Other Sources Of Fatigue
Your fatigue is not always directly related to your arthritis disease activity, inflammation or pain. In fact according to a 2017 study published inCurrent Rheumatology Reports your fatigue level probably has more to do with other contributing factors, including obesity, physical inactivity, sleep disturbance and depression. Several of them may work together to cause your extreme tiredness, but identifying and treating even one of these factors can provide relief.
Managing Pain
How Can We Reduce Fatigue
Like so many things in life, its better not to go it alone. There are things that can be done by your doctor, friends, family, and even your workplace, that can help you in your day to day life.
Your doctor can:
- Suggest lifestyle changes that may improve your energy.
You can:
- Make a to-do list and cross off the least important things.
- Do some exercise exercise supports the joints.
- Eat healthy. Get your protein for strong muscles and carbs for energy.
- Check out CBT and learn how to reframe your mindset.
- Talk to your boss at work perhaps you could work from home or change your hours.
- Try to ask for help when you need it people cant always see or know when you need help.
How Rheumatoid Arthritis And Other Chronic Diseases Cause Fatigue Symptoms
There are many reasons why chronic disease can cause fatigue. Fatigue is extremely common and is associated with significant and oftentimes disabling consequences in patients with chronic diseases, explains Vinicius Domingues, MD, a medical adviser to CreakyJoints and a rheumatologist based in Daytona Beach, Florida. Fatigue can be related to the underlying disease, especially when it’s an inflammatory disease such as lupus and rheumatoid arthritis , or it might be a consequence to certain medications. Often, patients are anemic , which can also increase their fatigue, he says.
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Gut Health And Fatigue
The state of your gut health is directly related to how much energy you have each day, as well as your mental state. We know that a balanced microbiome with a diversity of beneficial bacteria is likely to improve energy levels and mood .
Chronic inflammation also often begins in the gut, and inflammation is another leading cause of fatigue, especially in autoimmune conditions . Inflammation can also get worse over time as the gut lining weakens from causes like an inflammatory diet, emotional stress, and environmental pollutants. These inputs continue the cycle of inflammation and fill up your metaphorical stress bucket, until the bucket overflows and symptoms manifest.
Accepting Fatigue As A Symptom Of Disease
Domingues notes, One thing I usually recommend to my patients is accepting fatigue as part of their disease in the same way that joint pain is a feature. By accepting it, patients will try to find a way to better deal with it. Afternoon naps are very useful in recharging the battery and providing an extra boost in energy to carry out the day. Some of my patients with lupus will plan their day and place a slot for 25 minutes after lunch in their schedule dedicated for a quick nap.
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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
Try Yoga With Plenty Of Quick Movements
Similar to walking, you may want to do some yoga only when you feel up to it and not push yourself too hard on days when you’re experiencing severe RA fatigue. Jewell says practicing vinyasa yoga energizes her because it includes plenty of quick movements. When there is a bit more movement and joint mobility in the practice, I get a huge boost of energy after my yoga sessions, she says. But, she points out, if she does slower, more restorative-style yoga, then she feels relaxed and ready for bed. There are plenty of virtual classes in a variety of yoga styles and class length, so getting started may feel a bit overwhelming. This list of the 20 best YouTube yoga accounts describes what youll find on each channel and is a good place to get started.
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Addressing Fatigue During An Ra Flare
Beyond chronic symptoms, an RA flare can happen due to a number of factors that trigger the immune system such as consuming reactive foods, going through a stressful period, or environmental triggers. These triggers activate the autoimmune response and increase systemic inflammation, often worsening RA symptoms like fatigue, joint pain, and possibly mental health disturbances .
When a flare happens, the cause needs to be addressed, whether thats stress, an environmental component, or something else. If youre paying close attention to your body, you may be able to get ahead of a predictable flare by doubling down on self-care and rest as soon as you notice a change in your symptoms. You can try to:
- Alternate heat/cold therapy using heating pads and cold packs on painful joints
- Take warm baths
- Practice regular, deep breathing to calm the stress response
- Try slow movement like yoga or tai chi to keep your muscles loose and prevent joint damage
- Stick to foods you know will not cause distress to your gut
- Minimize sleep disturbances and maintain a sleep schedule
- Use meditation or other mindfulness techniques to navigate any emotional responses that come up
- See a therapist to talk through whats going on
Eat Breakfast Every Day
Your mother likely harped on this when you were a small child. Guess whatMom was right. When you first wake up, your blood sugar is low. Eating a proper breakfast can serve as an energy booster. Skipping breakfast drains your energy, contributing to the fatigue problem. It’s important to eat nutritiously at every meal but focus on breakfast to start your day off right.
