How to Manage Fatigue With Psoriatic Arthritis

Reviewed by: HU Medical Review Board | Last reviewed: July 2022 | Last updated: March 2023

Fatigue is a common symptom in many people with chronic inflammatory diseases like psoriatic arthritis (PsA). In fact, about 1 in 3 people with PsA have fatigue. For some, fatigue is the most troublesome symptom of PsA because it affects more than just the body. It affects the mind, too.1

What is fatigue?

Fatigue is extreme tiredness that does not go away with sleep or rest. Fatigue can impact your quality of life, making it hard to:1,2

  • Concentrate or focus
  • Go to work
  • Engage in activities you love
  • Exercise
  • Have a social life

The connection between PsA and fatigue

PsA is an autoimmune disease. This means that the body’s immune system is overactive and attacks its own tissues. In PsA, the immune system releases chemical messengers called cytokines, which cause inflammation throughout the body. This causes pain and swelling in the joints.1

These symptoms can lead the body to feel drained, weak, and worn out. The more severe your PsA is, the more likely you are to have fatigue.1

In addition to physical fatigue, PsA also can lead to mental fatigue. This is also known as brain fog. Brain fog makes it hard to concentrate and can even affect how well you remember things.1

Other ways PsA can lead to fatigue include:1,3

  • Insomnia – Chronic pain can lead to sleepless nights. Not getting enough sleep at night makes the body and mind even more exhausted.
  • Anxiety and depression – PsA takes a big toll on mental well-being. If you are feeling anxious, it can be hard to sleep at night, leading to more fatigue. If you are depressed, this can amplify painful symptoms, which worsens fatigue. Fatigue is a known symptom of depression, too.
  • Anemia – A common type of anemia is iron-deficiency anemia. When your body is low in iron, it can make you feel tired and lethargic. Talk with your doctor about checking your iron levels. Adding iron to your diet could help.
  • Certain medicines – Some medicines used to treat PsA, particularly methotrexate, can cause fatigue.

Drug treatment options for PsA and fatigue

Treating PsA as a whole can help lessen your fatigue. There are several treatment options available for people with PsA, including:1

  • Non-steroidal anti-inflammatory drugs (NSAIDs) – These over-the-counter medicines can reduce pain and swelling.
  • Steroids (corticosteroids) – This is a short-term option that decreases inflammation. They can be taken as oral medicines or injections.
  • Disease-modifying anti-rheumatic drugs (DMARDs) – DMARDs are drugs that help calm symptoms and slow the progression of PsA.
  • Biologics – These medicines fight the inflammation linked to PsA.

Managing fatigue through lifestyle habits

Fatigue is a difficult symptom to manage, and it can be disabling. But adopting a healthy lifestyle can make a huge difference in managing fatigue and PsA.1

Exercise when and how you can

It might seem counterintuitive to exercise when you are feeling exhausted, but it can help with fatigue. Exercise gets your blood moving and can improve energy levels. Even a simple walk or a gentle stretch can help you feel more energized. Be consistent and move your body daily.1

Eat a balanced diet

Eat a healthy diet with plenty of protein, vegetables, and whole grains. Also reduce the amount of sugar and processed foods you eat, as these can make fatigue worse.1

In addition to eating the right foods, taking the right vitamins and minerals for you may help you feel better from the inside out. Being anemic or deficient in a vitamin or mineral can affect your energy level. Talk to your doctor about getting tested for deficiencies and any supplements that may be able to help you.1

Practice good sleep habits

You know how good it feels to have a great night’s sleep. By adopting a few key sleep habits and staying consistent, you can help manage fatigue levels. These tips can help improve your sleep:1,4

  • Stick to a regular sleep schedule. Go to bed at the same time each night, and get up at the same time each morning.
  • Turn off the screens. Blue light from phones, computers, and TVs can make it harder to fall asleep. About an hour before bedtime, turn off any electronics to get your mind ready for sleep. Instead, do something relaxing like reading a book to help you wind down.
  • Create a calm environment. Keep your bedroom cool, dark, and quiet.
    Avoid alcohol and caffeine close to bedtime. Both alcohol and caffeine are major sleep disruptors.
  • Keep your dinner light. A heavy meal right before bed can make it both uncomfortable and hard to get to sleep.

If your fatigue is not getting any better or is getting worse after adopting some of the above tips and treatments, talk with your doctor.

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