Maintaining Control of Your Health While Dating With Arthritis
Arthritis, like most chronic conditions, can be life-altering. But with the right perspective and support, people with arthritis can lead active and fulfilling lives.
"People think that once they have arthritis, that's the end of the story. I don't think so," Nilanjana Bose, M.D., a rheumatologist at Lonestar Rheumatology in Houston, said in a phone interview. "You can still live a very functional life with arthritis as long as you are upfront with your doctor, maintain a healthy lifestyle and see your doctor regularly."
The word "arthritis"—derived from the Greek phrase meaning "of the joints" and the Latin phrase meaning "pain in the joints"—doesn't refer to a single disease but rather a group of more than 100 conditions classified as osteoarthritis (OA) or inflammatory arthritis (IA).
Osteoarthritis, the most prevalent form of the disease, is known as a degenerative joint disease (DJD). It occurs when the cartilage and other tissues between joints wear down or change structurally. Typically, these alterations occur gradually over several years, and people older than 40 are most likely to be affected.
Inflammatory arthritis results from autoimmunity, wherein the immune system errantly attacks healthy cells and tissues. Although IA starts in a joint, inflammation and subsequent damage can spread to other body parts. The most common type of inflammatory arthritis is rheumatoid arthritis (RA). Both osteoarthritis and inflammatory arthritis progress, or worsen, over time.
Each type of arthritis has distinct symptoms and effects, but all produce joint swelling and pain. Some people's symptoms dissipate or disappear altogether for days or weeks before worsening or reappearing. These resurgences, known as "flare-ups," can be spurred by factors such as stress or menstruation. Many people find their symptoms are worse at certain times of the day or in cold weather.
How arthritis affects a person depends on factors such as the type of arthritis they have, its severity and the resources available to them. For some people, arthritis can be debilitating, and it's recognized as a leading cause of disability worldwide. Even mild forms of the disease can pervade multiple facets of life, from work to dating and relationships, and give rise to comorbidities and complications that present distinct challenges.
Understanding these difficulties and how to cope with them can help you maintain control of your health and well-being after an arthritis diagnosis. And if you know someone with arthritis, educating yourself is one of the best ways to support them.
Living with arthritis
Arthritis is a lifelong disease. Medical intervention can prevent or delay some of the more severe consequences, such as disability or disfigurement, especially if you begin treatment when the disease is in its early stages. However, arthritis is a progressive and incurable condition. Therefore, people with arthritis are advised to work with one or more healthcare providers to manage the disorder.
Depending on the individual's condition, a doctor might recommend pharmaceutical pain relievers, anti-inflammatory medications, bracing, physical therapy or a combination of these treatments. In severe cases, surgery may be warranted. Lifestyle changes can also help in managing symptoms and slowing disease progression.
Pain, stiffness and diminished mobility can make exercise daunting for some people with arthritis. However, according to Kuljit Kapur, D.O., chief medical officer at Transitions Care in Naperville, Illinois, physical activity is vital.
Bose agreed and recommended low-impact exercises, such as walking, elliptical machines, stationary cycling and swimming.
"Even a moderate amount of physical activity can be beneficial," Kapur said. "We should view exercise as essential, not optional. With exercise can come weight loss, which can also reduce extra stress on the joints. Being physically active can reduce pain and improve function, mood and quality of life."
Eating a healthy, anti-inflammatory diet—such as a plant-based diet or the Mediterranean diet—can curb arthritis symptoms, too, according to Brett Smith, D.O., a rheumatologist at East Tennessee Children's Hospital in Knoxville.
"A vegan-based diet, a whole-food, plant-based diet, is known to improve disease activity—not cure, but improve disease activity—in people with rheumatoid arthritis," Smith said. "The reason, I think, is that upward of 70 percent of our immune system is in our gastrointestinal tract, and there are trillions of bacteria in there that are heavily involved in autoimmune diseases like arthritis."
It's possible to down-regulate and up-regulate genes and influence the immune system with nutrition, Smith said. He explained certain foods, such as animal products and ultra-processed foods, tend to be pro-inflammatory and adversely affect the gut microbiome, exacerbating arthritis symptoms. Alternatively, plant-based foods impact the gut microbiome positively and reduce inflammation.
Bose noted that elimination diets—which cut out and reintroduce several foods over weeks or months to determine if someone is intolerant of them—can be helpful for some people. However, these are difficult to maintain. If eliminating certain foods isn't sustainable for you, Bose advised minimizing pro-inflammatory foods such as ultra-processed products, red meat and processed sugar.
