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Erika, that's entirely possible. The cycle can begin and end at any point, it doesn't just start with the disease. Stress can cause the disease to flare, it can also lead to tense muscles and difficulty sleeping, both of which contribute to the disease flaring.
I can't take credit for the chart. It's the one we use at the Arthritis Self-Management Program. For many people who are newly diagnosed, it's a revelation that so many things contribute, and that you can break the cycle at any point.
For me, by the way, pilates does what swimming does for you. It's one of the tools I have to break the cycle.
Warm hugs,
Kat
A life lived in fear is a life half lived. "Strictly Ballroom"