Managing RA Fatigue #RA Blog


RABlogbadgeIrony.  Today at around 4pm I chatted to a fellow blogger friend, bemoaning how exhausted I was, and stressed because it’s Day Two of the RA Blog week, and I haven’t even looked up the topic for today, much less written a blog.

She informed me today’s topic is ‘fatigue’.  Much mirth ensued.

Fatigue is a tough one, because I have to admit, there are days when NOTHING helps.  It’s a brick wall, and all I can do is lie down.  But there are levels of fatigue, and sometimes there are things I can do that help me.  These are a few of my go-tos:


  • Pure bloody mindedness. Stubbornly refusing to give in to it.  Very risky tactic, because ultimately I DO fall in a heap.  The fatigue WILL win.  But hopefully that’s after the kids have been fed and gone to bed or are safely on the bus to school, and falling in a heap is OK.   Ultimately everything that doesn’t have to do with my kid’s welfare, or my welfare, just has to wait, but sometimes sheer stubbornness will delay the inevitable.


  • Exercise. I know this sounds counterintuitive, but some light exercise will often energise me.  It’s murder trying to get moving initially.  But once I am, I start to think more clearly, start to feel more energy, less pain and (gasp!) feel happier.  It’s quite possible that it is purely the enjoyment factor that is working for me – I used to be a gym junkie and love to work out, pre RA. (Yes, even cardio).  But I do believe that exercise itself is beneficial in its own right.


It’s all about the right exercise though.  I don’t ever lift heavy weights anymore.  And I never push myself to maximum intensity, or even high intensity, which I used to do regularly (and really enjoy) in my pre-RA days.  Now its light weights, or bodyweight exercises.  Yoga based classes, static poses and isometric holds (yep, you can exercise without moving at all!), riding a recumbent bike.  And stretching.



  • Eat easy nutrition packed foods. I’m not a big fan of junk food, and it doesn’t like me much either.  I try to keep frozen, home cooked meals in my freezer for the days when I am in too much pain, or too fatigued to cook.  I keep boiled eggs in the fridge – nature’s own protein balls.  And plenty of fruit. Requires no preparation.  Just grab and eat.


  • Prioritise. Be brutal in what is really important, and conserve energy.  I’m a big fan of lists.  I couldn’t get by without my iPad, and the several ‘to do’ list type apps I have on there.    Of course they drive me crazy by popping up reminders to ‘mow the lawn’, and I just laugh until I pig-snort at the ridiculousness of that idea and what was I thinking when I wrote THAT down…and click the ‘dismiss’ button.  Perhaps, once again, it’s just the enjoyment factor there…of telling my ‘to do’ list to shove it up it’s…anyway you get what I mean.


Seriously though, I prioritise what needs to be done, what would be great to get done, and what can wait (until the next Ice Age comes, if necessary).

There is a huge satisfaction factor in ticking tasks off as well, however.  And I’m very happy with myself if I just achieve one thing per day.   Which leads to the next one…

  • Have realistic expectations.  I don’t compare myself to anyone else, or to the person I used to be before RA, and what I was capable of.  That path leads to the dark side….


I don’t beat myself up for not being able to get things done like I used to. I used to be an over achiever, anyway.  Which is totally over-rated!

I know how hard it is for me to move these limbs some days.  They feel like dead weight, they drag me down, they hold me back.  The energy expended in just moving a little bit, in forcing my thoughts into some sort of logic is hard to explain.  But I celebrate the small victories.  And I give myself credit for what I do achieve. I focus on the ‘can’ more than the ‘can’t’.


  • Keep a sense of humour. Not easy when you feel like all your muscles are breaking down and you’ll just melt into a puddle of molten metal like the Terminator.  And that becoming a molten puddle sounds like a good thing.  That just flowing away would actually be blissful…



  • Hardest one of all? Say ‘No’.  You can add some sugar coating and apologies if you like, not that it’s your fault!  As in ‘Sorry, I would love to help, but I’m just not physically able today.’  Just remember you’re not apologising for yourself or your abilities. You have nothing to apologise for.  You are merely genuinely sorry that you can’t help.



  • Wait, that last one wasn’t the hardest of all. This one is the hardest of all. Ask for help. Sometimes I just need help. I’m stubborn (see point number 1) but it doesn’t do me any good to keep pushing through to the point of complete collapse. There are often people that are happy to help, they just don’t know what you need. So, hard as it is to do, ask them for help. You know you would do it for them.


The fatigue that goes along with RA, and many autoimmune diseases, seems like the forgotten symptom sometimes.  There aren’t any specific treatments directed at fatigue.  Sometimes it’s a function of pain, and if you can get your pain and inflammation under control, the fatigue follows suit.

Sometimes it’s an entity all of its own.  Another beast to tame, or at least to learn to run with.

One day medicine my pinpoint a cause and a treatment. Until then, especially on those days when nothing helps, be kind to yourself.


  1. It is amazing how similar our thoughts were on this topic. As I read your post, I kept thinking how many times our thoughts overlapped. I did miss the ‘just say no approach’. As i read it I said oh darn (not really darn) I missed a big one.


    • Hi Rick, I just read your blog post – very cool! We do think along the same lines :). I’m off to read more blog posts now, the last two days have been crazy, and I haven’t had much reading time. Loving the Ra Blog week – thanks for putting it all together!

  2. Your first thing reminds me of my first rheumatologist when, after some months of dealing with me, announced that along with the RA, he was adding a second diagnosis: Chronic Stubborn Pigheadedness! He did say that it was probably going to be a fairly useful ‘ailment’, given what could be ahead of me with the RA, but I had to laugh. And yes, it’s one of my chief tools in fighting fatigue too! Great post AC.

  3. Hi
    I have had R/A for several years. On methotrexate for 2 Yrs and I’m not sure it’s working. Every morning when I get up my left hand is in a claw position and my middle finger can’t extend for over an hour once I get out of bed. Using my iPhone doesn’t help. I have a secret. About 8 Yrs ago I took one of my sons Adderall pills 20mlg and I got more work done that day. I went to my Dr and got a prescription for it and I take it twice a day. One at 5:00am and one at 1:00pm. It not only handles my fatigue but it allows me to get the work done of three healthy me’s. I also have T2 Diagetes and I don’t let that stop me either. I take Afrezza the new inhaled insulin. I know have great control over my life. I run 2 business’s and work 18 hr days. I have not let Fatigue get the best of this guy.


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