The Stress & Arthritis Cycle

Arthritis is a chronic condition that not only affects physical wellbeing, but mental and emotional wellbeing.

Many people who live with chronic pain report having higher levels of stress, anxiety, even depression however, it’s these psychological challenges that can worsen symptoms and make disease management a lot harder.

How stress affects arthritis?

Pain and stress manifest separately in the body, and whilst we often think these of being independent of one another, they interestingly share very similar processes and features. They both exist to protect the body, however when they become dysregulated and persistent, it can severely compromise our quality of life and wellbeing.

When the brain receives an acute pain signal, we release a number of hormones and chemicals in the body that can help fix the underlying cause of the pain and promote healing. This is similar to what happens when we are stressed out. It is an adaptive response to help instigate the healing, but also protect the body from any further damage. Stress and pain can also cause increases in blood pressure, affect our digestive system, and increase tension in the muscles, which can amplify pain signals.

Our brain helps us remember what caused this pain, what it felt like, and our emotional state fluctuates accordingly. We need this feedback occasionally, but when we are experiencing persistent signals of pain or we are under constant stress, this can cause changes in different sections of the brain that can alter decision making and make us more sensitive to pain. It can also set off our immune system and cause a persistent inflammatory response.

Inflammation is what fuels joint damage in rheumatoid Arthritis (RA), psoriatic arthritis (PA), ankylosing spondylitis (AS) and other inflammatory types of arthritis. When these maladaptive changes occur, specialised therapies and treatment may be required.

How arthritis worsens stress?

Arthritis can have debilitating symptoms, such as pain, stiffness, fatigue and swelling, and sometimes these symptoms can be very stressful. The stress and fear you have associated with these particular symptoms, not only amplifies the stress but this can worsen behaviours that worsen other symptoms.

For example, if you fear exercise on the days you wake up with stiffness, this could lead to more sedentary behaviour throughout the day, make you more inactive and worsen the stiffness. If you are feeling like you’re not able to go to a social event because your pain has worsened. Isolation can lead to feelings of loneliness and depression, both of which are closely linked to increased stress.

Building your stress resilience

Get your arthritis pain under control – speaking with your doctor is important for dealing with symptoms like pain, stiffness and swelling. They can help you find the most appropriate treatment options to get your arthritis under control before it continues to worsen your stress levels.

Speak to a therapist – if your condition is controlling your life and you find yourself constantly stressed out, you might benefit from speaking with a therapist who can provide appropriate interventions to help you reframe unhelpful thoughts, fears and worries which could be adding to your stress levels.

Exercise – walking, swimming, water aerobics are not only great for better managing your arthritis, but promote the release of endorphins, our happy, feel-good hormones which can reduce the perception of pain and combats stress.

Meditation – yoga, tai chi, pilates are great for incorporating flexibility exercises and combining deep breathing techniques. Deep breathing is known to stimulate the vagus nerve, which runs from the brain down the neck, all the way to our colon. It activates our relaxation response and helps slow down our heart rate, ease our muscle tension and reduce stress. This is a very powerful technique for reducing stress, anxiety and depression.

Find hobbies you enjoy – doing something you love, whether its reading or knitting, activities that bring you happiness and joy, can help distract you from disruptive symptoms and put you into a calmer state.

If you have very high stress levels and its affecting your condition, you can find some more information & additional resources from the following organisations

Beyond Blue  

Black Dog Institute


NSW Health 

Take a look at our Arthritis & Mental Health Webinar Recording where we explore the link between arthritis and mental health, discussing the potential psychological challenges such as depression, anxiety, and stress that individuals with arthritis may face. We will delve into the bi-directional relationship between arthritis and mental health, exploring strategies for coping with emotional difficulties, seeking support, and promoting overall mental well-being.

Mary Zagotsis
Health Educator
Arthritis NSW

August 2023