Ankylosing spondylitis and fatigue

Ankylosing spondylitis (AS) is known for complications related to inflammation of the spine. While the pain and discomfort may disrupt your daily activities, you could be contending with another debilitating side effect: fatigue.

According to the National Ankylosing Spondylitis Society, fatigue is one of the most common complaints among AS patients. Excessive tiredness can be attributed to AS itself, but it can also be a side effect.

Keep reading to learn what’s causing your fatigue and how to stop it in its tracks.

The biggest culprit behind AS-related fatigue is inflammation.

Inflamed tissues within your spine release small, protein-based chemicals called cytokines, considered to play a major role in fatigue, pain, and psychological disturbances. Cytokines, which are produced by cells in your immune system, react in your body similarly to those produced when you have a cold or flu. This is why you may feel like you have a viral illness when you really don’t.

Treating inflammation with medications can help reduce the excessive fatigue. But keep in mind that prescription drugs that contain opioids or codeine may increase tiredness.

In some cases, fatigue isn’t exclusively related to inflammation. Pain and discomfort can make it difficult to fall asleep at night, adding fuel to exhaustion. Your pain may also cause you to wake up during the night.

Here are a few ways you can ensure a more restful night’s sleep:

  • Go to bed at the same time every night, including weekends.
  • Take breaks throughout the day instead of naps.
  • Do relaxing pre-bed activities, such as deep breathing exercises.
  • Avoid sleeping in on the weekends or vacation days.
  • Take a warm bath before bed.
  • Add thicker curtains in your bedroom so the sunlight is less likely to awaken you.
  • Regulate the temperature in your bedroom.

Inflammation from AS increases your risk for anemia, a condition marked by a lack of healthy red blood cells. These cells are responsible for transporting oxygen to organs.

Fatigue is one of the first signs of anemia. Other symptoms of anemia include:

  • frequent headaches
  • dizziness
  • shortness of breath
  • pale skin

Anemia is diagnosed with a blood test. If you’re diagnosed with anemia, your doctor may prescribe an iron supplement to restore your red blood cell levels.

Your doctor will also want to make sure you don’t have ulcers or bleeding from nonsteroidal anti-inflammatory drug use or heavy menstrual periods.

A lack of energy can lead to decreased activity and trigger weight gain. Being overweight presents many long-term health concerns and can also make your AS symptoms worse.

Extra fat adds more stress to your spine and worsens inflammation. Being overweight can also make everyday tasks more difficult to complete.

If you’re still gaining weight despite eating right and exercising, talk to your doctor. You may need further testing, like thyroid function tests, to get to the root of the cause.

Weight gain often calls for changes to your diet. But when it comes to battling AS-related fatigue, dietary changes mean much more than cutting calories. Your focus should be on eating nutrient-dense foods that will keep your energy high all day.

Fill up on whole grains and carbs derived from produce rather than foods filled with sugars or refined flours. Also, swap caffeinated beverages for water. That extra latte may give you a boost now, but the caffeine, cream, and sugar will ultimately make you feel run-down.

When you’re on your last thread, working out is likely the furthest thing from your mind. Still, regular workouts can help improve energy levels and flexibility over time.

Exercise is also important for keeping your bones strong against osteoporosis, a disease that AS patients are at an increased risk of developing later in life.

Start with short walks and work your way up to longer, higher intensity exercises. Swimming is a great exercise for people with AS. Also, you may find it easier to fall asleep at night if you’ve worked out that day. Just make sure not to exercise too late in the evening as it can actually disrupt your sleep.

Because there’s no cure for AS, fighting related symptoms requires diligence. If you frequently don’t have enough energy to make it through the day, it may be time to reanalyze your current treatment plan with your doctor.

A different approach to treating AS may be enough to keep fatigue at bay. Above all else, remain positive and calm: Stress only adds to feelings of tiredness. So cut yourself some slack as you aim for more rest.