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.
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.
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.4Klippel JH et al, eds. Primer on Rheumatic Diseases, 13th edition. Springer. 2008.
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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.
Many Ra Patients Who Take Mtx Want To Know If They Can Help Their Fatigue By Stopping The Medication To Find Out We Conducted A Study Involving 1082 Ra Patients
Methotrexate is one of the most common drugs used to treat Rheumatoid Arthritis . It is also used to treat many other diseases, and in much higher doses it can also be used to treat cancers of certain types. Even though MTX is effective in reducing pain and joint damage and improving joint function, patients taking MTX commonly report experiencing fatigue. And it isnt just a feeling of being tired. CreakyJoints Facebook community describes fatigue as influenza without end and exhausted by exhaustion!
It is no surprise that many RA patients who take MTX want to know if they can help their fatigue by stopping the medication.
To find out, we conducted a study involving 1,082 RA patients and compared levels of fatigue among those taking different combinations of MTX and biologic disease modifying antirheumatic drugs .
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Fatigue Is Different Than Feeling Tired
Fatigue is different than ordinary tiredness. Fatigue is disruptive and interferes with all aspects of daily living. About 10 million healthcare provider visits each year are attributed to fatigue, and many of those are tied to arthritis-related conditions.
According to the Arthritis Foundation, 98 percent of rheumatoid arthritis patients and 50 percent of people with lupus or Sjogrens syndrome report fatigue. The percentage escalates with obesity and depression, and complications of secondary conditions such as fibromyalgia, lung conditions, and cardiovascular problems.
People often feel that fatigue is inadequately addressed during healthcare provider visits, likely because there is no quick fix. The impact of fatigue is significant. Many people describe its effect on their lives as greater than pain. Fatigue is extreme weariness, overwhelming exhaustion, a feeling of being wiped-out, and having no energyeven after a nights sleep. Fatigue affects your ability to think, and its unrelenting presence can cause emotions to change quickly.
Here are 10 tips for fighting fatigue. Talk with your healthcare provider and make sure all of these issues have been addressed.
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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When To Get Medical Advice
See a GP if you think you have symptoms of rheumatoid arthritis, so they can try to identify the underlying cause.
Diagnosing rheumatoid arthritis quickly is important, because early treatment can prevent it getting worse and reduce the risk of joint damage.
Find out more about diagnosing rheumatoid arthritis.
Fighting The Fatigue Of Ra
Symptoms of rheumatoid arthritis dont stop at joint pain and swelling. Most people with RA also experience mental and physical exhaustion, a symptom known as fatigue. Studies show that up to 80% of people with RA have at least some sense of feeling run down, and more than 50% have high levels of fatigue.
Terence Starz, MD, a rheumatologist at the University of Pittsburgh Medical Center, says the feeling can be described as overwhelming or different from just being tired because it is extreme and seems to come from nowhere. In fact, fatigue may have a greater impact on daily life than pain.
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Balance Rest With Activity
Everyone needs to allow time for rest, and when you have RA, getting adequate rest is particularly important. However, its still important to be active.
Doing too little can also lead to fatigue, according to the Arthritis Foundation. Do some light exercise every day to help keep your joints in shape and to avoid muscle deconditioning.
This showed that physical activity can help people with RA manage fatigue. Regular exercise also can make it easier to get a good nights sleep.
Comparison Of Fatigue As A Predictor Of Work Disability Between Ra And As
The most consistent predictive factor for both populations was the baseline level of the predicted work outcome. Otherwise, although overall fatigue was a commonly identified independently significant predictor of work disability in both RA and AS patients, its effect appears more prominent among RA patients in relation to other putative predictors while, in AS patients, the effect of anxiety/depression was relatively stronger. In contrast, other variables such as disease activity and pain did not appear to be important in these study samples.
When considering the associations between fatigue and the different work disability components, both similarities and differences existed across RA and AS patients. For both diseases, fatigue was associated with presenteeism and activity impairment . However, fatigue was identified as a significant predictor of all four work disability components under investigation in our RA population, while fatigue was not identified as an independent predictor of absenteeism or work productivity loss among AS patients. In both studies, no interactions between fatigue and visit were significant, suggesting a consistent effect of fatigue over the following 12-month period.
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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.
What Else Causes Fatigue
Some lifestyle habits can make you feel tired. Here are some things that may be draining your energy:
- Staying up too late. A good night’s sleep is important to feeling refreshed and energetic. Try going to bed and waking up at the same time every day.
- Having too much caffeine. Drinking caffeinated drinks like soda, tea, or coffee late in the day can keep you from getting a good night’s sleep. Limit the amount of caffeine you have during the day and avoid it in the evening.
- Drinking too much alcohol.Alcohol changes the way you think and act. It may also interact with your medicines.
- Eating junk food. Say “no thanks” to food with empty calories, like fried foods and sweets, which have few nutrients and are high in fat and sugars. Choose nutritious foods to get the energy you need to do the things you enjoy.
- Getting too little or too much exercise. Regular exercise can boost your energy levels, but dont overdo it.
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Tips To Manage Rheumatoid Arthritis Fatigue
- People with rheumatoid arthritis experience significantly more fatigue than the general population.
- Lifestyle changes such as exercise and a healthy diet may help relieve RA fatigue.
- Good communication with your doctor can help ensure you are getting the care you need to fight RA fatigue.
Many people with rheumatoid arthritis are eager for tips to help manage fatigue, one of the most commonly reported RA symptoms. In fact, more than 33,000 myRAteam members report experiencing fatigue, which can have a significant impact on quality of life.
Ive been very tired and fatigued . How do you all deal with fatigue? Any tips? one myRAteam member asked. Sometimes I think the fatigue is worse than the pain, another member wrote.
Fatigue from RA can lead to drowsiness, exhaustion, difficulty concentrating, and physical weakness. RA fatigue is much more than ordinary tiredness and can be both physically and emotionally draining. Chronic fatigue from RA can impact mental health and make daily life and physical activity overwhelming. People with RA experience fatigue levels between four and eight times higher than the general public.
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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Talk About How Youre Feeling
Fatigue can make you feel low or depressed. Talking about how you feel can really help. Dont keep your feelings to yourself. Try to talk to a member of your healthcare team, members of a support group, your family or friends.
There are things that can help if youre feeling low. Your healthcare team may recommend a talking therapy, such as cognitive behaviour therapy also known as CBT. You can do it as one-to-one or group sessions.
Talking therapies aim to help people change the way they see their condition and any negative feelings towards it. Sessions, led by trained therapists, can help people change the way they react to and feel about their condition by making positive changes to the way they think and behave.
NHS England has a dedicated programme called Improving Access to Psychological Therapies, known as IAPT. It aims to connect people with anxiety and depression to local talking therapy services. You can refer yourself to this service by visiting the NHS England website and searching for IAPT or ask a health professional to refer you.
Health services in Scotland, Wales and Northern Ireland dont currently offer a self-referral service, but you can ask your doctor to refer you to a local NHS therapy service or group.
Joining a support group for people living with similar conditions can help you talk openly about your problems with people in similar situations. They may also be able to share tips on how to get around some of your problems.
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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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 .