How Is Ra Treated
RA can be effectively treated and managed with medication and self-management strategies. Treatment for RA usually includes the use of medications that slow disease and prevent joint deformity, called disease-modifying antirheumatic drugs biological response modifiers are medications that are an effective second-line treatment. In addition to medications, people can manage their RA with self-management strategies proven to reduce pain and disability, allowing them to pursue the activities important to them. People with RA can relieve pain and improve joint function by learning to use five simple and effective arthritis management strategies.
Other Approaches To Managing Fatigue In Ra
One way to manage RA fatigue is to keep a schedule. Arrange your day to get the most done when you know youll have the most energy. One myRAteam member said, I do what I can in the morning because, if I don’t get my chores done early, I’m too tired in the afternoon. I try to rest more in the afternoon.
Often, the psychological anxiety of having an invisible illness a condition other people do not immediately recognize adds to the fatigue of rheumatoid arthritis. Counseling and therapy can relieve this anxiety and help you learn better ways to manage your emotions and communicate with others. Researchers have even found therapy can relieve fatigue. In a 2011 study, people with RA who participated in cognitive-behavioral therapy reported feeling less tired. They also reported better sleep.
Above all, self-care is essential to managing RA fatigue. Its OK to know your limits. Sometimes, you may simply need to stop and sit down or take a rest.
How Ra Fatigue Feels
RA fatigue can be “multidimensional, overwhelming, and unpredictable, with physical, cognitive, and emotional components,” according to a 2016 report in BMC Musculoskeletal Disorders.
RA fatigue can feel like whole-body all-over exhaustion. Some people with the condition might describe it as deep tiredness or the slowing down of the body as if you are recovering from an illness like the flu.
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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.
Diseases That Mimic Rheumatoid Arthritis
A number of diseases can be similar to rheumatoid arthritis . There is notable overlap between symptoms of RAjoint pain, stiffness, fatigueand those of RA-like rheumatic or autoimmune diseases, other types of arthritis, and some viral and bacterial infections.
Ruling out other conditions that mimic RA, such as Lyme disease, lupus, and fibromyalgia is part of diagnosing RA. This process relies on a combination of your physical examination, medical history, laboratory test results, and imaging studies.
Even after you’ve been diagnosed with RA, your healthcare providers may consider other conditions if your symptoms are still not improving, despite treatment with disease-modifying anti-rheumatic drugs .
Research published in the Annals of the Rheumatic Diseases found that more than 40% of people who were diagnosed with RA actually had a different condition.
It’s also possible that you could have RA and another condition.
Verywell Health / Hilary Allison
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What Are The Symptoms Of Rheumatoid Arthritis
The symptoms of rheumatoid arthritis include the following:
- Stiffness, especially in the morning or after sitting for long periods
Rheumatoid arthritis affects each person differently. In most people, joint symptoms may develop gradually over several years. In other people, rheumatoid arthritis may proceed rapidly. A few people may have rheumatoid arthritis for a limited period of time and then go into remission .
Cartilage normally acts as a shock absorber between the joints. Uncontrolled inflammation causes the destruction and wearing down of the cartilage, which leads to joint deformities. Eventually, the bone itself erodes, potentially leading to fusion of the joint . This process is aided by specific cells and substances of the immune system, which are produced in the joints but also circulate and cause symptoms throughout the body.
Reason : You’re Trying To Have A Social Life
For the average person, maintaining relationships and a social calendar can take a toll on energy, but RA patients have an extra layer of complexity to contend with. Theres always an issue with interpersonal relationships with your spouse, with your children, being able to go out, social interactions, and working your job, Dr. Greer says. All of those areas, if they are impaired, can lead to fatigue. All of this may culminate into the aforementioned depression, as well.
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You Might Be Aware Of Joint Pain But Its Important To Be Aware Of The Other Ra Symptoms That Can Help Clinch A Diagnosis
Aches and pains are a common part of life at every age, and can occur for many reasons an especially tough workout, too much snow shoveling, lifting something the wrong way, dancing too enthusiastically, or engaging in repetitive hand motions like typing or knitting.
But pain is also the most common symptom of rheumatoid arthritis , a chronic, inflammatory disorder in which the bodys own immune system attacks the lining of the membranes that surround the joints. According to the American College of Rheumatology, RA is the most common type of autoimmune arthritis, affecting more than 1.3 million Americans 75 percent of whom are women. The disease usually strikes first between the ages of 30 and 60.
The symptoms of RA may be obvious or not, and can sometimes mimic other diseases, especially in the early stages. The most common symptoms of RA such as pain, swelling, and tenderness around the joints tend to come on gradually. People may discount minor pains or morning achiness as just a sign of aging or indication of an overuse injury. It may take a while before someone suspects that RA is the cause of their discomfort. But rheumatoid arthritis has many other symptoms as well, and recognizing what they are can help patients get diagnosed and treated as early as possible, so they can prevent or minimize permanent damage to the joints, and lead active, less-painful lives.
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Prepare Well For A Night Of Quality Sleep To Fight Fatigue
If you want to get refreshing sleep that helps you feel less tired when you wake up, plan your evenings carefully. Avoid big meals, caffeine, and alcohol before bedtime, suggests Dr. Araujo. You should also avoid caffeine late in the day. Consider what type of media you consume in the late evening, too stimulating television shows or upsetting movies may disrupt rest. And keep in mind that while a nightcap may help you fall asleep, its likely to cause you to wake up later and distract you from a restful night. Finally, consider going to bed earlier, so that you can wake up earlier and ease into your day at a more leisurely pace.
