More than half of people with rheumatoid arthritis report feeling fatigued. While experts do not fully understand why, they think inflammation, anemia, and inadequate sleep may play a role.

The above information comes from a 2007 study published in the Journal of Clinical Nursing.

Rheumatoid arthritis (RA) is an autoimmune condition characterized by joint inflammation. The immune system fails to distinguish the body’s cells from harmful substances, attacking healthy tissues by mistake.

This can cause joint swelling, stiffness, and pain. It can also cause fatigue, which can make it difficult for people living with the condition. A person may feel exhausted despite getting enough rest and may lose interest in activities they usually enjoy.

Read more to learn about how RA causes fatigue and how individuals can manage this symptom.

A person with rheumatoid arthritis experiencing fatigue.Share on Pinterest
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Many people with RA experience persistent fatigue.

A 2007 study looking at 150 people with RA notes that approximately 50% said they had severe fatigue. At a follow-up appointment one year later, 40% said they still experienced fatigue.

However, experts do not fully understand why people with RA have such high rates of fatigue.

Although RA causes high levels of inflammation, experts are unsure if it is to blame for fatigue. Studies have not been able to show causation between the two factors.

A 2016 study suggests that people experienced fatigue when their RA was in remission. This means that fatigue continued when the inflammation went away.

According to research, anywhere from 30–70% of people with RA have anemia. Anemia can cause weakness, shortness of breath, and headaches, which may contribute to fatigue in some individuals.

A 2019 study examined factors that made people with RA more likely to experience fatigue. They found that pain, poor sleep quality, mental health challenges, and disability all increased a person’s likelihood of fatigue.

While the exact cause of RA-related fatigue is not yet understood, people may benefit from knowing whether they are at a particularly high risk of experiencing it.

Many people with RA say fatigue is one of their biggest challenges. In addition to making them feel uncontrollably tired, it can have a far-reaching effect on their lives.

Fatigue can increase a person’s need for sleep, which may restrict them from participating in work, social activities, and family life. It can also make it difficult to concentrate during daily living.

The extreme exhaustion can make even simple activities overly demanding.

People may not be able to work full-time hours, need more breaks, and may not be able to work at all. A 2002 study found that around one in three individuals with RA had to leave their employment within 5 years of diagnosis.

The unpredictable nature of RA symptoms can also make it difficult for people to plan work, social engagements, appointments, and more. This can leave individuals feeling out of control and hopeless.

Fatigue is overwhelming and draining, and it can be incredibly hard to explain to others who are not experiencing it. While people with RA may feel alone in their struggles, there are several steps they can take to manage fatigue, including:

Managing expectations

Living with fatigue is challenging, but sometimes, the best thing a person can say is “no”. People could try to plan the day based on when their energy is usually highest and adjust it accordingly. It is always better to plan too little than too much.

Planning time to rest

This goes beyond setting an early bedtime. Spreading demanding, tiring tasks and activities throughout the week will make more time for people to rest during the day. Taking breaks before reaching a point of exhaustion may help individuals with severe fatigue.

Practicing self-care

While it sounds cliche, practicing self-care encourages people to listen to their bodies and understand when they are tired. This can mean people planning time to rest midday, eating a satisfying meal, or using a relaxation breathing technique before bed.

Talking to others

It is hard to understand fatigue if a person has not experienced it firsthand. People can talk about their fatigue with their friends, loved ones, and colleagues to help them accommodate their condition.

Severe fatigue does not always improve with other RA symptoms. This means that doctors may try other treatment options for the fatigue itself.

These treatment options vary depending on an individual’s particular case, and notably, what may be contributing to their fatigue. For example, if a person has anemia, treating this may improve their fatigue symptoms.

Some possible treatment options for fatigue include:

  • Anemia medication: If a doctor determines that an individual is anemic, they may recommend iron supplements.
  • Sleeping aids: If people have difficulty sleeping, a doctor may prescribe medication to help them sleep. Some sleeping aids include lorazepam (Ativan), zaleplon (Sonata), or zolpidem (Ambien). An individual is less likely to become dependent on these new medications than some older sleeping aids.
  • Antidepressant medication: If a person is experiencing mental health challenges, a doctor may feel that they would benefit from taking antidepressants.

RA may cause other symptoms throughout a person’s body. The most recognizable signs of RA are tenderness, swelling, stiffness, and pain in the joints, leading to deformities.

RA frequently affects the hand and wrist joints and usually affects both sides of the body equally.

Other symptoms may include:

  • weight loss
  • fever
  • weakness

RA is a progressive condition, and generally, people’s symptoms increase over time. However, early diagnosis and treatment can minimize the impact and remission from RA is obtainable for around 10–50% of individuals.

Fatigue is a challenging symptom of rheumatoid arthritis (RA) that can impact people’s lives.

While experts do not fully understand why this happens, factors that contribute to fatigue may include inflammation, chronic pain, interrupted sleeping patterns, anemia, mental health difficulties, and more.

Certain lifestyle changes and medication may help people experiencing RA-related fatigue.