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Does ra make you tired. Rheumatoid Arthritis Fatigue: Causes, Impact, and Management Strategies

by alexxlab

How does rheumatoid arthritis-related fatigue affect daily life. What are effective strategies for managing RA fatigue. Can exercise help reduce fatigue in rheumatoid arthritis patients. What treatment options are available for RA-induced exhaustion.

Understanding Rheumatoid Arthritis and Fatigue

Rheumatoid arthritis (RA) is a chronic inflammatory condition that primarily affects the joints. However, one of its most debilitating symptoms often goes unnoticed: fatigue. This overwhelming exhaustion is more than just feeling tired; it’s a pervasive sense of physical and mental depletion that can significantly impact a person’s quality of life.

Why does RA cause such extreme fatigue? The answer lies in the body’s inflammatory response. As the immune system mistakenly attacks healthy joint tissue, it triggers a cascade of inflammatory processes throughout the body. This constant state of inflammation can lead to:

  • General physical weakness
  • Persistent drowsiness
  • Extreme exhaustion, known as “fatigue”

For many individuals with RA, fatigue is not just a side effect; it’s often described as the most challenging aspect of the disease to manage.

The Multifaceted Impact of RA Fatigue on Daily Life

How does RA fatigue differ from normal tiredness? Unlike typical exhaustion that can be remedied with rest, RA fatigue is often described as:

  • Overwhelming and uncontrollable
  • Draining all energy and motivation
  • Increasing the need for sleep
  • Impairing concentration and productivity

The far-reaching effects of this chronic fatigue can touch every aspect of a person’s life. From personal relationships to professional endeavors, the constant battle with exhaustion can lead to:

  1. Difficulty maintaining an active lifestyle
  2. Mood changes, including depression, irritability, and anxiety
  3. Challenges in planning ahead due to unpredictable symptom flares
  4. Reduced ability to engage in favorite activities or hobbies
  5. Strained relationships with family and friends
  6. Decreased sexual desire and intimacy
  7. Struggles with work performance and productivity

Strategies for Coping with RA-Induced Exhaustion

While living with RA fatigue can be challenging, many individuals have found effective ways to manage their energy levels and improve their quality of life. What are some practical strategies for coping with RA-related exhaustion?

  • Learn to prioritize and say “no” to non-essential tasks
  • Break larger tasks into smaller, manageable chunks
  • Reassess and adapt personal and professional goals
  • Implement careful planning and pacing of activities
  • Incorporate regular rest periods throughout the day
  • Establish a consistent sleep routine with early bedtimes
  • Practice relaxation techniques and stress management
  • Plan outings during less busy times to conserve energy
  • Communicate openly about RA with friends, family, and colleagues
  • Connect with other RA patients to share experiences and coping strategies

The Role of Physical Activity in Combating RA Fatigue

Is exercise beneficial for individuals experiencing RA-related fatigue? Contrary to what one might expect, gentle physical activity can actually help alleviate exhaustion in many cases. Research has shown that regular exercise can lead to reduced fatigue levels in approximately 15% of RA patients.

Which types of exercise are most suitable for individuals with RA? Some recommended activities include:

  • Stretching and strengthening exercises
  • Yoga and tai chi
  • Brisk walking
  • Cycling
  • Water aerobics
  • Swimming

While the optimal form of exercise may vary from person to person, incorporating regular physical activity into one’s routine can contribute to improved energy levels and overall well-being.

Medical Interventions for Managing RA Fatigue

When lifestyle adjustments and exercise alone are not sufficient to combat fatigue, what medical treatments can help? Healthcare providers may consider several approaches:

  1. Optimizing RA medication regimens to better control inflammation
  2. Addressing underlying conditions that may exacerbate fatigue, such as anemia or thyroid disorders
  3. Prescribing medications to target specific symptoms, like pain or depression
  4. Recommending cognitive behavioral therapy to develop coping strategies
  5. Exploring the potential benefits of complementary therapies, such as acupuncture or massage

It’s crucial for individuals with RA to work closely with their healthcare team to develop a comprehensive treatment plan that addresses both the physical symptoms of arthritis and the debilitating effects of fatigue.

