Most people think of rheumatoid arthritis (RA) as a disease that causes joint pain. But if you have RA, you know that fatigue and weakness can exact their toll as well.
"RA is actually much more than a joint disease," says M. Elaine Husni, MD, MPH. Husni is vice chair of rheumatology and director of the Arthritis and Musculoskeletal Center at the Cleveland Clinic. "RA is a systemic [body-wide] inflammatory disease," she explains. "That's why you get the other, what we call "constitutional," symptoms -- the malaise, fatigue, and exhaustion."
When rheumatoid arthritis flares up, it makes joints feel stiff and achy. That discomfort may go away at times, but there may still be permanent damage. Eventually rheumatoid arthritis can harm joints so they don't work as well even when the disease itself is not active. How does joint damage occur, and how can it be prevented?
Periods of active inflammation are called high disease activity. When joints are inflamed, white blood cells enter the joint space.
Inside the joint, these white blood cells...
Most rheumatoid arthritis patients experience fatigue on a regular basis. Gayle Freling, 61, was diagnosed with RA more than two decades ago. At the time, she felt completely exhausted. "Before I had treatment," she tells WebMD, "I couldn't get out of bed. I had no energy. I just wanted to lie in bed and sleep."
In addition to fatigue, RA pain can cause you to feel weakness so severe it gets in the way of even the most basic everyday activities. "People with RA get up in the morning and can't turn a doorknob," says Eric Ruderman, MD. Ruderman is associate professor of medicine at the Northwestern University Feinberg School of Medicine and attending physician at Northwestern Memorial Hospital. "That's because their wrists hurt," he says. "The pain and the inflammation there really interfere with the function of those muscles."
Lorrie Bearden, a 44-year-old mother of three who lives in Canton, Ga., knows about the weakness. "To pick things up, I have to use both hands," she says. "The strength in my hands is diminished."
Coping Strategies to Relieve RA Fatigue and Weakness
Taking the medications your doctor prescribes is one way to target your RA symptoms. But lifestyle changes can also help you feel less tired and more energized. Here are a few things you can do every day to relieve the weakness and fatigue of rheumatoid arthritis.
1. Arrange your day to accommodate your RA symptoms. RA often strikes people at a time in life when they are juggling working, raising a family, and handling dozens of other responsibilities. One way to balance all of that is to structure your day so that you can minimize how much your symptoms interfere with what you have to do. If your employer will let you, telecommute. That way you can take extra time to ease yourself out of bed in the morning rather than rushing to get to the office by 9 a.m. Schedule time for taking naps or giving yourself brief periods of rest throughout the day. Doing so will help you handle the fatigue that RA causes.
2. Stay active. Exercise can help strengthen the muscles around your joints and improve joint function and flexibility. It will also reduce fatigue and give you more energy. "I encourage patients to stay as physically active as they possibly can," Ruderman says, "because it maintains their level of function." Don't let your rheumatoid arthritis stop you from exercising. But also, don't assume that you can jump right into a high-impact aerobics class. Start slowly and gradually work your way up to more intense exercises. You might take an easy walk or do some gentle water exercises first to slowly strengthen your muscles before joining a gym. Talk to your doctor or a physical therapist before you begin any exercise program to make sure you're working out at the appropriate level. Eventually, try to work up to doing 30 minutes of aerobic exercise at least three times a week.