Reason : Your Brain Is On Overdrive
For patients new to RA, there can be a lot of emotions tied to the initial diagnosis. First, theres the overwhelming nature of this disease, which can have so many painful and scary physical effects. Then theres the realization that this is a long-term condition, which Dr. Greer says can weigh heavily on the minds of patients. While a rheumatologist will be the principal provider for RA care, there are times when a specialistperhaps a psychologist or psychiatristshould be consulted to ensure well-rounded care.
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.
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.
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The Causes Of Rheumatoid Arthritis Fatigue
by Patient Advocate
You wake up exhausted, drag yourself through the day, and keel over into bed with nothing left. This is rheumatoid arthritis fatigue. Many of us have been known to say that the pain is bad, but the fatigue is almost worse.
We are not talking about just being tired. RA fatigue is pervasive. To make others understand what it feels like, you can liken it to the fatigue that people feel when they have the flu. An editorial in the journal Rheumatologydefined fatigue as physical and/or mental exhaustion that leads to a marked impairment in normal activities, whether mental, physical, domestic, social, or occupational. It is not improved substantially by bed rest and may be worsened by normal levels of physical or mental activity.
Living with a chronic illness is exhausting, and chronic pain certainly contributes to feeling like a wrung- out dishcloth. However, there is also a biological reason for RA fatigue.
Understanding RA fatigue
At the 2015 annual Congress of the European League Against Rheumatism it was reported that not only is there a biological basis for the fatigue experienced by people with rheumatic conditions, such as RA, but that this fatigue is also gene regulated. A Norwegian researcher presented the results of a study, stating his belief that interleukin 1 beta is the fatigue cytokine.
What you can do about RA fatigue
But this isnt the case for everyone. In fact, levels of fatigue are not always associated with the level of inflammation.
Ethics Approval And Consent To Participate
Ethical approvals for the original studies, and further use of data , were obtained from the Ethics Committee of the State Chamber of Physicians . Consent to participate was obtained from all participants at the time of recruitment to each trial. At the time of recruitment, participants also provided consent for their data to be stored and used further without naming names .
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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 .
Is Sleep A Factor
Some studies report an apparent association between the number of sleep problems one has and the level of fatigue. However, other studies indicate that a relationship between sleep problems and fatigue isnt significant.
This means that a person with RA can get enough sleep, or even quality sleep, and still experience fatigue.
Whats known is that fatigue can impact prognosis and it also seems that lifestyle changes can help people better cope with and manage fatigue.
A study published in August stated that Fatigue is a key contributor to increased clinical care costs, primary care consultations, and employment loss. Despite this, our understanding of the prognostic of factors of poor fatigue outcomes is lacking and fatigue is poorly managed.
The available data appears to implicate generic factors such as pain, mental health, disability, and sleep as consistent predictors of fatigue outcome while the role of disease activity and inflammation seems less clear, the study authors wrote. However, the existing data are not without methodological limitations and there have been no specific studies primarily designed to investigate the inflammatory biomarkers of fatigue.
The researchers also found that broad factors such as disability, mood, and pain appear to amplify or drive fatigue in people with rheumatoid arthritis.
Fatigue also plays a role in a persons ability to keep working.
Another vicious cycle is that of exercise.
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Why Does Rheumatoid Arthritis Cause Fatigue
The occurrence of fatigue can vary from person to person. It may last only a short time or a long time and it may be predictable with specific trigger or may strike at any time . Overall, it can be a sign of many different health problems. It also can be a consequence of chronic rheumatoid arthritis , how and why?
Fatigue is a common symptom in RA
It is a common cause that makes many people to visit their doctors. If you have RA and often complain about feeling of tiredness, you are not alone. Most sufferers with this chronic joint disease report that they experience fatigue.
Actually, it is a vague symptom, because there are so many people with lots of different medical conditions experience it. So, finding the cause is not always easy.
Moreover, it is also not easy to describe. In general, if you experience too low energy even though after a full nights rest, you may have it.
However, sometimes it is not only about the normal need of the body for rest! In other words, there are lots of factors attribute to fatigue.
Why and how does RA cause fatigue?
Various chronic conditions can lead to come and go symptoms. And in RA, the symptom like fatigue could be chronic or long-lasting. It also can become unwarranted since many times it is not preceded by certain trigger , and even sometimes it flares when the joints are not painful or feeling good!
Pain and poor function in the affected joints
Systemic inflammation
Poor sleep
Reason : Its A Byproduct Of Ra
Eighty percent of RA patients experience significant fatigue. The reason: RA causes the body to make inflammatory proteins, called Tumor Necrosis Factor, or TNF, and weve known for a very long time that they cause fatigue,, says Jonathan M. Greer, M.D., a rheumatology and internal medicine specialist in Palm Beach County, FL, and assistant clinical professor of medicine at both Nova Southeastern University and the University of Miami. But that doesnt mean all is lost. A Rheumatology study found that patients receiving anti-TNF therapies experienced clinically important improvements in RA-related fatigue.
