Psoriatic Arthritis Fatigue

Fatigue is more than feeling tired after a long day or a poor night's sleep. An overwhelming sense of physical and mental exhaustion persists despite sufficient rest. For those with PsA, fatigue can be a constant companion, impacting every aspect of daily life.

At its core, fatigue in PsA stems from the body's inflammatory response. 

Inflammation is a hallmark of arthritis. Triggers are a cascade of immune reactions that affect the joints and disrupt normal bodily functions, including energy regulation and sleep patterns. This disruption leads to profound feelings of fatigue that can be debilitating.

Fatigue is not simply a consequence of pain and physical limitations; it is a distinct symptom of PsA that requires attention and management. Understanding the nature of fatigue in this context is crucial for effectively addressing its impact on individuals' lives.

Can Psoriatic Arthritis Make You Tired?

Absolutely.

PsA can make you tired, and this fatigue is often disproportionate to the level of physical activity. Studies have shown that a significant proportion of individuals with inflammatory arthritis experience fatigue, with estimates ranging from half to as high as 8 in 10 people. This fatigue can persist even during disease remission, highlighting its complex and multifactorial nature.

The reasons behind this fatigue are different. In addition to the inflammatory processes directly impacting energy levels, other factors such as pain, sleep disturbances, and other symptoms like depression and anxiety can contribute to feelings of tiredness. Furthermore, the unpredictable nature of PsA, with flare-ups and periods of remission, can further exacerbate fatigue as individuals navigate the physical and emotional toll of the condition.

Understanding the connection between PsA and fatigue requires a holistic approach that considers the condition's physiological and psychological aspects. By addressing the underlying inflammatory processes and adopting strategies to improve sleep quality, manage pain, and support mental well-being, individuals can take proactive steps to mitigate the impact of fatigue on their lives.

The Link Between Arthritis and Fatigue

The link between arthritis and fatigue is complex. Inflammatory markers play a central role in both the development of arthritis and the experience of fatigue. These markers contribute to joint inflammation and damage and affect the central nervous system, disrupting standard sleep patterns and energy regulation.

Research has shown that individuals with higher levels of inflammatory markers are more likely to experience fatigue, highlighting the direct relationship between inflammation and fatigue in arthritis. Furthermore, studies have demonstrated that effective control of inflammation through medications, such as biologic agents, can improve fatigue levels, further emphasising the connection between arthritis and fatigue.

However, fatigue in arthritis is not solely attributable to inflammation. Pain, another hallmark symptom of arthritis, can contribute to fatigue by disrupting sleep and limiting physical activity. Additionally, the emotional burden of living with a chronic condition like arthritis can take its toll, leading to feelings of fatigue and exhaustion.

Living with PsA fatigue can feel like an uphill battle, but there are strategies you can employ to help manage this challenging symptom and improve your quality of life. From lifestyle adjustments to medical interventions, here's a comprehensive guide to managing PsA fatigue.

1. Prioritise Rest and Sleep

Ensuring enough rest and prioritising quality sleep are crucial for managing fatigue. Aim for a consistent sleep schedule, create a relaxing bedtime routine, and optimise your sleep environment to promote restful sleep. 

Avoid caffeine and electronics before bedtime, and consider incorporating relaxation techniques such as meditation or deep breathing exercises to help you unwind.

2. Maintain a Balanced Lifestyle

Maintaining a balanced lifestyle is essential for managing PsA fatigue. Pace yourself and avoid overexertion by breaking tasks into manageable chunks and incorporating regular rest breaks throughout the day. 

Balance physical activity with rest periods, and listen to your body's signals to avoid pushing yourself too hard.

3. Stay Active

While fatigue may make exercise daunting, staying physically active can help alleviate fatigue and improve overall energy levels. 

Choose low-impact exercises such as swimming, cycling, or yoga, which can help improve joint mobility and reduce stiffness without placing undue stress on your joints. 

Start slowly and gradually increase the intensity and duration of your workouts as tolerated.

4. Manage Stress

Stress can exacerbate fatigue and worsen symptoms of PsA. 

Incorporate stress-reducing activities such as mindfulness, meditation, or hobbies that you enjoy into your daily routine to help manage stress levels. 

Additionally, consider seeking support from your doctor to develop healthy coping mechanisms for dealing with stress.

5. Eat a Healthy Diet

A balanced and nutritious diet can help support overall health and energy levels. Aim to include a variety of fruits, vegetables, lean proteins, and whole grains in your meals, and stay hydrated by drinking plenty of water throughout the day. 

Avoid excessive consumption of processed foods, sugary snacks, and caffeine, which can contribute to energy crashes and fatigue.

6. Seek Medical Treatment

If lifestyle modifications alone are insufficient to manage your PsA fatigue, don't hesitate to seek medical treatment. Your doctor may recommend disease-modifying antirheumatic drugs (DMARDs) or biological therapies to help control inflammation and reduce fatigue. Additionally, addressing any underlying medical conditions or comorbidities, such as sleep apnoea or depression, can also help alleviate fatigue.

While PsA is a significant contributor to fatigue in affected individuals, it's also essential to consider other potential causes of fatigue. Common factors that can contribute to fatigue include:

1. Sleep disturbances, such as insomnia or sleep apnoea

2. Medications used to treat PsA or other medical conditions

3. Anaemia is a condition characterised by low red blood cell count due to:

   • Iron-deficiency
   • Vitamin B12-deficiency
   • Folate-deficiency
   • Others

4. Thyroid disorders, such as hypothyroidism or hyperthyroidism

5. Depression, anxiety, or other mental health conditions

If you're experiencing persistent fatigue, it's essential to discuss your symptoms with your doctor or rheumatologist to rule out any underlying medical conditions and develop an appropriate treatment plan.

PsA fatigue is a challenging symptom that can significantly impact your quality of life. By understanding the link between arthritis and fatigue and adopting strategies to manage your symptoms effectively, you can take control of your energy levels and improve your overall well-being. From prioritising rest and sleep to staying active and seeking medical treatment when necessary, there are many steps you can take to alleviate fatigue and live a fulfilling life despite PsA. Remember to listen to your body, pace yourself, and seek support from healthcare professionals and loved ones on your journey towards better management of fatigue.