From everydayhealth.com
If you live with rheumatoid arthritis, you probably know of a few things that make you feel worse. But, you may be surprised by some of the lesser-known provokers.
We often discuss treatment options for rheumatoid arthritis (RA), and we keep an eye on what’s in the pipeline. We are focused on what can help manage RA symptoms and disease progression, as you would expect. But it is equally important to be cognizant of what can make rheumatoid arthritis worse. You need to know what you shouldn’t be doing, just as much as what you should be doing.
I have compiled a list of a dozen things that can make you feel worse, cause your symptoms to flare, or cause your disease to progress. While you may be aware of about half of these, the rest are lesser known in terms of being linked to RA.
1. Non-adherence to Treatment
After you are diagnosed with RA, your doctor will recommend a course of treatment. The treatment regimen is prescribed to help manage RA symptoms and disease activity. If you fail to adhere to the treatment regimen — by not filling prescriptions, not taking medication as directed, not exercising, skipping appointments — there is an increased risk of worsening symptoms and disease activity. That’s the case even when the non-adherence is unintentional (for example, due to forgetfulness). While your reasons for non-adherence may be entirely valid, it is your responsibility to discuss those reasons with your doctor before you make changes to the prescribed treatment regimen on your own. A medication change may be indicated, or perhaps the addition of an adjunct treatment would be to your benefit. Be sure to have that conversation with your doctor and decide on your next move together.
2. Sedentary Lifestyle
Regular physical activity is necessary for everyone, including people with RA. There are numerous health benefits associated with regular physical activity. Improved muscle strength, as well as better bone and joint health, is essential for people with RA. Rest is also needed, to restore the body from episodes of intense pain and fatigue, which are characteristic of RA. Striking a balance between rest and activity is optimal. Rest can’t become a way of life. A sedentary lifestyle actually does the opposite of what you want, leading to increased pain, fatigue, and weakness.
3. Pro-Inflammatory foods
Certain foods are believed to increase inflammation in the body. Sugar, saturated fats, trans fats, omega-6 fatty acids, refined carbohydrates, MSG, gluten, aspartame, and alcohol are among the foods and additives thought to be pro-inflammatory. A diet for rheumatoid arthritis should include anti-inflammatory foods, while pro-inflammatory foods are reduced or avoided. Check out
Dr. Andrew Weil’s anti-inflammatory food pyramid.
4. Overdoing Activities
Despite the importance of regular physical activity, which we already discussed, there is a limit. It is imperative for someone with RA to respect pain signals and to recognize and accept that they have a physical limit. Ideally, you will learn to recognize your limit and stop just before you reach it. If you overdo, you risk a flare of symptoms.
Did you overexert yourself on a shopping spree? Overdoing activities can worsen RA symptoms
5. Smoking
In research published in the journal Arthritis & Rheumatism, the authors concluded that both current and past smokers had worse symptoms and more joint damage than those who never smoked. A more recent study, published in July 2014 in the journal Annals of the Rheumatic Diseases, compared radiological progression for RA patients that were never, past, and current smokers, and found a significant association between smoking and more severe joint damage.
6. Stress
If you have rheumatoid arthritis, you don’t need me to tell you that stress makes it worse. You know because you live it. Interestingly, many rheumatoid arthritis patients are able to point to a stressful or traumatic event that occurred just before the onset of their RA. According to a study published in the journal
Arthritis Research and Therapy, both immune mechanisms and nonimmune mechanisms may be responsible for increased disease activity and increased symptoms during stressful periods. Still, the association is real.
7. Negativity and Pessimism
Simply put, it takes a positive attitude to achieve positive results. The opposite is true of a negative or pessimistic attitude. It is logical that you need a positive approach to stay on track with your treatment regimen, exercise routine, diet, and more. You must believe in the goal. In 2015, researchers at Penn State University concluded that greater positive mood in the moment is associated with less pain and fewer arthritis-related activity restrictions in the moment. Negative mood was associated with more activity restrictions.
8. Dehydration
We are often reminded to drink water and stay well hydrated. But for some reason, we often don’t. Dehydration is linked to fatigue, slower metabolism, worse cognitive functioning, and the formation of kidney stones. You may be surprised to learn that lack of hydration is also tied to increased joint pain.
9. Failure to Protect Joints
Joint protection is recognized as an important part of any treatment program for RA. The goal of joint protection is to reduce pain, prevent deformity, stabilize the joints, and reduce stress on the joints. This is accomplished through the use of splints, braces, assistive devices, exercise, proper body mechanics, pacing your activities, and modifying your environment if necessary. Failure to protect the joints can make RA worse.
10. Neglect of Oral Health
Research suggests that tooth loss may predict rheumatoid arthritis and its severity. Researchers who have studied the connection between RA and periodontal disease discovered similarities in the joint and oral tissues, and in the inflammatory processes that affect them. The types of cells that infiltrate tissues of the mouth in periodontitis and the tissue of the joint in RA are similar. Also, the levels of pro-inflammatory proteins (such as tumour necrosis factor, interleukin-1, and interleukin-6) are also similar in both RA and periodontitis. There are potential consequences when oral health is neglected.
11. Quack Cures
A quack cure is essentially “hope in a bottle.” A quack cure is an unproven remedy that at best is ineffective, and at worst is potentially harmful. It is a waste of time and a waste of money. Usually, while someone is wasting time and money on quack remedies, they stop the prescribed treatment from their rheumatologist. If you abandon your prescribed treatment for an unproven remedy which is cloaked in deception, you risk making your RA worse.
12. Ignoring Early Symptoms of RA
It is not unusual when you experience the first symptoms of RA to think you somehow injured yourself. You hope it will go away, given a little time. When it doesn’t go away, you find yourself in the drugstore aisle that’s devoted to over-the-counter pain relief products — and you begin to self-treat. How long you spend in this phase of waiting and self-treating is crucial because, with RA, early diagnosis and early treatment is imperative to slowing disease progression and preventing joint deformity. Waiting too long can make your RA worse.
