Talk About How Youre Feeling
Fatigue can make you feel low or depressed. Talking about how you feel can really help. Dont keep your feelings to yourself. Try to talk to a member of your healthcare team, members of a support group, your family or friends.
There are things that can help if youre feeling low. Your healthcare team may recommend a talking therapy, such as cognitive behaviour therapy also known as CBT. You can do it as one-to-one or group sessions.
Talking therapies aim to help people change the way they see their condition and any negative feelings towards it. Sessions, led by trained therapists, can help people change the way they react to and feel about their condition by making positive changes to the way they think and behave.
NHS England has a dedicated programme called Improving Access to Psychological Therapies, known as IAPT. It aims to connect people with anxiety and depression to local talking therapy services. You can refer yourself to this service by visiting the NHS England website and searching for IAPT or ask a health professional to refer you.
Health services in Scotland, Wales and Northern Ireland dont currently offer a self-referral service, but you can ask your doctor to refer you to a local NHS therapy service or group.
Joining a support group for people living with similar conditions can help you talk openly about your problems with people in similar situations. They may also be able to share tips on how to get around some of your problems.
Tips To Manage Psoriatic Arthritis Fatigue
If you have psoriatic arthritis and need a nap to get through the day, some simple changes can boost your energy and make you feel better.
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Treating The Symptoms Of Rheumatoid Arthritis
People living with rheumatoid arthritis commonly develop anemia either from the condition itself or from medications taken as treatment. If their anemia seems more profound, if they have tachycardia or fast heart rate, or theyre feeling short of breath, it might mean they have anemia on top of their arthritis, says Dr. Rosian.
This isnt necessarily out of the ordinary. You can live with rheumatoid arthritis and other conditions, such as heart disease and high blood pressure, or experience stress from kids and work. Thats why its sometimes difficult to tell whats causing your fatigue.
If the fatigue is worse with rheumatoid arthritis, you treat that, explains Dr. Rosian. Thats where you focus on a steady diet, the exercise and sleep. When the rheumatoid arthritis is quiet and people still have a lot of fatigue, thats trickier.
Dr. Rosian also says some people like to take a hot shower or soak in a warm bath to help manage their stiffness and fatigue. Others might practice mindfulness or meditation, get a massage or practice Tai Chi. Finding what works for you to help your rheumatoid arthritis is key.
Some people with fatigue get better if they do an activity or a hobby something that makes them happy and something positive for them, encourages Dr. Rosian. If something makes you feel better and reduces your pain, its going to help you with your fatigue.
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Doctors Agree On Fatigue Symptoms
Sluggish, weary, lethargic sometimes, these words arent enough to capture how RA fatigue makes us feel. The source of fatigue is even tougher to pinpoint. Is it tiredness? Maybe I didnt get enough sleep? Did I overdo myself a few days ago? Is it all in my head? But there is a bit of good news your doctors are listening! Although its complicated for patients to describe fatigue, doctors recognize that fatigue is a bothersome symptom of RA.
Rearrange Your Kitchen Counter
A simple natural way to prevent fatigue: Put everything you use often within easy reach. Then do the same in your bathroom and bedroom. Set up your home to make life a little easier on you, particularly on the more difficult days, say experts.
And use specialized assistive tools throughout the day zipper pulls, gripping tools, electric can openers, and long shoe horns can all help conserve energy and ease pain.
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Try To Keep A Reserve Of Meals And Supplies That You Can Use On Days When You Need Extra Rest
, 38, is a mom of three, and she says juggling the demands of motherhood and her rheumatoid arthritis fatigue can be tough. Shes found that meal prepping and reserving special toys that keep her kids entertained for longer give her more time to rest on particularly tiring things.
When Im feeling up to it, I cook big-batch meals and put some in the freezer for days when I have less energy, she tells SELF. Mariah also keeps a cupboard full of quiet activities and crafts that her kids can work on if she needs extra rest time. We also use a system of toy rotation, where about one-third of our toys are out in the playroom and two-thirds are off-limits in a closet, she says. So on days when I am in pain or have less energy, I can bring out new toys that will keep the kids attention longer because they havent been played with for a while.
Remission Does Not Necessarily Equate To Low Fatigue
When in remission in ERA, many patients have low levels of fatigue but some still have significant fatigue. RA patients with a sustained state of low disease activity had a mean FACIT-F score in the 40s so residual fatigue persisted for many patients. The SF-36 vitality domain demonstrated all but approximately 15% were not in fatigue remission when in DAS remission .
