My Rheumatoid Arthritis Makes Me Very Tired. Is That Normal?

Fatigue is a common feature of RA and occurs in most patients. As individuals with RA know all too well, fatigue is different from drowsiness. Fatigue is a feeling of weariness, tiredness, or lack of energy, whereas drowsiness is a lack of alertness and a feeling that you need to sleep. In other words, fatigue is characterized by a lack of energy and motivation. While this symptom is not as commonly discussed as the pain and stiffness associated with RA, fatigue can be just as devastating. For example, some patients complain of severe fatigue four to six hours after waking. This problem keeps them from being able to hold a job or even accomplish things at home.

Fatigue

A condition characterized by a lessened capacity for work and reduced efficiency of accomplishment, usually accompanied by a feeling of weariness and tiredness.

Fatigue is characterized by a lack of energy and motivation. While this symptom is not as commonly discussed as the pain and stiffness associated with RA, it can be just as devastating.

The fatigue of RA is different from the fatigue most people feel after performing strenuous work or not getting enough sleep. The fatigue associated with RA often occurs despite adequate sleep and nutrition and lasts much longer than typical fatigue. This symptom has many causes, and a patient may suffer from more than one of these causes at the same time:

  • The inflammatory process itself. The body of a person with RA is busy making extra white blood cells and extra inflammatory chemicals that result in the pain and swelling of joints associated with RA. The energy expended while making these mediators saps the energy that might be otherwise spent getting dressed in the morning or walking the dog.
  • Chronic pain. Chronic joint pain means that a person walks, lifts, carries, and accomplishes other physical tasks less efficiently. It takes more energy to do less work when you have RA.
  • Poor sleep quality. The pain and stiffness of RA result in a shorter duration of sleep and more frequent awakenings during the night.
  • Depression. RA changes a person's life. These changes can have negative repercussions on employment, relationships, and feelings of self-esteem. As a result, the patient may experience feelings of hopelessness and helplessness and a lack of motivation.
  • Anemia. Patients with RA can develop low red blood cell counts. This condition, which is called the “anemia of chronic disease,” results from the inflammatory process that causes RA. Additionally, some of the medications that are commonly prescribed for RA can result in low blood counts owing to their effects on the bone marrow; others may cause stomach ulcers and bleeding.
  • Lack of exercise. The pain and stiffness of RA keep many patients from participating in exercise programs or even taking a walk. Lack of exercise leads to muscle weakness, which in turn causes the individual to expend more energy doing a task than when he or she was exercising regularly and was in better shape.

Fatigue is very common in patients with RA and can be disabling. Nevertheless, this symptom is treatable in most cases. You should discuss the amount of fatigue you have with your physician. Your doctor can offer advice on how to deal with or eliminate the fatigue. It is especially important to notify your physician of any sudden worsening in your level of fatigue, as such a change may signal a disease flare, depression, or a drug side effect.

I was fortunate in my final working days to have the type of job where I could take power naps for about 1/2 to 3/4 hour when I felt the need. It was a big help and a relief from stress. People with RA learn to adapt to their disabilities and weaknesses and work around them.