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The Impact Of Fatigue On Work & Career
Employment is an important part of providing for our family and loved ones. For some, their jobs and careers are a part of their identities. But when fatigue is a constant, its increasingly challenging to show up physically or even mentally. 55 percent agreed* that fatigue interferes with their responsibilities.
Because symptoms like fatigue are sometimes invisible, many in the community often feel misunderstood by their employer. As one person shares, I gave up my job because my employer did not understand or care about this disease with few physical signs to the normal person.
Get A Good Nights Sleep
Its important to try to get a good nights rest because poor sleep patterns can cause fatigue or make it worse.
If youre having trouble sleeping, or you regularly wake up feeling unrefreshed, it would probably help to look at ways you might be able to sleep better. Healthcare professionals talk about a principle called sleep hygiene, which covers things you can do to improve your chances of getting a good nights sleep.
Too much sleep can also cause fatigue. Thinking about what a good nights sleep means to you, can help. Your activity charts can tell you a lot about how youre sleeping.
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Develop Good Sleep Habits
There are well-known sleep tips, and you should follow themgo to bed at the same time each night, get up at the same time each day, establish a ritual so that your body will recognize it’s time to sleep . If you still have trouble falling or staying asleep, you may wish to discuss sleep medications with your healthcare provider.
Check In With Your Rheumatologist
If your RA isn’t under control, your fatigue wont be either. RA is a complex disease and your symptoms may change over time. Luckily, advances in treatment happen frequently and your arthritisand bonkers exhaustion!might benefit from a new or additional treatment. Although some RA drugs can cause fatigue , most RA treatments are thought to improve fatigue by improving inflammation, says Dr. Deane. If your energy level has dipped, start with a visit to your rheumatologist.
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Dealing With Inflammation Saps The Bodys Energy Levels
In addition, a study showed that 95 percent of patients with RA report suboptimal levels of energy that impact their quality of life. There is a biological explanation for it, says Dr. Domingues: When there is an inflammatory process, such as RA, lupus or ankylosing spondylitis, your immune system is constantly producing and carrying inflammation and, therefore, using energy.
Importantly, chronic fatigue syndrome, also called myalgic encephalomyelitis, or ME/CFS, differs from fatigue. ME/CFS is a complex disease characterized by extreme fatigue that is not associated with an underlying medical condition and lasts for six months or longer. Researchers dont know what causes it, but they do know that it will often worsen with physical or mental activity, according to a consensus report by the Institute of Medicine of the National Academies.
Rest Before And After Particularly Active Days Whenever Possible
Its been 12 years since Creaky Joints volunteer Elisa C., 55, was diagnosed with rheumatoid arthritis, and making sure she has plenty of downtime before and after busy days is one of the habits that have helped her most in that time.
If Im going to have a fun day with my husband at the park, I know to plan several days for that, she tells SELF. For her, that can mean doing food prep in advance and freezing meals so that she doesnt use up too much energy cooking the day before her planned activity. She also plans on having a rest day filled with naps and just taking it easy, after her activity day, Elisa says.
Although you cant always anticipate every single event that pops up, this can be helpful to try whenever you make plans in advance. Or you can try to modify this by scheduling a quick 20-minute nap or fitting in a few rest breaks whenever possible in the days after a super-hectic time.
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Therapy For Rheumatoid Arthritis
If you have rheumatoid arthritis, your doctor may recommend you to a physical or occupational therapist who can teach you stretching and strengthening exercises to help keep your joints flexible while also stretching and strengthening your muscles. In addition, the therapist will also most likely provide you with suggestions on how to modify certain activities that exacerbate Rheumatoid arthritis symptoms, such as avoiding repetitive work with your wrists and elbows.
Rheumatoid Arthritis: Living And Dealing With Fatigue
People with rheumatoid arthritis typically have several permanently inflamed joints. The inflammation inside the body can lead to general physical weakness, drowsiness and exhaustion. This feeling of extreme tiredness is also called “.” Some people find this to be the worst symptom of the disease.
