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.
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, it’s 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.
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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Strategies To Boost Your Energy
Any plan to fight fatigue begins with taking good care of yourself. Start with these tips to help you manage chronic RA fatigue and regain energy.
1. Talk to your doctor about controlling RA inflammation. You dont need to battle fatigue on your own working with your doctor to get any underlying RA-related inflammation under control can help significantly. Cytokines proteins produced by cells can amplify inflammation, which may have a direct influence on brain receptors to cause fatigue. So the first step is to work with your rheumatologist to get inflammation under control,” Ali says. “Medications that decrease inflammation often decrease fatigue.”
Consequences Permeate Every Sphere Of Life
The consequences of fatigue permeate every part of life such that activities are reduced to a minimum or âdumbed downâ: âIt affects everything. It sort of dumbs down everything that I want to do reallyâ . Participants struggled to carry on with work, leisure, and household activities: âWell, I’ve always liked to go out to dancing, and liked night clubs, and now I find I just don’t have the energy to do that any moreâ âWhen I get home I feel as though I’ve done a week’s, what I should have done in a week, and we’ve just gone and got some groceries. I mean my husband brings it in and unpacks it and puts it all away, which I would normally do and I just collapse on a chair. It just, I don’t know, it just don’t seem rightâ .
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Ra Fatigue: How Do I Control Chronic Fatigue From Ra
Rheumatoid arthritis is a debilitating condition that causes a wide range of symptoms. One of the most prevalent symptoms experienced in suffering from rheumatoid arthritis is chronic fatigue. Fighting fatigue for rheumatoid arthritis patients seems like an ongoing uphill battle.
For those who suffer from rheumatoid arthritis, feelings of fatigue and constant tiredness can make it difficult to get through each day. But there are some ways to help beat fatigue, stay alert, and feel more rested and happy.
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.
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Social Life Hobbies And Family
The impact of RA fatigue doesnt stop at work, career, or daily responsibilities. Fatigue also finds its way into a persons social and family life. When combined with pain, many people may set aside their favorite hobbies or activities in order to rest. 59 percent* said that fatigue interfered with their family and social life.
How Can We Reduce Fatigue
Like so many things in life, its better not to go it alone. There are things that can be done by your doctor, friends, family, and even your workplace, that can help you in your day to day life.
Your doctor can:
- Suggest lifestyle changes that may improve your energy.
You can:
- Make a to-do list and cross off the least important things.
- Do some exercise exercise supports the joints.
- Eat healthy. Get your protein for strong muscles and carbs for energy.
- Check out CBT and learn how to reframe your mindset.
- Talk to your boss at work perhaps you could work from home or change your hours.
- Try to ask for help when you need it people cant always see or know when you need help.
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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 .
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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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 I’m 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 haven’t been played with for a while.
Talk To Your Doctor About Fatigue Intensity And Frequency
Fatigue is a serious symptom, so be sure to frame it to your doctor in a way that stresses the significance of this issue. As many women living with autoimmune diseases know, it can be difficult to discuss signs of disease, of which there are often many, in a specific way that is not ambiguous to a doctor. You may have to make a concerted effort to convince a doctor to take your symptoms seriously.
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What Are The Signs That Ra Is Progressing
Signs Your RA Is Progressing Flares that are intense or last a long time. Diagnosis at a young age, which means the disease has more time to become active in your body. Rheumatoid nodules bumps under your skin, often around your elbows. Active inflammation that shows up in tests of joint fluid or blood.
Try These Lifestyle Tweaks To Ease Symptoms Of Fatigue
You don’t know from tired until you’ve 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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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 Sjogren’s 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 night’s 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.
Doctors Agree On Fatigue Symptoms
Sluggish, weary, lethargic – sometimes, these words arent enough to capture how RA fatigue makes us feel. The source of fatigue is even tougher to pinpoint. Is it tiredness? Maybe I didnt get enough sleep? Did I overdo myself a few days ago? Is it all in my head? But there is a bit of good news – your doctors are listening! Although its complicated for patients to describe fatigue, doctors recognize that fatigue is a bothersome symptom of RA.
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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.
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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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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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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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.
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.
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