Within the Outcome Measures in Rheumatology flare working group, a Delphi exercise was performed, and fatigue did not meet consensus for inclusion within the development of the flare questionnaire in RA. Fatigue in RA is multifactorial and only partially related to disease activity which may have accounted for poor agreement with respect to a fatigue domain within a flare questionnaire in RA.
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What Causes Ra Fatigue
Inflammation from RA leads to pain and stiffness. Pain can lead to problems with sleep. The combination of disease symptoms and lack of sleep can make fatigue a disabling feature of RA. Also, medicines used to treat RA and its complications may cause or worsen fatigue. Depression can lead to fatigue.3,4
Can Psoriatic Arthritis Make You Tired
Yes. Studies show close to 80% of people with psoriatic arthritis have some degree of fatigue.
When you have this disease, your body makes proteins called cytokines that cause inflammation. They make your joints swell and become painful or stiff.
These proteins may also cause fatigue, although doctors arenât sure why. When you have a flare, the cytokines set your immune system off. But instead of fighting an infection, your immune system attacks your joints. Maybe the fatigue comes from your body using energy to do this.
The joint pain and skin rashes that can come with this type of arthritis may also keep you from getting a good nightâs sleep. If you have trouble falling or staying asleep, talk to your doctor. A medication might help you get better rest.
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Timing Of Maximal Improvement In Fatigue When In Sustained Remission In Era
An ERA cohort which included 1864 patients studied how fatigue varied over time. A quarter had low fatigue, nearly 20% moderate and approximately 60% high fatigue at baseline. The baseline fatigue and pain scores were similar, around 5 out of 10. DAS28 seemed to be moderately related to fatigue at baseline where the DAS28 score was highest in the highest fatigue level, next highest in the middle level and smallest in the lowest fatigue group.
The baseline SF-36 mental component summary scores also were different differed significantly between the fatigue groups. The mean baseline fatigue score measured by a VAS was highest at baseline than follow-up visits. Fatigue decreased by the 3-months visit where the largest between visit change occurred .
What Causes Rheumatoid Arthritis Rashes
People with RA are prone to episodes known as flares. A flare indicates that theres increased disease activity in a persons body.
During a flare, they may have more symptoms associated with the condition, including fever, joint swelling, and fatigue. An RA rash is more likely to occur during a flare.
RV is a complication of RA. Its caused by the immune system and high levels of rheumatoid factor in the blood interacting with blood vessels.
This triggers inflammation of small arteries and veins. It can be serious and, while rare, RV
RA can cause complications beyond a rash. Vasculitis can affect blood flow in arteries and veins. The results of severe episodes of vasculitis can be:
- numbness and tingling in the nerves, including loss of sensation in the hands and feet
- affected blood flow to the extremities that can cause gangrene in the fingers or toes
- systemic vasculitis that affects blood flow to the brain or heart that can result in a heart attack or stroke
The occurrence of RV is rare, and the complications above are even rarer. However, its possible that a rash could be a indicate that something more severe may occur. See a doctor if you experience any symptoms of RV.
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Conserve Your Energy And Protect Your Joints
You can also learn ways to save your energy and protect your joints during daily tasks. These tips may also help you cope with fatigue, or reduce its impact on your life:
- Pace yourself. Carefully plan and organise your activities so you make the most of your energy. Here are some simple tips to help you pace your activities:
- Try to plan your day so that you can alternate periods of activity with periods of rest.
- When you know you have a large task to do, such as preparing a meal or cleaning a room, plan ahead and break the job into smaller tasks. Then work on completing the tasks one at a time, and follow each with a rest break.
- Try to prioritise jobs. Do the hardest jobs when you are feeling your best.
- Take advantage of good days to do the things you may have been putting off. Remember not to overdo it on these days as it could result in pain and fatigue the following days.
- Simplify tasks. For example, buy pre-cut vegetables and meat to make cooking simpler. Find out about equipment that can make tasks easier .
- If you are having a bad day, be ready to change your plans and not force yourself to work through pain.
- Ask for help when you need it.
Get Moving And Stay Strong
Dr. Rosian says stretching and staying active are both important. Even though you might have fatigue, its so important to move your joints. You want to keep your flexibility and your strength.