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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.
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Why Are Ra And Fatigue Linked
Fatigue is extremely common in RA, and there are many different processes that can happen to cause it, says Laura Howe, M.D., a rheumatologist at UCHealth Rheumatology Clinic – Greeley in Greeley, CO. One main cause of fatigue is directly related to the disease process itself, in which the immune system mistakenly attacks the body, resulting in inflammation.
This is called cytokine fatigue, or autonomic nervous system fatigue, and it is the same fatigue you see in bad infections like the flu or that we are seeing with long COVID, Dr. Howe explains. Basically, the immune system goes into overdrive in RA, using up your energy to produce proteins called cytokines. Cytokine signals reach the brain and result in major mental and physical fatigue, along with reducing your motivation, according to a study in Frontiers in Immunology.
Typically, if the fatigue someone has is related to RA, the joint activity should parallel the level of fatigue, says Brett Smith, D.O., rheumatologist with Blount Memorial Physicians Group Rheumatology in Maryville, TN and East Tennessee Children’s Hospital in Knoxville. This means if your joints are in remission, you should not be experiencing high levels of fatigue that should prompt a workup for alternative causes of fatigue.
So in addition to this main type of fatigue, what are the other indirect causes of fatigue in those ? Here are some of the potential culprits:
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Rheumatoid Can Attack Your Foot And Ankle
Rheumatoid arthritis affects joints because the immune system sees your own body as an invader. Classically, the inflammation involves the joints, and these can include your foot and ankle. Thats when it can become nearly impossible to walk.
A swollen and painful ankle and foot make it hard to support your body weight while standing or walking. After all, these joints make up the supportive base for the rest of your body. Walking also involves having to move your ankle and foot, which could exacerbate any symptoms involving these joints. The swelling could also make your feet much bigger than they normally are, making it impossible to fit them into your shoes.
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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 ways 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 struggle against the pain, deal with the pain or manage the pain on a daily basis. Ongoing, grinding pain was debilitating, people couldnt 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 didnt immediately notice more severe joint damage.
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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.
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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Solve Your Sleep Problems
In a vicious cycle, RA fatigue can contribute to depression and physical inactivity, which can lead to poor sleep, which then leads to more daytime tiredness. Poor quality sleep and nighttime awakenings have been linked to fatigue in RA patients, Dr. Singh says. Improving sleep may help prevent the development of fatigue in RA. Talk to your doctor about addressing pain or other issues that may be keeping you up at night. For one patient, a solution might be a splint to wear at night so the pain of carpal tunnel doesnt keep waking them, Dr. Goodman says. Also, make sure you sleep in a cool, dark room, turning off electronics at least an hour before bedtime, and avoid caffeine.
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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
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Reason : Youre Experiencing Side Effects
Speaking of antidepressants possibly causing fatigue, medications also come with a dose of this debilitating side effect. Certain drugs, for example, beta blockers that slow down the heart rate, can cause fatigue, Dr. Greer says. What makes things worse is that even the medications prescribed to help with RA pain can also make patients tired, Dr. Cohen says. For instance, methotrexatean anti-rheumatic, is prescribed to help control active RA, but this medication may also induce fatigue by negatively impacting the bodys metabolism.
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Recognizing Rheumatoid Arthritis Fatigue
See Rheumatoid Arthritis Diagnosis
Some of the more common reasons fatigue is often underestimated and left untreated include:
Because of the above reasons, researching, recognizing and treating fatigue is difficult.5
However, patients who experience chronic fatigue are advised to report it to their health care provider as it should be addressed as part of their overall treatment plan.
- Recognizing Rheumatoid Arthritis Fatigue
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Lanas Perspective About What Rheumatoid Arthritis Feels Like
RA varies from person to person and no two people develop the disease in the same way.
For some people, RA develops gradually, and for others, there is a sudden onset with no explanation. Symptom severity varies by person, and disease progression can be mild, moderate or severe. And symptoms and progression change with time.
Some people with RA are lucky enough to experience remission, a period where disease activity stops. But for most, remission doesnt occur, and they have persistent symptoms that require aggressive treatments.
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Baseline Fatigue Severity Across Different Forms Of Early Arthritis
presents the characteristics of the studied patients. First, we studied whether the fatigue severity differed between patients presenting with RA and other forms of early arthritis. Of the 2442 patients with fatigue data at disease onset, 902 patients had RA and 1540 patients other diagnoses. A presents medians of fatigue severity for different diagnoses. Patients with SCTD and RS3PE recorded significantly more severe fatigue than patients with RA . Patient groups that experienced significantly less fatigue than patients with RA were patients with UA , PsA/SpA and septic arthritis . Four included patients were finally diagnosed with post-traumatic joint swelling these patients had a median fatigue severity of zero . Evaluating available data on the fatigue course over the first 3years of disease revealed a similar trend as for the baseline data: patients with SCTD remained more severe fatigued than patients with RA and patients with PsA/SpA and gout had less severe fatigue also during follow-up .
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