Fatigue in Psoriatic Arthritis - How to Cope With It?

Introduction:

Fatigue or exhaustion is a feeling of tiredness that makes a person feel that they do not have sufficient energy to carry out their day-to-day activities. In 2017, researchers considered fatigue to be an important medical issue for those living with psoriatic disease. This can result in issues at work, causing social isolation and poor quality of life. Dealing with psoriatic arthritis can be challenging, and chronic fatigue can further add to the problem. Studies reveal that about 50 percent of individuals with skin conditions suffer from moderate to severe fatigue, and about 25 percent of individuals experience severe fatigue.

What Causes Fatigue in Individuals With Psoriatic Arthritis?

Psoriatic arthritis can cause fatigue due to various reasons. Since it is an inflammatory condition, in the presence of an inflammatory response, the body releases cytokines (proteins) as a byproduct of the inflammatory process. These cytokines are also released by the body during a cold or flu. When this occurs, the body becomes fatigued. Anemia, obesity, and depression accompanying psoriatic arthritis can also contribute to fatigue. Other reasons include:

• Chronic pain.

• Not physically fit.

• Diabetes.

• Cardiovascular disease.

• Sleeping issues.

• Fibromyalgia (extensive muscle pain and tenderness).

Certain medications to manage pain and other issues of psoriatic arthritis can cause drowsiness and fatigue. Drugs that do not cause direct fatigue might hinder one’s sleep cycles, resulting in a situation wherein one experiences drowsiness while awake.

Psoriatic arthritis can result in another type of fatigue called brain fog, and one might experience issues with memory, concentration, and other thinking skills. Brain fog can also occur due to insufficient sleep at night due to chronic pain. The inflammation caused by psoriatic arthritis can also affect brain function in some way.

What Are the Most Common Symptoms of Psoriatic Arthritis?

The following are some of the most common symptoms:

• Stiffness and joint pain.

• Redness or discoloration near the affected joints.

• Pain or tenderness in regions where tendons and ligaments attach to the bones (like near the Achilles tendon).

• Swelling in the fingers and toes (‘sausage fingers’ or dactylitis).

• Fatigue.

• Discoloration or pitting on the fingernails or toenails (nail psoriasis).

• Appearance of gray or silvery patches on the skin, especially on the scalp, knees, elbows, and lower back (psoriasis rash).

Who Is at Risk of Developing Psoriatic Arthritis?

Anyone can be affected by psoriatic arthritis. It commonly occurs in individuals between 30 and 50 years of age. Individuals with psoriatic arthritis usually develop psoriasis in their teens or early 20s and do not experience any symptoms in their joints till later in life. A rheumatologist who is an expert in treating inflammatory conditions, musculoskeletal conditions, and autoimmune disorders can help those suffering from psoriatic arthritis. Physical examination, blood tests, and imaging tests are usually suggested to diagnose psoriatic arthritis. Imaging tests like X-rays, CT (computed tomography) scans, ultrasound, or MRI (magnetic resonance imaging) scans may be suggested.

How Can One Cope With Fatigue in Psoriatic Arthritis?

One can cope with fatigue in psoriatic arthritis in the following ways:

• Identifying the Triggers: Though difficult, one must try to identify the triggers of their fatigue to obtain a solution. Various sources like diet, mood, environment, sleeping patterns, and stress levels can cause fatigue. One can maintain a record of their fatigue to identify the cause. The record can be maintained by noting down things like what one eats in a day, when one wakes up and goes to bed, and other activities done by the individual in a day.

• Setting Reminders: One may be prescribed medications to keep the condition under control. A majority of individuals report a reduction in their fatigue when taking medications for psoriatic arthritis. It is essential that one takes their medications regularly and not miss any doses. This can be ensured by setting a reminder on the phone to take the medication at the correct time each day. If one experiences any side effects, it must be reported to the physician.

• Exercising Regularly: Exercise is necessary to deal with fatigue. Exercise enhances heart health and helps increase strength, muscle mass, and flexibility. This provides a sufficient energy boost. The endorphin rush that occurs while exercising can enhance the overall quality of life, including sleep. One must exercise for at least 30 minutes a day and must stay hydrated during and after the workout since dehydration can be a hidden cause of fatigue.

• Comfortable Sleep: One’s sleep may be affected if the mattress is not comfortable. Since one spends about a third of their day in bed, it would be wise to invest in a good mattress.

• Proper Diet: One must consume a diet containing a lot of vegetables, fruits, whole grains, lean proteins, and healthy fats. Processed and sugary foods must be avoided. Certain foods that are enriched with omega-3 fatty acids like tuna, nuts, salmon, flax, and olive oil; foods rich in antioxidants like dark chocolate, tea, colorful vegetables and fruits, and coffee; and whole grains like oats and brown rice are known to decrease inflammation. The medical board of the National Psoriasis Foundation states that vitamin D supplementation may benefit individuals with psoriatic arthritis or psoriasis.

• Relaxing Bedtime Routine: One must practice hitting the bed and waking up at the same time every day. Taking a warm shower before bedtime can ease joint pain. Other healthy habits to get a good sleep include keeping the bedroom cool and dark, refraining from alcohol, nicotine, and caffeine intake, switching off the TV, mobile phones, or computers before bedtime, keeping electronic gadgets outside the bedroom, and avoiding heavy meals before bedtime.

• Treating Other Health Issues: Many individuals with psoriatic arthritis have other health issues like anemia, depression, anxiety, insomnia, and diabetes, which can cause fatigue. One must discuss with their physician and sort out other health issues by taking iron supplements for anemia, multivitamins for nutritional deficiencies, and so on.

• Stress Reduction: The stress of suffering from a chronic illness can be stressful. This can worsen the symptoms. One can lower their stress levels by practicing yoga, meditation, and so on. If one still faces difficulty coping with the situation, they can get help from a counselor or a mental health specialist.

• Rest Time: When suffering from a chronic illness, one might often feel tired. This can be managed by taking short breaks or naps in the middle of the day. One can do intensive tasks when they are high with energy. Also, one must not hesitate to obtain help from colleagues, friends, or family members if they have any difficulty doing daily tasks or activities.

• Optimal Vitamin D Levels: Research reveals that low levels of vitamin D can result in fatigue, and taking necessary supplements can help improve fatigue, but few others argue that the evidence is not satisfactory.

• Mobility Device: If moving around seems to drain one’s energy, then one can consider using a mobility device like a cane, walker, or so on to enhance mobility and reduce fatigue.

Conclusion:

Fatigue is a common symptom associated with psoriatic arthritis and can be challenging to deal with. Fatigue can worsen pain and stiffness. Pain can make one feel more tired, which can aggravate exhaustion. One can consult their physician to find out if other accompanying conditions may further result in fatigue. By following the above-mentioned strategies, one can cope with fatigue in psoriatic arthritis. Fatigue can be overcome with the appropriate combination of treatments and lifestyle changes.