Fatigue and arthritis

The following factors can contribute to taigue:

• The disease process – Inflammation of joints or other tissues can cause fatigue in rheumatoid arthritis. In this condition fatigue and disease activity often change together. Cytokines (chemicals found in inflamed tissues) are similar to chemicals released during viral illnesses such as colds and flu, and can cause extreme fatigue.
• Pain – especially constant pain, wears you down and can wake you up at night, contributing to tiredness.
• Your medication – Certain drugs used to treat arthritis can cause drowsiness and interfere with concentration, which may make fatigue worse.
• Weakness and wasting of the muscles – often seen in arthritis as a result of inactivity, contribute to fatigue since more effort will be required to perform certain activities.
• Anaemia – often found with inflammation, may also contribute to fatigue.
• Sleep disturbance – due to pain, anxiety or stress.
• Distress – Any chronic illness can cause distress and uncertainty about the future. This can lead to depression, which is associated not only with a low mood but also with various physical symptoms, one of which is fatigue.

• Medication for the arthritis – Drugs that control inflammation in diseases such as rheumatoid arthritis can ease pain, stiffness and fatigue.
• Diet – There are no products that have been proved to help treat fatigue in arthritis. Eating a well-balanced diet will help to provide all the vitamins you need and will also help you control your weight.
• Pacing yourself – Getting enough rest and pacing activities may help. Try to prioritise jobs so you don't need to spend time doing unnecessary tasks, and do the hardest jobs when you're feeling at your best. Simplify tasks and use appliances to make them easier.
• Exercise – People with arthritis often become unfit because of their condition. Try gradually increasing the amount and time spent exercising, and you will slowly feel an increase in well-being, strength and energy. If you are unsure about this ask a physiotherapist for advice.
• Relaxation – Taking time to relax is just as important as taking exercise. How much rest and how often will vary from person to person, but resting for 10 minutes every hour is often recommended. Learning relaxation techniques can help – or just making time for the things you enjoy.
• Sleep – There’s a lot you can do to promote a good night’s sleep:
  • Get into a routine.
  • Avoid caffeine in the evening.
  • Try to relax just before going to bed – a hot bath often helps.
  • If you are on painkillers, taking the painkiller in the evening may also help you sleep better.
  • If particular joints are troublesome, a steroid injection can prevent pain from disturbing your sleep
  • Seek the advice of an occupational therapist about splinting and supporting painful joints
  • Make sure your mattress and pillow are comfortable.
• Dealing with anxiety or depression – Even if these are a reaction to your disease, antidepressant medication might make you feel better and more energetic. If possible share your worries with someone else – it often helps to acknowledge negative feelings and thoughts.