She likens keeping your joints active to a gate hinge. If it rusts, and you keep using it, its still going to be useful. But if you dont use it, its going to lock up. The same sort of thing happens to our joints.
Strengthening is as important as stretching, she adds. You want your muscles to stay strong because they move your joints. When you use your muscles, youre less fatigued. Some studies say a 15-minute walk is as refreshing as a 15-minute or half-hour nap. Sometimes activity is actually good for you to reduce pain and stiffness.
Lifting light weights, swimming and walking are great options. Tai Chi is also good for balance and strengthening and stretching, says Dr. Rosian. Some people also find yoga helpful, although others might not due to the strain it puts on the wrist.
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Possible Factors Involved In Fatigue
The factors below are associated with RA fatigue, meaning each factor may cause fatiguedirectly or indirectlyor is simply correlated with it.
Disease activity Rheumatoid arthritis is an autoimmune disease that causes inflammation in the joints. The immune system cells can release substances called cytokines, proteins that act as messengers throughout the body. Rheumatoid arthritis disease activity can spur a release of cytokines that lead to inflammation that leads to joint pain and possibly fatigue.
Anemia Between 20% and 60% of people with rheumatoid arthritis have abnormally low levels of red blood cells, a condition called anemia. People with anemia may experience fatigue along with other symptoms, including but not limited to pale skin, dizziness, or irregular heartbeat.
Some people with RA experience anemia as a result of chronic inflammation. Others may experience iron deficiency anemia because of chronic use of NSAID medications for treatment of arthritis pain.4
Not everyone agrees with the idea that anemia is the cause of RA chronic fatigue. At least one study found that patients fatigue correlated with RA disease activity rather than anemia.5
Contributing Role Of Inflammation
High levels of inflammation might be a cause of RA fatigue. According to a 2018 review, chronic low-grade inflammation might create imbalances in cellular energy availability and expenditure. That imbalance ultimately causes you to become drained and worn when RA symptoms are active.
RA inflammation also increases pain, leaving a person feeling further worn out. When joints hurt, pain makes it harder to sleep and get good quality sleep. When your rest is unrefreshing, you experience more fatigue. It is a vicious cycle.
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Reason : Your Brain Is On Overdrive
For patients new to RA, there can be a lot of emotions tied to the initial diagnosis. First, theres the overwhelming nature of this disease, which can have so many painful and scary physical effects. Then theres the realization that this is a long-term condition, which Dr. Greer says can weigh heavily on the minds of patients. While a rheumatologist will be the principal provider for RA care, there are times when a specialistperhaps a psychologist or psychiatristshould be consulted to ensure well-rounded care.
Beating Chronic Fatigue By Improving Lifestyle
The effects of Chronic Fatigue cant be managed overnight. It requires small daily habit changes and lifestyle shifts to incorporate more activity, better rest, and improved dietary habit. By assessing and adjusting your daily activities, you can help determine what is contributing to your chronic fatigue, and make the appropriate lifestyle changes. Successfully managing these factors that contribute to Chronic Fatigue associated with Rheumatoid Arthritis, a patient can drastically improve energy levels and overall wellbeing.
If youre concerned about how chronic fatigue is affecting your life, talk to your rheumatologist about the options to beat fatigue and improve your wellbeing.
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Can Rheumatoid Arthritis Fatigue Flare If You Do Certain Activities
Rheumatoid arthritis fatigue tends to flare when your inflammation is running its course. People living with rheumatoid arthritis get stiff during the night while they sleep, Dr. Rosian explains. In the morning, especially if they havent slept well, theyre very stiff and achy. As they get moving, they get less stiff and achy. They get more energy.
In other words, good news: Physical activity doesnt make rheumatoid arthritis fatigue worse. Things that have an impact on your immune system stress, not sleeping and having anesthesia could bring on flares, says Dr. Rosian. But exercise doesnt bring on flares. Physical therapy isnt going to bring on flares. Going to the gym and working out does not give you a flare-up.
Maintaining Ability To Work
Patients with RA who maintained their ability to work had less fatigue compared to those who were work disabled, and these differences seemed related to better mental health, not physical health. However, other factors are likely related to an ability to work, which may not have been measured, where both fatigue and work disability are a consequence of joint damage, age, type of job, less flexibility at work and so on. A prospective study is needed to determine if a programme that keeps people in the workplace will improve fatigue.
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