Psoriatic arthritis is a chronic inflammatory condition that involves pain, swelling, and stiffness in the joints, as well as fatigue. For some, fatigue can make it difficult to manage their daily life.

The symptoms of psoriatic arthritis (PsA) tend to come and go. During a flare up, symptoms will get worse, but during a period of remission, they will reduce and may disappear. Fatigue can be a problem during flare ups.

This article will look at why fatigue occurs with PsA and how to manage it.

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Fatigue is a tiredness or exhaustion that leaves a person feeling that they do not have enough energy to function fully in their daily life.

In 2017, researchers described fatigue as “an important medical problem” for people with psoriatic disease. They pointed out that it can lead to problems at work, social isolation, and a lower quality of life.

PsA can lead to fatigue for several reasons.

PsA is an inflammatory condition. When inflammation is present, the body releases proteins called cytokines as a byproduct of the inflammatory process. These are the same proteins that the body releases when it is fighting a cold or flu. When this happens, it can lead to feelings of fatigue.

Anemia, obesity, and depression can also occur with PsA and contribute to fatigue.

In 2018, a study reported that 67.7% of people with PsA experience poor sleep quality, compared with 14.6% of people in a control group.

Pain and loss of sleep

Pain from PsA may disrupt sleep cycles, leading to:

  • difficulty falling asleep
  • frequently waking up
  • sleep that is not refreshing

Dealing with the chronic pain of PsA may cause fatigue. It adds to mental stress, as a person needs to take it into account when planning and carrying out daily tasks. Tiredness can also worsen the feeling of pain.


Some medications to manage pain and other aspects of PsA can cause drowsiness and fatigue.

Those drugs that do not cause fatigue directly might disrupt their sleep cycles, leading to a person experiencing drowsiness while awake.

Other causes

Pain that worsens before or during a PsA flare is likely due to PsA-related inflammation.

However, other conditions that often occur alongside PsA may increase the risk of fatigue.

These conditions include:

What is the link between PsA and depression? Find out more.

When to see a doctor

A person should see a doctor if they experience new or worsening symptoms of fatigue or fatigue that affects their ability to function in their daily life.

A doctor will investigate whether there is an underlying cause or condition that requires additional treatment.

A doctor will recommend treatments and strategies to help a person manage the fatigue occurring with PsA.

Some lifestyle choices can help a person manage PsA.


Exercise can boost overall well-being and may help reduce stiffness and pain. Exercise releases chemicals called endorphins that fight depression and boost mood and energy levels.

Current guidelines recommend low-impact exercise as a way of managing PsA, as long as it will not cause further damage. Activities that might help include yoga, swimming, and tai chi.

When necessary, a person might find it helpful to use shoe inserts, wear a brace, or use a cane for support.

What is the link between weight gain and PsA? Learn more here.

Diet and weight management

As with psoriatic disease, obesity features inflammation, and it commonly occurs with PsA.

Weight gain can add to fatigue by making it harder to move around and by putting pressure on the body’s organs, including the lungs. It can also worsen joint pain from the extra strain on the joints.

Maintaining a healthy weight can lead to better energy levels.

Tips for maintaining a healthy weight include:

  • following an anti-inflammatory diet, with plenty of whole grains, fruits, vegetables, and lean protein
  • avoiding excess fat and added sugar and salt
  • staying hydrated by drinking plenty of fluids, preferably water
  • limiting or avoiding alcohol

A varied diet that contains plenty of fresh, plant-based and whole foods can have many benefits.

It can help a person:

  • achieve and maintain a healthy weight
  • improve body functions, such as digestion
  • avoid other complications and comorbidities, such as diabetes and high blood pressure
  • maintain a stable source of energy by preventing blood sugar fluctuations

People should limit their intake of refined carbohydrates and simple sugars. These may boost energy but lead to a drop soon after consumption.

What should you eat and avoid on an anti-inflammatory diet?

Rest and sleep

People with PsA should be ready to reduce their activity levels if they are experiencing or may be about to experience a flare. Fatigue is an early sign of a flare, but resting may help prevent symptoms from developing.

Here are some tips:

  • Plan periods of rest or reduce activity levels to allow time to recover during waking hours.
  • Get enough sleep, possibly more than people usually need. If a person needs to get up earlier than usual, they should try to go to sleep earlier. Establish a routine that includes cooling the sleeping area and leaving any mobile devices outside of the room.
  • Ask for help with childcare and chores when it is difficult to do them alone and be ready to say “no” to additional tasks and requests for help from others.
  • In some cases, a mobility device, such as a scooter, might help a person stay mobile.

These methods will not resolve the problems associated with fatigue, but they can help a person preserve their energy for necessary tasks.

If a person’s levels of fatigue remain high after trying various lifestyle remedies, a doctor may be able to suggest a treatment option that can help.

Examples include:

  • Medications that increase energy: Some antidepressants or psychostimulants may help.
  • Iron treatments: Excessive fatigue may be a sign of anemia, and iron treatments can address this.
  • Sleep aids: If pain or anxiety cause sleep disturbances, prescription sleep aids may help a person sleep better at night. This can help reduce fatigue.
  • Therapy: If fatigue stems from anxiety, depression, or the challenges of living with chronic pain, cognitive behavioral therapy (CBT) or other counseling may help.

A doctor can advise anyone with PsA on ways to manage fatigue.

Current treatment options for PsA include long-term drugs, such as biologics. These drugs can target specific parts of the immune system and help reduce the risk of flares, as well as the severity of symptoms should a flare develop. By reducing symptoms, these drugs may also help manage fatigue.

People should work with a doctor to ensure they have the treatment option that suits them. Once their treatment plan is in place, they should follow the plan and any instructions from the doctor. This can help reduce the risk of flares and the fatigue that occurs with them.

People often ask the following questions about PsA and fatigue.

Can psoriasis cause extreme fatigue?

Fatigue is a known symptom of psoriatic disease, and it can be challenging and debilitating. Some studies suggest that 50% of people with PsA experience moderate to severe fatigue and 29% experience severe fatigue. Fatigue may be more severe among those with PsA than those with psoriasis, but it can be challenging for anyone with psoriatic disease.

Can psoriatic arthritis make you feel unwell?

PsA is a chronic, inflammatory disease. Inflammation can lead to symptoms, such as pain and fatigue. People with PsA often have other conditions, such as depression, obesity, and anemia. All of these factors can make a person feel unwell.

What helps fatigue psoriatic arthritis?

Lifestyle tips include planning for more rest and sleep and asking others for help with tasks. Gentle exercise and a varied diet that is high in fresh, whole ingredients and low in added fat and sugar may also help. A doctor may also prescribe medications.

Fatigue is a common symptom of psoriatic arthritis. Contributing factors include inflammation, chronic pain, sleep disturbances, and related conditions, such as obesity and depression.

To manage fatigue, a person may need more rest than usual. Tips include sleeping longer and planning periods of activity and times of rest during normal waking hours. If fatigue is difficult to manage, a doctor may prescribe medication that can help.