Arthritis With Involvement Of The Soft Tissues
It can happen that the inflammatory process present in the joints of the leg extends to the soft tissues, aggravating the present symptomatology .
When this happens, the whole dynamics of the leg is affected and the patient is prevented from engaging in daily living activities.
*All individuals are unique. Your results can and will vary.
This type of arthritis is common in those who have overused their joints for example, professional athletes, runners, joggers. Physical injuries can trigger the appearance of this form of arthritis as well.
The inflammatory process can stem from the soft tissues as well, affecting the joints as consequence. In making the diagnosis of arthritis, it is important to diagnose the root of the problem and treat it accordingly.
If the leg pain is severe, involving a large surface and being resistant to medication, the condition one is suffering from might be fibromyalgia.
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How Rheumatoid Arthritis Triggers Chronic Fatigue
More than just being tired, chronic fatigue is a feeling of exhaustion that cant be fixed with sleep. Its often associated with brain fog and a lack of motivation or inability to complete tasks. Chronic fatigue is common in people who have certain autoimmune conditions, including rheumatoid arthritis .
Chronic fatigue is a common struggle for those with RA. Read Rheumatoid Arthritis and Fatigue
Below are 6 possible reasons why a person with RA experiences chronic fatigue. These underlying factors may work alone or together to contribute to an individuals overall fatigue.
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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Tell Your Physician About Your Fatigue
In addition to the 6 items listed above, other factors can contribute to fatigue, such as vitamin B12 and D deficiencies, thyroid problems, and infections. Determining the underlying cause of fatigue is not an easy task for doctors or patients. The more information you give your physician about your fatigue and how it affects your life, the better the chance that, together, you can take steps to alleviate it.
What Blocks Pain Signals
Many scientists think pain control methods help reduce pain by blocking pain signals. Pain signals are sent through a complex system of nerves in the brain and spinal cord.
There are many things that can block these signals and thus prevent the pain message from reaching your brain.
Pain signals are blocked by chemicals made by the brain called endorphins. There are several things that can cause the brain to produce endorphins. These include ânaturalâ controls, such as your own thoughts and emotions, or âoutsideâ controls such as medicines.
Natural controls
A father driving with his children is hurt in a car accident. The father is so worried about his children that he doesnât feel the pain from his own broken arm. The concern for his children somehow blocked the pain signal and kept the pain from affecting him.
Outside controls
Certain medicines such as morphine imitate the bodyâs endorphins and block the pain signal. Other pain control methods, such as heat and cold treatments, physical therapy, exercise, relaxation and massage can stimulate the body to release its own endorphins or to block the pain signal in other ways.
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Symptoms Of Fatigue In Inflammatory Arthritis
Just like there are many causes of fatigue, there are also many symptoms that may indicate what you have is inflammatory arthritis-related fatigue. Its very subjective and not quantifiable with a lab or measurable outcome, which is why fatigue can feel so frustrating and overwhelming, says Dr. Cohen. You cant quantify it, but you know its not normal.
Heres a look at some of the key symptoms to discuss with your health care team:
Extreme tiredness
Dr. Khattri says that while symptoms of fatigue and feeling tired do overlap, fatigue is often at the extreme end. You feel like you have no control.
With normal tired you know sleep can fix it, says CreakyJoints community member Lel. Fatigue decides when its over youre just a helpless bystander.
Change in energy levels
While some patients wake up feeling fatigue, others experience sudden, overwhelming changes in energy levels and simply hit a wall.
RA fatigue stops me in my tracks. I feel myself fading out suddenly, then I have to rest . It feels like sandbags dropped on me, says CreakyJoints community member Kristina H. It hits me around the same time every day, or sometimes I wake up knowing its going to be a low energy day.
Increase in flares
Poor sleep
Research shows that poor sleep can make the symptoms of fatigue worse, increasing sensitivity to pain, irritability, and making it that much harder to concentrate, says Dr. Cohen.
Brain fog
Reduced quality of life
Irritability
Low motivation
Headache
Effects Of Fatigue On Physical Activity In Osteoarthritis
A 2012 study showed fatigue was a factor in reduced levels of physical activity in people with symptomatic knee and hip osteoarthritis. The coping strategies of guarding, resting, task persistence, and pacing were shown to moderate the effects of fatigue. Guarding includes bracing, limping, and stiffening. Pacing refers to breaking up activity time by alternating activity and rest periods. People who used pacing often did it because they were having symptoms rather than planning to pace their activities. Task persistence means that a person continued with the activity despite feeling symptoms.