The Psychological Impact of Chronic Fatigue in RA

How does persistent fatigue affect the mental health of individuals with RA? The constant battle against exhaustion can take a significant toll on emotional well-being, leading to:

  • Feelings of frustration and helplessness
  • Increased risk of depression and anxiety
  • Loss of self-esteem and confidence
  • Social isolation and withdrawal
  • Strain on personal and professional relationships

Addressing the psychological impact of RA fatigue is crucial for overall disease management. Mental health support, whether through individual counseling, support groups, or mindfulness practices, can play a vital role in helping individuals cope with the emotional challenges of living with chronic fatigue.

Navigating Work and Career Challenges with RA Fatigue

How can individuals with RA maintain their professional lives while managing fatigue? Balancing work responsibilities with the unpredictable nature of RA symptoms can be challenging, but several strategies can help:

  1. Open communication with employers about RA and its impact
  2. Exploring flexible work arrangements, such as remote work or adjusted hours
  3. Implementing ergonomic modifications to the workspace
  4. Prioritizing tasks and delegating when possible
  5. Taking regular breaks to rest and recharge
  6. Utilizing assistive technologies to increase efficiency
  7. Exploring vocational rehabilitation services if needed

By proactively addressing workplace challenges, individuals with RA can often find ways to maintain their careers while managing their health effectively.

The Importance of a Support Network

Why is a strong support system crucial for individuals dealing with RA fatigue? Living with chronic exhaustion can be isolating, but having a network of understanding friends, family, and fellow RA patients can provide:

  • Emotional support during difficult times
  • Practical assistance with daily tasks
  • Opportunities to share experiences and coping strategies
  • Motivation to maintain healthy habits and treatment plans
  • A sense of community and belonging

Encouraging open communication about RA and its impact can help strengthen relationships and ensure that individuals have the support they need to navigate the challenges of living with chronic fatigue.

Emerging Research and Future Directions in RA Fatigue Management

What new developments are on the horizon for managing RA-related fatigue? Ongoing research is exploring several promising avenues:

  1. Novel pharmaceutical interventions targeting specific fatigue pathways
  2. Advanced imaging techniques to better understand the neurological basis of RA fatigue
  3. Personalized medicine approaches to tailor treatments to individual patients
  4. Digital health technologies for real-time symptom monitoring and management
  5. Innovative rehabilitation programs combining physical and cognitive therapies

As our understanding of RA fatigue continues to evolve, new treatment options and management strategies are likely to emerge, offering hope for improved quality of life for individuals living with this challenging aspect of rheumatoid arthritis.

The Role of Diet and Nutrition in Managing RA Fatigue

Can dietary changes help alleviate fatigue in RA patients? While there is no one-size-fits-all diet for RA, certain nutritional strategies may help manage inflammation and boost energy levels:

  • Incorporating anti-inflammatory foods such as omega-3 rich fish, fruits, and vegetables
  • Reducing intake of processed foods and refined sugars
  • Ensuring adequate hydration throughout the day
  • Considering vitamin D supplementation, as deficiency is common in RA patients
  • Exploring the potential benefits of probiotics for gut health and immune function

Working with a registered dietitian who specializes in rheumatic conditions can help individuals develop a personalized nutrition plan that supports overall health and may contribute to reduced fatigue.

The Impact of Sleep Quality on RA Fatigue

How does sleep quality affect fatigue levels in RA patients? Poor sleep is common among individuals with RA and can exacerbate feelings of exhaustion. Improving sleep hygiene can have a significant impact on overall fatigue management:

  1. Establishing a consistent sleep schedule
  2. Creating a relaxing bedtime routine
  3. Optimizing the sleep environment for comfort and temperature control
  4. Limiting screen time before bed
  5. Managing pain effectively to reduce nighttime discomfort
  6. Exploring cognitive behavioral therapy for insomnia (CBT-I) if sleep problems persist

By prioritizing sleep quality, individuals with RA may find that they have more energy and resilience to face the challenges of daily life with chronic illness.

