Introduction
Fatigue is a widespread and serious issue in many diseases, including rheumatologic illnesses, and it severely impacts health-related quality of life. For some individuals suffering from rheumatoid arthritis (RA), persistent exhaustion can be just as crippling as physical discomfort. A person could sleep for eight hours and wake up feeling as if the person had never slept. This weariness can impair mental concentration and make a person feel irritated and helpless.
What Are Rheumatologic Diseases?
Rheumatic diseases are specific disorders that primarily affect the body's musculoskeletal system. It may or may not involve other organs, depending on the severity of the disease and the early or late diagnosis of the condition. This broad group of diseases can be classified into subcategories based on their cause of occurrence. The rheumatic diseases are either:
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Auto-immunity Mediated: These diseases are acquired when immunity cannot distinguish between healthy living cells and harmful, foreign invasion. The immune system thus attacks its living tissues by releasing inflammatory chemicals that lead to necrosis (death) of the cells and tissues. Examples of such diseases include rheumatoid arthritis, systemic lupus erythematosus (SLE), systemic sclerosis (SSc), ankylosing spondylitis, vasculitis, and many more.
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Metabolic Diseases: Several diseases fall under this category. The main underlying cause of these diseases is the disruption of the body's metabolic process, resulting in various disorders due to a surplus of some or a lack of a few essential nutrients needed to sustain healthy body function. Examples include osteoporosis, calcium and phosphorus disorders, osteomalacia due to vitamin D deficiency, and Paget’s disease.
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Degenerative Diseases: The most common rheumatic disease in this subtype is osteoarthritis. It is mainly caused by chronic wear and tear of the bones, unlike rheumatoid arthritis, which is triggered by auto-immunity.
How Are These Diseases Clinically Presented?
Every disease mentioned above has characteristic signs and symptoms. They differ based on their age of onset, the nature of the disease, or the line of treatment administered to manage the disease. The common ground that applies to all is their classic involvement in the body's musculoskeletal system. Rheumatologic diseases, in general, share a set of symptoms that are found in almost all their subtypes. However, the severity of symptoms may vary from person to person.
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Pain in the joint.
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Inflamed joints that are tender to touch.
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Morning stiffness in joints is experienced for about 30 minutes to one hour after waking up.
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Chronic stiffness leads to reduced range of motion and decreased overall mobility.
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Extreme fatigue and weakness; always appearing tired.
Symptomatic management of the disease is always the priority of the health care provider. The doctor's primary goal is to relieve pain and enable the patient to live a normal life. The patient's mental and physical well-being will be considered during the treatment planning. These two aspects are often inter-dependable, meaning when the physical demands are fulfilled, the patient can also feel its impact mentally. Out of all the symptoms, fatigue is one undesirable but inevitable symptom that is constant in a patient with rheumatic disease. The rest of the article discusses how one can manage fatigue and its frequency, especially in rheumatologic patients.
How to Manage Fatigue Effectively in Rheumatic Patients?
Fatigue is the most common symptom of someone with bone and joint disorders. Yet, it is often the most neglected when planning the management of the disease. The more pressing symptoms like pain and stiffness often top the priority list, and thus, the doctors fail to recognize how severely fatigue can impact a patient’s life equally, if not more. Being tired with zero enthusiasm to show up for any event is mentally frustrating for the patient, except one does not have enough energy to express it. Over time, it becomes a way of life for the patient, who is seemingly clueless about living differently. The lack of social interaction and participation complements the deteriorating mental health and self-esteem of the patient. Some strategies one can attempt to practice to overcome fatigue are discussed below.
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Keeping Inflammation in Check: Swollen and inflamed joints characterize rheumatic diseases. The release of cytokines (inflammatory chemicals) contributes to this inflammation. An inflamed joint results in pain and tenderness at the site, allowing for restricted movement. This potentially induces fatigue. Controlling the inflammation with appropriate drugs as the doctor prescribes can help with fatigue.
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Staying Active: It is no surprise that exercise has been scientifically proven to increase one’s energy levels. Regular exercise boosts muscular endurance and increases muscle and bone strength, strengthening the weak joints of rheumatic patients. The changes exercising brings about in the body describe how it helps with fatigue. Regular physical activity allows for an increased supply of oxygen and nutrients to the tissues, which improves the cardiovascular system's efficiency. The improved heart and lung function results in higher energy levels throughout the day.
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Getting a Good Night’s Sleep: Although rheumatic fatigue is not as easy to manage by merely improving sleep, the long-term effects of having a healthy sleep routine have made one feel much more prepared for the next day. One should aim for a fixed sleep-wake cycle by going to bed at the same time every night and waking up at the same time in the morning. A minimum of seven to eight hours of sleep is sufficient to keep the body well-functioning. One should avoid taking afternoon naps as it can hinder the sleep routine at night. Not drinking caffeine at bedtime to avoid sleep deprivation is a good habit. A well-rested body is the key to having a highly energized personality.
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Making Use of Assistive Devices Where Necessary: The invention of self-help devices has become a blessing for rheumatic patients. These devices not only make one undependable but also reduce the possibility of fatigue one can acquire by performing everyday tasks that are already difficult for these patients. Some examples include zippers, velcro fasteners, long-handled knives, electronic slicers, choppers, and button fastening aids.
Conclusion
Reduced fatigue levels seem like an impossible goal to achieve at first. However, having good mental support and practicing positive affirmations daily can help one achieve it in no time. A disciplined approach is essential to tackling fatigue caused by rheumatic diseases. Living an active life is the best reward one can give to oneself.
