Coping with fatigue

Fatigue is a characteristic symptom of arthritis which differs from normal feelings of tiredness. Many of us have experienced tiredness at the end of a long day but recover after a good night’s sleep.

But arthritis sufferers experience a chronic form of tiredness which remains with them in spite of how much rest they take or the amount of sleep they have. They are constantly tired or exhausted which affects their quality of life after a time.

Fatigue and exhaustion are often experienced by people with rheumatoid arthritis and fibromylagia.

The issue of fatigue is a major one which is discussed as follows:

• Causes of fatigue
• Coping with fatigue

Causes of fatigue

We know arthritis causes fatigue amongst other symptoms but how exactly does it do this?

There are various aspects of arthritis which cause this and they include:

• Side effect of medication
• Pain
• The arthritis process
• Sleep problems/insomnia
• Stress/anxiety/depression
• Muscle atrophy
• Anaemia

Side effects of medication

Many arthritis drugs cause drowsiness and/or tiredness as one of several side effects. They can impair your concentration which only worsens your fatigue.

Pain

Constant pain or episodes of pain can interfere with sleep thereby causing fatigue. Plus constant pain can be soul destroying which lowers your confidence and self-esteem, also leading to tiredness.

In many ways, the tiredness can be as much a mental issue as a physical one.

The arthritis process

Arthritis is a progressive disease which worsens over time. The joints become stiff and swollen and inflammation occurs. Pain is one of several by products of this process.

This process often causes fatigue, especially with rheumatoid arthritis and other similar forms of arthritis. This condition is characterised by periods of flare ups where the symptoms are at their most intense, followed by intervals where these symptoms ease and settle.

Chemicals are found in inflamed tissues and joints which have a similar effect to those produced during a cold or viral infection. These chemicals cause fatigue and other symptoms.

Sleep problems/insomnia

The pain, stress or anxiety caused by arthritis often disrupts the sufferer’s ability to get a good night’s sleep which results in fatigue the following day.

If you have a period of several nights of broken sleep then exhaustion can occur.

Stress and anxiety

Arthritis along with any progressive disease causes stress and anxiety. Depression is another side effect which is due to the uncertainty of this condition plus the impact it has upon the sufferer’s quality of life.

These psychological effects cause feelings of low self-worth and esteem which manifests itself as fatigue.

Muscle atrophy

Muscle wasting is a common problem with arthritis which is due to long periods of inactivity. If the muscles are not exercised or used on a daily basis then they start to shrink (atrophy) and weaken over time.

This means that they are less able to support an arthritic joint which further restricts mobility.

More effort is required to use those muscles which is tiring and leads to fatigue.

Anaemia

This is a common problem with inflammatory conditions such as rheumatoid arthritis. It causes a range of health problems which includes fatigue.

Coping with fatigue

It is difficult to quantify fatigue but one way of doing so is to use a grading system for the symptoms. If you are suffering from fatigue then speak to your GP about this as he/she can suggest ways of dealing with this.

Your GP will use this grading system as part of a questionnaire which he/she will ask you to complete. It will assess the level of your fatigue by means of intensity, duration and the effect it has on your daily activities.

In other words: how severe is this fatigue, how long does it last and does it disrupt your daily routine and by how much?

The results of this questionnaire will inform the type of treatment you receive. Treatment for arthritis related fatigue includes:

• Pace yourself during the day
• Relax
• Exercise
• Sleep
• Medication
• Self-help group/network

Pace yourself during the day

Arthritis means that you will have times when you have the energy to do things and other times when you are tired and need to rest. While it is important that you remain active and move around it is also important that you do not overdo this.

So look at ways of making your daily tasks easier. Use aids and specially designed gadgets wherever possible and try and do these tasks when you have plenty of energy. Ask for help with tasks which are physically too demanding.

Relax

Use relaxation techniques such as yoga or meditation. Another option is to find something you like doing which also relaxes you.

Exercise

Exercise is good for you and helps to keep your joints flexible and mobile. Gradually increase the time you spend exercising and ask your GP or physiotherapist for advice.

Sleep

The importance of sleep cannot be underestimated. Get into a routine of going to bed at the same time each night, avoid caffeine late on in the evening and ensure that your mattress and bedding are comfortable. If you take painkillers then take one of these before you go to bed as this may help you to sleep.

Medication

There are arthritis drugs such as those used to treat rheumatoid arthritis which can reduce fatigue.

Self-help/network

There are arthritis groups where people are encouraged to meet and discuss any issues with others. You may find it easier to talk about your fatigue and other symptoms with fellow sufferers who can suggest ways of coping.

Plus the effort of getting out of the house and meeting others can make you feel less tired.