People with rheumatoid arthritis typically have several permanently inflamed joints. The inflammation inside the body can lead to general physical weakness, drowsiness and exhaustion. This feeling of extreme tiredness is also called "fatigue." Some people find this to be the worst symptom of the disease.
“It is a systemic type of exhaustion, meaning it affects your whole system instead of just a certain body part.” People who have RA often describe their fatigue as a deep tiredness or slowing down, akin to the feeling someone might have while recovering from the flu.
Activity and Exercise
Besides controlling your underlying inflammation and disease, probably the most important thing you can do to lessen your fatigue is to get moving! If you're exhausted, the last thing you want to do is exercise. But studies show that increasing your activity level will improve your fatigue.
The inflammation you have with rheumatoid arthritis can cause fatigue as well as joint swelling and pain. Maintaining a healthy lifestyle with exercise, a healthy diet and good sleep can help keep this fatigue to a minimum.
Sometimes a medication can both relieve fatigue associated with disease activity and induce fatigue. For example, methotrexate (Rheumatrex, Trexall, Otrexup) is used to help bring active RA under control, leading to a reduction in disease-related fatigue.
Sometimes fatigue is still a major problem despite adjusting your daily schedule, doing physical exercise and getting support from other people. Then professional help may be an option, for instance in the form of psychological treatment or occupational therapy.
About 90% of RA patients use methotrexate at some point. Typically you will start with a weekly dose of 7.5 to 10 mg taken by mouth – equal to three or four pills. If that doesn't help with symptoms, the doctor may raise your dosage to 20 to 25 mg per week, or as high a dose as you can tolerate.
Malaise can be caused by a number of illnesses, medications, and lifestyle habits. In my case, malaise is a result of my rheumatoid arthritis, which occurs when your immune system turns against your body's tissues, causing inflammation, swelling, and pain that impacts the lining of your joints.
Overexertion, poor sleep, stress or an infection like the flu can all set off RA symptoms. With a predictable flare you'll temporarily feel worse, but your symptoms will resolve in time. Unpredictable flares have more uncertainty associated with them.
More frequent flares
“If you are experiencing flares more frequently, usually manifesting as increased pain, stiffness, and swelling, your RA could be getting worse,” adds Dr. Ghosh.
Rest will make inflamed joints feel more comfortable, but without movement your joints will stiffen and your muscles will become weaker. Find the best activities and the right balance for you. It's usually best to increase the amount of exercise you do gradually.
If you get tired, take a nap or do something restful like reading, listening to music, meditating, or a creative activity. Schedule rest breaks throughout the day if that helps. Plan ahead. If you have limited energy, use if for the most important activities on your calendar.
Blood tests.
Erythrocyte sedimentation rate (ESR, or “sed rate”) and C-reactive protein (CRP) levels are markers for inflammation. A high ESR or CRP combined with other clues to RA helps make the diagnosis. Rheumatoid factor (RF) is an antibody found (eventually) in about 80 percent of people with RA.
Slow, gentle, flowing exercises like Pilates, tai chi, and yoga help boost your balance and flexibility. They may even ease your pain. Research by the Arthritis Foundation shows that yoga poses, breathing, and relaxation lower joint tenderness and swelling for some people with RA.
Should I avoid certain types of exercise if I have arthritis? For arthritis that affects the joints, running, jogging, jumping rope, high impact aerobics or any other exercise where both feet are off the ground at the same time are to be avoided.
It can cause pain, disability, and premature death. Premature heart disease. People with RA are also at a higher risk for developing other chronic diseases such as heart disease and diabetes. To prevent people with RA from developing heart disease, treatment of RA also focuses on reducing heart disease risk factors.
For one thing, rheumatoid arthritis (RA) is an autoimmune disease that disrupts normal immune function, so if you have this form of arthritis you're more vulnerable to contagious illnesses such as influenza, says Eric Ruderman, MD, the associate chief of clinical affairs for the division of rheumatology at Northwestern ...
The symptoms of rheumatoid arthritis often develop gradually over several weeks, but some cases can progress quickly over a number of days.
In addition to, or instead of, painkillers such as paracetamol, your doctor may prescribe a non-steroidal anti-inflammatory drug (NSAID). This may be a traditional NSAID, such as ibuprofen, naproxen or diclofenac. Or your doctor may prescribe a type called a COX-2 inhibitor, such as celecoxib or etoricoxib.
Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission — when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place.
On the other hand, warm, dry climates with a relatively stable high barometric pressure may ease the stress on joints. This means that people with arthritis may have fewer painful episodes than those who live with dramatic, cold, and wet weather.
The newest drugs for the treatment of rheumatoid arthritis are the Janus kinase (JAK) inhibitors, which are FDA approved under the brand names Rinvoq, Olumiant, and Xeljanz.
Olokizumab, the new drug under consideration, is a humanized monoclonal antibody like adalimumab. It is similar to TNF drugs because it acts like a messenger molecule.