Rheumatoid arthritis (RA) has a reputation for causing serious joint pain, but RA fatigue is another symptom that can be just as debilitating as the pain.
“Fatigue is a frequent symptom in rheumatoid arthritis,” Naomi Schlesinger, M.D., chief of the Division of Rheumatology at the Rutgers Robert Wood Johnson Medical School, tells SELF. With rheumatoid arthritis, your immune system mistakenly attacks healthy cells in your body and causes inflammation that results in painful, swollen joints. The reason for RA fatigue isn’t clear, but some experts theorize it’s the chronic inflammation itself that may cause lethargy, according to Richard Chou, M.D., a senior rheumatologist at the University at Buffalo. And the bodily pain that comes with rheumatoid arthritis doesn’t help either, he explains. “The pain is with you, often 24/7, and that will wear you out,” Dr. Chou tells SELF.
People with rheumatoid arthritis are also more prone to experience depression, anemia (a condition where you don’t have enough healthy red blood cells to carry the right amount of oxygen to your body’s tissues), and sleeping problems—and all of those factors can wipe you out, too, Dr. Schlesinger says.
Basically, there’s a lot about rheumatoid arthritis that can affect your energy levels and make it difficult to get through an entire day of work or to meet a friend at the park. Unfortunately, managing RA fatigue isn’t as simple as drinking a cup of coffee, so we asked people with rheumatoid arthritis about how they deal with it. Hopefully, some of their strategies can help you make particularly tiring days more bearable.
1. Rest before and after particularly active days whenever possible.
It’s been 12 years since Creaky Joints volunteer Elisa C., 55, was diagnosed with rheumatoid arthritis, and making sure she has plenty of downtime before and after busy days is one of the habits that have helped her most in that time.
“If I’m going to have a fun day with my husband at the park, I know to plan several days for that,” she tells SELF. For her, that can mean doing food prep in advance and freezing meals so that she doesn’t use up too much energy cooking the day before her planned activity. She also plans on having a rest day “filled with naps and just taking it easy,” after her activity day, Elisa says.
Although you can’t always anticipate every single event that pops up, this can be helpful to try whenever you make plans in advance. Or you can try to modify this by scheduling a quick 20-minute nap or fitting in a few rest breaks whenever possible in the days after a super-hectic time.
2. Share your experiences with family and friends if you feel comfortable doing so.
When she really isn’t up to meeting friends or family, Elisa prioritizes her health over social engagements and virtual events, instead of trying to push through the fatigue. She finds that people are more understanding when she explains why she needs to cancel plans at the last minute. “I used to try to not talk about my rheumatoid arthritis very much and just come up with some reason that I needed to go home or to cut plans short,” she explains. But Elisa says constantly coming up with excuses was exhausting too. Now she’s just honest. “I try to take the approach that I do a disservice to those around me when I don’t want to share my journey,” she says. “I’m okay with saying, ‘I know it’s only 10:30 in the morning, but I’ve got to shower and lie down for an hour.’”
3. Try to keep a reserve of meals and supplies that you can use on days when you need extra rest.
Mariah L., 38, is a mom of three, and she says juggling the demands of motherhood and her rheumatoid arthritis fatigue can be tough. She’s found that meal prepping and reserving special toys that keep her kids entertained for longer give her more time to rest on particularly tiring things.
“When I’m feeling up to it, I cook big-batch meals and put some in the freezer for days when I have less energy,” she tells SELF. Mariah also keeps a cupboard full of “quiet activities” and crafts that her kids can work on if she needs extra rest time. “We also use a system of toy rotation, where about one-third of our toys are out in the playroom and two-thirds are off-limits in a closet,” she says. “So on days when I am in pain or have less energy, I can bring out ‘new’ toys that will keep the kids’ attention longer because they haven’t been played with for a while.”
4. Take a midday stretch or walk break if you can.
Jewell S., a 37-year-old yoga teacher, uses her lunch break to get in some type of movement. (There may be times where getting up to go to the bathroom feels overwhelming, so you might want to try this only when you feel up to it.) “Midday walks in the park or around my neighborhood help to refresh me and fight off fatigue and lubricate my feet, knee, and hip joints,” she tells SELF. On days when she is too busy to go for a walk, Jewell takes a short stretch break instead. “Sometimes [my activity] is as simple as taking a tech break and doing a wrist and finger stretch. Simple movements like bending and straightening my fingers, knees, ankles, and toe joints for a few repetitions help [with fatigue] a lot,” she says.
Whenever possible, Sandra B., CEO and founder of the Rheumatoid Arthritis Foundation, takes a walk as soon as she begins to feel tired. “I stop what I’m doing and go for a walk,” the 57-year-old tells SELF. “I feel so much better once I start being active.” If the weather is crummy or walking outside feels too overwhelming, then Sandra will take a few laps around her house. “Just 15 minutes of movement make a difference [in my energy levels],” she says.
5. Try yoga with plenty of quick movements.
Similar to walking, you may want to do some yoga only when you feel up to it and not push yourself too hard on days when you’re experiencing severe RA fatigue. Jewell says practicing vinyasa yoga energizes her because it includes plenty of quick movements. (There are various styles of yoga, and it can be confusing to understand the differences between them all. Generally, vinyasa yoga involves faster movements that flow into one another while hatha yoga is typically used to describe slower-paced classes. This guide may help you choose the right type of yoga for your needs.) “When there is a bit more movement and joint mobility in the practice, I get a huge boost of energy after my yoga sessions,” she says. But, she points out, if she does slower, more restorative-style yoga, then she feels relaxed and ready for bed. There are plenty of virtual classes in a variety of yoga styles and class length, so getting started may feel a bit overwhelming. This list of the 20 best YouTube yoga accounts describes what you’ll find on each channel and is a good place to get started. (There are even 15-minute yoga sessions if you don’t have a lot of time.)
6. Schedule naps into your day, if you can.
Renee A., 40, says that her fatigue comes in spurts. “Some days, I wake up feeling like I can conquer the world; other days I wake up feeling like a Mack truck hit me,” she says. “It’s very difficult and it requires a lot of mental fortitude.” Renee home-schools her three children and says she sometimes holds lessons in her bedroom or on the couch, which allows her to rest. If Renee doesn’t take time to nap or even sit for a while, then her fatigue and other rheumatoid arthritis symptoms flare up and she feels much worse, she says. “I have learned that the hard way,” Renee says.
If you don’t work from home, or if your schedule is packed with Zoom meetings and tight deadlines, then you may not be able to nap whenever you feel exhausted. However, if you can, lying down even for a few minutes after work may be helpful. Creaky Joints volunteer Eileen D., 35, says taking a short nap can make a big difference in her energy levels. “Sometimes I need to have a quick rest. Just 20 minutes can be a lifesaver,” she tells SELF. Sleeping for too long can make you feel groggy—and make fatigue worse—so it’s a good idea to nap for 10–20 minutes, according to the Mayo Clinic.
If you find that your fatigue is getting worse and severely interfering with your ability to do daily tasks, then it’s worth talking to your doctor about your RA and whether other factors, like anemia or insomnia, could be contributing to your exhaustion. In those cases, your physician may offer additional treatment plans to help you feel or sleep better. And if you need help getting the most out of your doctor’s visit, this story can help you prepare for your next rheumatoid arthritis appointment.
Related:
- This Is What Rheumatoid Arthritis Remission Really Feels Like
- 10 Little Life Hacks People With Rheumatoid Arthritis Swear By
- 5 Tips for Getting the Most Out of Your Next Rheumatoid Arthritis Appointment