Showing the different phases of fatigue when living with RA.

The Many Shades of Fatigue

Last updated: August 2021

Fatigue is a blanket term for extreme tiredness. If you have a chronic illness like rheumatoid arthritis, then you are probably quite familiar with this term and have firsthand experience with it.

Even without exerting ourselves, physically or mentally, we can feel extremely tired.

That makes sense, though, right? Our poor, confused immune systems are constantly attacking our bodies.

Now, add expected everyday activities to that and forget about it. We might as well stay in bed and pull the covers over our heads.

Different types of fatigue that I feel

While fatigue is an over-arching term, I have come to realize there are different types of fatigue.

They all produce an intense amount of lethargy, but each has a distinct feel to them. Or, maybe I have nothing better to do with my time than to organize the types of tiredness I feel.

Weariness before a flare

For example, I experience a debilitating overall weariness two or three days before a bad flare.

I do not experience pain, but every part of my body feels heavy and it takes a great amount of energy to do anything.

Brain fatigue before getting sick

If I am getting sick, I experience more targeted brain fatigue.

It takes an absurd amount of energy to think, speak, or do. When I feel this type of fatigue, I can easily sit and stare at the wall or ceiling for hours and time just stands still.

Lowered energy while healing

On that note, if I am healing from a procedure or got a nasty cut or bite (I work with animals), my energy thresholds are just plain lower.

It doesn't take more effort to do things; I just tire more quickly. Awww, my poor little immune system can’t keep up with itself.

Odd muscle fatigue when I need more prednisone

This one is a little weird, but I experience an odd muscle, prickly (not really prickly but I can't think of a better term) fatigue when I need more prednisone.

I feel like a zombie who cannot move fast and I just feel totally out of it. I get a feeling of pins and needles (??) around my joints.

It's not painful, it's just...exhausting. This fatigue is almost always an indicator of a flare and the need for an increase in my prednisone dose.

Crashing waves of fatigue

Okay, this one might be even odder so bear with me, but I often feel an ebb and flow of fatigue.

By that, I mean that I feel waves of fatigue crashing over me, and within the same day - even within the same hour - I will perk up. But then, that next wave hits again.

Logically, if I can, I would try to nap through these times. But when my body wakes up, so does my brain and I can’t sleep.

This back and forth tiredness usually means I am about to flare, as well. It’s like my body can’t make up its mind whether it can handle itself or not.

Not all fatigue is the same

For the longest time, fatigue was fatigue, for me. I was tired, I was lethargic, I was drained. It all felt the same. (Hehe, that rhymed!)

But, I realized fatigue was not all made the same. With a little bit of investigation, journaling, and strength (hey, I don’t like to do anything when I’m this worn out), I realized my lethargy was a great tool in figuring out what was going on with my RA.

Do you experience different types of fatigue? LMK in the comments!

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