A small study of older adults with osteoarthritis found that a bout of standardized physical activity produced increased fatigue on the day of the activity and that participants reduced their overall activity for the rest of the day . Interestingly, however, their fatigue was lowered during the three days after the task and their activity levels returned to normal, as measured by the fitness device.
Another small study of older adults found that those with osteoarthritis were four times more likely to have more fatigue than people without the condition after a period of high-level physical activity.
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Joint pain you expect. Stiffness and swelling, too. But with rheumatoid, psoriatic, and other kinds of inflammatory arthritis, theres another symptom thats just as common, but much less tangible: chronic fatigue.
Fatigue in inflammatory arthritis is different than just being tired or a little worn out. Fatigue is a more overwhelming feeling, a deeper sense of slowing down that can be tough to define.
Some patients describe it as not feeling like doing much, says Elena Schiopu, MD, a rheumatologist at the Michigan Medicine Rheumatology Clinic in Ann Arbor, Michigan. Others say its falling asleep all day long, at the drop of a hat.
Research shows as many as 80 percent of people with RA report chronic fatigue. Experts believe inflammatory arthritis activates inflammatory proteins in the body, which not only cause pain but also fatigue.
Much like influenza, when the body is fighting the viral burden with increased inflammation, deep muscle aches and fatigue are present, explains Dr. Schiopu, who also serves as associate professor of rheumatology and internal medicine at the University of Michigan.
Fatigue can come and go in bouts one day you feel fantastic and ready to do it all the next day you cant get yourself out of bed. That unpredictability can make arthritis fatigue a tough symptom to manage. And its not a symptom that others who havent experienced it can easily understand or empathize with.
Reasons For Fatigue In Ra
There are several causes of fatigue in RA. For instance, active RA with inflammation and pain cause fatigue directly by altered cytokines but also disruption of sleep due to pain. Chronic pain alters sleep through changes in mood affecting sleep patterns. Decreases in physical activity and stress due to a chronic disease that is life altering will impact energy in a negative way. Medications such as methotrexate and even sulfasalazine can cause fatigue. Different routes of administration or dosing of methotrexate may be helpful to reduce fatigue as a side effect. Treatments should be multidimensional in order to improve fatigue in people living with RA.
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What My Arthritis Pain Feels Like
Morning stiffness and pain One key sign of inflammatory arthritis is morning stiffness. This means pretty much what it sounds like: Im extra stiff in the morning. For me personally, this also means some morning pain. Its different than pain later in the day, as its more like pain from my joints taking a while to warm up in the morning. When Im doing well, my morning stiffness and pain last about 30 minutes. When Im not, it can take at least 2 hours to wear off.
Because of this, I like to wake up way earlier than I might otherwise. If I start work at 8, for example, I want to wake up between 6 and 7. This gives me time to mentally and physically fully wake up. My morning pain is around the joints that are particularly stiff. For example, my good knee feels not-terrible most of the time, but it is difficult first thing in the morning. It is stiff and I have more pain in the morning in that knee than I do during the rest of the day.
Daily normal pain My traditional daily pain is like an ache focused around the particular joints that are affected and bother me. When it is really bad, that ache radiates out from the joint. I put ache in quotation marks because while it is the best description for it, I personally feel like it downplays the pain.
Let me be clear: that aching can hurt incredibly badly.
That being said, lets go back to what my daily pain is like.
How Can I Feel Less Tired
Some changes to your lifestyle can make you feel less tired. Here are some suggestions:
- Keep a fatigue diary to help you find patterns throughout the day when you feel more or less tired.
- Exercise regularly. Almost anyone, at any age, can do some type of physical activity. If you have concerns about starting an exercise program, ask your doctor if there are any activities you should avoid. Moderate exercise may improve your appetite, energy, and outlook. Some people find that exercises combining balance and breathing improve their energy.
- Try to avoid long naps late in the day. Long naps can leave you feeling groggy and may make it harder to fall asleep at night. Read A Good Nights Sleep for tips on getting better rest at night.
- Stop smoking.Smoking is linked to many diseases and disorders, such as cancer, heart disease, and breathing problems, which can drain your energy.
- Ask for help if you feel swamped. Some people have so much to do that just thinking about their schedules can make them feel tired. Working with others may help a job go faster and be more fun.
