Talking To Your Doctor About Fatigue
There are several things that can reduce the impact of fatigue. Firstly, it helps if you can work out what could be causing it.
There arent any specific tests for fatigue. However, you can help your doctors diagnosis by writing down how you feel, what could be causing it and how its affecting your life. They may also be able to provide you with a self-assessment questionnaire to fill out.
Depending on your symptoms your doctor may recommend you have blood tests to check your fatigue hasnt been caused by another condition. If it has been, treating this condition may improve your fatigue.
There arent any specific drug treatments for fatigue. However, your doctor, physiotherapist, occupational therapist or rheumatology team, should be able to help you recognise the signs and learn to manage them.
How Is Rheumatoid Arthritis Diagnosed
Your healthcare provider may refer you to a physician who specializes in arthritis . Rheumatologists diagnose people with rheumatoid arthritis based on a combination of several factors. Theyll do a physical exam and ask you about your medical history and symptoms. Your rheumatologist will order blood tests and imaging tests.
The blood tests look for inflammation and blood proteins that are signs of rheumatoid arthritis. These may include:
- Erythrocyte sedimentation rate or sed rate confirms inflammation in your joints.
- C-reactive protein .
- About 80% of people with RA test positive for rheumatoid factor .
- About 60% to 70% of people living with rheumatoid arthritis have antibodies to cyclic citrullinated peptides .
Your rheumatologist may order imaging tests to look for signs that your joints are wearing away. Rheumatoid arthritis can cause the ends of the bones within your joints to wear down. The imaging tests may include:
In some cases, your provider may watch how you do over time before making a definitive diagnosis of rheumatoid arthritis.
Pharmacologic Treatment Of Fatigue
Pharmacological treatment of fatigue in RA has been primarily studied by treating disease activity and/or pain. Treating to a target and achieving rapid remission or very low disease state in ERA predicts lower fatigue early and later . Effective treatment in RA will only partially reduce fatigue if it is related to the disease activity in RA.
Virtually all treatments in RA will reduce fatigue, including conventional synthetic disease-modifying anti-rheumatic drugs , targeted synthetic DMARDs, biologic DMARDs and corticosteroids. The average effect of treatment on fatigue in active RA with various advanced therapies is meaningful but not large. Treatment of disease activity in RA has a small impact on fatigue, whereas physical inactivity, poor sleep and depressed mood explain most of the fatigue. Often fatigue is an exploratory outcome in trials. Medications can cause or exacerbate fatigue. A strong predictor of nonadherence to methotrexate was fatigue .
Improvement in fatigue has been related to the line of therapy in a review of abatacept trials. Abatacept improved fatigue more than placebo, and improvements in fatigue were higher in ERA compared with biologic exposed patients. More than 1500 patients from the three trials were analysed, and the authors concluded that improvement in fatigue and other outcomes such as pain, sleep and remission had poor agreement and earlier lines of therapy had more responsiveness with respect to fatigue in patients treatd with abatacept.
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What Are The Diagnostic Criteria For Rheumatoid Arthritis
Diagnostic criteria are a set of signs, symptoms and test results your provider looks for before telling you that youve got rheumatoid arthritis. Theyre based on years of research and clinical practice. Some people with RA dont have all the criteria. Generally, though, the diagnostic criteria for rheumatoid arthritis include:
- Inflammatory arthritis in two or more large joints .
- Inflammatory arthritis in smaller joints.
- Positive biomarker tests like rheumatoid factor or CCP antibodies.
- Elevated levels of CRP or an elevated sed rate.
- Your symptoms have lasted more than six weeks.
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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Fatigue Is As Daunting As Rheumatoid Arthritis Pain
Most people are aware that RA is a chronic pain condition. Managing the pain and learning to live with pain become the focus after being diagnosed with RA. Most people dont realize that, with RA, fatigue is as big of a problem as pain. Research published in the journal RMD Open suggests that fatigue in RA is a persistent problem and an unmet need. Even with improved treatment strategies, fatigue persists.
Whats The Age Of Onset For Rheumatoid Arthritis
RA usually starts to develop between the ages of 30 and 60. But anyone can develop rheumatoid arthritis. In children and young adults usually between the ages of 16 and 40 its called young-onset rheumatoid arthritis . In people who develop symptoms after they turn 60, its called later-onset rheumatoid arthritis .
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How To Report Fatigue To Your Doctor
Patients should tell their providers exactly how chronic fatigue is disrupting their routine. Patients should be as specific as possible. For example:
I have trouble getting going in the morning
I used to cook my dinners but I dont anymore.
