support your immune system and overall health.

- Adequate Sleep: Ensure you are getting enough restorative sleep, as poor sleep can exacerbate anxiety and physical symptoms.

- Professional Support: Consider speaking with a mental health professional who can provide strategies to manage anxiety effectively.

In summary, while anxiety can manifest as physical symptoms and may influence overall health, the direct link to developing RA is not straightforward. Your previous evaluations suggest that you are not currently at high risk for RA, but managing your anxiety is crucial for your overall well-being. If your symptoms continue to cause concern, don’t hesitate to reach out to your healthcare provider for further guidance. Remember, taking care of your mental health is just as important as addressing physical symptoms.

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