Rheumatoid arthritis (RA) is an inflammatory joint condition that causes joint swelling, pain, and stiffness. But those who have RA know that this autoimmune disorder also can lead to serious fatigue.
More than 50 percent of people with RA experience high levels of mental and physical exhaustion.
RA fatigue can make it hard to get through your daily activities at home and work. It may have more of an impact on your daily life than the pain associated with RA.
There are a few different factors that may contribute to RA fatigue.
The inflammation that causes joint pain and swelling may leave you feeling drained and worn down.
Being in chronic pain can also cause you to be less physically active or depressed, both of which may lead to fatigue.
Some people with RA may have trouble sleeping at night, which, over time, can cause daytime exhaustion.
RA fatigue can feel overwhelming, but there are treatments to help provide relief.
- Cognitive behavioral therapy (CBT). CBT may help with fatigue by showing you how to recognize and change negative thoughts and behaviors. One study suggests that these coping skills had a positive effect that lasted over a year for participants with RA.
- Online or in-person support groups. Sharing your experiences with others may help relieve stress and feelings of isolation. Online groups include the RA Symptoms Forum and the Rheumatoid Arthritis Support Group on Facebook.
- Methotrexate and prednisone. A recent study shows that early and intensive treatment with the drugs methotrexate and prednisone may help relieve RA fatigue and reduce systemic inflammation.
- Treating anemia. If you have anemia along with RA, an iron supplement or injections of epoetin (Epogen), a hormone that increases red blood cells, may help ease fatigue.
- Vitamins. Your doctor may suggest that you take vitamins to boost nutrient intake.
- Antidepressants. An antidepressant, such as bupropion (Wellbutrin), or a psychostimulant, such as modafinil (Provigil), may help increase your energy.
If you have RA fatigue, the following tips may help you manage it.
Don’t take it personally
Recognize that feeling tired can be a part of having RA. If you experience this symptom, understand that it’s not weakness on your part. Fatigue is something that many with RA experience.
It’s important to understand this and to make any necessary changes, rather than deny the fatigue you’re experiencing. If you’re realistic about your condition and symptoms, you’re more likely to lessen or overcome your fatigue.
Revise your schedule
Adapt your schedule to help control fatigue. How you change your daily schedule depends on your personal needs, and on your decision regarding the best time for you to rest and sleep.
For example, you might consider beginning your daily activities a few hours later than usual. By doing so, you can sleep in and may have an easier time with RA-related morning stiffness.
Another option is to plan a regular afternoon rest time. For some people with RA, a midday nap provides more energy to get through the rest of the day.
Talk with your doctor about how revising your schedule can help with your condition.
Balance rest with activity
Everyone needs to allow time for rest, and when you have RA, getting adequate rest is particularly important. However, it’s still important to be active.
Doing too little can also lead to fatigue, according to the Arthritis Foundation. Do some light exercise every day to help keep your joints in shape and to avoid muscle deconditioning.
The snooze factor
People with RA have special challenges when it comes to sleep. For example, you may experience any of the following:
- having a hard time falling asleep due to pain
- waking up from pain before you’ve gotten enough sleep
- waking up frequently while trying to sleep
Trouble sleeping at night can make you feel drowsier during the day. Consider resting and taking daytime naps.
If you’ve tried lifestyle changes, such as daily exercise and changing your sleep and rest schedule, and you still have trouble sleeping, talk to your doctor about possible sleep aids and evaluation for sleep apnea.
Individuals with RA may tire more easily than those without it, so they need to try to make choices about how to spend their time and energy efficiently.
Conserve your energy by skipping certain physically strenuous activities. This may make it easier to do other more important activities later on.
Decide which activities are your top priorities and save those things for the time of the day when you have the most energy.
While it’s not always easy to turn down things you want to do, being selective can help you conserve energy for what matters most to you.
Delegate when needed
One of the best ways to get more energy is to draw on the strength of others. Friends and loved ones can lend you their energy and support when you feel tired.
Asking for help can make it easier for you to accomplish what you need to do. If it’s difficult for you to reach out for help, think about exchanging errands with someone.
Perhaps you can ask someone to do a favor for you when you’re too tired, and you can return the favor when you have more energy.
It’s important to learn how to effectively address your RA fatigue. By following proven tips and consulting your doctor, you’ll have a better chance of managing it so you can enjoy your daily activities.