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We’re All a Little Fragile

As the years go by (22 of them with RA) I have come to realize that as strong as I think I have become in my battle against so many aspects of managing this chronic disease, I still have a daily battle with self-image.

RA not only has the obvious physically painful symptoms that we all know about like joint discomfort, swelling, redness, muscle pain and fatigue, brain fog, mobility limitations, to name a few, but it also has visual symptoms that we do not often address or acknowledge. Ignoring them is not wise and will create self-defeating habits and perpetuate negative self-esteem.

The most obvious and overt images are the joint distortions. Thankfully, I have very few, mostly nodules or slight finger bends but I did have some really distinctive ones in my feet prior to my successful surgeries on both feet several years ago. Another one is the bodily changes, like my waistline, which has become more inflated thanks to, not only aging but the use of some medications like corticosteroids. Add to that the adjustments we must make to our exercise choices, which tend to make finding aerobic activities challenging at best, and the recipe for negative self-image is written.

These types of self-image issues are prominent and pervasive and can have significant effects on, not only our self-esteem but our ability to manage RA. Managing RA, not only means dealing with the physical effects, but also the emotional and psychological effects of dealing with a life-changing, chronic disease. So when our self-image is negatively impacted it directly affects our emotional health and well-being. That, in turn, can lead to depression which has a whole set of side effects, all of which make managing RA even more challenging.

So, how do we counter this and/or can we?

The answer is yes we can. The how is a little more complicated. I think one way is to tackle the areas individually. When I start to look at the laundry list of self-image issues I have it is overwhelming. So, instead, I take it one at a time and try to deal with it as best I can. For example, my waistline. I know that the medications I take contribute as does the limitations in my activity level that has come to be since RA. So, I worked with my Care Team to consider how to deal with this. First of all, I found exercises to replace those I could no longer do. That meant letting go of tennis and jogging and adding swimming and Tai Chi. Not only did this help my weight, but it lifted my spirits as physical activity does. Secondly, I have learned through lots of personal introspection and meditation, as well as a conversation with others, that how I look is not just about weight and waistline but also self-care. I buy clothes that flatter my current figure and I pamper myself with manicures and pedicures and hairstyles that boost my confidence.

In addition, I find that when I take care of my RA, it is reflected in my self-image and so the better I manage this disease the better I feel about myself and the greater my degree of self-confidence.

Let’s be realistic.  In the best of times, all things being copasetic, our self-image can be fragile. So, given all that we contend with in dealing with RA, it is no surprise that we can succumb to poor self-esteem. But, as with everything else we battle when it comes to RA, this too is a fight we can win and with the help of our Care Team we will!


This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Pamgoddess
    2 years ago

    One thing that was not mentioned is the facial appearance of always looking exhausted and drawn! Most days, I look like hell!

  • Nan Hart moderator author
    2 years ago

    You are so right! Makeup has been my best friend for years and it makes me feel much better. Thanks for your comments

  • queenbprods
    2 years ago

    Thanks for sharing this. It’s nice not to feel alone in this particular struggle. Its even harder for me since I struggled with an eating disorder when I was younger, but still struggle with body dysmorphia. It’s almost as if the universe is forcing me to love myself as I am, without “losing weight” or being toned. After three kids and RA with Fibro, I feel like I’m really losing the body image battle. Even a gentle yoga class left me reeling in pain. Very much want to swim but finding a pool that’s affordable is also hard. Anyway, just glad to hear I’m not alone in this struggle. Peace and love.

  • Nan Hart moderator author
    2 years ago

    I look for the small victories now and by doing that I am finding myself being more positive overall. Thanks for your comments. Best, Nan

  • Lawrence 'rick' Phillips moderator
    2 years ago

    I have little outward appearance of having RA. Like you my hands and I walk forward as if I am bracing for a stiff wind.

    I think because of the insulin pump I got over these issues of outward appearance of chronic disease at a younger age. One thing I have learned is to embrace who we are. Not worse, better or even different, rather whole in a different way.

  • Monica Y. Sengupta moderator
    2 years ago

    I really like this, Rick! I recently attended my high school reunion. It was a long event, in very humid weather. On top of that, I parked rather far and an upward hill away. I used my cane so I was a little nervous about what people would say. I got over it pretty quickly though because I put effort into my appearance and looked really good!

    I got some questions about the cane but honestly, nobody noticed. I put a lot more pressure on myself than anyone else did!

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