Good Marriages Help People with RA

Being happily married is a plus if you have rheumatoid arthritis (RA).

A new study in the Journal of Pain shows that people with RA – a painful and potentially debilitating form of arthritis that’s three times more common in women than in men – have a better quality of life and experience less pain if they are in a good marriage.

"There's something about being in a high-quality marriage that seems to buffer a patient's emotional health," says lead researcher Jennifer Barsky Reese, Ph.D., at the Johns Hopkins University School of Medicine.

People with RA in distressed marriages were no better off in terms of quality of life and pain than the unmarried patients she studied.

Understanding types of pain

For the study, researchers looked at 255 adults with RA and assessed them for their marital relationships, severity of disease, and pain. Forty-four were in distressed marriages, 114 were not in distressed marriages, and 97 were unmarried. Their average age was 55.

The group answered questions about how happy they were in their marriage. Researchers also noted how much they agreed or disagreed in key areas, including finances, affection, sex, approach to life, and in-laws.

When the researchers looked at age and disease severity, they found that better marital quality was related to lower “affective” pain and lower psychological disability.

Evaluating the pain

Affective pain is an emotional evaluation of pain – how unpleasant a person finds it. Another measure, sensory pain, reflects how a person feels pain.

Marriage had a greater effect on psychological disability than affective pain, Reese says.

Reese can't say for sure that being in a high-quality marriage leads to better functioning. "It could be people with better emotional health may be more likely to get into a high-quality marriage," she says.

Coping reduces stress, inflammation

The findings back up what researchers in the field of psychoneuroimmunology have found, says Nancy Klimas, M.D., at the University of Miami.

Studies in that field have found that inflammation – the hallmark of RA – may be modified by changing the way a person copes with stress.

Because Reese’s study found that being in a distressed marriage was no different than being alone, Dr. Klimas says that would suggest a supportive relationship is key.

We have internal coping mechanisms – ways we learn to deal with pain and chronic disease, she says. And we have an external support system, in the form of a supportive partner.

"It adds a whole other layer of support that someone alone or in a nonsupportive relationship won't have," she says.

For people with RA who have troubled marriages, improving communication with a partner and learning new coping skills may help manage the disease.

Always talk with your health care provider to find out more information.