Fatigue & Weakness

Reviewed by: HU Medical Review Board | Last reviewed: January 2021

Fatigue is overwhelming tiredness, extreme lack of energy, and weakness over time. When you are fatigued, you feel exhausted and tired. Fatigue can impact your quality of life, making even the simplest of tasks challenging.1

Fatigue is a common symptom of RA. More than 80 percent of people with RA live with fatigue. Being constantly tired can be disabling and may make you feel like you cannot plan your life. Fatigue may lead to feeling irritable, anxious, or depressed.2,3

What causes RA fatigue?

Inflammation from RA leads to pain and stiffness. Pain can lead to problems with sleep. The combination of disease symptoms and lack of sleep can make fatigue a disabling feature of RA. Also, medicines used to treat RA and its complications may cause or worsen fatigue. Depression can lead to fatigue.3,4

How can I manage my fatigue?

Managing your fatigue may seem like an impossible task. Pain, stiffness, and fatigue may seem like an unending cycle. There are methods you can use to try to help manage the fatigue from RA.

Make the most of your energy

RA symptoms such as joint pain and stiffness can make it challenging to carry out daily tasks. The extra energy you spend may leave you exhausted. One approach to beating this kind of fatigue is to learn how to conserve energy. You can take many different steps to become smarter about how you use your energy and more efficient in carrying out tasks:3,4

  • Ask for help - Pick and choose what you want to do. You do not have to do everything. Ask for help with some chores or hire someone to take care of certain duties. You can save a lot of time and energy this way.
  • Talk to your doctor - Your doctor can help you to figure out what may be causing your fatigue. If you have depression, you may benefit from seeing a therapist. Talk to your doctor about what treatment is best for you.
  • Get organized - Try to streamline as many household tasks as you can, from cooking to making your bed. Setting out all of your ingredients and pots and pans before cooking can save time and energy.
  • Technology may help – At-home technology devices may be useful to help in managing your energy. Some of these may include activity monitors, food logs, or various apps for your phone.
  • Get accommodations when needed - If you work, you may need some accommodations to keep you productive and happy. There are laws in place to make sure you can continue to work and find fulfillment in your job. Some ideas on accommodations to help with fatigue related to RA may include things like getting a parking place close to your workplace or shifting to a flex-time schedule so you can work during your peak energy level.

Options for controlling drug side effects

Fatigue can be a side effect of many different medicines. Some drugs used to treat RA have been shown to cause fatigue. Talk to your doctor about which medicines might be causing you to have less energy. Your doctor may have options to better manage the side effects of the drugs.4

Methods for improving your sleep

There are many reasons why a person with RA may not be getting enough sleep, from stress to depression to joint pain. You can work with your doctor (and perhaps a sleep expert) to determine the cause of sleep problems. There are a variety of solutions for sleep problems, depending on the specific problem.

Sleep hygiene is an important part of getting a good night’s rest. Some ways to improve your sleep may include:5

  • Avoid alcohol, nicotine, and caffeine because they can disrupt sleep
  • Go to bed and get up at about the same time every day
  • Get some exercise during the day, when possible
  • Make your bedroom cool, dark, and comfortable
  • Turn off your computer, cell phone, and television
  • Follow a bedtime ritual to signal your body that it is time to sleep

Get and stay active when you can

Deconditioning or loss of muscle and stamina from lack of exercise can be at the root of fatigue. Exercise also increases endorphins, your brain chemicals that produce a sense of well-being. Ask your doctor for advice. He or she may be able to suggest a physical therapist, occupational therapist, or personal trainer who can help you get active and rebuild muscle and strength.4

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