7 Joint Pain Triggers That Can Make RA Worse

Not only is smoking linked to an increased risk for developing RA, but continuing to smoke if you do have RA can make joint pain worse. “Smoking makes it harder for RA treatment to be effective,” says Kevin Deane, MD, PhD, a rheumatologist and associate professor of medicine at the University of Colorado School of Medicine Anschutz Medical Campus in Aurora.

People with RA who continue to smoke have higher levels of certain chemical markers in their body that show ongoing disease activity and joint damage, even with treatment, according to research. “Smoking has also been associated with higher pain scores, more active disease, and lower likelihood of achieving disease remission among people with RA,” says Ashima Makol, MBBS, an assistant professor of medicine in the division of rheumatology at the Mayo Clinic School of Medicine in Rochester, Minnesota.

If you need help quitting smoking, talk to your doctor.

Foods rich in inflammation-fighting omega-3 fatty acids, such as salmon and other cold-water fish, may help fight pain related to RA. The National Institutes of Health notes that increased omega-3 intake could help manage RA and complement other treatments. According to a meta-analysis, consuming omega-3 fatty acids was found to improve RA, including reducing inflammation. You can get them by eating more fish, flaxseed, and foods fortified with omega-3s or taking supplements, as recommended by your physician.

Waiting to talk to your doctor about your RA symptoms can make it harder to get joint pain under control, which is why the Arthritis Foundation recommends early and aggressive treatment. “Catching RA early is the most important thing people can do to make sure joint pain doesn’t get worse,” Dr. Deane says.

“The majority of joint damage and cartilage destruction has been noted in people with RA during their first two years of disease, and this has a strong impact on long-term function, disability, and mortality,” Dr. Makol adds. “This is why the first six months to a year after disease onset is considered a precious window of opportunity during which doctors target disease remission as the goal, or trying to achieve minimal to no disease activity.”

Prompt treatment with disease-modifying antirheumatic drugs (DMARDs) or biologics can help slow the progression of RA and prevent joint damage, according to the ACR guidelines. Talk to your doctor, who can help create an RA treatment plan that’s right for you.

“As with many forms of arthritis, ‘motion is lotion,’ meaning that some form of physical activity and exercise is beneficial,” says Makol. People with arthritis who exercise regularly have better daily functioning, more energy, and less pain, according to the American College of Rheumatology.

A sedentary lifestyle can harm your health in many ways, from increasing your risk for heart disease to further damaging your joints. “A lack of muscle strength can mean a lack of joint protection,” Deane says. “Exercise and physical activity also seem to have some anti-inflammatory effects that may have benefits for people with RA.”

You don’t need to run a marathon to reap the benefits of exercise. “Low-impact aerobic exercises incorporating some strength training, joint protection principles, and stretching for flexibility are most optimal for people with RA,” says Makol. Talk to your doctor or physical therapist about creating a personalized exercise plan that works for you.

Exercise is important for building muscle strength and protecting your joints, but high-impact activities, such as running, may cause joint pain during an RA flare or in cases of advanced disease. When joints are inflamed, don’t force yourself to do more than feels comfortable, the Arthritis Foundation recommends. Instead, try gentle range-of-motion exercises such as stretching to keep your joints flexible. Once the flare is over, start exercising again slowly with low-impact aerobic activities, such as walking, and gradually increase the intensity of your workouts.

“Stress comes as part and parcel of having a chronic disease, undergoing long-term treatment, monitoring, and medical bills,” says Makol. Stress in daily life may also increase joint pain by altering your immune function and exacerbating your RA. Researchers are still trying to understand the connection between RA and stress, but stress can clearly affect how people with RA feel. “Stress can make perceived symptoms worse,” Deane says.

Need to reduce your stress? “Talking with a therapist or using other means of stress reduction like meditation, deep-breathing techniques, or guided imagery can be helpful for better control of RA in the long term,” Makol suggests.

Excess weight puts additional stress on your joints, and that can make RA symptoms worse and increase your risk for other health problems, such as heart disease. According to one study, obesity is common in people with RA and associated with RA disease activity.

Losing weight and maintaining a healthy weight may help improve your quality of life and the success of your treatment strategies. If you need to lose weight or aren’t sure if your body weight is healthy, ask your doctor for input.

Additional reporting by Erica Patino.