Balancing Activity and Rest: The Energy Envelope Theory

What is the Energy Envelope Theory, and how can it help manage RA fatigue? This concept suggests that individuals with chronic fatigue should aim to operate within their available energy limits to avoid overexertion and subsequent crashes. Key principles include:

  • Identifying personal energy limits through careful self-monitoring
  • Planning activities to stay within these limits
  • Gradually increasing activity levels over time as tolerated
  • Learning to recognize early signs of fatigue and responding promptly
  • Balancing periods of activity with adequate rest and recovery time

By learning to work within their energy envelope, individuals with RA can often achieve a more stable and manageable level of fatigue, leading to improved overall functioning and quality of life.

Rheumatoid arthritis: Living and dealing with fatigue – InformedHealth.org

Last Update: May 20, 2020; Next update: 2023.

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 “fatigue.” 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.

How does fatigue change your life?

Fatigue is different than normal feelings of tiredness. People describe it as being overwhelming and uncontrollable. They feel worn out and drained of energy, and sometimes even lose all interest in anything.

It can increase the need for sleep and make it hard to concentrate or do anything. Constantly feeling exhausted and not being able to maintain an active lifestyle can affect your mood too: Many people who have rheumatoid arthritis also feel depressed, irritable or anxious. These feelings can be hard for others to fully understand.

The severity of rheumatoid arthritis symptoms may vary a lot over time. This can make it difficult to plan ahead. You don’t know how you will feel the next day or whether the symptoms will get better or worse. This means that people with rheumatoid arthritis feel like they have lost control of their lives. If they are too exhausted, they may not have enough energy even for simple everyday activities or for playing with their children or grandchildren. Appointments may need to be rescheduled, and some people give up their favorite activities if they prove to be too demanding.

The effects of the disease can also change how you see yourself, as well as your role in your relationship, family or at work. Mutual give-and-take is often an important part of friendships and family relations. But rheumatoid arthritis can make it harder to continue to care for others – and may also mean that you need more and more help yourself. Fatigue can affect relationships because it becomes more difficult to carry out plans you make together. Exhaustion can also affect your sex drive.

And at work it may be difficult to accept that you can’t do as much as you used to. You might need more breaks, or certain tasks might need to be reassigned.

How do people cope with exhaustion?

Many people gradually come to learn how to regulate their energy better and to accept the changes associated with the condition. They pay more attention to their body’s signals and then adjust what kinds of activities they do based on their symptoms.

As well as the phases where the arthritis gets much worse, there are also periods where it’s possible to live a quite normal life. It often helps to start seeing the condition as a part of your life and to set new goals that you can still achieve anyway. Some people say that the disease has helped them to live their lives more consciously.

Many mention in interviews that they’ve discovered practical ways of dealing with fatigue:

  • Learn to say “no” sometimes

  • Don’t plan to do too much at once

  • Reconsider and adapt your goals

  • Plan activities carefully, take your time, spread out demanding tasks across the week.

  • Take breaks before you become too exhausted

  • Get to bed early, take naps and learn relaxation techniques

  • Avoid going out at busy times of the day, for instance when you go shopping or on a trip

  • Talk with others about your disease so that they can better understand how it affects you

  • Talk to others who have rheumatoid arthritis so that you can learn from their experiences

Can physical activity help to lessen fatigue?

Some people who have fatigue try to get fitter by doing gentle physical exercise, with the aim of fighting the exhaustion that way. A number of different activities are well-suited for this, including stretching and strengthening exercises, yoga, tai chi, brisk walking, cycling, water aerobics and swimming. These activities may also be done in specialized exercise therapy.

