How Long A Flare Lasts
The length of a flare varies, and can be different for different people. Some may experience it for a year, months, or days. A flare can last as long as there isn’t a change in treatment. In one study, flares lasted longer than two weeks in 30% of participants, one to two weeks in 13%, and less than one week in 57%. Longer duration of a flare was associated with changes in disease-modifying therapy.
It’s essential to work with your healthcare provider to monitor your symptoms and tweak your treatment plan accordingly when you experience RA flares.
Patients with RA experience flares more often when noted to be in higher disease activity states than when in remission.
Lifestyle Changes To Manage Ra Fatigue
Lifestyle changes can combat RA fatigue, especially mental and emotional fatigue. A gentle exercise regimen can improve energy levels and well-being. Stretching, short walks, aquatic therapy, and yoga are all recommended exercises for people with RA. Exercise can reduce the symptoms of conditions associated with rheumatoid arthritis, such as depression and fibromyalgia.
A healthy diet also helps smooth out energy highs and lows. Lowering sugar levels and pacing meals throughout the day can help avoid reactive hypoglycemia, otherwise known as a sugar crash. One myRAteam member said, A healthy snack can give a boost my favorites for that are unsalted nuts, dried apricots, or one or two dark chocolate candies.
How Can I Help Myself
There are a number of things you can do to help manage your fatigue.
Planning your time wisely to spread your energy over the course of a day or week can help. Its also important to factor some gentle exercise into your day and to have a healthy diet.
Theres a strong link between getting enough good quality sleep and fatigue. And there are several positive steps you can take to improve your chances of sleeping well.
Stress and worry can make your fatigue feel worse, so its a good idea to spot anything that is causing you stress and try to deal with them in good time.
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Psoriatic Arthritis: Flares And Fatigue
Psoriatic arthritis might cause fatigue in several ways. In part, the disease process itself may be to blame.
When you have psoriatic arthritis, your immune system releases proteins called cytokines. Those proteins trigger inflammation throughout your body a hallmark of the disease. Researchers believe the cytokines also cause fatigue, perhaps through several different pathways in your body.
Psoriatic arthritis symptoms come and go. Sometimes, they are relatively mild. Other times, the pain and swelling become significant. Those bad periods are known as flares. And when a flare occurs, fatigue often comes along for the ride.
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What Is Ra Fatigue And What Causes It
Chronic fatigue in RA is described as having the following characteristics:
- Extremely low physical and mental energy that may be difficult to explain to other people, more than just tiredness
- Lack of motivation
A 2015 systematic review of 29 observational studies involving 21,076 patients found that the symptom most consistently associated with fatigue was a low mood . Researchers concluded that interventions focusing on mental health and perceptions of RA may be helpful for those who experience fatigue .
One literature review explained that disease activity is associated with RA fatigue. However, RA medications that reduce disease activity such as methotrexate and biologic DMARDs have small impacts on fatigue . This suggests that other factors including obesity, physical inactivity, disrupted sleep , and depression may also contribute to fatigue in RA.
One other interesting review of chronic pain and fatigue suggests that fatigue may be an adaptive evolutionary strategy that weve learned to help us rest and prevent further pain and nervous system stress . While this knowledge doesnt negate the powerful impact fatigue has on a persons quality of life, it may be comforting to know that fatigue is, from the physical bodys perspective, a healing strategy meant to keep you alive and safe.
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Consider Cognitive Behavioral Therapy
Having a chronic and unpredictable physical condition is exhausting, and it can take a toll on your emotional health. CBT, which is a form of talk therapy, teaches you to change the way you think about fatigue and changing your thinking can alter the way you feel and act.
Findings from a review published in May 2020 in the journal RMD Open suggest that RA-related fatigue may often be from causes outside the condition itself and that the best ways to reduce fatigue might be cognitive, such as cognitive behavioral therapy, as well as behavioral, such as getting exercise.
Treat Ra Fatigue By Reducing Ra Disease Activity
I believe the other part of rheumatologists not tackling fatigue head-on is that they believe if they can reduce disease activity, fatigue will also be reduced.
