Does Stress Worsen Inflammation?
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Stress has become an almost constant part of life in today’s fast-paced world, affecting everything from how you think to how you feel physically. While occasional stress is a normal response to challenges, chronic stress can take a heavy toll on the body over time.
It doesn’t just impact your mental well-being – it can also aggravate physical health problems, particularly for those living with inflammatory conditions such as arthritis or cardiovascular disease. In this blog, we’ll explore how stress and inflammation are linked and why managing stress is a key step in improving overall wellness. We speak to Mohammad Hassaan Khan, M.D., a rheumatologist with INTEGRIS Health Medical Group Rheumatology, to learn more.
“There is a significant link between stress and rheumatic autoimmune conditions, especially rheumatoid arthritis,” Khan says. “Our aim as physicians is to focus on the physical and mental wellness of our patients. If you have increased stress in your life, please do not hesitate to bring it up during doctor’s visits.”
The stress response explained
What to know: When your body experiences stress, a series of physiological responses unfold. Stress can be positive when it helps you respond to a challenge, such as meeting a deadline. However, prolonged or chronic stress can have significant adverse effects on both the brain and the body.
When you encounter a stressor, your brain processes this event as a potential threat.
- The amygdala, the brain's emotion center, sends an alert to the hypothalamus, which serves as the control center for your autonomic nervous system.
The hypothalamus activates the sympathetic nervous system (part of the autonomic nervous system that controls involuntary body functions) flipping your body into "fight or flight" mode within seconds.
- Your adrenal glands pump out adrenaline and noradrenaline hormones, which sharpen your focus, increase your heart rate, and boost energy to prepare you for action.
While the sympathetic nervous system initiates an immediate response, the hypothalamus-pituitary-adrenal axis (a system that connects your brain and endocrine glands to initiate a stress response) steps in to sustain the stress reaction if the perceived threat continues.
- The hypothalamus signals the pituitary gland, which tells the adrenal glands to release cortisol, a stress hormone.
- Cortisol prolongs the response by mobilizing energy and maintaining alertness.
Short- and long-term impact of stress on the body
Key points: The fight or flight reaction and the release of stress hormones triggers a cascade of changes across various body systems. The brain, cardiovascular system, musculoskeletal system, respiratory system, digestive system and immune system are all affected.
Cardiovascular system
Short-term effects increase heart rate and blood pressure.
- Stress hormones such as adrenaline make your heart beat faster and cause blood vessels to constrict to direct blood flow to the brain and muscles.
- Glucose and fatty acids are released into the bloodstream for quick energy.
Long-term effects include high blood pressure and cardiovascular issues.
- Chronic stress can lead to persistently high blood pressure.
- Prolonged exposure to stress can increase the risk of heart attack and stroke due to wear and tear on your cardiovascular system.
Immune system
Short-term effects actually boost immune function.
- Acute stress can temporarily enhance immune responses, as the body prepares to heal from potential injury or infection.
Long-term effects lead to immune suppression and chronic inflammation.
- Chronic cortisol exposure reduces the production of white blood cells, leaving you more vulnerable to illnesses and infections.
- Prolonged stress can trigger the release of pro-inflammatory cytokines, which contribute to autoimmune disorders such as rheumatoid arthritis.
Digestive system
Short-term effects can lead to gastrointestinal symptoms.
- Stress diverts blood flow away from the digestive tract to prioritize the brain and muscles, resulting in slowed digestion.
- You may experience nausea or a knot in your stomach.
Long-term effects include developing GI disorders and appetite changes.
- Persistent stress can disrupt the gut lining and alter gut microbiota, leading to irritable bowel syndrome or stomach ulcers.
- Some people overeat (stress eating), while others lose their appetite, both of which can cause digestive imbalances.
Musculoskeletal system
Short-term effects involve muscle tension.
- Muscles tense up to protect your body from injury during perceived threats.
- After the stress dissipates, the tension typically fades.
Long-term effects include chronic pain and may make existing conditions worse.
- Prolonged muscle tension can lead to headaches, back pain and shoulder stiffness.
