Fatigue is different than ordinary tiredness. Fatigue is disruptive and interferes with all aspects of daily living. About 10 million doctor visits each year are attributed to fatigue, and many of those are tied to arthritis-related conditions.
According to the Arthritis Foundation, 98% of rheumatoid arthritis patients and 50% 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.
Patients often feel fatigue is inadequately addressed during doctor visits, likely because there is no quick fix. The impact of fatigue is significant. Many patients describe its effect on their lives as greater than that of pain. Fatigue is extreme weariness, overwhelming exhaustion, a feeling of being "wiped-out," and having no energy -- even after a night's sleep. Fatigue affects a patient's ability to think, and its unrelenting presence can cause emotions to change quickly.
Here are 10 tips for fighting fatigue. Talk with your doctor and make sure all of these issues have been addressed.
1 - Treat Arthritis Pain and Other Symptoms
Chronic pain alone can cause fatigue. Pain also can lead to depression and mood changes that can worsen fatigue. To control fatigue, it's important to have pain well-managed. Talk to your doctor about drug and non-drug techniques for effective pain management.
Higher-than-normal levels of cytokines -- chemical messengers involved in inflammation -- have been found in the blood of patients suffering from fatigue. It's important to control inflammation and monitor active inflammation.
2 - Be Aware of Medication Side Effects
While it is necessary for most arthritis patients to take medications to treat pain and other symptoms, drowsiness is a common side effect of many of these drugs. Pain medications, some NSAIDs, DMARDs, and tricyclic antidepressants are among the medications that list drowsiness as a known side effect. If the medications are part of a daily regimen, drowsiness may add to already-present fatigue.
3 - Be Tested for Anemia
It used to be called "anemia of chronic disease," but more recently it is referred to as "anemia of inflammation." With anemia, the size and number of red blood cells is affected. Consequently, there is too little iron to bind to oxygen in the red blood cell -- causing a decrease in energy production. Have your blood tested for anemia. If present, discuss solutions with your doctor. Also be tested for any underlying conditions that might relate to fatigue.
4 - Exercise Regularly
Moderate and consistent sessions of aerobic exercise, 3 or 4 times a week for 30 to 45 minutes, will help increase your energy level. Overdoing exercise is counter-productive to your goal of increased energy and decreased fatigue. Keep it at a moderate level. Discuss a moderate exercise program with your doctor or physical therapist to ensure you are on the right track.
5 - Eat Breakfast Every Day
Your mother likely harped on this when you were a small child. Guess what -- Mom was right. When you first wake up, your blood sugar is low. Eating a proper breakfast can serve as an energy booster. Skipping breakfast drains your energy, contributing to the fatigue problem. It's important to eat nutritiously at every meal, but focus on breakfast to start your day off right.
6 - Learn How to Control Stress
When a person is under excessive stress, breathing becomes more shallow, limiting oxygen that's available to the body. Start breathing deeply to consciously ward off the effects of stress. Take 5 or 10 deep breaths when you feel stressed and fatigued. Breathing exercises and meditation are techniques you can practice any time; practicing them will arm you with the tools you need to react to stress and fatigue.
7 - Drink a Sufficient Amount of Water
Dehydration can cause a person to feel very tired or fatigued. Drinking 8 glasses of water each day should become part of your routine. It seems like such a simple thing, but hydration must be taken seriously.
8 - Develop Good Sleep Habits
There are well-known sleep tips, and you should follow them -- go to bed at the same time each night, get up at the same time each day, establish a ritual so that your body will recognize it's time to sleep (i.e., warm bath before bed, read before bed). If you still have trouble falling or staying asleep, you may wish to discuss sleep medications with your doctor.
9 - Protect Your Joints
Joint protection can reduce stress on arthritic joints and decrease pain. There are several joint protection principles which, if followed, will help to conserve energy. Use adaptive equipment to protect joints too. Good body mechanics can also help decrease fatigue.
10 - Pace, Plan, Prioritize
It's important to balance fatigue and rest, but what about those times when you must be doing something? Devise a plan for how to accomplish certain tasks. Plan for all that needs to be done. Prioritize the list and what needs to be done first. Pace yourself as you go through your prioritized list. The trick is to be organized and deal with tasks in manageable chunks.
Don't forget to schedule time for yourself. Time for something you enjoy is the only criteria. Take just a half hour or hour a day for yourself and reap the benefits.
Future Rheumatology. Fatigue in rheumatoid arthritis: from apathy to action. October 2007, Vol.2, No.5, pages 439-442.
How to Beat Fatigue. Arthritis Today Magazine. May-June 2007.