"Everyone gets tired. That is how the body signals it needs to rest and recharge. Physically: you feel it in your muscles or joints. Mentally: you may need to take a break. But when your need for rest seems excessive and becomes life-disrupting, what once may have seemed normal-but-frequent tiredness has become the symptom called fatigue.
You could have chronic fatigue syndrome if your condition meets the following diagnostic criteria:
-- Severe fatigue persisting six months or longer, with other conditions excluded
-- Four or more of he following symptoms that have persisted or recurred for six or more months:
Fatigue lasting more than 24 hours after activity
Headaches of a new type, pattern or severity
Multi-joint pain without swelling or redness
Substantial impairment in short-term memory or concentration
Tender lymph nodes
Sleep and Pain.
For many people with arthritis, fatigue often is triggered by insomnia and unrefreshing sleep due to unrelieved pain. Getting into a sleeping position that is comfortable enough is a challenge when joints are swollen and sore.
People with obstructive sleep apnea may wake briefly hundreds of times per night as they gasp for air. Weakened muscles or excess tissue in the throat can block the airway and lower the amount of oxygen in the blood. Sensing the low oxygen level, the body arouses itself. Waking up briefly to allow the airway to open interrupts normal, restorative sleep. Studies show that disrupted sleep or too little sleep may heighten pain.
Chronic pain can cause fatigue directly, or it can lead to depression, which can increase fatigue. Depression is the most common cause of fatigue among all patients who visit doctors. While fatigue occurs most often with depression, it also accompanies other mood disorders, including anxiety, bipolar disorder and seasonal affective disorder.
Many medications list drowsiness as a common side effect. If drowsiness or insomnia is a side effect of your medication, do not stop taking it without talking to your doctor first.
In those with autoimmune diseases, the system targets the person’s own tissues. Researchers have found the foremost fatigue inducers to be higher-than-normal levels of cytokines – chemical messengers that regulate the intensity and duration of immune responses. The higher the levels, the more unwell the study participants felt.
Anemia affects up to two-thirds of RA patients and is most common in those with severe joint disease. Fortunately, if the anemia can be successfully treated, the joint pain, swelling and tenderness responds better to treatment, and improving those symptoms decreases fatigue and increases energy.
Loss of Muscle Mass.
The loss of muscle tissue means the loss of cells that produce energy. More than half of people with severe RA, according to one study, are affected by a condition called cachexia, in which muscle mass decreases and fatigue increases.
Once a doctor has sifted through possible causes for fatigue, he then takes cues from the body, treating each symptom individually. Your doctor can help relieve your most troublesome symptoms. But there are several other tactics to further control and reduce your fatigue and then prevent it from returning.
What You Can Do:
Want more energy? Get moving. It may seem counterintuitive, but movement generates energy. Exercise combats fatigue in several ways. The gain in muscle mass and strength makes movement easier, and the increased blood circulation and flexibility also reduces pain. In addition, exercise generates endorphins, which are brain chemicals that produce a sense of well-being and more energy.
Recommended is gradually working up to two or three days per week strength training, with aerobic activity on most of the other days. Exercise is especially important for those with cachexia, who are losing muscle mass. But strength training is not the only way to improve your fitness. Walking, cycling and swimming increase your endurance and strength, and flexibility exercises, such as yoga or tai chi, not only increase your range of motion but also reduce stress and energize you, too. In a recent study, attending two 90-minute yoga classes per week for 12 weeks generated significant reductions in anxiety, depression and fatigue and significant improvements in well-being and vigor.
Eating is a pleasure with purpose – nourishing your cells and creating energy. Adopt the habit of always choosing healthy foods as your energy source. Reaching for nuts, fruits and vegetables, fortified cereals and whole grains will help provide omega-3 fatty acids and the “workhorse” B vitamins that take the energy in food and make it usable by the body. Always start your day with breakfast. This jump-start meal increases energy levels and attention spans. Make sure to include some protein, like an egg or yogurt, along with carbohydrates, like whole-grain bread or oatmeal.
Support your joints.
Wearing a brace or using a cane when necessary can help take stress off your joints and the muscles surrounding them, which can help decrease fatigue.
Develop good sleep habits.
Consistency is key when it comes to sleep. Go to bed and get up about the same time every day. Each night, follow the same bedtime ritual as a signal to your body that it’s time to sleep. Whether it’s taking a warm bath, reading a book, listening to music or doing a crossword puzzle, the ritual is right if it works for you.
Be judicious with rest.
Learn your body’s cues so you know when to counter activity with rest. Rest allows muscle tissues to repair themselves and refuel for more activity. But rest shouldn’t exceed activity, most days, unless a fever or infection is present.
You can overcome fatigue. Stay positive when working to identify and eliminate your fatigue triggers. Remember that each person is unique in what causes their fatigue; likewise each person is unique in what treatment options work for them. Keep trying to feel your best and know that, in the meantime, doctors and researchers will continue to study how and why most people with inflammatory diseases experience fatigue, with the hope of creating more new treatment options.
How Bad Is Your Fatigue? Find out here.
~Linda Richards and Donna Rae Siegfried, Arthritis Foundation."
A merry heart does good, like medicine, But a broken spirit dries the bones.