Dating with arthritis
People with chronic illnesses can face unique challenges in dating. This is not only due to their condition's physical and psychological implications but also to others' misconceptions and perceptions about the disease, or health and sickness generally.
Chronic pain and fatigue, coupled with mobility restrictions, can diminish a person's confidence and self-esteem while zapping their energy and libido. Anxiety and depression, which frequently co-occur with arthritis, can exacerbate these difficulties. It may be challenging to disclose your condition to a new partner since there's no guarantee of how they'll react. However, Bose said it's best to be forthcoming from the start.
"I think it's very important to be upfront with your partner right off to bat with what conditions you have because your partner can then appropriately conduct themselves and help you in your journey," she added. "I just think it's best to be honest."
Michael Mongno, M.F.T., Ph.D., a psychotherapist and relationship counselor at Present Centered Therapies in New York City, agreed. He acknowledged it's difficult to feel like the best version of yourself—the version you want to present to a new or prospective companion—when a chronic condition compromises the vision. However, he advised that communicating your limitations and needs can ultimately help forge a stronger bond. And if a date isn't compassionate or doesn't respond appropriately, knowing sooner rather than later allows you to move on and seek a better match.
"Telling a new partner about one's physical limitations doesn't need to be difficult or stressful," he said. "It's simply part of sharing the wholeness of oneself. If one's arthritis affects how one is able to feel close or intimate, honesty is best with those limitations as well as the ways that one has learned to work with such physical realities. Sex can be a multidimensional experience and can be approached in many ways so that physical limitations can be worked around creatively, even playfully, as people get to know each other over time."
Prevention and aftercare
There's no certain way to prevent arthritis, especially inflammatory arthritis. In part, that's because scientists don't know exactly what causes autoimmunity, though multiple factors are likely involved. However, according to Bose, it may be possible to reduce your risk of osteoarthritis by exercising safely and maintaining a healthy, active lifestyle. When exercising, she advised avoiding high-intensity, high-weight regimens, which can lead to damage.
Benjamin Service, M.D., an orthopedic surgeon at Orlando Health in Florida, agreed.
"High-repetition resistance exercise is recommended to optimize bone health, increase muscle tone and improve blood glucose clearance," Service said. "However, very intense, high-weight exercises should be avoided to decrease the stresses on the cartilage in the body's joints."
Being careful about posture can help as well, as can maintaining a healthy weight to avoid straining the joints. If you sit or stand for long periods, take breaks to walk or stretch and alleviate stress.
When living with any kind of arthritis, low-impact exercise, anti-inflammatory and pain-relieving medications, an anti-inflammatory diet and physical therapy can help assuage symptoms and keep the disease under control. Topical pain relievers may be useful as well. If you're overweight, a doctor may recommend weight loss to reduce joint strain.
For moderate and advanced arthritis, a doctor may recommend steroids or hyaluronate acid injections. With inflammatory arthritis, disease-modifying anti-rheumatic drugs (DMARDs) might be necessary to reduce joint destruction and prevent the disease from spreading to other parts of the body. If nonsurgical treatments don't suffice, joint replacement might be an option.
"In the knee, shoulder and hip, a total joint replacement [arthroplasty] can be a game changer to restore mobility, alignment and function while reducing pain," Service explained. "These surgeries are not small and should only be considered if nonsurgical management is no longer working."
Surgeons consider many factors, including the patient's age, bone quality, job requirements and activity level as well as the health of surrounding tissues, when determining the best course of action, he added.
Supporting someone with arthritis
Whether it's a romantic partner or a parent, caring for someone with arthritis can be challenging.
A good first step is to educate yourself about your loved one's particular condition and talk to them to better understand their unique experience. From there, you can take measures to support them emotionally, physically and practically.
"Arthritis can equal pain, and pain causes stress and dysregulation emotionally," Mongno said. "So being able to validate a partner's discomfort and show empathy is very important."
Kapur noted caregivers can use heat therapy to soothe a loved one's aching joints and calm muscle spasms. Encouraging your loved one to lead a healthy lifestyle through exercise and an anti-inflammatory diet is helpful as well, as is offering practical support with daily activities, such as cleaning or running errands.
She also noted it's important to keep in mind that there will be times when a person welcomes care and attention, and others when they'd prefer to go it alone. Respect their needs and communicate openly to ensure you're on the same page.
Many resources are available for people with arthritis and their caregivers, including local and web-based educational materials and support groups. Bose noted doctors and clinics are typically excellent sources of information and support. Other places to look include the Arthritis Foundation and the American College of Rheumatology, which maintain materials with information on everything from pain management to the latest research developments.