In addition to fatigue, patients should also identify excessive sleeping or sleeplessness. They should report if they have been told that they snore at night .
Keeping a diary, filling out a questionnaire , or using a phone app to record symptoms can help patients track fatigue levels and their changes over time. Patients can record fatigue at various times in the day to identify trends.
For example, a patient who has a high level of fatigue in the morning might have sleep issues. The more accurate patients can be in describing their fatigue, the easier it will be for doctors to assess and address it.
Symptoms Affecting The Joints
Rheumatoid arthritis is primarily a condition that affects the joints. It can cause problems in any joint in the body, although the small joints in the hands and feet are often the first to be affected.
Rheumatoid arthritis typically affects the joints symmetrically , but this is not always the case.
The main symptoms of rheumatoid arthritis affecting the joints are outlined below.
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Impact Of The Diagnosis Of Rheumatoid Arthritis On Family & Others
Rheumatoid Arthritis can be diagnosed at any age so the impact on the family can vary greatly. Sometimes a couple went to the appointment together and heard the diagnosis first hand. Most of the people we talked to had informed their close relatives soon after they returned home. Family members and friends were often not sure how to react since they knew little about rheumatoid arthritis. Few knew the difference between RA and the more common osteo-arthritis . Some relatives and friends, not in everyday contact with the person, did not understand the full effects of the disease on the person and thought it might be only short-term.
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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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.
Fatigue: The Most Misunderstood Ra Symptom
The Arthritis Foundation estimates that up to 98 percent of people with rheumatoid arthritis suffer from fatigue. The percentage grows if there are associated conditions such as fibromyalgia, obesity, or depression. In fact there is a lot of discussion about Chronic Fatigue Syndrome which is often closely associated with fibromyalgia.
A major problem with treating fatigue is that many of its symptoms, such as muscle or joint pain, can also be caused by other conditions which must be ruled out. The fact that fatigue often accompanies these conditions makes it doubly difficult to identify and treat.
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What Is The Difference
Rheumatoid arthritis vs. osteoarthritis
Rheumatoid arthritis and osteoarthritis are both common causes of pain and stiffness in joints. But they have different causes. In osteoarthritis, inflammation and injury break down your cartilage over time. In rheumatoid arthritis, your immune system attacks the lining of your joints.
Rheumatoid arthritis vs. gout
Rheumatoid arthritis and gout are both painful types of arthritis. Gout symptoms include intense pain, redness, stiffness, swelling and warmth in your big toe or other joints. In gout, uric acid crystals cause inflammation. In rheumatoid arthritis, its your immune system that causes joint damage.
Increase Your Physical Activity
Adding some gentle exercises to your day can increase the amount of energy you have.
Staying active increases your fitness levels and strengthens your muscles. Weak muscles use more energy, so doing too little can be as damaging as doing too much.
Exercise also increases your circulation and improves the health of vital organs, such as your heart and lungs, which can also give you more energy.
Its important to give yourself time to recover after exercise by taking a break before you move onto your next activity.
When you start exercising
Introducing more physical activity to your day may be tiring at first. Dont overdo it, start your activity slowly, perhaps just add a 510 minute walk or some gentle stretching exercises to begin with.
If youre in pain you can take painkillers before you exercise.
Gradually build up the amount of activity you do. For example, when youre ready, walk for 5 more minutes or add some strengthening exercises to your routine.
Generally, the best way to build up your fitness levels is to do a little exercise as often as you can. Stick with it because as you get fitter youll start to feel better, stronger and more energetic.
You could try using a step counter such as a fitness tracker, a pedometer, or a mobile phone app. When youre ready and depending on how youre feeling, you could try to beat your previous records.
You should aim to exercise every day. But be aware some days will be easier than others.
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How To Stop An Arthritis Flare Up
Is heat or cold better for arthritis pain?. Lets consider some arthritis flare triggers and how to manage your pain.. If the pain persists, prescription medications or pain injections may be necessary.. If youre experiencing a mild flare-up in a joint youre used to experiencing pain, your doctor may be able to help you manage that pain by prescribing medications over the phone but only if he or she is already familiar with you and your condition.. Also Check: Symptoms Of Severe Arthritis. Working with your doctor is important when you have an arthritis flare.. References Rheumatoid Arthritis Flares: How to reduce them and tips to manage them. A knee joint affected by arthritis may be swollen and painful.. Other signs and symptoms of osteoarthritis of the knee may include:. Recommended Reading: What Makes Rheumatoid Arthritis Worse. When you experience a flare-up, a joint or joints may swell or become more swollen you may even feel more pain and stiffness, especially in the morning then your body may feel more fatigued.. There are ways to deal with your flare-ups, here are three steps you may want to take to help yourself when you have an arthritis flare-up.