- Chronic stress may exacerbate conditions like tension-type headaches, fibromyalgia and temporomandibular joint (TMJ) disorders.
The relationship between stress and inflammation
Talking points: Chronic stress disrupts the immune system, triggers pro-inflammatory cytokines and impairs cortisol's ability to regulate inflammation. This, combined with heightened sympathetic nervous system activity, can make pre-existing inflammatory conditions worse.
Cortisol, a key stress hormone, is designed to help regulate inflammation.
- Under chronic stress, the body may develop cortisol resistance or dysregulation, diminishing its anti-inflammatory effects.
- Without proper cortisol function, inflammatory processes can spiral out of control, worsening symptoms in pre-existing conditions.
Immune system disruption can occur when stress causes an overproduction of pro-inflammatory cytokines, molecules that promote inflammation.
- When the immune system becomes overactive, conditions characterized by chronic inflammation, such rheumatoid arthritis or asthma, can flare up.
- Additionally, stress can weaken the immune system’s ability to respond effectively, creating a cycle of persistent inflammation.
Activation of the sympathetic nervous system occurs in response to the body’s fight-or-flight activation.
- This leads to increased heart rate and higher blood pressure, which can promote vascular inflammation.
- Over time, this chronic activation can worsen cardiovascular conditions, such as atherosclerosis and hypertension.
The release of substances like C-reactive protein (CRP) and interleukins, which are markers of inflammation, are released when chronically stressed.
- Elevated levels of these markers can worsen inflammatory conditions.
Oxidative stress, which damages cells and tissues, further promotes inflammation.
- This can worsen atherosclerosis and neurodegenerative diseases.
Stress can also lead to behaviors that increase inflammation.
- People under stress typically have a poor diet, don’t exercise regularly and have poor sleep patterns, all of which fuel inflammation.
Can stress make existing inflammation worse?
Why it matters: Yes, stress can exacerbate existing inflammation. Many conditions, such as arthritis, autoimmune diseases and chronic pain may be amplified or trigger symptoms when stress occurs.
Stress is particularly harmful to people with conditions already fueled by inflammation.
- Chronic stress can intensify joint pain and swelling in rheumatoid arthritis and osteoarthritis.
- Stress can increase airway inflammation, triggering more frequent or severe asthma attacks.
- Stress heightens vascular inflammation, worsening atherosclerosis and raising the risk of heart attacks or strokes.
- Stress exacerbates inflammatory bowel disease symptoms such as abdominal pain, diarrhea and fatigue by disrupting gut and immune function.
- Skin conditions such as psoriasis and eczema can flare under stress due to its inflammatory effects, worsening rashes and discomfort.
- Chronic pain syndromes such as fibromyalgia or chronic back pain may become more acute due to stress heightening inflammation and pain sensitivity.
Ways to manage stress
Overview: Effectively managing stress is essential to reducing its impact on inflammation and improving health outcomes for people with inflammatory conditions.
Exercise regularly to boost endorphins, which improve mood and reduce stress.
- Aim for at least 30 minutes of moderate exercise most days of the week.
Practice mindfulness and meditation to calm the mind and reduce stress levels.
- Techniques such as progressive muscle relaxation, guided imagery or aromatherapy can also help reduce stress.
- Keeping a gratitude journal or regularly reflecting on positive aspects of life can shift focus away from stressors.
Eating a balanced diet rich in fruits, vegetables, lean proteins and whole grains can support overall health and help manage stress.
- Reduce caffeine and alcohol intake to help prevent exacerbating stress and anxiety.
Improve sleep patterns to help the body recover.
- Aim for seven to nine hours of quality sleep per night.
Prioritize tasks, set realistic goals and break tasks into smaller steps to reduce feelings of being overwhelmed.
- Keeping your environment tidy and organized can help reduce stress and improve focus.
Connect with others and lean on friends, family or support groups.
- Spend time doing activities you enjoy, such as reading, gardening or playing music, to relax and unwind.
- Learn to say no and set limits to avoid taking on too much responsibility.