An analysis summarizing the research on different types of exercise shows that physical activity can help reduce fatigue. About 15 out of 100 people felt less exhausted after exercising. It’s still not clear what form of exercise would be most suitable, though.

What kind of treatment could help against fatigue?

Sometimes fatigue is still a major problem despite adjusting your daily schedule, doing physical exercise and getting support from other people. Then professional help may be an option, for instance in the form of psychological treatment or occupational therapy. Some specialized programs have been developed specifically for people who have fatigue as a result of autoimmune diseases like rheumatoid arthritis. They’re designed to do things like help you plan activities and make sure you don’t use up all of your energy at once.

Cognitive behavioral therapy (CBT) strategies can also be learned to help cope with fatigue. Some involve recognizing and then changing certain thoughts, beliefs and behaviors that make it more difficult to live with the disease.

Studies on non-drug treatments show that approaches used in occupational therapy and psychotherapy can relieve exhaustion.

Sources

  • Cramp F, Hewlett S, Almeida C, Kirwan JR, Choy EH, Chalder T et al. Non-pharmacological interventions for fatigue in rheumatoid arthritis. Cochrane Database Syst Rev 2013; (8): CD008322. [PubMed: 23975674]

  • Dures E, Kitchen K, Almeida C, Ambler N, Cliss A, Hammond A et al. “They didn’t tell us, they made us work it out ourselves”: patient perspectives of a cognitive-behavioral program for rheumatoid arthritis fatigue. Arthritis Care Res (Hoboken) 2012; 64(4): 494-501. [PubMed: 22162339]

  • Hewlett S, Cockshott Z, Byron M, Kitchen K, Tipler S, Pope D et al. Patients’ perceptions of fatigue in rheumatoid arthritis: overwhelming, uncontrollable, ignored. Arthritis Rheum 2005; 53(5): 697-702. [PubMed: 16208668]

  • Nikolaus S, Bode C, Taal E, van de Laar MA. New insights into the experience of fatigue among patients with rheumatoid arthritis: a qualitative study. Ann Rheum Dis 2010; 69(5): 895-897. [PubMed: 19854716]

  • Repping-Wuts H, Uitterhoeve R, van Riel P, van Achterberg T. Fatigue as experienced by patients with rheumatoid arthritis (RA): a qualitative study. Int J Nurs Stud 2008; 45(7): 995-1002. [PubMed: 17662291]

  • IQWiG health information is written with the aim of helping
    people understand the advantages and disadvantages of the main treatment options and health
    care services.

    Because IQWiG is a German institute, some of the information provided here is specific to the
    German health care system. The suitability of any of the described options in an individual
    case can be determined by talking to a doctor. We do not offer individual consultations.

    Our information is based on the results of good-quality studies. It is written by a
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Tips to Manage Your RA Fatigue

In this Article

 

If you have rheumatoid arthritis and struggle with fatigue, you aren’t alone. It’s a common symptom of the disease.

Fatigue is much more than just being tired. It makes you feel like you’re totally out of energy. It can be so severe that you think you have the flu.

You might feel worn out even though you haven’t done more than usual. Often, nothing seems to help, not even sleep.

Fatigue can take a toll on your body, mind, and emotions. You may feel weary, foggy, or forgetful. It might be hard to enjoy get-togethers with friends or family.

 

Why Does RA Cause Fatigue?

Antibodies that cause the inflammation of RA affect your central nervous system, not just your joints. High inflammation levels can lead to severe fatigue.

RA also causes long-term pain. It can leave you feeling worn out by the end of the day. But when your joints hurt, it’s hard to sleep. RA fatigue makes it hard to feel refreshed when you wake up in the morning.

 

When you have RA, fatigue, pain, and mood problems can become a vicious cycle. Doctors think high levels of inflammation might cause all three of these symptoms.

 

How to Manage RA Fatigue

You may need a mix of treatments, lifestyle changes, and a new attitude to keep fatigue under control.