Can Physical Activity Help To Lessen Fatigue
Some people who have try to get fitter by doing gentle physical exercise, with the aim of fighting the exhaustion that way. A number of different activities are well-suited for this, including stretching and strengthening exercises, yoga, tai chi, brisk walking, cycling, water aerobics and swimming. These activities may also be done in specialized exercise therapy.
An analysis summarizing the research on different types of exercise shows that physical activity can help reduce . About 15 out of 100 people felt less exhausted after exercising. It’s still not clear what form of exercise would be most suitable, though.
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What Causes Rheumatoid Arthritis
The exact cause of rheumatoid arthritis is unknown. Researchers think its caused by a combination of genetics, hormones and environmental factors.
Normally, your immune system protects your body from disease. With rheumatoid arthritis, something triggers your immune system to attack your joints. An infection, smoking or physical or emotional stress may be triggering.
Is rheumatoid arthritis genetic?
Scientists have studied many genes as potential risk factors for RA. Certain genetic variations and non-genetic factors contribute to your risk of developing rheumatoid arthritis. Non-genetic factors include sex and exposure to irritants and pollutants.
People born with variations in the human leukocyte antigen genes are more likely to develop rheumatoid arthritis. HLA genes help your immune system tell the difference between proteins your body makes and proteins from invaders like viruses and bacteria.
Lets Dig Into Everything About Ra
Rheumatoid arthritis is a chronic autoimmune disease that causes pain, swelling, stiffness, and loss of function in the joints.. A rheumatologist is a medical professional who specializes in musculoskeletal and autoimmune diseases and is specially trained to handle the diagnosis and treatment of RA and other arthritis diseases .. Whereas rheumatoid arthritis is an autoimmune disease that causes joint malfunction due to inflammation, osteoarthritis is a mechanical disease brought on by the destruction of joints through wear and tear.. Joint pain and stiffness Knobby swelling at the joint site Grinding or cracking noises at joint site during movement Decreased joint function. While rheumatoid arthritis occurs symmetrically in the bodymeaning that when a joint on one side is affected, the joint on the other side will likely be affected as wellosteoarthritis does not occur symmetrically in the body.
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Ra Is Not Osteoarthritis
Rheumatoid arthritis is an autoimmune disorder. My immune system is confused and does not work correctly in my body. RA causes joint erosion and deformity. RA not only attacks my joints but also can attack various body systems and organs. The disease is very unpredictable when it affects a person.
Please do not confuse rheumatoid arthritis with osteoarthritis. They both are very debilitating and very different diseases. RA is not a result of the aging process. It is not just a joint issue, but an issue with my immune system. This disease affects my joints, my body systems, and my organs.
Tells How It Affected Her Daughter Age 9 And How She Explained It Wasnt Life Threatening
One woman told her relatives and friends but tried to hide the full symptoms and problems it was causing and put on an act until she got behind her own front door. Not until family members spent some time with her did they realise what impact the disease was having. Another young woman appreciated the encouragement and support from others that helped her get over her own shock at the diagnosis.
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How Do People Cope With Exhaustion
Many people gradually come to learn how to regulate their energy better and to accept the changes associated with the condition. They pay more attention to their body’s signals and then adjust what kinds of activities they do based on their symptoms.
As well as the phases where the arthritis gets much worse, there are also periods where it’s possible to live a quite normal life. It often helps to start seeing the condition as a part of your life and to set new goals that you can still achieve anyway. Some people say that the disease has helped them to live their lives more consciously.
Many mention in interviews that they’ve discovered practical ways of dealing with :
- Learn to say “no” sometimes
- Don’t plan to do too much at once
- Reconsider and adapt your goals
- Plan activities carefully, take your time, spread out demanding tasks across the week.
- Take breaks before you become too exhausted
- Get to bed early, take naps and learn relaxation techniques
- Avoid going out at busy times of the day, for instance when you go shopping or on a trip
- Talk with others about your disease so that they can better understand how it affects you
- Talk to others who have rheumatoid arthritis so that you can learn from their experiences