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Reason : Youre Not Sleeping
Whether youre in pain or worried about complications related to your diagnosis, know that insomnia is common in RA patients. Virtually all of my patients suffer with chronic fatigue during bouts of active rheumatoid disease, says Robert G. Hylland, M.D., assistant clinical professor of medicine at Michigan State University College of Osteopathic Medicine in North Shores, MI. He suggests examining your sleep habits and discussing the possibility of using sleep medication with your physician. And if youre prone to worry and guilt, ask to be referred to a cognitive behavioral therapist, he advises.
Try Yoga With Plenty Of Quick Movements
Similar to walking, you may want to do some yoga only when you feel up to it and not push yourself too hard on days when you’re experiencing severe RA fatigue. Jewell says practicing vinyasa yoga energizes her because it includes plenty of quick movements. When there is a bit more movement and joint mobility in the practice, I get a huge boost of energy after my yoga sessions, she says. But, she points out, if she does slower, more restorative-style yoga, then she feels relaxed and ready for bed. There are plenty of virtual classes in a variety of yoga styles and class length, so getting started may feel a bit overwhelming. This list of the 20 best YouTube yoga accounts describes what youll find on each channel and is a good place to get started.
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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.
Take Breaks When You Need Them
If you do too much exercise or do it too intensely, it can sometimes backfire. It could leave you more tired than when you started. And if you’re in the middle of an RA flare-up, even normal activities may be too much for your body to handle.
“There are enormous benefits to what I would call common sense,” says Susan Goodman, MD, associate professor of clinical medicine at Weill Cornell Medical School. “If you’re exhausted just doing the housework, get someone to help. If you’re feeling really run down, take a nap or a day off of work.”
You can also use devices to help you get around more easily, like a walking cane or a brace, which take stress off your joints and may help you feel less worn-out.
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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.
What Is Ra Fatigue
Fatigue is a general state of physical or mental exhaustion. When someone is fatigued, they are tired and drained, and accomplishing even the simplest tasks can seem nearly impossible.
Fatigue is a relatively common symptom of RA and there are several ways this symptom can manifest:
- Abnormal and extreme whole-body exhaustion
- Physical tiredness or weakness, not related exertion
- Ongoing fatigue lasting more than a month
- Fatigue that is not resolvable by sleep or rest
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Accepting Fatigue As A Symptom Of Disease
Domingues notes, One thing I usually recommend to my patients is accepting fatigue as part of their disease in the same way that joint pain is a feature. By accepting it, patients will try to find a way to better deal with it. Afternoon naps are very useful in recharging the battery and providing an extra boost in energy to carry out the day. Some of my patients with lupus will plan their day and place a slot for 25 minutes after lunch in their schedule dedicated for a quick nap.
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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Sleep Hygiene Can Help Improve Fatigue Symptoms
Many underestimate the importance of maintaining good sleep habits. Further, poor sleep has been associated with increased levels of pain in RA and fibromyalgia. Domingues offers the following tips to chronic disease patients looking to improve their sleep hygiene:
- Only go to your bed to sleep. Do not read, watch TV, play cards, or use computers in your bed. Instead, make your bed the place where your body knows, implicitly, that it is time to sleep.
- Try minimizing exposure to plain blue light from devices such as phones and tablets. Most of the newer versions have an option for “warmer light” that kicks in at nighttime.
- Coffee is a good friend to many, but avoid caffeine intake after 6 pm.
CreakyJoints is an online community of patients and families who are looking for arthritis resources and support. Founded in 1999, it now includes more than 100,000 arthritis patients and their family members. To learn more and to join for free, go to CreakyJoints.org.
Important: The views and opinions expressed in this article are those of the author and not Everyday Health.
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Take A Midday Stretch Or Walk Break If You Can
Jewell S., a 37-year-old yoga teacher, uses her lunch break to get in some type of movement. Midday walks in the park or around my neighborhood help to refresh me and fight off fatigue and lubricate my feet, knee, and hip joints, she tells SELF. On days when she is too busy to go for a walk, Jewell takes a short stretch break instead. Sometimes is as simple as taking a tech break and doing a wrist and finger stretch. Simple movements like bending and straightening my fingers, knees, ankles, and toe joints for a few repetitions help a lot, she says.
Whenever possible, Sandra B., CEO and founder of the Rheumatoid Arthritis Foundation, takes a walk as soon as she begins to feel tired. I stop what Im doing and go for a walk, the 57-year-old tells SELF. I feel so much better once I start being active. If the weather is crummy or walking outside feels too overwhelming, then Sandra will take a few laps around her house. Just 15 minutes of movement make a difference , she says.
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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.