Numerous studies have documented that psychological issues play a role in pain conditions, although the exact nature of this relationship is not well understood.
In this study, researchers took a group of 36 rheumatoid arthritis (RA) patients, and had them talk privately into a tape recorder about a stressful event in their lives (the Disclosure group). Another 36 RA patients were asked to talk about trivial topics (the Control group). Both groups participated in these activities for four consecutive days, and the researchers measured pain levels and psychological functioning. The RA patients were also evaluated at two weeks and at four months after the experiment.
The Disclosure patients were found to have significantly increased negative mood reactions immediately after the disclosure period—especially on scales of Dejection/Depression, Anger/Hostility, and Fatigue/Inertia. No such trend was found in the Control patients.
The authors found that disclosure did not have an effect on pain. However,Disclosure patients did show significantly reduced emotional dysfunction and increased general health over a period of four months, as compared to the Control group patients.
The authors explain the role of emotions and physical health as such:
"The effects of a stressful experience appear to be mediated by one's emotional processing of the event. Although the normal response to a stressful event is a complex process that may involve both avoidance and intrusion of memories, most theorists agree that excessive avoidance, or prolonged and rigid inhibition of negative memories, prevents the reappraisal, reintegration, and eventual resolution of the experience...Because inhibition requires effort, chronic psychological arousal may occur, potentially leading to physical symptoms, autonomic and immune dysfunction, and disease. In contrast, volitional and repeated exposure to distressing memories permits their emotional processing and resolution, potentially yielding better subjective, behavioral, and physical health."
The authors conclude by stating that addressing traumatic life events, as well as how the patient has inhibited emotional reactions to such traumas, is an important issue that should be considered when working with patients with RA, and perhaps other health conditions as well.
Kelley JE, Lumley MA, Leisen JCC. Health effects of emotional disclosure in rheumatoid arthritis patients. Health Psychology 1997;16(4):331-340.
This recent study1 examined the effects of an 8-week dance-based exercise program in a group of 10 women with rheumatoid arthritis (RA, Class III). Previous research by the same authors had found that the EDUCIZE program, developed by arthritis researchers,2 was helpful for patients with Class I and II RA. The subjects in this study had a mean age of 54 years.
Both before and after the 8-week program, all participants were carefully evaluated in regard to health status, use of medications, joint pain and swelling, cardiorespiratory fitness, daily activity, and psychological status.
The researchers found that while there was no significant increase in aerobic power, there were other benefits. Social activity increased, and depression, anxiety, anger, and tension decreased after the experimental period. "Many of [the patients] reported significant improvements in stability, improved mobility, and a decrease in pain and stiffness."
Most importantly, no aggravation of joint pain or swelling was found in the participants.