How to Manage Fatigue From Rheumatoid Arthritis

Medically Reviewed by David Zelman, MD on October 20, 2016
4 min read

When your rheumatoid arthritis leaves you feeling drained, reboot your energy levels with the right moves. Exercise, healthy food, and good sleep habits are secret weapons in your fight against fatigue.

It might seem counter-intuitive, but regular exercise can help you strike back against extreme tiredness. It makes your muscles stronger, which takes some of the strain off your damaged joints. It also boosts blood flow to your brain, which makes you more alert. And when you're active during the day, it can help you sleep better at night, too, so your body's able to recharge.

Jean Foster, who's had RA for 14 years, learned that lesson firsthand. She does some type of exercise every day. "This does wonders for my energy levels because I sleep better and have less stress," she says. "If I’m tired or stiff, sitting in the same position makes it worse."

Walking, cycling, and swimming are activities that get your heart pumping but are easy on your joints. In one study from the University of California, San Francisco, people with RA who wore pedometers and kept track of how many steps they took every day had less fatigue than those who didn't.

Foster tries to be smart about the other workouts she does, too. "If I run, I go on trails so that my joints have a softer impact," says the 32-year-old resident of Boulder, CO. "If I do yoga and certain joints hurt, I modify my poses."

If you do too much exercise or do it too intensely, it can sometimes backfire. It could leave you more tired than when you started. And if you're in the middle of an RA flare-up, even normal activities may be too much for your body to handle.

"There are enormous benefits to what I would call common sense," says Susan Goodman, MD, associate professor of clinical medicine at Weill Cornell Medical School. "If you're exhausted just doing the housework, get someone to help. If you're feeling really run down, take a nap or a day off of work."

You can also use devices to help you get around more easily, like a walking cane or a brace, which take stress off your joints and may help you feel less worn-out.

It sounds like a bit of a no-brainer, but you might have fatigue because you're not sleeping well. Even one night of tossing and turning can affect how you feel during the day. "It's harder on patients with RA to lose sleep than it is for other people," Goodman says.

You'll get more shut-eye if you take up the right bedtime habits. Make sure your bedroom is dark and cool, and avoid looking at your cell phone or watching TV in bed, Goodman says. If pain keeps you awake, talk to your doctor about whether there are better ways to manage your symptoms.

RA and some of the medicines that treat it raise your risk for depression, which can make you feel more tired than usual.

A therapist can help you manage your emotional health. A psychiatrist may also prescribe antidepressants if he thinks that's right for you.

Goodman also recommends joining a support group to talk to others who have rheumatoid arthritis. "They can make you feel less isolated if you're having a tough time," she says, and help you find different ways to approach the challenges that come with RA.

Ask your doctor if any of the meds you take could play a role in your fatigue. Drugs such as nonsteroidal anti-inflammatories (NSAIDs), antihistamines, and selective serotonin-reuptake inhibitors (SSRIs) can cause you to feel drowsy.

Also, keep in mind that RA is an autoimmune disorder, which means it makes the body's immune system, your body's defense against germs, work overtime. This can make you feel exhausted, almost like you're constantly fighting the flu. Medicines that stop the immune system from working so hard may help you feel better overall and boost your energy levels.

Eat balanced meals that have plenty of fruits, veggies, and lean protein. It will give you a steady stream of energy throughout the day.

Avoid food that's high in fat and sugar, and keep an eye on portion sizes. When you put on pounds it can make you feel sluggish, and your RA symptoms may get worse.

Your energy levels are affected by a lot of different things when you have RA. Some are directly related to your disease, but some are not. "I think the major strategy in managing fatigue is to try to sort out what's causing it," Goodman says. "Then you and your doctor can address it at its source."

Since she was diagnosed, Foster says she's gotten good at learning what makes her RA symptoms better or worse. "Every time I have a flare-up, I think about what I've done differently in the past few days," she says. "Educating myself about my condition, and understanding how it impacts my body, has been very helpful in keeping my energy levels up."