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.
Treating Psoriatic Arthritis And Chronic Fatigue
Treating psoriatic arthritis can help reduce fatigue as well as pain. There are several medications doctors use to treat the disease:
- Nonsteroidal anti-inflammatory medications reduce pain and swelling.
- Cortisone injections and oral steroids can quickly reduce inflammation in the short term.
- Disease-modifying antirheumatic drugs protect joints by decreasing inflammation.
- Biologics target specific parts of the immune system and block the inflammation.
Still, medications may not eliminate fatigue completely, especially during a flare. Thats a tough pill to swallow when weariness is keeping you from doing what you love.
But there are ways you can maximize the time youre feeling good. While fatigue in people with psoriatic arthritis cant be cured, it can be managed, Dr. Rosian says.
These tips can help you fight fatigue.
Fatigue In Chronic Rheumatologic Diseases
Unusual and chronic fatigue with various etiologies was described for 27 % of patients in a primary care clinic . Fatigue is common in RA, SpA, Sjögren syndrome, systemic lupus erythematosus and vasculitis, although most publications concerned fatigue in RA or SpA . In RA and SpA, the frequency of fatigue ranged from 42 % to 80 % depending on the definition and methods of assessment . For 75 % of patients with ankylosing arthritis and 50 % of those with RA, fatigue was considered severe .
Several methods of evaluation have been used to investigate fatigue in rheumatologic diseases . The simplest and quickest scale is the visual analog scale , but this is a unidirectional scale. Multidirectional scales developed to include the different aspects of fatigue are the Medical Outcomes Study Short Form 36 vitality subscale , the Functional Assessment of Chronic Illness Therapy Fatigue Scale , the Profile of Mood States, the RA-specific Multidimensional Assessment of Fatigue scale, the Multidimensional Fatigue Inventory, the Brief Fatigue Inventory, and the Fatigue Severity Scale . With the VAS scale, the mean fatigue level in patients with RA was 42.1 .
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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.
Psoriatic Arthritis And Brain Fog
Some people find that psoriatic arthritis leads to another kind of fatigue: brain fog. People have reported problems with concentration, memory and other thinking skills.
In part, this fuzzy-headed feeling may be the result of not getting enough sleep at night because of chronic pain. Its also possible that the inflammation caused by psoriatic arthritis may affect brain function in some way.
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Possible Factors Involved In Fatigue
The factors below are associated with RA fatigue, meaning each factor may cause fatiguedirectly or indirectlyor is simply correlated with it.
Disease activity Rheumatoid arthritis is an autoimmune disease that causes inflammation in the joints. The immune system cells can release substances called cytokines, proteins that act as messengers throughout the body. Rheumatoid arthritis disease activity can spur a release of cytokines that lead to inflammation that leads to joint pain and possibly fatigue.
Anemia Between 20% and 60% of people with rheumatoid arthritis have abnormally low levels of red blood cells, a condition called anemia. People with anemia may experience fatigue along with other symptoms, including but not limited to pale skin, dizziness, or irregular heartbeat.
Some people with RA experience anemia as a result of chronic inflammation. Others may experience iron deficiency anemia because of chronic use of NSAID medications for treatment of arthritis pain.4
Not everyone agrees with the idea that anemia is the cause of RA chronic fatigue. At least one study found that patients fatigue correlated with RA disease activity rather than anemia.5
Tips For Getting A Hold Of Ra Fatigue
Talk with your healthcare provider about RA fatigue. They may be able to address other health issues that contribute to fatigue like:1
- Review or adjust medications
- Discuss medications like antidepressants that may help with physical tasks during the day
- Discuss sleep aids that may help you get a good nights rest
- Suggest lifestyle changes that may improve your energy such as manageable ways to maintain physical activity
You can:1
- Make a to-do list and cross off the least important things
- Find small ways to stay physically active
- Maintain a balanced nutrition. Protein helps build strong muscles and complex carbs are great for energy
- Check out CBT to cope with the impact of fatigue on mental health
- If youre comfortable, talk to your employer about adjusting your hours
- Ask for help from a friend or family member that you trust
* Top 2 box on a 7-pt. scaleThe 8th Annual RA In America survey was conducted online from April 6 to June 25, 2020. A total of 3,511 people completed the survey.
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Describes Some Of The Pain She Has Experienced With Her Ra And How Sometimes You Need To Go
Pain also increased fatigue and people described tiredness and lack of energy as significant symptoms of RA. People had to rest more, either in the daytime or by going to bed earlier, or sometimes for much of the weekend if they worked during the week . This reduced their time to do other things particularly their social life. Pacing activity helped but often people felt they hadn’t got the will power to do things when they were feeling generally tired and unwell.
Some of those people taking anti-TNF alpha medication said they were now less tired and had more energy .
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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Its Not Just My Ra That Makes Me Feel Unwell
It has been shown that many people with RA dont take their treatment as prescribed because of side effects including: 7,8
- Nausea
- Hair loss
- Skin rashes
This can result in reduced disease control and increased pain or other symptoms.9,10 People living with RA should speak with their doctor about their options.
Cytokines And Rheumatoid Arthritis Fatigue
Likely, there are multiple contributing factors. Most suspicious-sounding to me are the cytokines. These are chemicals which some scientists believe cause the fatigue of colds and flu. They are the chemical messengers of the immune system. There are over 150 different kinds of these protein-based molecules.
These chemicals are used by cells as a means of communication. Cells can talk to each other through cytokines, but in people with Rheumatoid Arthritis, excess amounts of them are produced and dumped off into the bloodstream. Some theorize that cytokines cause several RA symptoms, including fatigue, anemia, sleep problems, and skeletal muscle shrinkage .
One reason that Im willing to blame the cytokines is that they are reduced by TNF blocking medications . And guess what results? Yes, usually fatigue is lessened. This is one of the reasons that fatigue is said by some to mirror disease activity or reflect inflammation levels: when medications slow inflammation, fatigue tends to improve.
The fatigue of Rheumatoid Arthritis is not caused by exertion. However, activity can aggravate it. It sounds like heads I win tails you lose. Rest is critical to surviving life with Rheumatoid Arthritis, but it will not necessarily prevent fatigue.
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How Chronic Fatigue Affects You
Fatigue can be a serious and debilitating symptom of rheumatoid arthritis. Those who suffer from chronic fatigue report that it makes them feel so physically exhausted that everyday tasks of life become a burden. They report that their limbs feel heavy, weak and are difficult to move.
Fatigue also affects ones ability to focus, making it difficult to perform daily tasks at home, work or school. It may also be challenging to pay attention during conversations. Chronic Fatigue can lead to decreased workplace productivity, social isolation, and depression.
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.
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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.
Try These Lifestyle Tweaks To Ease Symptoms Of Fatigue
You dont know from tired until youve dealt with a condition like rheumatoid arthritis . As many as 98 percent of people with RA report energy-sapping fatigue, according to the Arthritis Foundation.
Debilitating exhaustion is also common with conditions like fibromyalgia, depression, and, of course, chronic fatigue syndrome. Like rheumatoid arthritis pain, RA fatigue is a legitimate, real symptom, a common complaint that drives people living with these diseases to the doctor.
While you should discuss treatment changes that may improve your symptoms with your doctor, it is worth considering your own routine, too. As it turns out, a few little lifestyle changes can go a long way toward boosting energy levels and helping to ease rheumatoid arthritis symptoms for some people.
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Ways To Fight Chronic Fatigue
Fighting fatigue for rheumatoid arthritis patients can be a challenge. However, there are some ways to improve your energy levels and lessen chronic fatigue. Here are some of the things you can do to help fight chronic fatigue in your daily life:
- Exercise regularly
- Rule out medication side effects
- Seek counseling and support
Causes Of Fatigue In Arthritis
Inflammation, pain, inactivity and lifestyle factors can cause extreme tiredness when living with arthritis.
Everyone gets worn out from time to time. But exhaustion that disrupts your daily life and doesnt get better after a good nights sleep has its own medical term: fatigue. Fatigue significantly affects the quality of life for people with many forms of arthritis-related diseases, includingrheumatoid arthritis,psoriatic arthritis, spondyloarthritis, lupus, fibromyalgia andosteoarthritis. Your lack of energy may be caused by your inflammatory disease and other health conditions you have, as well asmedications side effectsand lifestyle habits.
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Make The Most Of Your Energy
RA symptoms such as joint pain and stiffness can make it challenging to carry out daily tasks. The extra energy you spend may leave you exhausted. One approach to beating this kind of fatigue is to learn how to conserve energy. You can take many different steps to become smarter about how you use your energy and more efficient in carrying out tasks:3,4
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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Can Vitamin B12 Help Arthritis
Vitamin B complex is a type of non-antioxidant vitamin. We dont fully understand how this type of vitamin may treat arthritis-related conditions, but evidence from trials suggests that vitamins B3, B9 and B12 might be of some benefit for treating osteoarthritis, particularly in improving joint mobility and hand grip.
What Do Ra Fevers Feel Like
For some people with RA, periods of active disease may bring many systemic symptoms including fatigue, appetite loss, and low-grade fever alongside the typical joint pain, swelling, and stiffness. This fever may be accompanied by other unpleasant, flu-like feelings.
One myRAteam member described fever as one of the symptoms they experience during a flare: I started having a flare-up, they wrote, adding that they had started to feel the deep-down bone ache, the never-ending exhaustion, and fever. As another member shared, fever seemed to exacerbate other RA symptoms: The low fevers seem to magnify the pain for me miserable.
Some myRAteam members have fevers that last for consecutive days. Does anyone else get random fevers that last, say, an evening or two? wrote one member. It lasted two separate evenings in one week, then I felt better the next morning.
This member went on to describe the frequency and duration of their fevers: I have the fever about once every month or two. Itll go from 101 to 103. It will last about 10 or 12 hours, then the fever breaks, and Im OK. Another member found that their fevers have lasted even longer, asking others, Has anyone else had a problem with running a fever for weeks at a time?
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Can Rheumatoid Arthritis Cause Fatigue
Kebede doesnt just treat patients with rheumatoid arthritis she has it herself. From a productivity standpoint, they can function in their home, remain independent, continue to go to work.” The cause of the disease is not yet known,
Types of Peripheral Neuropathy Inflammatory. The cause of rheumatoid arthritis is unknown, Fatigue, at times accompanied.
What is Rheumatoid Arthritis | Causes, Signs & Symptoms Find information about rheumatoid arthritis including what causes it, some common signs and symptoms, and how it can damage joints over time.
When your rheumatoid arthritis leaves you feeling drained, reboot your energy levels with the right moves. Exercise, healthy food, and good sleep habits are secret weapons in your fight against fatigue. Move Your Muscles. It might seem counter-intuitive, but regular exercise can help you strike back against extreme.
Learn more about the symptoms and signs of rheumatoid arthritis. Fatigue and arthritis. UK fund research into the cause, treatment and cure of arthritis.
Once you recognize possible causes of your fatigue, write them down and discuss with your doctor. The two of you can come up with a comprehensive plan so you have the energy you need. The plan to regain your vigor may include medication and lifestyle changes.
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