The Unseen Battle Between PsA Pain and Fatigue

Living with PsA is like being caught in a perpetual tug-of-war between pain and fatigue. When people ask me whether the pain or fatigue is worse, I used to answer with certainty, but over the years, I've come to realize that the question needs a tweak.

It's not about which is worse; it's about understanding what makes each symptom uniquely challenging.

Debilitating fatigue: a clear winner

If I had to choose the more debilitating of the two, it's hands down fatigue. Unless PsA is unleashing its fiery pain in specific areas like my tailbone, sacrum, lower spine, or neck, I can usually manage to keep going.

Mobility aids help with the pain in my hips, knees, and feet, but there's no magic solution for the mental fatigue that wraps around me like a heavy fog. Fatigue is relentless, stripping away energy and leaving me with a profound sense of exhaustion that can't be easily alleviated.

Daily life with fatigue and chronic pain

When it comes to making daily life more difficult, it's a 50/50 scenario. If fatigue flares are infrequent, life carries on relatively smoothly.

However, it becomes impossible to accomplish even the simplest tasks when fatigue decides to linger like an unwelcome guest. Pain, on the other hand, is a different beast.

Unless it's the intense pain in my tailbone, sacrum, lower spine, or neck, I can modify activities, use mobility aids, or ask for help from family members. It's fascinating, not to mention a little horrifying, how much pain I've learned to navigate and function with.

Those who struggle to comprehend this are often individuals who haven't experienced chronic pain from an autoimmune disease, such as PsA. This is because, for them, an injury to the knee or foot might cause setbacks, whereas, for people like myself, pain in those areas is simply a routine aspect of daily life.

When fatigue masks the pain

One crucial question that often gets overlooked in medical checkups is what's more prominent at the moment: pain or fatigue? Asking me to rate my pain on a scale or emotion face chart is ineffective on a high fatigue day.

When fatigue wraps around me, my pain sensors seem to take a break, and the intensity of my pain diminishes. A pain level that was a 7 yesterday might feel like a 3 or 5 today, but it's not because the pain has lessened—it's because my brain's perception of it has changed. Once the fatigue fog lifts, the pain returns to its original intensity. A pain level answer when fatigued gives a false reading.

In essence, both pain and fatigue are awful. The way we perceive pain when drowning in fatigue is different than when we're not. It makes fatigue just as formidable a foe as the pain itself.

Living with PsA is a delicate balancing act. A dance between managing pain and navigating the relentless waves of fatigue. It's about adapting, finding support, and understanding that both pain and fatigue, while distinct, are inseparable companions in this journey.