Other typical symptoms are joint pain and swelling, and also joint stiffness and physical weakness later on. Non-specific symptoms like exhaustion often start earlier on in the disease. But the symptoms and course of rheumatoid arthritis can vary greatly. People also deal with the disease in different ways. Although people experience their symptoms differently and cope with the disease in different ways, there are some things that many people with rheumatoid arthritis have in common.
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Causes Of Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease. This means your immune system attacks the cells that line your joints by mistake, making the joints swollen, stiff and painful.
Over time, this can damage the joints, cartilage and nearby bone.
It’s not clear what triggers this problem with the immune system, although you’re at an increased risk if:
- you are a woman
Find out more about the causes of rheumatoid arthritis.
Symptoms Of Rheumatoid Arthritis
The symptoms of Rheumatoid Arthritis vary from one person to another and there is no known cure for this disease. It often starts with joint pain in the small and medium joints in the hands and feet, which then spreads to other joints over time. Sometimes it affects the large joints, such as hips or knees, but not always.
The severity of RA can range from mild to severe, which means that it may only affect a few joints or every joint in the body. When all joints are affected by RA, its called polyarticular disease, whereas when only a few joints are affected, its called oligoarticular disease.
RA commonly affects your hands and feet but may also occur in other parts of your body such as your elbows, knees, ankles, neck or shoulders. Rheumatoid arthritis symptoms may also occur at different times. For example, you may experience morning stiffness followed by periods of less pain and a greater range of motion as the day goes on. Also, symptoms can come and go for a short period of time before becoming more constant over time. Rheumatoid arthritis symptoms include:
Some common symptoms of RA include:
- Morning stiffness in your joints lasting longer than 30 minutes
- Joint pain or stiffness that worsens with activity
- Swelling from inflammation in your bodys tissues
- Weakness or fatigue because RA interferes with sleep patterns and restful slumber
- Tenderness, swelling or warmth in joints
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Disease Activity And Inflammation
Historically, fatigue has been perceived to be caused by disease-specific processes, such as inflammation and joint damage . Pro-inflammatory cytokines, which are pivotal to RA progression, have been linked to fatigue via sickness behaviour and it is possible that these inflammatory processes initially trigger fatigue in RA . Certainly, while the apparent response of fatigue to inflammation-focused interventions would indicate that an association between inflammatory disease activity and fatigue exists, it is now widely recognized that fatigue persists despite receiving the best available care for their disease , although anti-inflammatory pharmacological interventions do confer reductions in fatigue in subgroups of patients .
Where an association has been observed between inflammation and fatigue prognosis, it has tended to show both that higher and lower inflammation is associated with greater fatigue, depending on the study in question. Further, within a path analysis model , we found that when DAS-28 was substituted for ESR or CRP the direct relationship between disease activity and fatigue disappeared, indicating that it may be that the patient reported/influenced , which drive the associations between DAS-28 and fatigue. Overall, the balance of evidence would seem to indicate that while fatigue prognosis may be associated with composite measures of disease activity , it is not consistently predicted by traditional measures of inflammation, such as CRP or ESR .
Multiple Factors Associated With Fatigue In Rheumatoid Arthritis
Fatigue is a common symptom in patients with rheumatoidarthritis and contributes to the cost of clinical care, reasons for primarycare consultation, and even loss of employment. Patients with rheumatoidarthritis report rates of fatigue that are 4 to 8 times higher than the generalpopulation.1 In a review of current studies, however, fatigue is apoorly understood and poorly managed symptom.
While specific studies designed to investigate disease activity or the inflammatory biomarkers related to fatigue in rheumatoid arthritis are few, prognosis is generally limited to factors of pain, mental health, disability, and sleep. These general factors consistently drive outcomes of fatigue, and along with other disease-specific processes, warrant a closer look in elucidating the mechanism of fatigue. The ability to comprehensively and robustly understand the mechanism of fatigue in rheumatoid arthritis can provide insight into optimal treatment approaches, which may further benefit a number of other chronic diseases.
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What Is Ra Fatigue
Fatigue is a general state of physical or mental exhaustion. When someone is fatigued, they are tired and drained, and accomplishing even the simplest tasks can seem nearly impossible.
Fatigue is a relatively common symptom of RA and there are several ways this symptom can manifest:
- Abnormal and extreme whole-body exhaustion
- Physical tiredness or weakness, not related exertion
- Ongoing fatigue lasting more than a month
- Fatigue that is not resolvable by sleep or rest
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
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