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Fatigue Is Different Than Feeling Tired
Fatigue is different than ordinary tiredness. Fatigue is disruptive and interferes with all aspects of daily living. About 10 million healthcare provider visits each year are attributed to fatigue, and many of those are tied to arthritis-related conditions.
According to the Arthritis Foundation, 98 percent of rheumatoid arthritis patients and 50 percent of people with lupus or Sjogrens syndrome report fatigue. The percentage escalates with obesity and depression, and complications of secondary conditions such as fibromyalgia, lung conditions, and cardiovascular problems.
People often feel that fatigue is inadequately addressed during healthcare provider visits, likely because there is no quick fix. The impact of fatigue is significant. Many people describe its effect on their lives as greater than pain. Fatigue is extreme weariness, overwhelming exhaustion, a feeling of being wiped-out, and having no energyeven after a nights sleep. Fatigue affects your ability to think, and its unrelenting presence can cause emotions to change quickly.
Here are 10 tips for fighting fatigue. Talk with your healthcare provider and make sure all of these issues have been addressed.
Limitations Of The Available Data
It is first worth highlighting that a range of measures exist to study fatigue within RA populations . These measures, which have been validated to a greater or lesser extent within the population, may measure various things such as the magnitude or qualities of fatigue, including severity, impact or coping , or Numerical Rating Scales ). Measures may also distinguish between mental and physical fatigue or include assessment of both the quality and type of fatigue, such as measuring physical fatigue, emotional fatigue and the social consequences of fatigue ). Finally, measures may position people on a continuum from energy to fatigue ). It is clear that the measures used may have substantial impacts on the associations observed if a predictor is differentially associated with distinct dimensions of fatigue . It is notable that few studies have used scales that capture the multidimensionality of fatigue, instead relying on single-item visual analogue scales, or numerical rating scales . Equally, there is no consistency in the definitions and measures used to capture exposures of interest and no single study has investigated all predictors of interest, making it likely that residual confounding exists and precluding the development of an evidence-based causal model/diagram of fatigue.
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Ongoing Symptoms Of Rheumatoid Arthritis
Rheumatoid arthritis is a chronic illness and people described different symptoms which they experienced whilst living with the disease, some of which were eased by the medication prescribed but others that persisted. Joint instability, inflammation and deterioration are all causes of pain and most people we interviewed had these in some form. Some people also have rheumatoid nodules which are bumps/lumps which can appear overnight on tendons and joints. Most commonly nodules on elbows and fingers were mentioned. These were not necessarily painful, sometimes disappeared on their own or required aspiration, a steroid injection or surgery for removal.People described pain in many waysâ extraordinary, incredible, absolute agony, excruciating, pumping, intolerable, burning, tingling, nervy, like toothache without the teeth, a raging fever, feet shouting at me etc. Many felt that the hardest thing about RA was having to âstruggle against the painâ, âdeal with the painâ or âmanage the painâ on a daily basis. Ongoing, âgrindingâ pain was debilitating, people couldnât tackle problems, it sapped their energy and de-motivated them.One woman talked about the pain she had had and steeling herself against the pain to go through the pain barrier. People also said they had become used to the pain, learnt to cope with it and that their pain tolerance levels had been raised. Sometimes this was bad as they didnât immediately notice more severe joint damage.
Leg Pain: Arthritis Or Peripheral Artery Disease
If you suffer from leg pain while walking, you may blame arthritis. But if the problem is peripheral artery disease , it can have serious consequences.
When fatty depositsâcalled plaqueâaccumulate in your bodys arteries, the condition is called atherosclerosis. In PAD, these fatty deposits build up in the arteries that carry blood to your legs.
Untreated, PAD can lead to gangrene and even leg amputation. Its also a warning sign that arteries in the heart and brain may be blocked, increasing your chances for heart attack and stroke.
Signs of PAD
PAD starts slowly and may go unnoticed. Discomfort can occur in the affected legs, thighs, calves, hips, buttocks, or feet. In addition to pain, other common sensations are heaviness, numbness, or aching in the leg muscles. Rest usually helps. Other symptoms include:
- Pale or bluish skin
- Lack of leg hair or toenail growth
- Sores on toes, feet, or legs that heal slowly or not at all
See your health care provider if you have any of these symptoms. PAD can be diagnosed with a simple test that measures blood flow by comparing blood pressure in your arms and legs.
Arthritis Affects Joints
Because PAD is such a serious and progressive disease, its important to know the difference between arthritis pain and symptoms that indicate blocked blood flow.
If joint pain lasts beyond three days, see a health care provider. Also get medical attention for:
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