That’s because certain lifestyle choices may actually make RA symptoms worse. Consider these seven surprising factors that could be contributing to your RA aches and pains.

1. Smoking cigarettes

“There’s evidence that people who smoke have a higher risk of developing RA and possibly even a more severe form of RA,” says Harry Fischer, MD, chief of rheumatology at Lenox Hill Hospital in New York City. A study published in the December 2020 issue of Preventive Medicine Reports found that people who smoke and former smokers were over 50 percent more likely to be diagnosed with RA than non-smokers. “If you’ve been diagnosed with RA, stop smoking,” says Dr. Fischer.

2. Eating foods that promote inflammation

There’s no specific diet for RA, but certain foods may contribute to inflammation. Avoiding or limiting certain kinds of fats and oils, sugar, and ultra-processed and refined foods and replacing them with anti-inflammatory options is especially beneficial for people with RA, says Rachel Begun, MS, RDN, a health and wellness communications expert in Los Angeles. Inflammatory foods include fatty cuts of meat, packaged foods containing hydrogenated and partially hydrogenated oils, and foods with refined flours, empty starches, and added sugars, she says. So limiting these foods in your RA diet is essential. Instead, load your plate with anti-inflammatory foods, like those rich in omega-3 fatty acids, including wild salmon, anchovies, or walnuts, Begun says. Choose antioxidant-rich fruits, vegetables, and whole grains, and use olive oil, avocado, nuts, and nut butters, which contain healthy monounsaturated fats. “Ginger and turmeric are two spices known for their anti-inflammatory benefits, so using them to flavor dishes is both a beneficial and delicious idea,” she notes. If you have joint pain, the last thing you may want to do is exercise — but don’t skip it. Keep moving with low-impact aerobic exercises such as walking or swimming, and make adjustments to protect yourself if you need to. The U.S. Centers for Disease Control and Prevention (CDC) recommends that people with RA do a blend of aerobic, muscle-strengthening, flexibility, and balance exercises. The Arthritis Foundation has videos to show you how to safely stretch hamstrings, hips, calves, and other areas before and after exercising.

4. Overdoing it with alcohol

While there’s probably no adverse effect from alcohol consumption for RA itself, booze can interfere with some RA medications, says Fischer. Be sure to ask your doctor if you can safely drink alcohol. If you choose to drink, don’t overdo it. That means no more than one drink a day for women and two for men, according to the Arthritis Foundation. If you have questions about how much alcohol you can drink, your doctor can provide specific guidance.

5. Forgetting about vitamin D 

Everyone needs vitamin D — the sunshine vitamin — to build strong bones, joints, and cartilage. But not getting enough vitamin D may contribute to muscle and skeletal pain in people with RA, Fischer says. A review published in October 2020 by the International Journal of Molecular Sciences notes that vitamin D deficiency is common in people with RA and that this deficiency has been linked with more severe RA disease activity. Sunlight stimulates vitamin D production, so aim to soak up some sun for 15 minutes every other day. To get vitamin D through your diet, add egg yolks, salmon and sardines, fortified milk products, and their fortified plant-based alternatives, Begun says. If you’re still low on vitamin D — and many of us are, Begun notes — talk to your doctor about taking a vitamin D supplement.

6. Getting pregnant

Sometimes RA improves during pregnancy, possibly because of hormonal changes, Fischer says. But if you’re pregnant or are planning to have a child, it’s important to talk with your doctor first. Some medications for RA, including methotrexate, can cause serious birth defects and should be stopped months before you start trying to get pregnant, according to the American College of Rheumatology.

7. Changing weather 

If you can predict the weather based on your joint pain, you’re not alone. Temperature drops and falling barometric pressure are linked to more joint pain. You can’t change the weather, but you can be prepared. Plug in your zip code to predict your level of joint pain for the day based on the weather through this tool on the Arthritis Foundation website. Additional reporting by Brian Dunleavy