Each arthritis-related gene region bears about 35 percent of the weight of getting an autoimmune disease – and 65 percent comes from environmental factors. That’s good news, because we can do something about our environment. We can try to avoid irritants like smoke and pesticides, we can minimize risk of infection with simple steps like handwashing, and we can learn ways to cope with stress.

Before I became ill, I had been working 24/7, eating junk food and neglecting rest and exercise. Now I am careful to manage stress. I get plenty of sleep, eat a healthy, Mediterranean diet, exercise regularly and surround myself with loving support of friends and family. When I feel stiffness and my joints start to ache, I throttle back immediately, do gentle exercise like swimming and get plenty of rest. I increase my dose of nonsteroidal drugs and see my doctor if it gets worse.

We can’t completely control our environment, but we can take steps to lessen the chance of relapses and severity of our symptoms.

Esther M. Sternberg, MD, rheumatologist and researcher, is the author of Healing Spaces: The Science of Place and Well-being (Harvard University Press, 2009).