Doctor...Why
Does Arthritis Cause Fatigue?
By
Nathan
Wei
Fatigue
is extremely common in patients who have arthritis.
While it is a common complaint in patients who have “bread
and butter” types of arthritis like osteoarthritis, it is
even more common in patients who have inflammatory disorders such as
rheumatoid arthritis and systemic lupus
erythematosus.
Fatigue is often a sign of a flare of disease.
Another condition often
accompanied by fatigue is fibromyalgia.
There are many factors that may be responsible for fatigue.
Sometimes it is the body’s method for dealing with a chronic
painful condition. The body craves rest because it uses so
much energy to combat the pain.
Another common reason is that arthritis often interrupts
sleep. Not only is it more difficult to get to sleep but
patients will wake up during the night, they will have difficulty
falling back to sleep, and they will awaken early in the morning. This
early morning awakening may also signal the presence of depression
which is also a common problem in patients who have arthritis.
Depression is also a cause of fatigue in patients with arthritis.
A corollary to this is stress. Stress not only aggravates the
pain of arthritis; it can also aggravate fatigue.
Patients with more serious types of disease may have anemia which
compounds the fatigue problem.
Medications can also contribute to fatigue. For instance some
patients who are on methotrexate often report a
“washed-out” feeling that occurs for one to two
days after taking their methotrexate dose.
Fatigue has a major impact on the life of a person with arthritis. It
causes daytime sleepiness, difficulty concentrating, and limits
interpersonal relationships. Participating in all types of
activities becomes more difficult. Also, some people fall into a nasty
cycle of feeling tired, taking a nap during the day, which prevents
them from getting to sleep that night.
So what can be done?
The most important thing is to get the arthritis under good
control. That often improves fatigue by itself. Effective
medications often make a big difference!
Correcting anemia is another action step. Sometimes the anemia will
correct itself when the disease is controlled. Other times
iron deficiency or other problems need to be addressed.
Improving the quality of sleep can help. Changing to a
mattress made of memory foam is reported by some patients to be useful.
Getting into a regular sleep cycle is a good idea. Avoid
large meals and caffeinated beverages before going to sleep.
Sounds like common sense but too many people don’t follow
common sense rules1
Medicines that adversely affect sleep like prednisone and
hydroxychloroquine (Plaquenil) should be taken in the morning rather
than in the evening.
A nice hot bath or shower before going to bed sometimes is
helpful. Using warm moist heating pads is also a nice thing
to try. Getting into a regular relaxing routine that consists of
reading, listening to soft music, etc. can also ensure good quality
sleep.
Regular exercise is another contributor to good quality
sleep. Lack of exercise often causes fatigue.
Regular exercise provides more energy, increases stamina, and improves
sleep.
Stress reduction is an obvious benefit.
Eating a well-balanced diet can also contribute to less fatigue.
Patients should try to avoid prescription sleeping pills if
possible. Herbal remedies may be useful though.
Dr. Wei (pronounced “way”) is a board-certified
rheumatologist and Clinical Director of the nationally respected
Arthritis and Osteoporosis Center of Maryland (http://www.aocm.org). He
is a Clinical Assistant Professor of Medicine at the University of
Maryland School of Medicine and has served as a consultant to the
Arthritis Branch of the National Institutes of Health. He is a Fellow
of the American College of Rheumatology and the American College of
Physicians. For more information on arthritis and related conditions,
go to: http://www.arthritis-treatment-and-relief.com/arthritis-and-pain.html
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