Recognize that fatigue is a part of life with RA. You can’t always control it or predict when you’ll be too tired to work or join a social event. Listen to your body. You’ll feel better if you take the time to rest when you need to. Take breaks if you have a task that takes a lot of energy.

Tune out the guilt. Your friends and family may not really get how bad you feel. You aren’t lazy. You’re exhausted by your arthritis. Don’t feel guilty if you have to rest instead of going out or leave early because you’re too tired. Explain that fatigue is a symptom of your disease.

Don’t push yourself to keep up with everyone else. If you need help with household chores that exhaust you, ask others to give you a hand. Cut out any steps you don’t need to complete a task. Set your own pace. You decide what you can and can’t do on days when fatigue is high.

Get regular exercise. The last thing you may want to do is work out. But studies show that aerobic activity — the kind that makes your heart beat faster — cuts fatigue in people who have an immune system disorder like RA.

Exercise also strengthens the muscles around your joints, keeps your bones strong, and boosts your mood.

Start with a few minutes of brisk walking. Gradually work up to 30 minutes at least 5 times a week. Swimming or pool exercises are also good options, because the water is easy on your joints. Yoga and tai chi are two other gentle activities that help ease fatigue and lower stress.

Try to do something, even if it’s just stretching, on days when you’re really tired.

Take breaks.Don’t stay in bed. It might make you feel more tired. Instead, take regular rest breaks during the day. Find times that fit in with your life. Do you get more done in the morning? Schedule some rest at noon. Do you need energy before the kids get home from school? Take a nap shortly before they get home.

Two or three short periods of downtime may give you the boost you need.

Fuel up with the right foods. Your body gets energy from the foods you eat. Choose fresh, whole items like fruits and veggies, lean protein, dairy products, and healthy fats. Omega-3 fatty acids, found in foods like nuts and cold-water fish, help ease fatigue by easing inflammation.

Little changes can make a big difference. Eat small, healthy meals throughout the day, so you don’t feel sluggish. Go for snacks like an apple with peanut butter or tuna on whole-grain bread.

Is a cup of coffee your idea of breakfast? Choose foods that are rich in fiber, complex carbohydrates, and lean protein. A bowl of high-fiber cereal, fresh fruit, and low-fat milk can give you more energy for the rest of your day. Or try adding a hard-boiled egg, a cup of yogurt, or a banana to your morning.

Drink water. Your body needs fluids to keep going. Fatigue may be a sign that you’re dried out. Aim for about eight glasses a day. You may need more if you’re extra active or when it’s hot outside.

Stick to a sleep routine. Good habits help you get enough rest so you feel less fatigue the next day. Go to bed at the same time each night. Get up at the same time each morning. Cut back on caffeine, alcohol, and nicotine. All of these can disrupt your sleep.

When it’s time for lights-out, turn off devices like your smartphone or tablet. You’ll rest better in a dark, quiet room.

Seek counseling or therapy. Cognitive behavioral therapy or counseling with a mental health professional can ease the stress that worsens your fatigue. It can also help you control how fatigue affects your life.

Explore complementary treatments.Massage therapy often eases stress and anxiety. It helps you let go of your thoughts and get to sleep. Acupuncture also works for many people. Talk to your doctor before you take any herbal treatment or try any nonmedical therapy.

Talk to your doctor. If you’ve tried everything and still feel wiped out, let your doctor know. They can learn more about what the problem is.

It could be that you have anemia, which happens when you don’t have enough red blood cells to carry oxygen around your body.

Anemia can start up because of long-term inflammation from RA or as a side effect of your medicines. Your doctor can check to see if you have it and get you started on treatment.

Other things that can also cause fatigue include:

  • Pain
  • Depression
  • Medication side effects
  • Weakness when you lose too much muscle
  • Infections

 

© 2022 WebMD, LLC. All rights reserved.

SOURCES:

Current Rheumatology Reports: “Fatigue in Rheumatoid Arthritis.”