I personally have subscribed to that theory make RA less active and the fatigue will also be less so I was surprised to read a recent article that discussed several studies demonstrating that while biologics can be effective against disease activity , they arent always effective on addressing the debilitating effects of fatigue.
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What Causes Rheumatoid Arthritis Fatigue
Rheumatoid Arthritis fatigue is a weariness that rest cannot cure. It is tiredness without the benefit of the pleasure of activity. Over 90% of RA patients report fatigue as a symptom. It is counted second only to pain as the greatest difficulty of living with RA.
Unlike normal fatigue, pathological fatigue does not improve with rest. This kind of fatigue is seen in most acute and chronic inflammatory diseases, including arthritis
Where does this weariness come from? What causes us to feel precisely like Superman with Kryptonite pushed in his face? Does anybody know?
Stiffness In The Joints
In addition to pain, this disease causes stiffness in the affected joints. You may have difficulty getting out of bed or walking in the morning because of stiff and painful ankles, knees, or feet. This stiffness is usually worse in the mornings and can last for 45 minutes or more.
RA can also trigger swelling in the affected joints. Long-term inflammation can cause you to feel physically exhausted.
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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.
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
- you have a family history of rheumatoid arthritis
Find out more about the causes of rheumatoid arthritis.
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Schedule Naps Into Your Day If You Can
Renee A., 40, says that her fatigue comes in spurts. Some days, I wake up feeling like I can conquer the world other days I wake up feeling like a Mack truck hit me, she says. Its very difficult and it requires a lot of mental fortitude. Renee home-schools her three children and says she sometimes holds lessons in her bedroom or on the couch, which allows her to rest. If Renee doesnt take time to nap or even sit for a while, then her fatigue and other rheumatoid arthritis symptoms flare up and she feels much worse, she says. I have learned that the hard way, Renee says.
If you dont work from home, or if your schedule is packed with Zoom meetings and tight deadlines, then you may not be able to nap whenever you feel exhausted. However, if you can, lying down even for a few minutes after work may be helpful. Creaky Joints volunteer Eileen D., 35, says taking a short nap can make a big difference in her energy levels. Sometimes I need to have a quick rest. Just 20 minutes can be a lifesaver, she tells SELF. Sleeping for too long can make you feel groggyand make fatigue worseso its a good idea to nap for 1020 minutes, according to the Mayo Clinic.
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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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Funny Thing About Rheumatoid Arthritis Fatigue
I have read as many times that depression causes Rheumatoid Arthritis fatigue as I have read that fatigue causes depression. This is not a fair fight. We have to fight the fatigue while we are in a state of chemically-induced tiredness.
And we must fight back depression from an exhausted state. And how could we be anything BUT fatigued when managing such extreme pain levels over an extended time?
Other legitimate theories for explaining the fatigue of RA include anemia and nutritional deficiencies. Red blood cells can be reduced by both the disease and some of its treatments. Similarly, both Rheumatoid Arthritis and many of the medicines prescribed for it tend to curb normal appetite so nutrition may suffer. The impact of diet and nutrition in RA is being studied, including Vitamin D and potassium.
Get A Good Nights Sleep
Sleep is crucial for managing fatigue from rheumatoid arthritis. However, snoozing can be difficult. Once you fall asleep, you want to be able to stay asleep to get that restful or restorative sleep, states Dr. Rosian. But if you have a lot of joint pain, thats tricky to stay asleep. Sometimes, you might roll over and wake up.
Thats when some additional intervention might be needed to make sure you keep your pain managed before you hit the hay. When people have a lot of pain, theres nothing to distract you from the pain, says Dr. Rosian. If its important to get a good nights sleep, people might use an over-the-counter or prescription sleep aid.
Some people might benefit from taking Tylenol® for pain relief, or nonsteroidal anti-inflammatory drugs . However, you should ask your doctors before starting to take these to make sure it doesnt interact with other medications youre currently taking.
