PTSD and Rheumatoid Arthritis

Rheumatoid arthritis, general practitioner examining patient and hand for signs of rheumatoid arthri : Stock Photo CompAdd to Board Caption:Rheumatoid arthritis. General practitioner examining a patient's hand for signs of rheumatoid arthritis. This condition is caused by the immune system attacking the body's own tissues, causing progressive joint and cartilage destruction. As the cartilage is worn away, new bone grows as part of the repair process. This causes stiffness and deformity of the fingers. Treatment is with anti-inflammatory drugs and physiotherapy. Rheumatoid arthritis, general practitioner examining patient and hand for signs of rheumatoid arthritis
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Posttraumatic stress disorder (PTSD) and rheumatoid arthritis (RA) are sometimes linked. In fact, PTSD has been found to be associated with a wide range of negative physical health conditions, including cardiac disease, diabetes, cancer, headaches, chronic pain, and arthritis.

With regard to arthritis, several studies have found that veterans and people in the general community with PTSD are at higher risk of having arthritis. However, it is important to note that there are several different forms of arthritis. These studies did not look at a specific form of arthritis, including juvenile arthritis, osteoarthritis, and rheumatoid arthritis.

Researchers are beginning to specifically look at the connection between PTSD and rheumatoid arthritis gave that both conditions share several of the same risk factors (for example, cigarette smoking).​

What Is Rheumatoid Arthritis?

Rheumatoid arthritis affects approximately 1.3 million people in the United States. It is considered an autoimmune disease. This means that for some reason the body's immune system begins to attack a person's own tissue, including joint tissue. This causes inflammation in the joints, resulting in fluid build-up and pain. There is currently no cure for RA. As a result, RA is considered a chronic disease. That said, there are a number of ways in which its symptoms can be addressed.

The Relationship Between PTSD and Rheumatoid Arthritis

Few studies have been conducted that specifically look at the connection between PTSD and RA. However, some studies have shown that the two conditions are associated. One study in particular also looked at whether the connection between PTSD and RA could be explained by genetic or environmental factors. In this study, a group of researchers looked at a large number of twins (all men) who served in the Vietnam War.

They found that about 2 percent of people studied had RA. In addition, people with RA had more severe symptoms of PTSD. In fact, those with the highest level of PTSD symptoms were about five times more likely to have RA. In addition, the connection between PTSD and RA was not simply due to genetics or environmental factors. This suggests that there is something about PTSD, in particular, that may increase the risk for the development of RA.

It is not entirely clear exactly how PTSD would increase the risk for RA but there are some possible explanations. First, the constant stress that people with PTSD experience may increase inflammation or inflammatory diseases, such as RA. In addition, PTSD is associated with a wide range of poor physical health behaviors that may increase the risk for the development of RA, such as cigarette smoking.

Finding Help for PTSD and RA

If you have PTSD, it is important to take steps to address your symptoms. Doing so may prevent the development of physical health problems or reduce the severity of physical health problems if they have already developed. There are also a number of effective treatments available for PTSD. By addressing your PTSD symptoms, you may be able to lift some of the obstacles that are preventing you from making positive life changes. 

Sources
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  • Boscarino, J.A., Forsberg, C.W., & Goldberg, J. (2010). A twin study of the association between PTSD symptoms and rheumatoid arthritis. Psychosomatic Medicine, 72, 481-486.
  • Boscarino, J.A. (2004). Association between posttraumatic stress disorder and physical illness: results and implications from clinical and epidemiologic studies. Annals of the New York Academy of Sciences, 1032, 141-153.
  • Costenbader, K.H., Chang, S.C., De Vivo, I., Plenge, R., & Karlson, E.W. (2008). Genetic polymorphisms in PTPN22, PADI-4, and CTLA-4 and risk for rheumatoid arthritis in two longitudinal cohort studies: evidence of gene-environment interactions with heavy cigarette smoking. Arthritis Research and Therapy, 10, R52.
  • Pietrzak, R.H., Goldstein, R.B., Southwick, S.M., & Grant, B.F. (2012). Physical health conditions associated with posttraumatic stress disorder in U.S. older adults: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of the American Geriatric Society, 60, 296-303.
  • Qureshi, S.U., Pyne, J.M., Magruder, K.M., Schulz, P.E., & Kunik, M.E. (2009). The link between posttraumatic stress disorder and physical comorbidities: A systematic review. Psychiatric Quarterly, 80, 87-97.

By Matthew Tull, PhD
Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder.