11 Signs You’re Dealing with Fatigue from Inflammatory Arthritis (and Are Not Just Super Tired)

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From brain fog to irritability, here are some subtle signs that your inflammatory arthritis is causing fatigue.

Fatigue from inflammatory arthritis is, well, exhausting. But it’s different than just being super tired or feeling sleepy. “Fatigue is a debilitating physical and mental symptom that takes you out of your regular process of life,” says Aly Cohen, MD, a rheumatologist at Integrative Rheumatology Associates in Princeton, New Jersey, and founder of the social media platform TheSmartHuman.com.

Fatigue interferes with your ability to work, care for your family, do chores, run errands, and engage in social activities. For CreakyJoints member Ashley Z., fatigue makes basic things like using the bathroom or taking a shower “feel like a chore.”

Fatigue is a high-ranking issue for people with many types of inflammatory arthritis, including rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis (axSpA). In fact, a study from the Global Health Living Foundation (GHLF) and CreakyJoints found that fatigue is one of the most important symptoms that people living with arthritis say they want to monitor, due in large part to how much it affects their day-to-day lives. (You can use our ArthritisPower app to track your symptoms and disease activity and share your results with your doctor.)

“Patients anecdotally report that fatigue is one of the worst parts of having a chronic inflammatory disease, and that their loved ones and even sometimes health care providers don’t fully understand the magnitude and impact it can have on their lives,” says study coauthor Kelly Gavigan, MPH, manager of research and data science at GHLF.

Unfortunately, there’s no quick fix for fatigue. Unlike when you’re tired, you can’t just drink a cup of coffee, take a power nap, or psych yourself up to push through your day.

Fatigue is a symptom that you can’t shake and shouldn’t ignore, as it may indicate an arthritis flare or could be a red flag for another underlying disease, says Dr. Cohen.

By understanding the symptoms of inflammatory arthritis-related fatigue — and how they differ from merely feeling tired — you can have an informed conversation with your health care providers so you can pinpoint the underlying causes and start feeling better. “You owe it to yourself to go through life with energy,” says Dr. Cohen.

Causes of Fatigue in Inflammatory Arthritis

There’s no one single cause of inflammatory arthritis fatigue — it’s “multifactorial,” or due to a number of causes, explains Saakshi Khattri, MD, a board-certified dermatologist, rheumatologist, and internist at Mount Sinai in New York City. And the causes are often interrelated, which can make you and your rheumatologist do some detective work to figure out what’s going on.

Dr. Cohen shows her patient a “fatigue wheel” with fatigue in the middle and the potential causes around it. “There is so much overlap, so it’s my job to be the detective and tease away all of the different things on the fatigue wheel that contribute to fatigue,” she says.

The following factors and comorbidities are all potential causes of inflammatory arthritis fatigue:

  • Anemia
  • Anxiety and depression
  • Cardiovascular disease
  • Chronic stress
  • Chronic pain that disrupts sleep
  • Diabetes
  • Fibromyalgia
  • High disease activity or inflammation
  • Certain inflammatory arthritis medications (including disease-modifying antirheumatic medications, or DMARDs)
  • Lack of exercise or de-conditioning
  • Low thyroid
  • Nutritional deficiencies

Symptoms of Fatigue in Inflammatory Arthritis

Just like there are many causes of fatigue, there are also many symptoms that may indicate what you have is inflammatory arthritis-related fatigue. It’s very “subjective and not quantifiable with a lab or measurable outcome, which is why fatigue can feel so frustrating and overwhelming,” says Dr. Cohen. “You can’t quantify it, but you know it’s not normal.”

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