Hospital for Special Surgery: “Mastering the Impact of Fatigue in Rheumatoid Arthritis,”  “Mastering the Impact of Fatigue.”

Arthritis Care & Research: “Patients’ perceptions of fatigue in rheumatoid arthritis: Overwhelming, uncontrollable, ignored.”

Arthritis Research & Therapy: “Fatigue in chronic inflammation — a link to pain pathways.”

Molly’s Fund Fighting Lupus: “Chronic Fatigue Syndrome.”

Arthritis Foundation: “How to Beat Arthritis Fatigue. ”

Neuroendocrinology Letters: “In chronic fatigue syndrome, the decreased levels of omega-3 poly-unsaturated fatty acids are related to lowered serum zinc and defects in T cell activation.”

Better Health/Victoria State Government: “Breakfast.”

Pacific College of Oriental Medicine: “Massage and Chronic Fatigue.”

Alternative Therapies in Health and Medicine: “Acupuncture for chronic fatigue syndrome: a randomized, sham-controlled trial with single-blinded design.”

Arthritis Today: “Coping With Fatigue,” “Exercise as a Fatigue Treatment.” 

Annals of the Rheumatic Diseases: “Self-management of fatigue in rheumatoid arthritis: a randomised controlled trial of group cognitive-behavioural therapy.”

Prayer of the Optina elders for every day, at the beginning of the day

Prayer of the last Optina elders1

Audio:

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Lord, give me peace of mind to meet everything that the coming day brings me.
Let me completely surrender to the will of Your Holy One.
For every hour of this day, instruct and support me in everything.
Whatever news I receive during the day, teach me to accept it with a calm soul and firm conviction that everything is Thy Holy Will.
In all my words and deeds guide my thoughts and feelings.
In all unforeseen cases, do not let me forget that everything is sent down by You.
Teach me to act directly and reasonably with each member of my family, without embarrassing or upsetting anyone.
Lord, give me the strength to endure the fatigue of the coming day and all the events during the day.
Guide my will and teach me to pray, believe, hope, endure, forgive and love.
Amen.

Prayer of the Optina Elders2

Audio:

mp3″/> 3:03

Lord, give me peace of mind to face whatever the coming day brings me.
Lord, let me completely surrender to Your holy will.
Lord, for every hour of this day instruct and support me in everything.
Lord, whatever news I receive during this day, teach me to accept it with a calm soul and with the firm conviction that everything is Your holy will.
Lord, reveal to me Your holy will for me and those around me.
Lord, guide my thoughts and feelings in all my words and thoughts.
Lord, in all unforeseen cases, do not let me forget that everything is sent down by You.
Lord, teach me to properly, simply, reasonably deal with all those at home and those around me, elders, equals and juniors, so that I do not upset anyone, but help everyone for the good.
Lord, give me the strength to endure the fatigue of the coming day and all the events during the day.
Lord, guide Yourself my will and teach me to pray, hope, believe, love, endure and forgive.
Lord, do not let me be at the mercy of my enemies, but for the sake of Your holy name, lead and rule over me.
Lord, enlighten my mind and my heart to understand Your eternal and unchanging laws that govern the world, so that I, Your sinful servant, can properly serve You and my neighbors.
Lord, I thank You for everything that will happen to me, for I firmly believe that everything works for the good of those who love You.
Lord, bless all my goings and goings, deeds, words and thoughts, make me worthy to always joyfully glorify, sing and bless Thee, for Thou art blessed forever and ever.
Amen.

  • Optina Elders V.N. Lossky
  • Table: Optina Elders

1 Orthodox prayer book with prayers to the Most Holy Theotokos and saints of God. – M .: Publishing House of the Moscow Patriarchate of the Russian Orthodox Church, 2018. – 816 p.

2 The authorship of the famous “Prayer of the Optina elders” belongs to the Monk Ambrose of Optina, about which there is a corresponding narration in his life. However, some parts were brought into the prayer by the Optina Elders who lived after him.
Source: Optina Paterik. Applications. Prayers.

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