What Is RA Fatigue? Symptoms and How to Cope

Feeling sluggish, drained, and unable to focus can indicate fatigue in RA. Certain medications and lifestyle changes, including exercise and organization hacks, can help to reduce the severity and impacts of these symptoms.

If you live with rheumatoid arthritis (RA), you may find that fatigue is the worst symptom. RA fatigue can make it hard for you to plan ahead, get things done, or maintain the same levels of activity as you did before living with RA.

There are several tips and tricks, as well as some treatment options, that might help address your fatigue. Here’s what you need to know.

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Does RA cause fatigue?

Fatigue refers to a feeling of extreme tiredness. You may feel sluggish, unable to focus, or generally drained.

RA fatigue is when feelings of extreme tiredness are related to the condition of RA itself. It’s often referred to as fatigue in RA in the research literature. If you experience RA fatigue, you’re not alone. About 70% of people living with RA experience some level of fatigue.

A number of factors associated with RA could be the potential cause or trigger of fatigue.

RA is a type of inflammatory disease. This means your body’s immune system produces a lot of inflammation throughout your body. The constant high levels of inflammation can negatively affect a lot of areas of your overall health, including contributing to fatigue.

The pain associated with RA can also be a cause of fatigue. Chronic pain can disturb getting quality sleep, contributing to general feelings of tiredness.

But fatigue is not always directly related to arthritis disease activity, including inflammation and pain.

A 2017 review determined that RA fatigue level is more closely linked to other contributing factors, including obesity, physical inactivity, sleep disturbance, and depression.

These other factors can be influenced by your RA as well. For example, poor mental health, including depression, is more common in those living with chronic conditions, and it can contribute to feelings of fatigue. Chronic pain or a loss of muscle mass (also known as muscle wasting) from RA can make physical activity harder and require more energy to move your body.

Side effects from medications can also sometimes cause drowsiness and fatigue.

There is no single cause of RA fatigue, and it could be affected by a combination of factors. Experts are continuing to study the influence and impact of these different factors to understand more about RA fatigue.

Symptoms of RA fatigue

Fatigue is often described as extreme or really bad tiredness. But it’s different than being tired from a poor night of sleep or from exerting yourself physically. Even if you’re rested and have slept well, fatigue can mean you feel exhausted.

In her article about how fatigue changed her mindset as a disability activist, Rachel Charlton-Dailey explained: “[Fatigue] can affect people in different ways, but for me, it feels like my whole body is trying to wade through jelly.”

Fatigue associated with RA can be:

• overwhelming
• uncontrollable
• leave you feeling drained of all energy or completely worn out
• feeling like you need more sleep just to get by

The oppressive nature of fatigue can lead you to participate in fewer activities and have a hard time planning ahead. It can also lead to mental health issues, like depression or anxiety, feeling as though your life is out of your control, and feeling inadequate in relationships or at work.

And though you may experience changing levels of fatigue, never knowing what the day will bring can lead to increased stress and anxiety. Increased stress and anxiety can in turn make fatigue worse.

Fatigue can lead to a lower quality of life, which means it may affect how you go about your day, your work, education, or your overall level of contentment.

Ways to combat RA fatigue

If you’re living with RA fatigue or want to help support someone who is, there are several ways you may be able to cope. These can include lifestyle changes and medications.

Some experts recommend that you take some time to really listen to your body and start to learn the signs that your energy levels are changing. In doing so, you can make adjustments to your activity levels for the day. The spoon theory, and thinking about energy in terms of spoons, can be one way to help you think about your chronic condition and energy levels in new ways.

Some general lifestyle tips you can try include:

• Organization: Plan activities out ahead, giving yourself time for breaks and spacing out more difficult or demanding tasks. Do not plan to do too much all at once or on any given day, and avoid going places during busy times of the day.
• Adapting: Consider adapting and changing goals with your fatigue levels.
• Sleep and relaxation: Go to bed early, take naps and breaks as needed, and learn relaxation techniques that work for you (for more sleep tips, check this resource out).
• Self-care and advocacy: Learn to say “no” sometimes to what others ask you to do. Prioritize your own needs, especially at times of high fatigue.
• Connection: Try to connect with others living with RA to learn about how they have coped. Share with family and friends how RA makes you feel so they get a better understanding of what you’re dealing with.
• Nutrition: Try eating a balanced diet that focuses on fresh fruits and vegetables, lean proteins, and whole grains.
• Exercise: Regular physical activity can help you feel more energized. Physical activity may sound like the least attractive solution when you already feel exhausted. But it seems to be one of the most effective actions you can take. A 2017 study that gave patients living with RA a pedometer found that modest and consistent exercise decreased levels of fatigue.

You may also find that your fatigue levels decrease as you manage your RA with medications and medical treatments. Some ways to help fatigue can include:

• taking pain medications
• following doctor recommendations for taking medications that control inflammation
• taking steps to manage depression with medications, therapy, or both

Check out more tips for dealing with fatigue from the Bezzy community here.

Most importantly, you should take the time to find what solutions and treatments work best for you. Just like RA does not affect everyone exactly the same, different steps to manage fatigue will not work the same for everyone.

Some FAQs about RA fatigue

Does RA fatigue ever go away?

RA fatigue can, like other symptoms, come and go with symptoms and severity. Some people may experience only mild fatigue while others may experience severe fatigue. Unfortunately, you may experience fatigue even when you get inflammation and pain under control, so it may require continual management.

Does RA fatigue make you dizzy?

You may experience dizziness due to medications you take for RA or complications. If you experience dizziness, it’s not likely just fatigue, so you may want to talk with a doctor to figure out why you’re having dizzy spells.

Does RA make you sleep all the time?

RA fatigue can make you very tired and increase your desire to rest or sleep. Taking breaks, sleeping through the night, and exercising may help increase your energy levels and make you feel a bit better.

Takeaway

RA fatigue is a common symptom of RA. You may find that it improves sometimes and worsens at other times.

When fatigue occurs, you may find that planning breaks into your day, exercise, and other lifestyle changes may help. You might also find relief through treating the underlying RA, or treating other symptoms.

If your fatigue doesn’t improve with self-care and treating RA, you may want to talk with a doctor to see if they have any additional recommendations for what you can do to treat it.

While fatigue is a very common symptom in those living with RA, it’s less easy to diagnose or pinpoint, and patients sometimes feel it can be ignored by their doctors. But RA fatigue is real and affects everyone differently, so make sure to advocate for yourself when it’s needed.