Imagine being in too much pain to wash your face or to get dressed to go out. This is the reality for many living with rheumatoid arthritis (RA) and other forms of arthritis. More than 250,000 people living in Canada have RA. Symptoms, which can develop at any age and vary widely, not only affect physical health but also one’s body image, self-esteem and mental health.
Psychological Impact
The psychological impact of arthritis on body image is often overlooked, yet multiple studies, like Body image in patients with rheumatoid arthritis and Body Image and Self-Esteem in Patients with Rheumatoid Arthritis, show that people living with RA, especially those treated for over five years, struggle with a negative body image.
Chronic pain can make someone feel betrayed by their body, leading to feelings of inadequacy or frustration. Visible signs of pain, physical deformities in hands or feet, weight fluctuations from medication, scars from surgeries and skin changes can all contribute to a negative self-image. Reduced mobility and the need for assistive devices may also affect how individuals perceive themselves and how they believe others see them.
The agony of arthritis is more than pain; it bombards individuals from all angles, and can cause emotional distress, anxiety, depression and a negative self-image. These challenges can impact friendships and relationships, furthering isolation and loneliness.
According to a report by the National Rheumatoid Arthritis Society (NRAS UK) report cited in Psychology Today:
- 72% of women state that their RA negatively affects how they feel about their body some or most of the time.
- 48% of men with RA report similar feelings.
What can help someone's self-perception of their body and how can loved ones support them in this vulnerable area?
Five self-care tips for feeling good about your body:
Eileen Davidson lives with rheumatoid arthritis and passionately advocates, educates and inspires others living with arthritis. A regular contributor to Creaky Joints and an ambassador with Arthritis Society Canada, Eileen offers five tips to embrace your body and feel good about it while living with arthritis.
1. Stay active: Getting regular exercise and activity can help fight fatigue, manage pain, reduce depression and promote a positive body image. Joint-friendly activities can include walking, chair yoga or swimming. Eileen's favorite exercises include the elliptical and strength training with resistance bands.
2. Practice self-care: Mindfulness practices to become more aware of your body and thoughts can lead to a more realistic and positive body image. Good sleep improves mood, cognitive function and overall health. Nourishing food can improve your energy levels and physical health. "Setting boundaries and making space for rest helps you listen to your body's needs, set reasonable expectations, and accept your body as it is," shares Eileen.
3.Focus on what your body can do: Recognizing your body's perseverance through challenges can increase your admiration and gratitude for it. A study, More than my RA: A randomized trial investigating body image improvement among women with rheumatoid arthritis using a functionality-focused intervention program, examined the effects of focusing on body functionality rather than limitations. Women with RA were encouraged to reflect and journal on what their bodies could do (like hugging loved ones) and what that meant to them instead of what they couldn't do (like playing tennis). The findings showed that focusing on body functionality can improve body image and reduce depression in women with RA.
4. 
Find new hobbies/activities: "It's okay to acknowledge your disappointment in being unable to do an activity you love because of your body's limitations," says Eileen. "But don't stop there; try new activities and hobbies until you discover one you love that also works with your health in this season." A new activity can bring you joy and the potential of new friendships.
5. Connect with others for support: Positive social interactions can provide a sense of belonging and acceptance and reinforce a healthy body image. Join a peer support group like Arthritis Connections, make time for friends and family, or attend a social club. "Be honest about your current limitations," says Eileen. "Allow others to help you in practical ways."
3 ways to support your loved one:
You can help your loved one develop a healthier and more accepting view of their body by supporting them with empathy.
1. Listen and validate: Create a safe, non-judgemental space for them to be honest and open about their challenges and how they feel.
2. Focus on character strengths: Reinforce strengths and positive qualities unrelated to their appearance, encourage self-care and support mindfulness practices. Let them know what you appreciate about them and celebrate their small victories with them.
3. Model positive behaviour: Participate in regular movement, balanced nutrition and mindfulness activities with your loved one. If they are really struggling with body image concerns, gently suggest they speak to a healthcare professional who specializes in body image and self-esteem.
Kindness and compassion, to yourself and others, lead the way in learning to embrace the body through its limitations.
Sources:
- Alleva, J.M., Psychology Today, "Improving Body Image in Women with Rheumatoid Arthritis" (2018)
- Alleva, J. M., Diedrichs, P. C., Halliwell, E., Peters, M. L., Dures, E., Stuijfzand, B. G., & Rumsey, N. (2018). More than my RA: Improving body image in women with rheumatoid arthritis using a functionality-focused intervention programme. Journal of Consulting and Clinical Psychology, 86, 666-676.
- Jorge RT, Brumini C, Jones A, Natour J. Body image in patients with rheumatoid arthritis. Mod Rheumatol. 2010 Oct;20(5):491-5. doi: 10.1007/s10165-010-0316-4. Epub 2010 Jun 4. PMID: 20524027.
- Kurt E, Özdilli K, Yorulmaz H. Body Image and Self-Esteem in Patients with Rheumatoid Arthritis. Noro Psikiyatr Ars. 2013 Sep;50(3):202-208. doi: 10.4274/npa.y6195. Epub 2013 Sep 1. PMID: 28360544; PMCID: PMC5363436.