The inflammatory response associated with rheumatoid arthritis (RA) is systemic—meaning it affects the whole body. RA can cause a variety of symptoms, including pain, swelling, stiffness, loss of joint function—and fatigue. In fact, fatigue is one of the most common—and frustrating—symptoms of RA.
Fatigue is not the same as tiredness. Everyone feels tired now and then, but fatigue is characterized by an overwhelming lack of energy that is not relieved by sleep.
Many people with RA experience an overwhelming sense of fatigue—some describe it as paralyzing. It can have a tremendous negative impact on your energy levels, mood, social interactions, physical activity, and day-to-day life.
Unfortunately, fatigue is part of a vicious cycle—poor sleep and symptom flare can cause fatigue and in turn, fatigue can exacerbate pain and lead to more sleep disturbances.
Fatigue is often worse when RA is not under control. As such, managing fatigue hinges on managing inflammation. In fact, most doctors treat pain and inflammation, rather than treating fatigue directly. Inflamed joints zap energy. Once the inflammation is under control, fatigue tends to dissipate.
In order to manage RA-related fatigue, it’s important to work closely with your doctors to identify the underlying cause—such as pain or inflammation—and then treat it.
Preventing and Coping with Fatigue
Living with RA means finding ways to cope with fatigue. Follow these tips to keep fatigue at bay:
Sleep: Get plenty of sleep—at least seven to eight hours each night. Healthy sleep habits can help prevent fatigue and pain. For optimal sleep:
- Keep your bedroom quiet, dark, and relatively cool.
- Avoid alcohol, caffeine, nicotine, exercise, and large meals before bedtime.
- Avoid television, your phone and computers for at least an hour before bedtime.
- Create a soothing bedtime ritual, such as a warm bath or meditation before bed.
Rest: Get plenty of rest throughout the day. Build down time into your day; a simple 15-20-minute break can reenergize you. Take naps if you need them.
Time Management: Plan ahead. Set priorities for the day and create a realistic timeline for accomplishing them.
Pace Yourself: Overdoing it is a surefire way to exacerbate pain and fatigue. Instead, pace yourself and try not to take on too much.
Fatigue Journal: Keep a record of your activities and the associated energy levels. This will help you to track the activities that zap your energy and either avoid them or plan accordingly.
Nutrition: Food is fuel. Avoid energy-zapping foods such as refined sugars and processed foods. Instead, choose nutrient-dense foods that will help keep your blood sugar levels balanced, such as fresh fruits and vegetables, lean protein, and healthy fats. Learn more about RA and nutrition.
Stay Hydrated: Dehydration is exhausting and very taxing to the body. The best way to deal with dehydration is to prevent it. Drink plenty of water throughout the day.
Manage Pain: Pain has a way of zapping energy. Staying on top of your pain can help you to prevent fatigue. Cope with pain before it becomes severe. Learn more about managing pain.
Manage Stress: Stress can take an emotional toll on your health and exacerbate fatigue. Engage in relaxation techniques such as meditation, guided imagery, deep breathing, and laughter therapy to manage stress and fight fatigue. Learn more about relaxation techniques.
Exercise: It may seem counterintuitive, but exercise can actually boost your energy. Incorporate gentle daily exercise into your routine to keep fatigue at bay. Exercise can also help you to sleep better at night, another critical component of managing fatigue. Learn more about RA and exercise.
Sunlight: Sunlight sends waking signals to the brain and body. Aim for 30 minutes of natural sunlight each day to fight fatigue. However, it’s important to remember that some medications cause increased sensitivity to the sun. Depending on which medications you are taking, you may need to use extra caution with sun exposure.
Enlist Help: Ask for help when you need it. Enlisting your family and friends to help share responsibilities will help conserve your energy.
Let Go: Choose wisely where you spend your energy. Let go of any ideas of what you “should” be able to do. Choose to invest your energy in the things that are really important and let go of the