Mental Health Series Part 2: How A Positive Attitude Can Decrease Your Arthritis Pain

The mental distress of experiencing or even imagining the experience of pain from a total joint replacement surgery is very real in the lives of arthritis patients, but there are tools and treatments to strengthen patients’ mental health to overcome these challenges. 

Recent studies underscore the connection between arthritis patients and mental health conditions. Read more about this in Part 1 of our Mental Health and Arthritis blog series. But a deeper look into the connection shows that arthritis patients may not be addressing psychological symptoms as much as their physical ones. 

By not seeking mental health care or practicing self-care for these issues, patients put themselves at a disadvantage for having the best treatment outcomes possible.  

In a 2012 study by the American College of Rheumatology, 1,793 US adults ages 45 and older with arthritis were interviewed. Results showed that 30% of respondents suffered from anxiety and 18% suffered from depression. Out of the patients suffering from anxiety and/or depression, only half sought help for their mental health condition.

When to See a Doctor About Anxiety

Experts suggest that if the following symptoms are uncontrollable or interfere with your daily life such as making you dread regular activities like going to work, school or spending time with friends and family, it’s time to seek help from a medical professional.

You worry or obsess about concerns both small and large. 

You fear and dread things that may happen now or in the future. 

You feel restless, on edge and irritable. 

You have trouble concentrating. 

You worry about worrying. 

You can’t make decisions for fear of making the wrong decision. 

You have physical symptoms like muscle tension, rapid heart rate, upset stomach, dizziness or hot flashes. 

When to See a Doctor About Depression 

Feeling sad is a normal part of life- everyone has a bad day here and there. But if these low feelings last for two or more weeks, you may be clinically depressed. If you have any of these symptoms of depression, it's time to talk with a doctor. 

Your low spirits persist for two weeks or more. 

Your depression is interfering with your relationships or job. 

You have thoughts of harming yourself. 

You have physical symptoms such as headaches, digestive disorders and chronic pain not associated with arthritis that do not respond to routine treatment. 

Your symptoms include any five of the following: sleeplessness or oversleeping; loss of appetite or overeating; frequent tears and feelings of sadness; inability to concentrate; little interest in things you usually enjoy;  fatigue; irritability; restlessness or moving about in slow motion; a feeling of worthlessness or pervasive guilt.

How Does Improving Mental Health Affect Arthritis Symptoms?

Physical arthritis pain causes negative effects on patients’ quality of life and their mental health. Recent studies have shown that better mental health can actually reduce arthritis pain and improve surgical outcomes and rehabilitation. 

Patients’ psychological status is the major cause of pain intensity following a total joint replacement surgery. The more positive the patient was mentally before surgery, the less postoperative pain they reported experiencing. The study explained that optimistic patients generally pay less attention to pain stimuli. They are able to see past the short-term pain after surgery and remain hopeful that their pain will improve.

Patients with self-confidence, optimism, and motivation had better improvement of symptoms after surgery. One possible explanation is that patients with a positive mental state were able to focus on rehabilitation and home exercise rather than worrying about the surgical trauma or postoperative pain. They were also more likely to use effective coping strategies to decrease levels of anxiety and depression. 

Gaining an Optimistic State of Mind

The 2020 study on psychological symptoms of arthritis also listed the three most common types of psychological treatments for pain management following a hip and knee replacement surgery. 

The most commonly used psychological interventions are cognitive behavior therapy (CBT), psychoeducation (PE), and relaxation therapy (RT). CBT, therapy aimed at changing a patient’s belief and the related emotion or behavior, is the most effective tool. PE, a treatment that focuses on information given to patients, and RT, a treatment that works to reduce physical and psychological discomfort, are effective supplements in combination with other treatments. 

Similar to the techniques used in relaxation therapy, studies have found that mindfulness and gratitude as large factors in the reduction of depression and improving mental health in arthritis patients. 

Finally, exercise has been proven to improve mood long-term in the general population. Specific to arthritis patients, exercise has shown benefits to both patients’ physical and mental wellbeing. 

In Part 3 of our Mental Health and Arthritis blog series, we discuss recent research on each of these treatments used by arthritis patients and their care teams to improve their mental health. 

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