You have to balance the side effects from those, says Dr. Rosian. Your primary care doctor or your rheumatologist should know about those to monitor things like kidneys, blood pressure and blood count. These can cause stomach issues, too.
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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.
How An Ra Flare Ends
Just as the onset of the flare was marked by a gradual worsening of symptoms, the end of the flare will be marked by a gradual lessening of the severity of symptoms. Intense, constant pain will give way to less intense pain, a decrease in joint swelling, and a gradual return of movement. Additionally, as symptoms become less intense, the ability to sleep soundly returns.2
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Rheumatoid Arthritis Fatigue Is Related To Rheumatoid Disease Activity
In 2009, I read several abstracts and medical journals to see if anything new was being uncovered about the fatigue of RA. One experiment was done with mice to show how inflammation impacts the brain. Immune cells infiltrate the brain which, according to one reporter, causes the proverbial brain fog. More recent studies, reviewed in Fatigue in chronic inflammation a link to pain pathways, confirm that inflammatory activity is a likely source of fatigue symptoms in Rheumatoid Arthritis. Specifically, IL-1, IL-6, and TNF have been studied.
Evidence shows fatigue is clearly a symptom included in rheumatic diseases: in rheumatoid arthritis , it is an important outcome to evaluate according to OMERACT, and it has been associated with the Disease Activity Score in 28 joints and the Clinical Disease Activity Index.I dont know how the mice are coping, but Im sure hoping for answers because I am tired being tired. How did Superman ever solve his Kryptonite problem, by the way? It was blue Kryptonite.
Share Your Experiences With Family And Friends If You Feel Comfortable Doing So
When she really isnt up to meeting friends or family, Elisa prioritizes her health over social engagements and virtual events, instead of trying to push through the fatigue. She finds that people are more understanding when she explains why she needs to cancel plans at the last minute. I used to try to not talk about my rheumatoid arthritis very much and just come up with some reason that I needed to go home or to cut plans short, she explains. But Elisa says constantly coming up with excuses was exhausting too. Now shes just honest. I try to take the approach that I do a disservice to those around me when I dont want to share my journey, she says. Im okay with saying, I know its only 10:30 in the morning, but Ive got to shower and lie down for an hour.
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Helping People Around You Understand Fatigue
Fatigue is a major symptom of many conditions, such as arthritis often its as much of a problem as pain and inflammation. But its an invisible symptom and a lot of people avoid talking about it because they think their family, friends and colleagues wont understand.
It can be stressful if you think people around you dont understand how youre feeling. Even when you explain, some people may struggle to realise how fatigue affects you and that it stops you doing certain activities. This can be frustrating and tiring and can put a big strain on your relationships. Getting help, support and understanding from the people around you can make a huge difference.
Good communication and explaining clearly and calmly how fatigue affects you is important to help others understand.
Its ok to say that you need help with tasks around the home.
Learning to say you cant do something or go somewhere because of the way it will affect you can help. It may also reassure people that sometimes you just dont feel up to socialising and its no reflection on their company.
If people ask for your help with something, remember its ok to say no. Its ok to put yourself first.
If you find it difficult to talk about your fatigue, you could ask people to read this information.
How Can I Manage Fatigue
The good news is that there are ways you can deal with fatigue:
- Talk to your doctor. Make sure you let your doctor know if your fatigue does not improve, or is made worse by your arthritis medicines. Sometimes small changes in treatment can make major differences in how you feel.
- Exercise.Exercise is one of the best things you can do to combat fatigue. Exercise can help strengthen muscles and increase your fitness. Within a few months, you should feel an increase in strength and energy and be able to do more without getting as tired. The key to a successful exercise program is to begin gradually, listen to your body and build slowly. You may also find it helpful to get advice from a physiotherapist or exercise physiologist.
- Learn ways to get a good nights sleep.
- If pain is interfering with your sleep, talk to your doctor about learning ways to manage pain.
- Limit caffeinated drinks to five or less per day, and avoid these types of drinks after dinner.
- Try different relaxation techniques until you find one that works for you. For example, you could visualise a restful scene or focus on your breathing.
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